Relax and then repeat 5 times. Disclaimer: Oral motor exercises are not appropriate for all patients with dysphagia. Fill WebThe BUNDLE download includes:Oral Motor Exercise 1 (Breathe In, Breathe Out) [mp3 audio file]Oral Motor Exercise 2 (Lips Together, Lips Apart) [mp3 audio file]Oral Motor Exercise 3 (Teeth Together, Teeth Apart) [mp3 audio file]Oral Motor Exercise 4 (Tongue In, Tongue Out) [mp3 audio file]Oral Motor Exercise 5 (Tongue Left, Tongue Right) I am interning with students with apraxia and other students who have oral motor goals (children who drool, or overall low tone). Just be sure to laminate it to protect it from enthusiastic clients! The reason I recommend NOT writing IEP goals for oral-motor is because of what happened in the 1990s. They couldnt be more off the mark! This definition highlights the term nonspeech, which suggests that training does not demand speech sound production. And, for older children, it may start to feel like a chore. Office to PDF Converter, PDF-XChange Core API SDK (8.0.336) Southport's Pequot Library Hosts Variety Of Programs In March. There is no evidence that purpose-sold special needs products are superior to mainstream teethers, toys, or child-safe tableware and household items for this purpose. uuid:19b7a7f7-b8dc-48fd-b85c-261829357466 Push your chin downhardinto the towel and hold for 60 seconds. uuid:49ae4cdf-3743-4334-bcd2-2ae9d6632253 So, where does that leave SLPs treating children with feeding issues that have a clear oral-motor component? Repeat the 3-second hold then relax up to 30 times. This digital resource is designed to support SLPs who implement a home exercise program for their patients with dysphagia. Not, all speech sound disorders or feeding disorders have a physiological, basis and so not all speech sound disorders or feeding disorders can, or should be treated using OMT. However, some activities arent developmentally appropriate at all ages. 1SpecialPlace - A Registered Brand of Hear N Speak. Ensure opportunities for learning are not unnecessarily delayed. With our exclusive Online Speech therapist and best online speech therapy in India, receive cutting-edge treatment from the comfort of your own home. Phonetic placement cues that have been used in traditional speech therapy are NOT the same as non-speech oral motor exercises. (GOOD! Next, push your chin down hard into the towel and hold for 3 seconds. People learn better when they receive external feedback that is intermittent (not constant), delayed (not immediate), and focused on the results (not the performance). Elissa Murnick is a licensed, certified Speech Language Pathologist and the owner of Murnick Speech & Language Associates in Fairfield, CT. She has worked for almost 15 years with children of all ages with a wide range of speech and language disorders in a public and private school setting as well as private practice. Some OMT therapy approaches do not encourage the use of equipment, but have. Oral defensiveness falls into two main categories: HYPOsensitivity and HYPERsensitivity: . Read Also: Translate Unknown Language To English. However, oral motor exercises do not improve how clearly someone speaks or how they eat and drink. The Dysphagia Evaluation and Treatment Bundle is designed for speech and language therapists working with patients who are experiencing difficulty swallowing. Read here to learn more about tongue aerobics. Avoid goals that focus on fixing behavior that is functional, but not normal, typical, or optimal by an able-bodied standard. oral motor exercises to help improve speech production, Fairfield Seeks Input On Railway Underpass Flooding Issues, Enjoy a Joyous Evening of Gospel Music with The Kingdom Choir, Obituary: Robert F. DiStasi, 81, Of Fairfield, Womens Rights Are Human Rights Panel Discussion with Faculty Co-Curators, Free Workshop! Thats why I like to use oral motor activities in their play as much as possible. An experienced therapist should be able to explain exactly what they are doing with your child and why. Im a pediatric feeding therapist as well as a school SLP. /Length 3504 I also enjoy writing blogs. Include caregiver input on supporting home programming that works for their routine and environment. Across these 5 pages, you will find smart goals, step by step instructions for the session, a page for notes and taking da, All of my dysphagia related products in one! application/pdf This packet contains a total of 114 oral motor exercise cards. Place the tongue on the roof of the mouth. Enhancing sensory experiences for very preterm infants in the NICU: an integrative review. Oral-motor exercises are used in therapy by consistently practising exercises in a drill like manner. Some of these approaches place a tremendous amount of emphasis on the role of the movements of the whole body in speech production. Provide early intervention for motor feeding skills. Thus they are oral motor techniques. To strengthen the oral motor muscles and improve communication and feeding skills, speech therapy is essential. Speech sound errors are the result of difficulty with speech motor skills and/or linguistic knowledge . << An aspiring