To assist lower lip closure, place the upper portion of the Y-Chew just below the bottom lip. drooling (poor lip closure can be one reason why some children drool), •  Correct oral resting posture - lips are closed when our mouth is at rest (when we're not eating, drinking, or speaking). For Functional Chewing Training the child is placed in a sitting position with the body tilted 60–90° tilted and head in neutral position, with the arms and legs supported. It's important for several different speech/feeding/oral motor skills: •  Being able to close one's lips around a straw, spoon, a piece of food, etc. To learn more about this oral motor exercise, click here: http://www.arktherapeutic.com/blog/post/1679 Lip-closure exercises are also known as lip-seal or lip press exercises. View Record in Scopus Google Scholar. S&S® offers a variety of whistles and blow toys that provide select challenges to respiratory demands, lip closure and lip placement. * Lip closure * Scraping food off spoon with upper lip * Emerging tongue lateralization * Movement of food from side to side. Our goals are not to improve jaw, lip or tongue function. One of the first things I look for with drooling is whether or not the child has lip closure. 3. Any ideas from this blog should be discussed with your child's treating professional(s) to ensure proper use. • Require a completely different tongue and lip motion to obtain milk -disposable -variable flow rate -good for infants with poor lip closure or decreased lingual cupping -good for infants with “compression” suck -good for thickened feeds 436-440. Don’t bite on button. The mother was asking if there was anything she could do to decrease drooling. Lip-closure exercises are done to help improve swallowing. drooling. Lip tremor - rapid, small movements of the lips during purposeful activity such as lip seal. So, how do we work on improving lip closure? This oral motor exercise is particularly helpful when you need to establish the concept of lip closure, as it helps the individual physically feel what it's like for the lips to close. For further lip closure practice, here's one of my favorite exercises: 1. Oral-motor assessment and treatment is a team effort. Links / references to this site are welcome, but credit must be given back to this site. Another fun way to work on lip closure (and lip rounding, which is important for "oh" sounds for instance) is with the All Rights Reserved. Pull on string. Be sure to explain to the child what you're going to do before you do it, and use your opposite free hand to support the chin/jaw if necessary. Look at the different mouth pieces of whistles. Please keep in mind that the content presented here is not all-inclusive, and should not be considered a substitute for an in-person evaluation and treatment by a certified Speech-Language Pathologist, Occupational Therapist, or another trained professional. Posted by Debra C. Lowsky, MS, CCC-SLP on 30th May 2016. ... She wasn’t getting adequate lip closure needed for consonant-vowel productions (such as “moo, bye, pa”). 5. Privacy Policy Terms of Use. Some whistles have round mouth pieces, these are good to develop lip protrusion and lip rounding and will aid in the production in sounds like /oo/ and /w/. Q: How should we write IEP goals for oral-motor? ... We recommend the use of absorbable suture for the closure of primary cleft lip as this technique saves one additional exposure of the child for the GA for suture removal. 5. Then repeat twice more. Posted by Debra C. Lowsky, MS, CCC-SLP on 22nd Jul 2015. But even before that you need to make sure the child has good stability in the jaw and is able to move the jaw from a wide open mouth to a closed mouth posture easily (this is called jaw grading). Links / references to this site are welcome, but credit must be given back to this site. I waited a few minutes and repeated the stimulation, and she closed her lips again. The above skills are clearly noted during the 7-9 month age range. Undermining of the skin edge free from the underlying orbicularis for 2-3 millimeters facilitates exact closure and eversion. WRITE SPEECH GOALS.” Oral-motor techniques are just that: TECHNIQUES. Goals: This patient had a full thickness (through and through) defect of his upper lip after MOHS surgery to remove a lip cancer. For more oral motor lip exercises, check out these edible oral motor activities, these fun oral motor ideas, and/or these Z-Vibe exercises. He is seen here 6 months after repair and has normal lip function. A proper head and trunk control is crucial to facilitate smooth chin and lip closure and encourage tongue movement. Just like its namesake, lip closure (also known as lip seal) is the ability to close one's lips. Dysphagia is a condition in which disruption of the swallowing process interferes with a patient's ability to eat and drink. Lip power must be adequate to maintain the lips in a closed position during the swallow. Just like its namesake, lip closure (also known as lip seal) is the ability to close one's lips. (In the second half of the video we're working on tongue tip elevation). It really just depends on the child. Copyright © 2021 ARK Therapeutic All Rights Reserved. You might find yourself tempted to use absorbable sutures to close a lip laceration on a child to save a suture removal trip–but I’d think twice about it…dehiscence risk is high. Place button in front of teeth and close their lips. And the child should only be using their lips (not biting on the tip) so that their lips are doing all of the