Question:  I'm working with a client who has Down syndrome.  She can't differentiate her tongue from her bottom lip when drinking from a straw.  I've tried having her drink from a straw using a Lip block to see if that helps, but the tongue still just takes over everything.  Any ideas? .

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I always recommend getting children on straws (ideally with Lip Bloks) for their oral motor benefit.  The straw + Lip Blok combination can help naturally exercise and fine tune oral motor skills / oral positioning.

However, some skills / prerequisites have to be in place first before the child can effectively drink from a straw, such as trunk control, suck-swallow-breathe coordination, tongue and jaw dissociation, etc.  You have to walk before you run so to speak (and you have to have a certain amount of strength, coordination, etc. before you can do either).  Most children start straw drinking around 8-10 months old.  So if she's not at that age level developmentally yet, she may need time and/or your help to get there.

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It sounds like she’s suckling, so (without seeing her in person granted), you most likely need to work on tongue and jaw dissociation with her.  In other words, you need to have her practice moving her tongue independently from her jaw/lips.  Doing tongue elevation exercises, trunk turning, tongue lateralization exercises, and tongue pops can all help towards that.  These skills are also all covered in depth in this book.

For tongue pops, you may have to teach this activity in stages - work on tongue tip elevation first, then suctioning the tongue to the roof of the mouth, then popping it.  You might also be able to start with tongue tip clicks first (tsk tsk tsk).

On a related note, be sure to check out this post and this post for more oral sensory tips for children who have Down syndrome.

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All my best,

Debbie

Debra C. Lowsky, MS, CCC-SLP

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