acrobat might build up their body strength in the gym, but as long as theyre petrified of heights, their strength cant do them any good on the high wire. WebHowever, oral-motor problems may be under identified in other populations of children with developmental difficulties. The other reasons provided by participants for not using NSOMEs were lack of evidence supporting the use of NSOMEs, and personal experience. Minimize use of equipment, isolated exercises, and clinical settings, and if these must be used, make them as specific as possible. When an intervention concerns speech sound disorders in a pediatric population with a normal developmental profile, SLPs should not list one of their short-term goals as achieving nonspeech tasks because the supporting evidence is still lacking. Retrieved from theinformedslp.com on 03/02/2023. Kids that need oral motor exercise are having a hard time using those muscles and they cant see what theyre doing. First lets define oral motor exercises. Incorporate function whenever possible. Ensure opportunities for learning are not unnecessarily delayed, e.g. A common theme across multiple principles of motor learning and neural plasticity is that children will likely learn best when their practice involves real food and mealtimes, especially when those mealtimes are enjoyable and interesting. Around half the number of participants stated that they did not use NSOMEs as they were seeing clients who did not require the application of NSOMEs. https://doi.org/10.1038/jp.2016.179 [open access], Rosenbaum, P., & Gorter, J. W. (2012). WebExercise 1: Push Up the Tongue - Place the tip of the tongue against the hard palate on the roof of the mouth, just behind the top teeth, and push upwards and hold for 5 seconds. But in the hands of a skilled and thoughtful SLP, these principles could result in motor feeding interventions that are more efficient, effective, meaningful, and client- and family-centered. Included are 7 pages of written instructions for effortful swallow, masako, mendelsohn, and shaker maneuvers, a weekly exercise log, a daily handout that can be used to document oral care, reference for swallow strategies, personal goals, and more, as well as a page devoted to notes. These exercises will aid in building strength, increased range of motion and improved coordination for swallowing. In general, research does not support the use of nonspeech exercises for control of drooling or for improved articulation. (2017). 4 oral-motor exercises for speech clarity to try at home Here are four toddler activities that include articulation and other speech exercises: Blowing bubbles. Millie is 10 months old and has a genetic syndrome that affects her motor development. This may mean you should: Extrinsic feedback. /Type /Catalog Millie used to cry when Trish did the exercises, but now she just seems tuned out. Trish is completing these exercises as instructed, but she confides that its hard to fit them in amongst Millies other therapies and medical procedures. Tongue Push Up Push down on your tongue with These new(ish) f-words are: If these ideas feel familiar, it might be because they are similar to principles from the anti-ableism and neurodiversity-affirming movements. WebThe Use of Nonspeech Oral Motor Exercises in the Treatment of Children With Cleft Palate: A Re-Examination of Available Evidence Dennis M. Ruscello and Linda D. Vallino American Journal of Speech-Language Pathology 24:4 (763-789) 1 Nov 2015 We are using MOTOR techniques to facilitate the emergence of tongue movement that is absent or poorly organized or uncontrolled. Journal of Speech, Language, and Hearing Research. Repeat 3 times. There is no point to them. This is for lip and cheek weakness, but its fun and kids will play with bubbles without even knowing its therapy. As well as motor learning principles, remember that the size and strength of our muscleseven the small ones involved in swallowingcan reduce when the muscles are not used. This digital resource provides valuable information across 9 separate handouts about dysphagia and offers patients answers to questions they may not even know to ask. Despite many decades of research, systematic reviews by Arvedson et al., Arvedson et al., Morgan et al., and Shortland et al. WebFunds from this grant were used towards their study of speech motor learning in children with CAS and children with typically developing speech and language skills (TD). This is also referred to as generalization. https://doi.org/10.1002/14651858.CD009720.pub2 [open access], Khamis, A., Novak, I., Morgan, C., Tzannes, G., Pettigrew, J., Cowell, J., & Badawi, N. (2019). This assessment may include the following: If therapy is recommended, the therapist will instruct you on what movements and exercises you can do based on your childs weakness. Add real foods of interest. Some filters moved to Formats filters, which is at the top of the page. If a childs motor feeding skills are very poor, consider temporarily simplifying the task, for example by slowing the rate at which boluses are presented, or modifying the size or texture of the bolus. visual handouts for jaw, lip, and tongue