TalkTools Straw #7

Straw #7 is the second to the last one in the TalkTools straw hierarchy kit. Matthew used this straw for 3 months, from April through June.

It must have been harder to drink with this straw as he didn't transition to this straw as easily as he did with the previous one. It seemed longer than coily straw #6. But as with the others in the straw hierarchy kit, he used the straw daily for most of his drinks, even at school. I sent one straw and cup to his preschool daily for him to use at snack time. He eventually warmed up to this straw and could drink a whole cup of orange juice, lemonade, or chocolate almond milk without any issues.

In the beginning of July, we started with straw #8. On straw #8, I noticed he regressed back to a pattern of suckling (straw resting on tongue when the tongue is too far forward then moves forward more, rather than back, when sucking on the straw) instead of sipping (using lips only). We went back to straw #7 for a day to see if we had moved on too quickly. He did just fine for the most part and easily corrected with verbal cues from me (as seen in the video). The speech therapist whom we work with in NACD suggested that we move on to straw #8 with more manual support and a tactile cue such as a lip block or medical tape 1/4-inch from the drinking tip.

Toy Review Tuesday: Super Sorting Pie by Learning Resources

The kids love the Super Sorting Pie. It's been a versatile toy since Christmas (2011) and great for learning colors, sorting, counting, fine motor practice with tongs, and even pretend play.

Three 2-sided cardboard inserts come with the pie and provides a good visual for the kids to remember how I am asking them to sort the fruits. The inserts are easily interchangeable by simply lifting the sectioned-off part of the pie.

Elizabeth enjoys sorting by color and by type of fruit.



I've even used it for simple addition and subtraction practice with Matthew.



When not sorting or counting, the kids play with it many days in the week pretending to bake a fruit pie in their play kitchen. Today, they were so cute playing together. Matthew was telling Elizabeth what fruit he needed and how many and Elizabeth listened, understood him (she usually always does despite his struggle with articulating some words), and played along. I would've taken a longer video but stopped right after Elizabeth announced, "I'm pooping." Thankfully, she still wears diapers.



As of today, it's selling on amazon.com for less than $20. It's also available on the Learning Resources website but it costs more.

Tall Kneeling

In January this year, I emailed Matthew's physical therapist (PT) at school to ask how he was doing during his PT sessions. One of the things she said was that in the group he had difficulty staying in a tall kneeling (on knees, not sitting on buttocks) and half kneeling ( one knee up the other down on floor and balancing in this position).

When googling for information on tall kneeling, I came across Adaptivemall.com. We didn't need the equipment but it was very interesting to see that adaptive equipment to help with tall kneeling actually existed. Also to quote from the site:

Tall kneeling is achieved when someone is kneeling and the buttocks are not resting back on the feet. Tall kneeling can assist with the development of balance and leg strength. Note: This position can be difficult for people who have limited ankle bend (plantar flexion) or who wear ankle foot orthotics (AFO).

Matthew doesn't wear orthotics but he does have insole wedges in his shoes for ankle support since he has pronated ankles(but I don't think that matters). The gluteal/buttock muscles are needed to maintain the tall kneeling position. I imagine his gluteal muscles didn't inherently have the tone to easily get into a tall kneel and maintain it. He always preferred to sit on the backs of his feet to stabilize himself.

And of course, I wanted him to develop better balance and leg strength because that will make more physical play activities easier for him. So what do we do? We work on it at home!

How to Position?
His PT and NACD evaluator gave me a few suggestions:
- try kneeling at support surface.
- work on him imitating you go from sitting on heels to tall kneeling position, or in front of a mirror.
- (if he were still in diapers) try bridges, like when his diaper was being changed, ask him to raise his bottom up with knees bent and feet flat on the floor. Hold the position for 5-10 seconds....move a train, ball under his hips to keep hips up.
- have him get on hands and knees and cross creep (crawl on hands and knees). Then while facing him, model getting up into a tall kneel and ask him to do it. From there play something or sing something while maintaining that position.
- practice kneewalking around the room to get things off of the sofa or low tables.

Which strategy worked for him? Asking him to cross creep and then get into a tall kneel to kneewalk and then pause in the tall kneel position helped him understand the concept of tall kneeling. So we played around with kneewalking a lot. He liked jumping and running on giant bubble wrap so I used that as our kneewalking activity motivator.



Within days, his kneewalking improved. More importantly, he was developing the balance and strength to maintain the tall kneeling position for longer periods of time. He'd still sometimes take 3-second breaks to sit on the backs of his feet but he could now easily return to the tall kneeling position without falling over.

Just yesterday, Matthew, Elizabeth, and I had lots of fun playing a fast-paced game of rolling the beach ball back and forth to each other in the tall kneeling position.

At age 2, Elizabeth had no trouble with tall kneeling at all. Seeing her easily play in tall kneeling was one of the many reminders of how much more work Matthew had to put in just to achieve what Elizabeth could do so naturally and effortlessly (relatively). It's at moments like that when one simply appreciates each child's development as it is and admires and learns from Matthew's determination and can-do attitude.

TalkTools Straw #6

It's hard to tell if straw #6 is shorter than straw #5. Because of its coils, straw #6 doesn't stick out of the cup as far as straw #5. Matthew had an easier time drinking from this straw mainly because he didn't need to hold the cup out as far.

I also ordered two extra #6 straws as back-ups to replace the ones with internal residue build-up. Matthew easily transitioned from the previous straw to this one as they were the same diameter. Like the previous straws, he used this straw for most of his drinks including chocolate almond milk, orange juice, apple juice, and water everyday. The straw was sent to his preschool as well for him to use at snack time.

I'm not sure if I had mentioned it in any of my previous TalkTools straw posts but Matthew is on straw therapy as recommended in his NACD program. So we also used the straw as part of a set of oral motor stimulating activities specified in his daily program.

Matthew started on straw #6 during the Christmas break. He could've moved on to straw #7 after a month but I kept him on this straw for almost 3 months because there was so much going on that I just kept forgetting to move him on to the next straw in the hierarchy. It didn't hurt to keep him on the straw longer anyway. The instructions only discouraged from moving on to the next straw within a few days, which would be too fast of a transition. As of April this year, he was on straw #7.

Stickers Activity for Fine Motor Skills

I love great ideas, especially if it's a fun, productive, educational activity for the kids. I recently picked up two great resources for promoting fine motor skills from the facebook group "Educational Strategies for Children with Down Syndrome".

hands on: As We Grow - 30 Kids Activities & Materials for Promoting Fine Motor Skills
PreKinders: Resources for preK teachers - Fine Motor Skills

We tried the sticker activity from "hands on". It was a success! We used small stickers and $1 Shape Tracing activity books from Target. Since I haven't been working on handwriting with either of them, I thought this was a good opportunity to use the tracing books.

Elizabeth was determined to put stickers on the dotted lines to complete her square.

Matthew stayed focused putting stickers on the dotted lines for his oval.

They both did a great job!