The Speech and OT Connection

I had a really great question the other day from a parent who asked me if her child had difficulty with talking could occupational therapy help?
As an occupational therapist working with children for the last 25 years I have definitely noted that there is increased language production when children engage in movement activities especially those that are challenging at a just right level.

Why is it that when an occupational therapist works with kiddo, we often see them talk a lot more during the session?

First of all, movement accesses a part of your brain that increases your arousal level and therefore you tend to talk more. If you are working with a therapist who is savvy, that therapist will be able to elicit more conversation through play and effectively voilà, the child is making more sounds and sometimes talking more. Talking may not always be the end result…nonverbal language is noted too.

More interactions between the play partner, more back and forth.

Children who struggle with body-based movement disorders often have either oral dyspraxia (apraxia) or global dyspraxia)
If your child is apraxic or has dyspraxia of speech, they struggle with coordination of mouth movements. (opening closing mouth, licking lips, touching teeth together). This will generally be more notable with requested movements “open your mouth, like this” or “do this with your tongue”. (Sometimes you can see the child do the movement in functional everyday activities such as eating, but not upon command).

If you child has global dyspraxia you see struggles with coordination of actions through the whole body- learning to ride a bike, getting dressed, even more than that they may have trouble with coming up with a play scheme…the “I’m bored” kid. Or they play the same thing over and over again.

Early on, children’s language development seems to vary widely.

Typically developing children seem to start their language development slowly and then, around the average age of about 21 months, they suddenly pick up speed and start to speak much faster and use a combination of words. They will talk more and use baby sentences such as “more cookie” or “want milk”. Because development is so fast at this age, children look very different from each other.

Katie Alcock, PhD has done quite a bit of research regarding this particular issue. In general she found that language and or mouth movements are linked in both typical and atypical development and this link is not due to some children being more advanced in all abilities. There are some children who are good at imitating one thing and not another.

Also, there are children who are poor at coordinating any movement of their mouths and as a result, have difficulties both carrying out all kinds of movements (body movement and mouth movement) and caring out speech movements. So they had difficulty pronouncing words and demonstrating what they knew in the way of vocabulary to parents and others. She also found there wasn’t a strong link between children’s comprehension of words in their mouth movements.

Occupational Therapists typically look at oral praxis through a series of clinical observations and using a subtest of the Sensory Integration and Praxis test (SIPT). This test is appropriate for children ages 4-8 year 11 mos. Dr. Alcock’s research seems to agree that oral motor skills are fully developed by the age of 8 years old.

Dr. Zoe Mailloux published research shows that children engaged in occupational therapy or Speech therapy with a savvy therapist who can help parents and caregivers use sensory tools (to enhance body awareness, attention, thoughts, ideas, language, time, etc) will help improve overall language (verbal and non-verbal) output.

Here are some fun activities to use at home to enhance language and praxis.

Talk, talk, talk to your child. The more you talk, the more they talk and the more they’ll get to practice, be exposed to and try to make those BIG vocabulary words with their mouth skills.

Try some heavy work for the mouth. I love blowing a bubble mountain. You have to make sure that your child understands NOT to suck in first. Use a bit (I use a few squirts) of Dawn dish liquid to a gallon of water in a bucket. Add a straw (the longer the better- I like using Zoob tubes or oxygen tubing. Both adult and child blow into the tubing and watch the bubbles rise. It is a fun activity to do in the tub or outside. (it can get messy).

Use a mirror- You both look in a mirror and make funny faces. Have your child look at what their mouth is doing and if it is the same as yours. This gives them a little feedback visually to make a comparison.

Try a some strong flavors– some kids LOVE eating salsa, red hots or eating lemons. (not that I advocate this…(my dentist is probably rolling his eyes). Anyway, strong flavors can wake up the mouth and give a little input to those mouth muscles about what’s going on in there.

These are just a few tools to put into your tools bag. contact an OT if you’d like more great ideas to help with oral dyspraxia.

References:
Katie Alcock. Oral movement and Language development. Apraxia-kids.org
Mailloux,Zoe. (April 30, 2020). Influence of Sensory integration procedures on Language development. American Journal of Occupational Therapy, June 1981, Vol 35, 383-390.