Lip closure (also known as lip seal) is the ability to close one's lips around a spoon, straw, cup, etc.  It's also important in order to say certain speech sounds, such as /p/b/m/, and it's a factor in preventing drooling.

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Recently I was working with a 9-year-old child who has Angelman syndrome.  The mother was asking if there was anything she could do to decrease drooling. One of the first things I look for with drooling is whether or not the child has lip closure.  The child was not closing her lips and could not do so on command, so I touched the Z-Vibe to her lips for about 2-3 seconds, and voila - immediately her lips closed.  I waited a few minutes and repeated the stimulation, and she closed her lips again.  She just needed that extra sensory input to be aware of her lips to close them.

Sometimes a simple prompt like that will elicit lip closure.  Other times you may need to do extra practice until the concept "sticks," or until they have the oral motor skill to do it.  It really just depends on the child.

For further lip closure practice, here's one of my favorite exercises:

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1.   First explain to the child what you're about to do.  Demonstrate on yourself and/or on a puppet for clarity.

2.   Place the Fine Tip in between the middle of the lips.

3.   Instruct the child to squeeze the Fine Tip with his/her lips.  The lips should seal and show some pursing.  And the child should only be using their lips (not biting on the tip) so that their lips are doing all of the work.

4.   Repeat this in increments towards the corner of the mouth to one side.

5.   Repeat to the other side of the mouth.

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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).  In the first half of the video below, you can watch me do this with one of my therapy kiddos (isn't she adorable?).  (In the second half of the video we're working on tongue tip elevation).

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If this exercise is too difficult, try it with the Bite-n-Chew Tip XL instead.  This tip has a bigger diameter, and so it's easier to close the lips around it.

Another fun way to work on lip closure (and lip rounding, which is important for "oh" sounds for instance) is with the Popette Tip:

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1.   The Popette Tip is an adaptor that lets you use lollipops with the Z-Vibe (yum!).  Just twist the Popette Tip into the Z-Vibe handle like any other tip attachment.  Then press the stem of a lollipop into the Popette Tip (you can trim the stem of the lollipop if it's too long).

2.   Place the lollipop just inside the child's mouth.  Let him/her have a quick taste.

3.   Then instruct the child to close his/her lips over the lollipop (so that the candy is inside the mouth).

4.   Gently tug on the lollipop, and instruct the child to keep his/her lips closed.  Tell them, "don't let me get it out!"

5.   Do about 10 gentle tugs.  Then give them a chance to swallow.  Then repeat twice more.   Use your opposite hand to support the chin/jaw if necessary.

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This "tug-of-war" lollipop exercise helps encourage lip strength, closure, and rounding.  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.

For more exercises like these, check out the Z-Vibe book as well as ARK University.

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And as always, have fun with it!

Debbie

Debra C. Lowsky, MS, CCC-SLP

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