low oral muscle tone

lujain

Can anyone recommend a good book or website on hypotonia?  I'm trying to understand how this affects my daughter.  She is 17 months and is just starting to walk more than crawl.

We met with another SLP today.  She says DD has low oral muscle tone.  My LO didn't start babbling until almost 14 months.  We have zero words, and she says mostly wa, da, and ma.  She recently added ba to the mix.  How does the SLP diagnose low oral muscle tone?  How exactly does the low tone affect her speech and language development?  Is there any way for me to tell whether the problem is severe?

The SLP also said DD's mouth is unusually small.  Her mouth looks normal to me.  Is there a rule of thumb on how big a kid's mouth should be?  How might this affect her speech development?

Thanks for any help.

realisticdreams

Sorry, i'm not really going to be much help but Peyton has tone issues in her mouth too.  She isn't talking at all, and was non-verbal for quite a while (well into 7 or 8 months, no sounds).  

Our PT said that she had it just from watching her try to eat.  Also she would ONLY suck on GIANT pacifiers and only drink from avent bottles, bottles with smaller nipples she wouldn't.  They assume this is why she had trouble breast feeding as well.

Peyton has high tone in her legs, which the only way I can figure it out is that her muscles are really tight.  When I try to explain it to someone it's hard, because I really don't understand it all myself.

I would also recommend trying to find a feeding clinic  if she is having any food aversions from it.

Assembly_Reqd

Nate has low tone around his mouth. He has no full words yet and his sounds are all from areas of the mouth that do not need the lips! He is very good at ga, ka (as in cat), ayayah, and any other vowel tones. Nate is working on the sippy cup and juice boxes with straws, but he still has a lot of leakage. There is also a whole lot of drooling going on!

He has gotten better and his sounds have increased since we had his upper frenulum (tissue attaching lip to gums) snipped so we are glad we did this procedure. Our OT has shown us some massages to do around his mouth to wake-up the area before feeding, but I never think to do them. Another thing we tried for a bit was a vibrating spoon. I think they are called z-tip or something like that. It is basically a pen shaped vibrator that has a nubby end to chewing on and also has a spoon attachment. That did help him when we were first doing solids. He got better mouth closure with it and was able to understand what he needed to do when there was a spoon in the vicinity.

We have just started speech therapy and I a hoping the SLP has some suggestions. Our curent OT wants him to blow a whistle or blow through different shaped tubes, but he just doesn't get it and I think he is too young mentally to do these tasks. I am totally rambling now...But I think my answer is yes an SLP can diagnose low tone around the mouth. I haven't been able to find much info on the internet for low tone therapy ideas. I know there is a Down's Syndrome book someone was recommending that had low-tone exercises, but I am not sure if it had mouth exercises too....

thefuturemrskudla

Hi there,

My son has low tone, and oral motor weakness (decreased lip strength, esp. upper lip, and jaw strength).  He also has left cranial facial nerve paresis. He babbles, but has no real words (only word approximations).  He also has problems chewing.  His mouth is small, but so is he (overall under 3% percentile) and no dr or therapist has mentioned this as a concern (except for unrelated dental issues).

SLPs can diagnose oral motor issues, and some are certified in various forms of therapy to address this.  In fact, there is no separate category for insurance billing purposes, as "oral motor therapy"  It's considered speech therapy.

We live in Orlando, and DS receives oral motor therapy at Beckman and Assoc.  their method is called the "Beckman" method, and it's very well-known (though not w/o some controversy).  Our therapist is a CCC-SLP. 

I'm not sure of the mechanics, but my understanding is that low tone can and often does affect gross motor skills and speech production.  I've also read about "motor planning" issues affecting gross motor and speech.  I've gotten different opinions from different experts about the degree:  DS's craniofacial surgeon, fwho also holds a DMD, believes an expressive speech delay cannot be explained exclusively by oral motor/facial nerve issues - this dr said the later issues often arise in the child's articulation (if he can't round his lips, he can't say, "moo," or "wow.")

Is your SLP certified in any oral motor protocols?  Did the SLP explain exaclt what DS's weaknesses are (DS wasn't lateralizing his tongue when we started therapy, nor could he elevate the midblade or tip of his tongue). 

There is also a form of speech therapy called PROMPT (commonly used to treat apraxia, but not exclusively) that works on motor planning and speech; is your SLP familiar w/this method, and what are her thoughts on this?  

This is such a hard area, I understand how you are feeling.  I have the same questions you do, and b/c there are no clear answers that I've found, I've dealt with it by having DS evaluated by several SLPs, at the recommendations of drs I trust.  In fact, we have a SLP eval tomorrow at a hospital-based center.  I go through this b/c I need to get a sense of the different approaches, and whether different "experts' are suggesting different things.  DS has hearing loss, so this is very likely a component of his delay, but i don't believe it's the only reason.

I will say, I've noticed an improvement in DS (chewing, tongue movements, new sounds) since we started oral motor therapy 3 months ago.  

Marytza&Matthew

my son has low oral muscle and also fine motors 

 

 

he only says  dadda papppa but is all he also when he eats he chocks allot and drinking to he has slobbers drools allot i mean and therapist comes for speach and teach him sign language and how to swallow and he goes also therapi on learning to sit and crawl fine motor skills