This is part of the 31 for 21 Blog Challenge!
So, first of all, this happened:
Ellie was enthralled with her potty costume… Once her cousin Jimmy came over dressed as Curious George, it was over. Somehow, Ellie convinced him to shed his costume so that she could wear it and then the two of them had a grand ol’ time pretending to use the potty. Kids are weird.
A rough transition here…. on to Speech.
It was very perplexing to me that we could start Speech therapy on a 6-week-old baby. However, with Tessa unable to take her bottle in an upright position, we were set up with a type of Speech therapist who specializes in Oral-Motor therapy. Oral-Motor therapy teaches a child awareness, coordination, and strength of the muscles of the mouth (all related to that low muscle tone that we keep talking about).
(On a side note, because I know some are curious, no, my children have not really been nursed. Ellie got 5 days and Tessa got 12. That’s a whole other story.)
During a therapy session, we work a lot on building strength in her core muscles. When you think about eating, you use muscles throughout your abdomen, neck, and head to eat effectively. One of the ways that we can improve Tessa’s eating skills is to build strength throughout her body so that she will be stable when she is sitting and can begin to use her hands to move food to her mouth. This part of the session focuses on sitting and bringing toys to the mouth.
We also work on direct input to the mouth itself. We started by providing input with a tool like this:

We use it to teach her tongue and gums what different textures and pressures feel like. We also work on stimulating her tongue to move around the mouth to react to food. Lately, we have graduated to putting small crumbs of graham cracker or animal cracker on the sides of her mouth so that she learns to move the food and to swallow it.
We always end our session with feeding. Well, I shouldn’t say always. Sometimes, Tessa gets really mad when she doesn’t get fed first. And sometimes, she decides that she has had enough and just closes her eyes and goes to sleep. However, we like to do some “spoon work” with the therapist when Tessa will let us. 🙂 We have found that a forward-facing presentation of the spoon (how you or I would put a spoon in our mouth) is challenging for her, so we present the spoon sideways. However, we also continue to work on the forward presentation. We are teaching her to get the food off the spoon and swallow. She also has a habit of sticking her tongue out while she eats, so we have to wait until she puts her tongue in the right place before allowing her to take a bite. Remember that a tongue is made up of a lot of different muscles, so her low muscle tone affects her ability to keep it in the appropriate place and use it effectively.
Our next steps with Tessa are to introduce a straw cup (recommended over a sippy cup) and to slowly increase the variety of textures that she will tolerate. We have begun to work on the actual “speech” part of Speech therapy with practice mimicking noises, We have introduced signs for more, all done, eat, and drink.
The most important thing to remember is that while we have made modifications for Tessa and we do have to make a conscious effort to teach her some skills that may come naturally to others, our life is not work. We don’t live in a constant therapy session, always practicing, practicing, practicing. When we can, we do these things. That is all. There are weeks when we do a lot of practice. Sometimes, we don’t. Eventually, we’ll get there.
An excellent resource that I have just started to dive into is Early Communication Skills for Children with Down Syndrome. Click on the blue link to find it on Amazon.
Blurry, but perfect…
