What is the frequency and duration of use that you recommend for vibration during therapy?

This will vary according to each person's sensory preferences.  Some individuals may not be able to tolerate a lot of stimulation, while others may crave it.   Either way, I always recommend introducing the  Z-Vibe slowly (at least until they are comfortable with it).  Use it without vibration first.  Then turn it on, show it to the individual, and let him/her feel the vibration in the hands and on the arms, slowly working towards acceptance into the mouth.

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Once you're in the mouth, the length of time will vary depending upon what your goals are.  When working on tongue tip elevation, for example, I use the Z-Vibe with the Probe Tip or Mini Tip to touch alveolar ridge (just behind the upper front teeth).   I apply gentle pressure, then lean back and wait for a response.   If the tongue doesn't elevate, I'll repeat the exercise again (if the individual allows).   I’ll do that one more time and wait for elevation.   Sometimes this simple tactile cue is all that's necessary to trigger elevation.  If the tongue tip doesn't elevate, then I'll move on to another goal for the time being, then repeat the Probe/Mini Tip exercise.   If there still isn’t a response, I’ll continue again with feeding or sound production and repeat the exercise above a little later.  So, the duration that I'm using the Z-Vibe is quite short for this exercise. 

The same would apply for stroking the sides of the tongue for lateralization, applying pressure on the back of the tongue to assist elevation, applying pressure mid-tongue for a tongue bowl, etc.  With the Animal Tips I can be in the mouth longer, perhaps up to 30 seconds at a time having the child close their lips around the animal’s face, explore the bumps and ridges with their tongue, bite the blocks on the back of the tip for jaw grading practice, and so forth.  Then I’ll remove from the mouth to work on babbling, sound production, or feeding.

As a general rule: provide stimulation, monitor the response, and adjust accordingly. If at any point the individual shows signs of refusal (grimacing, pushing the tool away, turning his head, etc.), discontinue oral motor therapy at that point before the individual rejections stimulation. You can use it again in the next session, starting just below the point of rejection and ending before it occurs. Work on individualized progress and remember that frequent exercises throughout the day are more important than the amount of exercises completed in any one session.

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All my best,

Debbie

Debra C. Lowsky, MS, CCC-SLP

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