SPD and Oral Motor Problems

You also mentioned that R has aversions to certain food textures due to SPD.  Could that be related to his speech delay?

If you were to ask R's speech language pathologist (SLP), the answer is a resounding yes.  One of the red flags of SPD is language delay as well as feeding problems.  We had R assessed by an SLP around the same time as the OT, then another assessment with the SLP a few months after consistent OT sessions.

Language works in two ways- expressive and receptive.  Receptive language basically is how we understand words.  It's the ability to understand language.  This is how we learn to associate words with items and contexts.  Expressive language is the use of words, sentences and basically language.

R had no issues with receptive language.  I could give him instructions and he'll follow.  But he had problems with expressive language as he could not make any intelligible words by age 3.  The developmental pediatrician had diagnosed him with not just SPD but also communication disorder and fine motor delay as a result.

Upon assessment by the SLP, we found that what R had as an advantage was what they called intent to communicate.  He would try to find another way to tell us what he needed even though he was having difficulty talking.  The SLP then said what R had, as a result of SPD, was called Childhood Apraxia of Speech.

Wait, what?  What is that?

Childhood Apraxia of Speech (CAS) is defined by the American Speech-Language-Hearing Association as "a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words."

This is different from orofacial apraxia, which is a child's inability to coordinate his/her facial and oral muscles to perform actions like kissing, or sticking out one's tongue.  It can occur along with apraxia of speech, but they can also occur independently of each other.

Minor cases of apraxia is called dyspraxia.  Sometimes SLPs do use the two interchangeably so there is some confusion as to whether they are the same or not.  However, dyspraxia is considered as part of Sensory-Based Motor Disorder, a subtype of SPD.

R had minor orofacial apraxia as he couldn't kiss or stick his tongue out on command in the beginning, but that has since been overcome after several sessions of Oral Placement Therapy (OPT).  Now he's mainly being treated for CAS.

What is Oral Placement Therapy?

OPT is a series of exercises and activities designed to cater to a child's oral sensitivities and muscle toning.  It was developed by Sara Rosenfeld-Johnson, founder of TalkTools.

Each case of apraxia, again, is different, so an SLP is the best person to ask what tools your child would need.  This is not a stand-alone treatment program and is recommended to be used along with speech language activities.

R needed the following items to help treat his CAS.  Nearly all of them are from TalkTools.

Infadent brush by NUK. We don't necessarily have this brand in the Philippines, but SM and other department stores sell similar brushes in their baby care section.

The infadent brush is used for orofacial massage, over his forehead, cheeks, lips and even inside his mouth to desensitize them and stimulate the muscles.

Tongue depressors can be bought in any local drugstores in the Philippines.  However if your child prefers flavored ones, TalkTools sells them in strawberry, cherry or grape flavors.

Tongue depressors are used to help R learn to seal his lips, develop lip strength, and also used to help him position his mouth for "p", "m" and "b" sounds.

TalkTools Horn # 4

TalkTools Horn # 6

Horns are used to help R develop blowing strength, and also teach him how to drag sounds longer by blowing for longer period of time.

TalkTools Kazoo

The kazoo is used to help R shape his lips to make the "o" and long "u" sounds.  The wider end corresponds to "o", and the narrower end corresponds to "u".

TalkTools Tongue Tip Lateralization and Elevation Tools

The tongue tip lateralization and elevation tools teach R to move his tongue from side to side, and up and down.  These prepare him to make the sounds "l" and "n".

TalkTools Jaw Grading Bite Blocks

The jaw grading bite blocks come in different thickness, each corresponding to a sound from the "a", "e" or "i" vowels.  It also enhances jaw and bite strength.

TalkTools Chewy Tube Red

TalksTools Chewy Tube Blue

Chewy Tubes are for soothing the child.  R liked to grind his teeth a lot, and he would also chew on the teat of his bottle, so chewy tubes are really good in addressing that.  The softest one is yellow.  R started mid-range with the red, and has since progressed to the hard blue one.

As of this writing, there's not a lot of places in the Philippines selling these, so it's either you buy it straight from TalkTools, their Singaporean distributor Therapy Resources, or their Australian distributor Pro-Ed Australia.

I can attest that R has improved a lot since we started OPT.  He can now say "up", "yes" and "eat".  Still working on "mama" and "papa", but we're getting there.  And I pray that this post, in sharing our experience, has been helpful and informative to you.