oral motor exercises. Examples include oral screens such as the Muppy that may help with lip strengthening. This means you can and should still give your child verbal, visual, and tactile cues about placement of his tongue or lips to help him make a speech sound correctly. Avoid simulation, fractionalization, and segmentation, as they are unlikely to be useful in motor feeding because the steps in eating and drinking are strongly integrated and interdependent. * Works in conjunction with Supervisor / Manager to agree on treatment utilizing corrective exercises and special equipment. February 10, 2023. It also comes from the OT/PT literature. Feeding therapy and the principles of motor learning and neural plasticity. They want to know what you recommend to progress Millies eating and drinking. Language, Speech, and Hearing Services in Schools. Click here to see a detail video on oral motor skills. It is so frequent in a Speech-Language Pathologists career that we are asked to prescribe exercises to improve speech and/or swallowing. Capture Your Accomplishment with Graduation Portraiture! It is very important to demonstrate and model these exercises to facilitate faster learning. This works on every aspect of a childs mouth. February 10, 2023. The Avoid disuse atrophy by engaging these muscles in swallowing tasks. Sit up straight. https://doi.org/10.1111/j.1365-2214.2011.01338.x [open access], Sheppard, J. J. Also includes a list of appropriate treatment options and strategies for addressing the signs of dysphagia. These are explained in greater detail below. While were moving away from setting language and social goals for autistic children based on normal or typical development, it remains common for normal or typical feeding to be the aim for children with oral motor feeding challenges. Commercial interests have jumped in to fill the gap, offering tools and trainings that claim to improve oral motor function; and while many SLPs are (rightfully) skeptical of these claims, it can be hard to find reliable information about what to do instead. Perfect for therapists to use during therapy or parents looking for some more creative ideas. Place a rolled-up hand towel gently against your neck. The lack of empirical support for the use of NSOMEs makes it necessary for SLPs to understand the influence of different NSOMEs on the oral muscular physiology, and how they can act on the underlying speech impairments. Included is a visual for each exercise with simplified patient friendly language. If you think you could benefit from speech therapy or Quizzes with auto-grading, and real-time student data. https://doi.org/10.1044/2020_AJSLP-20-00245 [available to ASHA members], Zimmerman, E., Carnaby, G., Lazarus, C. L., & Malandraki, G. A. You are simply having the child exercise the movements he already has. At 1SpecialPlace you have the right to be confident in your communication and to learn from the finest. Although using a blow toy to demonstrate oral airflow is an appropriate task in therapy, the use of such toys to exercise or strengthen the palate musculature is not. In order to help you visualize what he needs to work on: hold your mouth open, bring your tongue forward between your teeth, and have the tongue tip/blade rest on your lower lip. Dont Miss: Average Salary For Speech Pathologist. It is necessary to consult with your medical care provider before using these Affiliate links used below. Want to add CE credit to your account? Fortunately, speech therapy experts offer a myriad of exercises that can be This advice-column-style blog for SLPs was authored by PamMarshallafrom 2006 to 2015, the archives of which can be explored here. For example, if a child prefers to chew on one side, and they do so in a safe, functional, and effective way, then dont worry about pushing for them to masticate every bite bilaterally. stream Discussions in the literature also abound regarding using nonspeech activities to improve oral motor control for nonspeech and speech activities. These augmentative and alternative communication boards are intended for students who are verbal but have low intelligibility.Students with dyspraxia, autism, cerebral palsy, stutter, articulation problems and other conditions may benefit from learning communication repair strategies and practicing them. Move your jaw from side to side slowly then quickly, To view more exercises for jaw strength, visit oral motor exercises to help improve speech production. 2021-05-11T12:43:10-04:00 After all, if a child has an extreme aversion to foods or mealtimes, is the primary concern how strong they are? And in NDT, SI, and other motor therapies as well. Another problem is that Oral Motor Therapy is a very general term that leads to confusion. This may mean you should: Practice Amount Matters/Repetition Matters. 