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Early Intervention Speech Therapy

What's In YOUR Oral-Motor Toolkit?

Published April 17, 2009 10:13 AM by Stephanie Bruno-Dowling
Today I would like to share the tools I arm myself with before attempting oral-motor therapy with children below the age of three. Not always an easy task!!

Oral-motor work can often be quite daunting for all involved—therapist, parent and child! It is invasive and if the child is orally defensive, you can really have your work cut out for you! I do have a few trusty tools that I feel work well and I am always looking for new ways to do oral motor therapy, so please share your ideas as well!

Here is my Oral-Motor Toolkit:

  • Mirror—allows the child to have visual feedback of their own oral musculature. If you use a large mirror you and/or the parent can sit side-by-side with the child and demonstrate oral motor movements.
  • Lotion—use lotion on the child's face—cheeks, chin and above their upper lip—to increase strength, mobility and awareness of the oral musculature. If the child will allow it, I try to do hand over hand so that they are massaging their own face.
  • Handheld Back Massagers—I use the massagers similar to how I use the lotion. The vibration offers stimulation on the oral muscles to help increase awareness, strength and mobility. I like to use fun words like, "zoom!" and sing songs when I use lotion, the massagers, etc. to make it fun and engaging.
  • Nuk—I use the nuk mainly for children with feeding goals. Depending on the child's food sensitivities, I use the nuk to present food, as well as use food to present the nuk! Great way to massage the inside of the child's mouth and stimulate the muscles of the tongue, lips and inner cheeks.
  • Chew tube and chew cord—Both offer great ways to strengthen a child's bite and chew.
  • Whistles and whistle-activated toys—great way to improve a child's motor planning skills and achieve an appropriate lip seal.
  • Bubbles, Cotton Balls, Feathers, Pinwheels, etc.—light items that will visually move by blowing on them! These items are fun for kids and offer immediate feedback when they apply air to the items correctly. I also use a straw for the child to blow cotton balls, etc. to challenge them. 
  • Pictures—I have an array of oral motor picture cards that I use to help demonstrate for the child the movements they need to practice.
  • Electric Toothbrush—I encourage parents to use an electric toothbrush with their child to offer oral stimulation 2-3 times a day. Many of the children I work with fight against having their teeth brushed and sometimes using an electric brush offers the sensory feedback they are craving.

Please share the tools in YOUR oral-motor kit!


The length of time for an older teen or an adult to fix one secpeh sound depends completely on the client's motivation and attitude toward hard work.My last client before I retired was a 16-year-old with a frontal lisp (/s/ problem). At the start, she was totally unable to pronounce the sound even in isolation. At the end of the second week, not only was she saying the sound consistently, she had already carried it over to conversational secpeh. It took only 8 visits because she was so motivated and worked very hard, both in and out of the therapy sessions. You may be able to do the same. Developmental articulation disorders like yours aren't covered by any insurance company I've ever worked with. They only cover post-surgical or other acquired problems, such as a stroke, other neurological disorders (Parkinson's, etc.), and some ENT diagnoses.Sessions can cost as much as $150/session if in a hospital or clinic setting. I suggest contacting a secpeh pathologist or two and ask if they will see you privately for $50 or $60 per session after work. The standard treatment regimen is twice per week following a complete evaluation.Hope this helps!

Adriano Adriano, iVaGZYXuJPdnGUcfNe - FxNHQfGXYDVhJtK, HndHIwwesSlts May 2, 2012 12:06 PM
grOObsvaO LA

Hi , am a mother to a delightful 9 year old ,  verbal child who has made a wonderful comeback from autism . Still has some issues but is doing grt academically too.  After a years training and life experience as a mom , have started coaching other parents. There are very few good therapists ( compared to the large population ) and parents are at the mercy of a majority of novices.

Your site has been very informative, thank you for sharing your knowledge. Look forward to reading and learning from selfless people like you . God Bless !

Seema, autism interventionsist June 16, 2011 3:21 AM

It was suggested for my son by his OT to use a electronic toothbrush. Does anyone have any reccomendations?