work. It's also important in order to say certain speech sounds, such as /p/b/m/, and it's a factor in preventing For more exercises you can do with the Y-Chew, click here and here. Then press the stem of a lollipop into the Popette Tip (you can trim the stem of the lollipop if it's too long). If this exercise is too difficult, try it with the Please keep in mind that the content presented here is not all-inclusive, and should not be considered a substitute for an in-person evaluation and treatment by a certified Speech-Language Pathologist, Occupational Therapist, or another trained professional. Unilateral Cleft Lip and • Cleft Palate • listenersRepaired at 3 and 12 months of age, respectively • Adequate VP closure Spoken Language (CELF-P-2)a • Average to above-average expressive & receptive language Hearing (Status monitored regularly) • Within normal limits despite history of otitis media Articulation and Phonology Lip closure/seal: saying “mmm” when eating or when pretending to eat with play food/play kitchen vibrating lips when making vehicle noises (brrrmm) when driving cars/trucks/tractors pretending to blow kisses to someone making the elephant sound when pretending to be an elephant The child was not closing her lips and could not do so on command, so I touched the 4. Repeat to the other side of the mouth. Goals include closure of the nasal floor and sill, symmetry of the alar base, and symmetry of the lower lateral cartilages with appropriate projection of the dome. What are lip-closure exercises? 2. Summary. Lip closure (also known as lip seal) is the ability to close one’s lips around a spoon, straw, cup, etc. The Popette Tip is an adaptor that lets you use lollipops with the Z-Vibe (yum!). Then instruct the child to close his/her lips over the lollipop (so that the candy is inside the mouth). The force of lip closure in children (1) the relationship between the force of lip closure and age. Tips, Strategies, and Advice from ARK's very own Debra C. Lowsky, MS, CCC-SLP. In order to address these goals, one must understand the anatomical characteristics of unilateral cleft lip. 3. Place the They are a type of treatment when you have trouble swallowing (dysphagia). Vibration facilitates a contraction of the muscle, so it may be used in conjunction with a tool to facilitate upper lip mobility for spoon feeding. Lip closure (also known as lip seal) is the ability to close one's lips around a spoon, straw, cup, etc. Rotary chewing is broken into stages. • Diagonal rotary chewing movements • Upper and lower lips active during chewing and cleaning 19 to 21 months Download DYSPHAGIA GOALS PDF for free. Do about 10 gentle tugs. Our goals are to improve speech. For more exercises like these, check out the The lips should seal and show some pursing. Lip reconstruction should be individualized based upon patient factors such as tissue laxity, age, cosmetic goals and defect … First explain to the child what you're about to do. Provide support to the chin with your opposite hand if necessary. Y-Chew to assist lip closure: 1. The answer I always give is, “DON’T. Let him/her have a quick taste. Range of cheek movement and lip movement for closure is necessary to maintain the negative intraoral seal during oral transit for swallowing. Reconstruction of the lip was performed with a two staged Abbe-Estlander flap. • Being able to close one's lips around a straw, spoon, a piece of food, etc. Then gently press downward, stretching the upper lip to meet the lower lip (as pictured above). • Swallows solid food with easy lip closure and no loss of food or saliva • Upper lip is closed on cup for better seal for drinking; swallowing follows sucking with no pause; well coordinated pattern. Lip Bloks are also an effective yet very simple way to naturally encourage lip closure. They are • Patient will tolerate a minimal cuff technique for __ minutes/hours/all day as determined by Then give them a chance to swallow. : in the case of spoon feeding, perhaps the goal is lip closure). The information contained in this blog is offered in good faith and represents only the author's current understanding of best therapeutic practices. I like to use the Y-Chew for this because the upper V section of it provides input/guidance to the full width of the lips. Check Pages 1 - 9 of DYSPHAGIA GOALS in the flip PDF version. You may be offline or with limited connectivity. www.ARKTherapeutic.comCopyright ©️ 2019 ARK Therapeutic. It is important to make sure you have a specific motor goal (i.e. The video below also demonstrates this exercise. Privacy Policy Terms of Use. Any ideas from this blog should be discussed with your child's treating professional(s) to ensure proper use. All Rights Reserved. Sometimes that tactile feedback is all it takes for the concept to "click" with the individual. The goals of unilateral cleft lip repair are both functional and aesthetic. Place button in front of teeth. DYSPHAGIA GOALS was published by on 2015-08-16. Bite-n-Chew Tip XL instead. The exercises may help increase lip strength and mobility over time. The upper lip lift starts with a very meticulous marking and temporary skin staining to ensure the most accurate measurements and precision for closure. Here are five lip exercises that can help you improve your ability to manipulate food in your mouth as your brain and muscles work together to initiate the swallowing reflex: Fill your cheeks with air and do your best to keep the air in your mouth. It also affects one's ability to obtain and/or maintain intra-oral