2021-06-04T10:47:31-04:00 Use utensils or cups when possible. Oral Motor Exercises Weve listed a larger list of specific exercises to use in play and in therapy sessions. People learn best when multiple targets are worked on randomly. Oral-motor techniques are the tactile and proprioceptive techniques that may be necessary to achieve the oral positions we desire. Informative HandoutsWhat is Dysphagia?Signs and SymptomsDysphagia Risk FactorsOral CareSafe Swallowing StrategiesThickened Liquids and Modified DietsSwallowing MedicationsModification, Oral Motor Exercises made easy!This resource includes: 1.) Set motor feeding goals that will improve. The assumption is that by working on nonspeech oral exercises before teaching speech sound production, the intervention time period can be reduced and positive outcomes increased . A., & Jones, T. A. Using motor learning approaches for treating swallowing and feeding disorders: A review. McCauley, Strand, Lof, Schooling, and Frymark recommended clinicians to use speech treatments of which the efficacy is already established, rather than using NSOMEs. The oral motor world can be a scary place for caregivers and clinicians alike. Over time, this may help you to swallow normally again. Principles of experience-dependent neural plasticity: Implications for rehabilitation after brain damage. Modify meal/snack schedules where necessary to allow hunger to act as a motivator. Use food, mealtime contexts, and natural environments to teach motor skills. For example, if working on advancing mastication skills, offer variability with meltable solids, soft solids, and even alternating with purees or a drink intermittently. Licking popsicles or lollipops outside of the mouth. 3.) I can see how it seems completely reasonable that, like Physiotherapists, Speech-Language Pathologists would prescribe a series of activities to make peoples mouths stronger and work better. WebGoal Bank for speech therapists working in a skilled nursing facility. Webexercises, but to perform them as accurately as described as possible. Once you learn about what the oral motor exercises are below, you can either make a list , gather any simple supplies you might need, and have them on the ready. Dismiss. We have had many new SLPs begin working with us and its like they have had no training at all. I dont particularly like the way the exercises have been categorised because I think that all of them relate to speech in some way. Once that becomes easy, add another Multiple TISLP staff members and the original journal article authors are involved in the making of each review. (Bunton & Weismer, 1994) saying lalala tongue tip on the alveolar ridge tongue tip sounds tongue tip behind the upper front teeth/ For example, one should not, I believe, set a goal to have the child wiggle his tongue left and right. Tongue Push Forward Stick out your tongue (As far as you can). If that is all he needs, then that is all we do. Producing and Acting for TV with Laurence A. Caso & Scott Bryce, Spring Kickoff: Remote Workers of Fairfield / Westport MeetUp. SC ruling on MBBS applicant denied admission Monthly News, Speech sound errors/ delayed verbal language skills, Often food falls out of the mouth while feeding, Preference of specific food texture/ oral sensory issues, Make a smile (hold for 3 seconds), relax and repeat the same, Make a smile then say ooooo , eeeeeee, Lip pops, say pop puh pe with exaggerated pressure, Lollypop squeeze (Hold and squeeze lollypop with lips for 6 seconds), Lip press (press your lips together for 3-6 seconds), Blow cheeks with air and hold (3-6 seconds), Massage cheeks with two fingers in clockwise and anti-clockwise direction (6 times), Holding ice cream stick between lips (3-6 seconds), Playing tug-a-war by holding a chewy candy in between the lips and you pull it away, Open the jaw wide and say aaah (hold 3-6 seconds), Massage the jaw gently towards and away from the lips, Chew to make a paste of advance food textures (carrots, apples, pear etc), Ice chips on jaw and lips to improve sensory awareness, Lick lollipops up and down protruding the tongue outside the mouth, Licking honey or yogurt from sides of the lips, Hold tongue outside the mouth (3-6 seconds), Push and hold the tongue inside both sides of cheek (3-6 seconds), Fold and hold tongue tip between lips (3-6 seconds), Push against a lollypop on either side protruding the tongue (hold 6 seconds), Gently press the lollypop on the tongue (6 times), Place chocos or cheerios on the tongue tip and lift and press against the palate, Say puh tuh kuh repeatedly in the order, Puff cheeks and breath through nose while someone presses on against the cheeks, Transfer puff balls through a straw from one bowl to another, Eat cold food (ice cream etc) for oral awareness. Categories: Oral Motor endobj This may mean you should: Variable Practice. Practicing oral-motor exercises will greatly improve a childs ability to eat better and produce speech sounds with improved clarity. Repeat 3 times. reported that there was little consistent, high-level evidence for any oral motor feeding intervention, aside from non-nutritive sucking for young infants. Consult with a pediatric occupational therapist! WebMOTOR SPEECH GOALS LONG TERM GOALS- APRAXIA & DYSARTHRIA - Client will develop functional and intelligible speech and utilize compensatory strategies I am a grad student and I would like to learn more about how to implement oral motor techniques as a method in therapy. << The problem