All material Copyright © May 2009 The Down Syndrome Centre
Reprinted with the express permission of the Down Syndrome Centre as originally published on their website.
By: Marinet vanVuren
Marinet vanVuren is a South African born Speech and Language Therapist. For the past seven years she has worked with a range of Irish disability organisations including Enable Ireland, St Michael’s House and the Children’s Sunshine Home. She recently set up her own private speech and language therapy practice where she sees children of all disabilities with various speech, language and feeding difficulties.
Developing oral-motor skills in children with Down Syndrome should be an important part of your child’s speech-language therapy programme. Targeting oral-motor skills from an early age will increase your child’s oral awareness; aid in strengthening the muscles used for eating, drinking and talking, as well as reduce tongue protrusion. Oral-motor therapy can be done throughout the day using everyday fun activities to target specific areas of the mouth. Over the next few weeks I will supply you with a list of activities recommended to increase your child’s oral muscle tone and improve jaw, tongue, and lip mobility and strength. This week we will look at developing adequate stability of the jaw to support the isolated and sequenced movements needed for speech.
The Jaw
Young children with Down Syndrome have low postural tone. This low postural tone affects the stability of your child’s jaw. The jaw needs to be stable in order for the tongue to move in a coordinated manner during eating, drinking and talking. But unfortunately, most children with Down Syndrome have difficulty with jaw stability. This is particularly evident when children are eating, drinking or talking. They might use large up and down jaw excursions during such tasks which can affect speech intelligibility or make chewing of food difficult. You can help to improve your child’s jaw stability by introducing some of the following activities.

1. Stimulate the muscles of the jaw. The temporo-mandibular joint, is the hinge of the jaw and can be found in front of your ear and below the cheekbone on the upper part of the jaw. If you put your fingers on this spot you can feel how your jaw moves when you open and close your mouth. You can stimulate the joints which attach the jaw muscles by firm tapping or stroking. You can use puppets, washcloths, your hands of different types of fabric.
2. Oral-motor activities like whistles and blow toys with flat mouthpieces will indirectly help to stabilise the jaw by strengthening the muscles. Get your child to blow these types of whistles / blow toys for 5 counts using sustained activation.
3. Pretend you are a pussy cat: Get your child to hold a few straws horizontally in his/her mouth using his/her teeth to make cat’s whiskers. Hold the ‘whiskers’ in your mouth for 5 counts.
4. Biting and chewing activities: play a game of tug-a-war with strong latex toys or elastic tubing. Fish tank tubing is very sturdy and available from pet shops. These tubes can also be used for straw drinking and bubble blowing activities.
5. If your child is able to cope with solid foods, give your child crunchy and chewy foods to eat as snacks, e.g. dried fruit, liquorice stick, pretzels or granola bars.
6. Typewriter Carriage (a TalkTools idea): Give your child a straw and have your child position their straw horizontally between their teeth (one end of the straw should be close to the left cheek and the other end should stick farther out on the right). Get your child to use their mouth to move the straw to the other side so the long end of the straw now protrudes from the left. If your child has difficulty with this task, get him/her to tilt his/her head laterally to one side and work on controlling the straw as it slides down. (Try not to drop the straw!)
7. Feed food laterally (the side of the mouth) e.g. chipsticks, crisps, strips of carrot.
8. Encourage your child to pick up straws off the table using his/her teeth.
9. Place a liquorice stick in between your child’s back teeth. Encourage your child to bite down. Do one side at a time. (Your child should not be expected to eat the liquorice unless he/she wants to.)
10. Bite and hold liquorice on back teeth as above but this time you pull slightly on the liquorice stick to create resistance.