Q: I am looking for suggestions for our 2-year-old son with epilepsy. He currently functions at a 6 month level. He can eat by mouth (only stage 2 or 3 baby foods), but lacks a suck. He can swallow well, but we have to use a syringe to get liquid into his mouth first. I do have the Z-Vibe with the Cat and Mouse Tips, but since his mouth is so tiny, they haven’t really helped. Can you suggest any others?
I’ve also tried a ton of cups and nothing has helped. If we don’t see improvements soon, we will probably get the g-tube just for liquids. He has had one before, but we would prefer to get him to take everything by mouth. I have seen him suck on his finger and make a sound – so he is doing it at times. He will be getting Hyperbaric Oxygen Therapy in three weeks along with intensive speech therapy, and I want to make sure I have all the products that he may need. Any thoughts?
Q: I use the Z-Vibe in therapy daily. I was wondering if there are any guidelines re. overuse of the Z-Vibe. Can it be harmful? Is it more effective to use it on and off?
A: Dear SLP,
My guideline has always been to check with the individual’s physician about using vibration intra-orally if there are any doubts or concerns. Since each individual is wired differently, how you use the Z-Vibe can vary. I am sure you know that some individuals dislike vibration. In this case, I still use the Z-Vibe, just without vibration. The length of time varies, depending upon what your goals are. If I am working on tongue tip elevation, I place the Probe Tip or Mini Tip at a 45 degree angle to place on the alveolar ridge. I apply pressure (not hard) and remove from the mouth to see what response I get. If I don’t get elevation, I repeat this, but only if the individual allows. I’ll do that one more time and wait for elevation. Then I’ll move on to something else, such as feeding or sound production, then I’ll repeat the Probe/Mini exercise. If there isn’t a response, I’ll continue again with feeding or sound production and repeat a little later. So, I am really not inside the mouth very long for this exercise. The same would apply for stroking the sides of the tongue for lateralization, applying pressure on the back of the tongue to assist elevation, applying pressure mid-tongue for a tongue bowl, etc. With the Cat, Dog, and Mouse Tips, I can be in the mouth longer, perhaps up to 30 seconds having the child close their lips around the animal’s face, explore the bumps and ridges with their tongue, bite the blocks on the back of the tip for jaw work, and so forth. Then I’ll remove to stimulate babbling, sound production, or feeding. I’ll repeat a few more times based on necessity, acceptance, needs, and tolerance.
Another technique that may work is to slowly introduce the Z-Vibe to the individual. I use the unit without vibration first. Then I turn on the vibration and show the Z-Vibe to the individual, letting them feel the vibration perhaps in their hand or on their arms, slowly working towards acceptance into the mouth. The Z-Vibe is very alerting. It provides the tactile stimulation that non-vibratory tools may not be able to do. I recommend that you use any oral motor tool on yourself to see how it feels. Is your pressure too firm, too light? Does the tool provide enough texture and interest? Remember, overuse of any oral motor tool may result in refusal, just as an individual may refuse to eat certain foods. Your questions indicate that you are a very caring and perceptive therapist. Keep the questions coming.
I hope this helped,