Important Nutritional, Oral Motor, Feeding, and Language ...

Important Nutritional, Oral Motor, Feeding, and Language Ideas to Ensure Optimal Development of Your Child with Down Syndrome Jill Rabin M.S. CCC-SLP/L IBCLC Pediatric Speech/Language Pathologist International Board Certified Lactation Consultant Medical Assessment/Intervention

Cardiology Gastroenterology Otolaryngologist Endocrinology Audiology Ophthalmology/Vision Specialist Brian Skotko-geneticist: www.brianskotko.com Nutrition

Physical/Occupational Therapy Speech Therapy/Lactation Consultant Developmental Therapy

Oral Motor/Feeding/Language Characteristics of Children with Down Syndrome Difficulty with motor planning Decreased oral sensory awareness due to low tone Overstuffing of food Tongue protrusion

Issues with middle ear fluid/hearing loss Motivated by music Excellent gestural imitation Telegraphic speech patterns Ideal Nutrition for Infants/Babies with Down Syndrome

Breastfeeding/Breast milk Organic foods/Clean diet Impact of gluten Impact of dairy Biomedical treatment

Vitamins/Supplements Appropriate feeding tools/aids Bottle-Feeding/Breastfeeding Techniques and Aids Sara Rosenfeld-Johnsons bottle-feeding technique Specialized bottles: Haberman Feeder, Dr. Browns, Innobaby, Calma, etc. Paced bottle-feeding

Firm bottle nipples Nipple shields Supplemental nursing system Bottle-feeding/Nursing Aids Oral Motor Activities/Exercises

Breastfeeding Straw drinking Open cup drinking

Tongue elevation and lateralization exercises Graded chewing Lip strength/closure activities Oral sensory awareness activities Horn hierarchy Lori Overland video Specific Oral Motor Exercises for Tongue

Tongue pointing exercises Lateralization of food bolus Tongue retraction Tongue tip definition/elevation Tongue-ties

Posterior Tongue Tie Specific Oral Motor Exercises for Lips/Jaw

Lip rounding Prolonged lip closure Lip isolation Graded chewing Bite and pull Oral tug of war Oral sensory awareness Oral proprioceptive input

Jaw Grading/Tongue Lateralization Chewy Tube Lip Rounding Exercises with Food

Combining crunchy with smooth Food shape (strips) Varying viscosity of liquids Isolating lips to pick up food items Lateralization of food items

Graded biting Foods Used in Therapy Oral Facial Tone Variability Oral Motor/Feeding Resources Debra Beckman: www.beckmanoralmotor.com Lori Overland-videos on youtube of oral motor and feeding assessments with children with Down syndrome.

Sara Rosenfeld Johnson: www.talktools.com -has special bottle feeding technique, developed many oral motor and feeding tools. Pam Marshalla: www.pammarshalla.com -gives presentations, has books, on stopping drooling, oral motor techniques, and apraxia. Speech/Language Strategies

Audiological Assessment Use of a Total Communication Approach Expansion and differentiation of vocabulary

Modeling and expansion of sentence structures Emphasis on articles in speech, e.g. the, a, etc. Incorporation of siblings in therapy Literacy Training Non-therapy activities: Tae kwon do, dance, swimming,etc. Speech/Language Resources Libby Kumin-author of Early Communication Skills in Children with Down Syndrome (2003)

focuses on speech and language skills in young children from birth to six years. What Did You Say? (2006 DVD): focuses on how to help children develop intelligible speech. Helping Children with DownSyndrome Improve Speech (2008): focuses on communication skills in older children from ages 6-14. Importance of Use of Sign Language with Children with Down Syndrome

Issues with motor planning Good at imitating gestures Allows communication until verbal speech is present Visual learners/hearing difficulties American Sign Language

Known as ASL Is the true language of the deaf Has its own syntax and grammar Best to use if child is truly deaf Third most used language in the United States Signing Exact English

Known as SEE Using ASL signs, with English grammar and syntax Its expanded with prefixes, tenses, articles, prepositions and endings Manual representation of English vocabulary and grammar Takes longer to communicate Used to teach deaf children English Example of SEE

Types of Signs Iconic Signs Nouns versus Verbs Have meaningful origins, e.g. boy, potato, onion, etc. Sign approximations Sign Language Strategies

Viewing of Signing Times videos Incorporation of siblings in therapy ASL.pro video dictionary Pairing sign with verbal words Resources to Learn Sign Language

www.signingtime.com www.babysigns.com www.asl.pro www.loveandlearning.com

www.signingsavvy.com Community Resources Gigis Playhouse National Association of Down Syndrome

Ups for Downs North Shore Down Syndrome Awareness Group Lutheran Generals Down Syndrome Clinic Questions???

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