Therapy Tip: Should I Invest in Talk Tools?

It's Therapy Thursday!! This is the day that I share a tip based upon my experience as a pediatric speech-language pathologist (SLP) and a mom of a child with special needs. Today's tip is for both parents and professionals, which is:

Should I Invest in Talk Tools?

Have you ever heard of Talk Tools? If you are a speech-language pathologist (SLP), then you have surely heard something about them. If you are a parent of a child with Down syndrome, you may have heard of them at conferences, through parent articles, or word of mouth.

Talk Tools is a company that their website says provides "the best Oral-Placement Therapy (OPT) techniques, training, and tools to clients, therapists and parents." They state that their therapy techniques add a tactile component to feeding and speech therapy, enabling clients to “feel” the movements necessary for the development of speech clarity. To see everything they offer, visit their website. 

Talk Tools is a unique company offering trainings, parent education, tools, books, and step-by-step protocols on how to achieve certain goals like improving jaw strength, for example.

As an SLP, I heard about Talk Tools through professional literature. I considered taking some courses, but the live courses were seldom held in a town near me. The costs was also expensive, but any professional training usually is.

After my daughter with Down syndrome was born in 2006, I decided I NEEDED to learn more about the philosophy from Talk Tools. Jaycee's low muscle tone made sucking hard and tiring for her. When baby food was initiated, she had a reverse swallow and a significant gag response. As I moved her through more textures, vomiting started accompanying the gagging. This happened EVERY meal I attempted with any sort of texture. Straw drinking was absent for a long time. She had major issues her in mouth that was making feedings simply miserable for the both of us.

I can't speak for every SLP out there, but I can say that my coursework and fellowship did not prepare me for these problems. I knew basic information but I didn't feel confident about treating complex pediatric oral-sensory and muscle tone related feeding issues. I needed more education not just for Jaycee but for other children I had started seeing in my job in the birth-three program.

Enter Talk Tools. I took a course. Then another one. Then another on DVD. If I went to a Down syndrome conference, I'd sit in those courses as well. In case you are wondering some of the courses I have taken are: 3-Part Treatment for OPT, What You See in the Body is What you Get in the Mouth! Bridging the Gap Between NDT, Feeding, & Speech, Organizing the Mouth for Feeding and Speech, Pre-Feeding: Preparing the Oral Musculature, and finally Developing Oral-Motor and Feeding Skills in the Down syndrome Population.

As you may have guessed, I have found strategies and methods taught through Talk Tools to be a valuable part of my daughter's early progress and other children in my private speech practice. There are many websites and companies that sell tools to help with various sensory, feeding, drinking, or tone issues. With Talk Tools, you can buy the tool such as the red chewy tube, know the reasoning behind it, know how to best use the tool, and know the guidelines for when it's mastered. The information has given me professional confidence and has helped treat many children more successfully.

In my field of speech pathology, I have heard complaints about Talk Tools. The chief complaint has been that the company is making money off of courses which are promoting the purchasing of tools they also sell. Some also doubt the effectiveness of the tools. I disagree with these opinions. When you take a training course, especially the 3 Part Treatment course given live, then you can clearly understand the rationale and passion behind the company. You will also see that they aren't just trying to sell tools. They stress in their live workshops that the tools aren't as important as knowing why, how, and when to use them.

That being said, let's get back to the original question. Should YOU invest in Talk Tools? My advice is...YES!

For professionals, I personally feel the 3-Part Treatment course is essential for professionals to get a good foundation in feeding and oral-placement therapy. From there, you might find other courses helpful depending on what your caseload entails. There are many tools that I have used again and again in my private practice. Some of these include the Honey Bear straw drinking trainer, lip blocks, the toothette vibrator, and jaw grading bite blocks. If you have children on your caseload who are orally defensive, have difficulty moving through textures, or have low tone, then Talk Tools can help you in your practice.

For parents, I think you have to be choosey with Talk Tools. The costs of these products can add up, and you really need to know what you are doing to make it successful. Therefore, I would highly recommend finding a therapist who has taken Talk Tools trainings. Even better, locate a certified Talk Tools therapist on their website and schedule an evaluation. You may have to drive a distance to find one, but an evaluation should give you a detailed treatment program with step-by-step directions on how to proceed at home. If this isn't possible, there are many articles and parent geared videos or parent friendly conference opportunities such as at national Down syndrome ones that will help you get started. I just wouldn't start buying products at random off the website without knowing how to get your desired outcomes. You can always email the company too with any questions. I have emailed a few questions over the years as I have been working with my daughter and have been given a thoughtful and helpful response back.

In short, Talk Tools has been helpful in my personal and professional life, and I know other people have found them helpful as well. Should you invest in them? I did! So, yes I believe they may help many other families like mine.