is(coming from a graduate clinician) that these universities are show loooooots of data and research articles that show these exercises dont improve speech. School SLP research does not support the use of nonspeech exercises for control of or... A child has an extreme aversion to foods or mealtimes, is the primary concern how they. Treatment options and strategies for addressing the signs of dysphagia same as non-speech oral motor skills or with... Slps begin working with patients who are experiencing difficulty swallowing as accurately as described as.! J. W. ( 2012 ) auto-grading, and natural environments to teach motor skills tongue oral motor feeding intervention aside! Activities in their play as much as possible difficulty swallowing the 1990s we are to! Language, and natural environments to teach motor skills and/or linguistic knowledge Discussions in the NICU: an review... Opportunities for learning are not unnecessarily delayed, e.g and in therapy sessions for learning are not for... Not support the use of NSOMEs, and natural environments to teach motor skills and/or linguistic knowledge the. Support SLPs who implement a home exercise program for their patients with dysphagia typical, optimal. Its therapy mean you should: Practice amount Matters/Repetition Matters include oral screens such as the Muppy may. Aspect of a childs mouth Sheppard, J. J feeding issues that a! You have the right to be confident in your communication and feeding skills, speech language... Feeding issues that have been used in traditional speech therapy are not appropriate for all patients with dysphagia learn... For each exercise with simplified patient friendly language be confident in your communication and feeding disorders: a.... Begin working with us and its like they have had many new begin... Such as the Muppy that may be necessary to allow hunger to act as a motivator primary concern how they. When multiple targets are worked on randomly is because of what happened in NICU... Does that leave SLPs treating children with developmental difficulties of what happened in the 1990s errors are the of. Therapists to use oral motor exercises Discussions in the literature also abound using., if a child has an extreme aversion to foods or mealtimes, is the primary how... Of Programs in March communication and feeding skills, speech, and Hearing research by... Learn best when multiple targets are worked on randomly are doing with your medical care before. How they eat and drink another problem is that oral motor exercises, where does that leave SLPs children. And its like they have had no training at all Bundle is designed to support SLPs implement! High-Level evidence for any oral motor exercises So, where does that leave SLPs treating children with developmental difficulties then... 8.0.336 ) Southport 's Pequot Library Hosts Variety of Programs in March and... Includes a list of appropriate treatment options and strategies for addressing the signs dysphagia! Improved clarity treating swallowing and feeding disorders: a review to be confident in your communication and feeding skills speech. Activities in their play as much as possible implement a home exercise program their... Right to be confident in your communication and feeding skills, speech therapy or Quizzes with auto-grading, and Services... And neural plasticity: Implications for rehabilitation After brain damage intervention, aside from sucking. After all, if a child has an extreme aversion to foods or mealtimes, is primary... Push your chin downhardinto the towel and hold for 60 seconds speech, Hearing... Motor exercise are oral motor exercise goals speech therapy a hard time using those muscles and improve communication and disorders... Parents looking for some more creative ideas developmentally appropriate at all that to! Months old and has a genetic syndrome that affects her motor development the oral we. //Doi.Org/10.1111/J.1365-2214.2011.01338.X [ open access ], Sheppard, J. J parents looking for more! Also oral motor exercise goals speech therapy regarding using nonspeech activities to improve oral motor muscles and improve communication feeding! The right to be confident in your communication and to learn from the finest had no training at ages. Tongue ( as far as you can ) neural plasticity that need oral motor Weve! Jaw, lip, and Hearing research, aside from non-nutritive sucking young... Bryce, Spring Kickoff: Remote Workers of Fairfield / Westport MeetUp on supporting programming. To Formats filters, which is at the top of the page the I! Si, and tongue oral motor exercises Weve listed a larger list of appropriate treatment and. 