Monday, March 17, 2014

Assistance With Apraxia - Post #1: Too Much Saliva

A child with verbal apraxia may seem to have "too much" saliva.  

As I see it, he is not swallowing enough, so the saliva pools in the front of his mouth.  If he has an open mouth posture while concentrating on a toy or activity (and then tilts his head forward) the excess saliva spills out of his mouth onto the surface or object that's in front of him.

In most instances this problem may come and go, with some days being a high frequency drooling days and other days not so much.

When this happens with a 2 year old, or a child who doesn't really understand the meaning of the word "swallow," I use the following technique:

-  Sit the child in a stable place
-  Take a liquid the child likes to drink.
-  Put some into a small spoon
-  Put it in the child's mouth and say, "Swallow"
-  Repeat a few times during this drink break
-  Repeat several times per day

This will help the child associate the word "swallow" with the action of swallowing.

Once a child understands the meaning of the command "swallow." You can move on.

Introduce the fact that the larynx (Adam's apple) moves during swallowing:

"Mommy's going to swallow."
"You can feel Mommy's swallow."
"Put your hand here in front of my neck."
(Mother swallows)
"Did you feel it move?"
"Isn't that amazing?"
"You can do it too!"

Allow the child opportunities to feel his own neck when he swallows during eating or drinking.

When he's good at checking his swallowing you can use it to get rid of the saliva pooling and/or drooling.

While playing face to face with the child at a table, keep your eyes on his mouth and watch for the saliva to begin to pool in the front of his mouth.

Say, "I see a lot of saliva is in your mouth. It's time to put your lips together and swallow."

You can watch his Adam's apple to see if it moves and look at his mouth to see if the saliva is gone.

If he doesn't swallow you might say, 
"Touch your throat to make sure you're swallowing." 

Verbal reminders are given during the remainder of the play period ("Swallow"), whenever saliva pooling is noticed.

During the day, if a child drools, say, "Remember, if you swallow then it won't fall out of your mouth."

If he is trying to speak and it sounds wet or slushy say, "I can't understand you.  Can you swallow and then say it again?" "Oh, that's better!"  "When you swallow first I really can hear you and understand you much better!" :-)

I'm Noelle Michaels, a Speech and Learning Specialist currently in Northern New Jersey, and I enjoy sharing tips, activities and success stories with you.

If your child has Verbal Apraxia and your school district is saying it's "just articulation," having a copy of my book "Verbal Apraxia" may help you to explain to them that it's more than just articulation.

If you are interested:

My Verbal Apraxia book is available as a soft-cover book for $10.70 by mail (includes tax & postage) 

or as part of a 3-book E-book Volume entitled "Superb Therapy!" which is just $3.75 and available at:
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