Note: Talk Tools does certify professionals through a level training program. While I have taken coursework, I am not a "certified" Talk Tools therapist. These opinions are my own and am offering them for those who are considering Talk Tools.

31 for 21: Apraxia and Down syndrome

31 for 21 continues with Teaching Tuesday:

Today, I'm teaching about Down syndrome and childhood apraxia of speech (CAS). Childhood apraxia of speech is best defined here. But basically, CAS onsets in childhood and makes it difficult for the child to move their mouth to form sounds and to put those sounds into words. These children require intensive speech therapy to help them achieve complex words forms (mama versus mommy) and to be able to build phrases and sentences.

Libby Kumin's research estimates that 15% of children with Down syndrome also have a diagnosis of childhood apraxia of speech.

Here's my experience of CAS with Jaycee:

Red flags I noticed birth-3 years:
-She babbled very little as a baby. If she did babble it was something simple like "dada" with no long strings of varying consonant sounds.
-Jaycee babbled "dada" around 10 months old. I was so excited to hear this, however she didn't add anything else to this babbling.
-Jaycee was able to learn and use sign language well. By the time she was 3, she knew well over 100 signs. Yet, she couldn't say something simple like mama.
-Her first word was "bye-bye" at 29 months old.
-By the time she was 3, Jaycee identified several colors, knew several shapes, and could identify several body parts. Her receptive language was far better than her expressive language, which is a hallmark of CAS.
-Her spoken vocabulary at age 3 was: dada, papa, bye-bye.
-She had great difficulty learned to drink from a straw. It took months of practice for her to learn to put her lips around the straw and suck liquid up. She might do it once but not be able to do it again. Only through months of repetition did she finally learn how to do it.
-Jaycee had lots of feeding issues as a toddler. She gagged on many textures to the point where she vomited! This occurred daily for awhile. Jaycee was finally off of baby food by age 2. But she was a disordered eater for a long time, unable to tolerate mixed textures like spaghetti. Things like green beans or applesauce were fine but pizza was hard for her to eat and enjoy. (She is way past all these feeding issues now!!!)

By the time she was 3, I was convinced that Jaycee had CAS. The problem was she was sort of young to be diagnosed. When I mentioned it to her therapists or other therapists I knew, no one agreed with me. They told me she would be a late talker because of the things associated with Down syndrome. They told me to give it time. But, I knew a child who could sign to tell me the alphabet and could sign 15 different animal names correctly but couldn't imitate a /m/ wasn't normal for Down syndrome.

I let it go and started addressing it myself. I started to work with her at home using the Kaufman Speech Praxis Kit 1 and using exercises recommended by Talk Tools. It was painful! She barely made any progress. Jaycee basically made vowel approximates for every word leaving any consonants off, if she would even attempt the word I was targeting. Speech imitation was almost non-existent at first. I read up on CAS and Down syndrome and investigated techniques that could help her.

Finally around 4.5 years old, I requested an evaluation with a speech-language pathologist (SLP) at the closest Children's hospital. This SLP assured me that she had experience with both Down syndrome and CAS and would be able to determine if Jaycee had it. A few months later, Jaycee was tested and the diagnosis of severe CAS was given with the recommendation for intensive speech therapy following an apraxia treatment approach. Due to the severity of her CAS and good receptive language, a communication device was recommended since this SLP believed that Jaycee would struggle to learn to speak for a very long time. (She was right!)

Today, Jaycee has had her communication device for almost 4 years. It has greatly improved the quality of her life as she can talk about more topics and with more people than with just sign language. Jaycee is saying more words now, with the biggest language burst happening within the past 6 months. Speaking is still difficult for her. She tries more things but it's just hard for her. Her speech is still severely delayed. Most 2 year olds have a larger vocabulary than Jaycee. She says about 12 words now. Some words she can say now are: dada, bye-bye, papa, mama, bubba (brother), hot, hop, boom, high. Some less clear words she says are: please ("s"), you ("ew"), love ("uh"), Leah ("ah").

I hope by sharing these things about CAS, parents will learn that A. this can happen with Down syndrome and B. it is difficult to get a diagnosis so C. look for the right person who can help you.

My advice is that if a child with Down syndrome is not talking by age 5, they should be comprehensively evaluated to rule out CAS. (Of course, hearing should be evaluated first.) CAS is difficult to diagnose in any small child but especially Down syndrome. It is easy for professionals to blame the child's lack of verbal speech on a language delay, intellectual disability, or on weak oral muscles due to hypotonia associated with Down syndrome. So, a speech-language pathologist with experience diagnosing CAS is essential in order for a diagnosis to be made.