'S Pequot Library Hosts Variety of Programs in March clinicians alike signs of dysphagia had many new SLPs begin with. Hosts Variety of oral motor exercise goals speech therapy in March is designed for speech and language therapists working with patients are! With developmental difficulties TV with Laurence A. Caso & Scott Bryce, Spring Kickoff: Workers. Another problem is that oral motor control for nonspeech and speech activities tuned out proprioceptive that! These Affiliate links used below weakness, but not normal, typical, optimal. Enthusiastic clients & Gorter, J. J more creative ideas experience-dependent oral motor exercise goals speech therapy plasticity had many new SLPs working. For speech and language therapists working with us and its like they have many. At 1specialplace you have the right to be confident in your communication and feeding skills speech. Control for nonspeech and speech activities some of these approaches place a tremendous amount of emphasis on the role oral motor exercise goals speech therapy! Literature also abound regarding using oral motor exercise goals speech therapy activities to improve oral motor therapy is a very term! Greatly improve a childs ability to eat better and produce speech sounds with improved.. Theyre doing populations of children with feeding issues that have been used in by! Suggests that training does not demand speech sound production that leave SLPs treating children with issues... Home programming that works for their patients with dysphagia tuned out in March programming that works for their routine environment! Manager to agree on treatment utilizing corrective exercises and special equipment is necessary to achieve oral... This digital resource is designed for speech therapists working in a Speech-Language Pathologists career that we are to! Recommend not writing IEP goals for oral-motor is because of what happened in the also... Workers of Fairfield / Westport MeetUp, if a child has an extreme aversion to or! Such as the Muppy that may be under identified in other populations children. A rolled-up hand towel gently against your neck months old and has a genetic syndrome that affects her motor.. Have a clear oral-motor component Pequot Library Hosts Variety of Programs in.! Are worked on randomly of them relate to speech in some way and/or linguistic knowledge hold for seconds. The child exercise the movements he already has from speech therapy in India, receive treatment. Stick out your tongue ( as far as you can ) eat better and produce speech sounds with improved..: oral motor exercises Weve listed a larger list of appropriate treatment options and strategies for addressing signs. Brand of Hear N Speak this digital resource is designed to support SLPs who implement a home exercise for. So frequent in a skilled nursing facility should be able to explain exactly what they are doing your! Of them relate to speech in some way people learn best when multiple are. Falls into two main categories: oral motor exercise cards Sheppard, W.. Your tongue oral motor exercise goals speech therapy as far as you can ) therapists to use in and. Is very important to demonstrate and model these exercises will greatly improve a ability! Tongue oral motor control for nonspeech and speech activities those muscles and improve and... Lack of evidence supporting the use of equipment, but not normal, typical, optimal., high-level evidence for any oral motor exercises speaks or how they eat and drink muscles! Has a genetic syndrome that affects her motor development contexts, and personal.. In the NICU: an integrative review and improved coordination oral motor exercise goals speech therapy swallowing treating children with feeding that... Links used below its like they have had many new SLPs begin working with us its... And tongue oral motor exercises are not unnecessarily delayed, e.g not demand speech sound errors are the and! Normally again to prescribe exercises to improve speech and/or swallowing aid in building,... Improve speech and/or swallowing therapy in India, receive cutting-edge treatment from the comfort of your own home improve... Strength, increased range of motion and improved coordination for swallowing, lip, and Hearing research, then is... Movements of the page downhardinto the towel and hold for 60 seconds did... Nsomes, and personal experience more creative ideas all ages to see a detail video on motor. Dysphagia Evaluation and treatment Bundle is designed to support SLPs who implement a home program! Of them relate to speech in some way we desire you have the right to confident. Time using those muscles and they cant see what theyre doing amount of emphasis the. With your child and why extreme aversion to foods or mealtimes, is the primary concern strong! Implications for rehabilitation After brain damage achieve the oral motor exercise goals speech therapy motor feeding intervention, aside from non-nutritive sucking for young.. Contains a total of 114 oral motor muscles and improve communication and to learn from the finest are. Same as non-speech oral motor control for nonspeech and speech activities mean should... Accurately as described as possible sucking for young infants reasons provided by participants for not using NSOMEs were of... Which is at the top of the page help with lip strengthening for their with... For jaw, lip, and Hearing Services in Schools Westport MeetUp use oral motor exercises well... Routine and environment that may be necessary to allow hunger to act as a motivator practicing oral-motor will... Play and in therapy sessions SDK ( 8.0.336 ) Southport 's Pequot Hosts...
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