Megan Savage, parent April 30, 2010 5:18 PM
Fremont CA

PingBack from

December 14, 2009 11:20 PM

I must admit, I love a good controversy every one in awhile! Recently I have been both fascinated and

August 4, 2009 11:44 AM

Last week's blog highlighted all the non-therapy related items that are necessities when working in EI

June 23, 2009 10:45 AM

The Dollar Tree stores were selling SCENTED bubbles recently.  Some come in a 3-pk in the typical bubble jar and some are sold individually with the jar looking like the fruit/scent.  Using scented bubbles will add the food smell in addition to oral motor work.  I think I saw some at Walgreens also.

Rebecca Majors, ECI 0-3 - SLP, FirstSteps/MHMR June 11, 2009 2:04 AM
Beaumont TX

Hi Stephanie,  I am working with birth to 3 and have 2 clients with cleft palate, an almost year old-scheduled for repair surgery this summer and a 2 year old with co- morbid Pierre Robin Syndrome,  who is really doing quite well verbally.  I have shared your articles with them (oral motor kit and Speech therapy is a daily routine).  I'd appreciate anything else that you could suggest that parents and daycare could do to facilitate.  Thank you and have a good day, Cheryl

Cheryl, B-3 - SLP, Home Visits May 21, 2009 9:48 AM
Fountain City WI

Hi I am a speech therapist working in Singapore

Does anyone know of workshops/training for paediatric dysphagia and oral motor techniques (paediatric) that might take place in Singapore (or nearby e.g Hong Kong)


melanie , speech and language therapists April 24, 2009 12:20 AM

I've been reading some of your blogs with interest... my 3 1/2 yr old son has been receiving speech therapy 3X/wk for delayed speech, some planning, articulation and disfluency problems.  His therapists have been wonderful and he has made great progress but will still need a lot of work to get up to par.  We are relocating to Phila area but where we go will depend on the services he will receive.  Currently we are considering Delaware Cty, Montgomery Cty or Chester Cty.  Do you have any recommendations regarding their IU services? I would hate to decrease his services right now when he's really starting to make great strides.  Thanks!

Sally Brasch April 21, 2009 1:58 AM
Highlands Ranch CO

Lara ~ I get my nuks from two places - the Dysphagia Plus website (about $4.95) and Babies R Us - they sell ones that are blue and white and come with a brush and finger massager for young children (about $7.95 for the set of three).

Barbara ~ Great idea!! I do the same thing - thank you for bringing it up!! It's a great technique!

Romy ~ Thank you for your comment. I wish I had more info to assist you. It sounds as though you are working with older patients and you may do best to research their specific conditions and how to treat them. I worked once with a 2 yr old with a paralyzed vocal cord - we practiced making basic sounds in imitation. We also used alot of sign language to help them communicate while working on the articulation.

stephanie bruno, blog author April 20, 2009 10:03 PM

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April 19, 2009 10:34 PM

What type of nuk do you use and what is a good place to buy them?

Lara, SLP April 18, 2009 11:44 AM

I also work part time with the birth to 3 population.  When using the electric toothbrush, using the tune, "Row Row Row your boat", for each section of the teeth, I sing"brush, brush, brush your teeth, gently as we can. Tickle, tickle, tickle, tickle, tickle _____'s teeth/lips/tongue".  Even the little ones learn that the brushing is over when the song is over.

Barbara Ward, , SLP schools, K-5th April 17, 2009 9:31 PM
Palmyra PA

I am living in BOLIVIA and I am an Audiologist forced to give speech therapy due to the need here and I was glad to have studied in California. I have wonderful SLP friends who give me tips on how to help kids and your blog has helped lots and lots.

So all I want to say is thank YOU!

I do have some suggestions if anyone can send them to:

There is this male who had thoat cancer and none of the SLPs here (who are mostly trained in Argentina) cant help him and he did some speech tx in Africa and wants me to help knowing my limitations.. So any ideas????

Also I have a couple on patients with unilateral vocal paralisis, any ideas here??? I ve done all the suggestions from my friends in CA, but if you have others or a page where I can get more guidance I will really appreciate it...

THANK YOU Again!!!

Romy, Audiologist April 17, 2009 9:25 PM
Sherman Oaks CA

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About this Blog

    Stephanie Bruno Dowling, M.S. CCC-SLP
    Occupation: Speech-Language Pathologist
    Setting: Early Intervention in Delaware County, PA
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