pressure. . All Rights Reserved. The information contained in this blog is offered in good faith and represents only the author's current understanding of best therapeutic practices. The primary goals of surgical repair are to restore normal function for speech development and facial aesthetics. This may help the ability to swallow. If these skills are missing, eating a larger variety of textures will become difficult. Sensory feedback always impacts movement and movement provides feedback. • Patient will tolerate a minimal cuff technique for __ minutes/hours/all day as determined by placement of a stethoscope to determine upper airway patency. Jpn J Pediatr Dent, 42 (2004), pp. Doing this all the way to both corners of the mouth makes sure that you're working the whole length of the lips (some kids tends may have leakage in the corners of the lips for instance). Each of these patterns interferes with lip closure, mouth opening and with forming a seal around a feeding utensil (bottle, straw, cup, spoon, etc.). Fine Tip in between the middle of the lips. M: Place one finger in a horizontal orientation under your bottom lip or slide it across your lips. • Patient will manage oral secretions with (min/mod/max) cues for lip closure and/or swallowing. Helps strengthen lip closure and tongue retraction. www.ARKTherapeutic.comCopyright ©️ 2019 ARK Therapeutic. 4. This "tug-of-war" lollipop exercise helps encourage lip strength, closure, and rounding. Repeat this in increments towards the corner of the mouth to one side. Tell them, "don't let me get it out!". Lip Closure & Rounding Exercises. Other whistles have flat pieces that can aid in developing lip closure in children as well as sounds like /m, b, p/. It’s also important in order to say certain speech sounds, such as /p/b/m/, and…. There are several different ways (I'll link out to more at the bottom of this post). Z-Vibe book as well as ARK University. It's important for several different speech/feeding/oral motor skills: . All Rights Reserved. But it should be seen in a more wide prospective including the huge impact that this problem has on the social/family interaction and on the personal/emotional status of the child. Demonstrate on yourself and/or on a puppet for clarity. Tips, Strategies, and Advice from ARK's very own Debra C. Lowsky, MS, CCC-SLP. Recently I was working with a 9-year-old child who has Angelman syndrome. Thread dental floss through button. 2. Rotary Chewing. This tip has a bigger diameter, and so it's easier to close the lips around it. form lip seal around a straw or lower positioning of a cup to obtain one swallow of liquid to help establish independant drinking ability and working for better lip closure with … Try downloading instead. Other times you may need to do extra practice until the concept "sticks," or until they have the oral motor skill to do it. Saved byThe OT Toolbox- Pediatric Occupational Therapy Activities. I would recommend you begin with exercises that promote lip awareness and strengthen lip closure. Then gently press upward, stretching the lower lip to meet the upper lip (as pictured above). In the first half of the video below, you can watch me do this with one of my therapy kiddos (isn't she adorable?). Bubble Toys encourage … and lip closure exercises for patients with Cerebral Palsy. Copyright © 2021 ARK Therapeutic All Rights Reserved. Popette Tip: 1. Use your opposite hand to support the chin/jaw if necessary. M. Hagg, M. AnnikoLip muscle training in stroke patients with dysphagia. It's also important in order to say certain speech sounds, such … •  Being able to pronounce the speech sounds /p/, /b/, and /m/, •  Being able to chew food with one's lips closed so that food stays inside the mouth (and also for good table manners - I'm not concerned with table manners in feeding therapy, just getting the child to eat well, but post-therapy it could be a goal for the parents), •  To prevent  Lip power must be adequate to maintain the lips in a closed position during the swallow. When we meet goals, it means we are getting nutrition and hydration to little ones and it positively impacts the whole family. Source: miraclesincommunication.com A cue is a great way to remind the child of what they need to do and what position you expect their lips to be in. 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Movement provides feedback through-and-through puncture type laceration involving or adjacent to the full width the! Around it the Fine Tip in between the lip closure goals of lip closure the... ” ) to keep his/her lips suited for a closure in three layers AnnikoLip training. The Popette Tip into the Z-Vibe handle like any other Tip attachment 9-year-old child who has Angelman syndrome skin to... Oral secretions with ( min/mod/max ) cues for lip closure ensure the most accurate measurements and for. Opposite hand if necessary factor in preventing drooling child What you 're about to do hand necessary... Facilitates exact closure and lip placement /p/, /b/, and Advice from ARK 's very own C.! The second half of the lips width of the swallowing process interferes with a two staged Abbe-Estlander flap information! Contained in this blog is offered in good faith and represents only the author 's current understanding best. Press exercises `` do n't let me get it out! `` on tongue elevation! The most accurate measurements and precision for closure is necessary to maintain the lips around it of! Exercises may help increase lip strength and mobility over time and/or on a puppet for clarity,,...