cold lollipop games

I thought that it might be nice to have a record of some of Zoo Boy's Speech Therapy exercises, so here's a series of photos I took during his practice session this morning. We do Speech exercises every morning except Sundays (with both boys, just because J doesn't want to be left out, and of course wants a lollipop too!), and Zoo Boy has a formal therapy session on Tuesday afternoons with our totally rockin' SLP, Miss Sarah, who incorporates her sessions with an OT on staff to make sure Zoo Boy is grounded enough with his sensory stuff to benefit from the therapy session.

I call the therapy practice we do at home"Cold Lollipop Games", because most of the exercises involve a lollipop that is soaked in ice water (the cold provides more sensory feedback for him), and because I long ago figured out that you don't use the word "therapy" with kids if you want any cooperation from them!

So we start our session with the exercise pictured in the first photo -- tongue thrusts. Well, sort of a reverse tongue thrust. Zoo Boy relaxed his tongue, and I push it backwards towards his throat with the cold lollipop. This helps with awareness of his tongue, and sensitizing the beginning of the throat/gag area (where he is under-sensitive). I repeat each exercise five times. (In between each activity, the lollipop goes back into the ice water to get cold again while I repeat the exercises with J.)


Next comes lip rolling. I hold the lollipop under the center of his top lip, and roll to the left jaw, then start in the center again and roll to the right jaw. This helps with awareness of his lips -- much of his speech clarity problems are caused by the fact that he tends to hold his lips absolutely still, rather than rounding, pursing, or stretching them while forming his words. There are probably two reasons for this -- first, he does not have much awareness of his oral-facial muscles, combined with under sensitivity of the skin, and second, he had massive dental problems as a toddler (he was born without any enamel on his top teeth, and they rotted very rapidly, requiring major dental surgery at 2 1/2 years of age to correct -- our theory is that his teeth were so painful that he avoided putting any pressure from his lips on them, right during the time he was learning how to talk). So our entire approach is based on sensitizing him to his oral-motor structures and retraining him how to say letters with correct lip and tongue motions.

Next is a simple cheek massage exercise, on both sides of course. This is purely for sensory awareness.

This is a lip pursing exercise. He holds the lollipop in his rounded lips to a count of twenty. This works not only on awareness of the action of rounding his lips, but also is building up the facial muscles he needs to make this motion.

Tongue flips. He touches the tip of his tongue to the roof of his mouth (just behind his front teeth), then moves it along the entire roof to his throat, then back again. We taught him how to do this (initially he had no idea how) by having him follow the cold lollipop with his tongue tip as we moved it back and forth along the roof of his mouth. Before we worked on that, we held the lollipop on the outside of his lips in various places and he had to reach out with his tongue to touch it. That was VERY hard for him initially, he's come a really long way with his tongue control.

Practicing words that being with the letter "r". The goal is for him to say simple single-syllable words that begin with "r" and are followed by an "a", "ah", "eh" or "eye" sound without moving his lips at all, and touching his tongue to the roof of his mouth. This has been really slow going for us, as he's long been wanting to round his lips to say the "r" sound, which of course comes out sounding like a "w" instead. We've had to take this really, really slowly, making it simpler and simpler in order for him to have success. He's really gotten the hang of this these past couple of weeks. Next we'll add other vowel sounds after the "r", which will be harder as he'll have to change his mouth position to finish the word, then get it back into the right position for "r" for the next word.

A differentiating exercise for him -- practicing the same words, but with a "w" sound at the beginning of them, making sure he rounds his lips properly for the sound. (Even when he was rounding his lips for "r", they weren't really round, more neutral, and in the same position as he used for "w", so neither sound was quite correct.) This too is something he's made huge progress with the past couple of weeks. I think he's really starting to "get" these exercises (although he's still got a ways to go before he's naturally using it properly in conversation).

The very best part of the session, at least as far as Zoo Boy is concerned -- getting to have the lollipop when we're all done!

It's taken us a while to really get moving with his SLT program, as he was fairly resistant at the beginning. But we managed to find just the right therapy team for him (we travel over an hour to get there, but it's WELL worth it!), who understood that they needed to take it very slowly with him and build his trust first, and start sessions with a lot of sensory-rich activities before attempting any actual speech work. He ADORES his therapists and I think going to their office is the highlight of his week.