[DYSPHAGIA] question re: sippy/spouted cups for pediatrics and speech problems

[SuzMorris@aol.com (SuzMorris@aol.com)]

Andrea,

Clearly it is impossible to give a specific recommendation regarding your 
daughter's use of a sipper cup without knowing her and her drinking 
skills.   Yet there are some questions that you can explore yourself and 
in partnership with your child's therapist.   You state that she drinks 
from several types of straws as well as an open cup.   Ask yourself why 
you have also continued with the sipper cup.   Perhaps it is because she 
drinks more from this type of cup and calories and prevention of 
dehydration are a big consideration.  Perhaps it is because the sipper 
cup is more stable and allows her to be more independent at mealtimes 
when she is with the other children at school.  Both of these 
considerations are just as important as oral-motor development in her 
life as a 6-year-old.   Perhaps, however, the sipper cup was appropriate 
months (or years) ago and has just been continued out of habit.  If the 
main reason for the sipper cup is your need to add duocal that is mixed 
ahead of time, you might consider sending a thermos bottle with her drink 
and a cup or cup and straw for the actual drinking.   Another alternative 
would be one of the sport bottles for kids that has a straw that folds 
into the bottle.  Playtex makes one that is easy to hold and drink from 
(See picture in the New Visions Mealtimes catalog which I know you have 
from previous e-mail conversations). It is a very age-appropriate 
drinking utensil for elementary school age children.  It is much easier 
to promote better oral-motor function with straw drinking than it is with 
a sipper cup (unless there are clear reasons for the sipper cup and the 
child doesn't drink well from a straw).   

Take a look at how she uses her mouth when she drinks from the sipper cup 
notice whether she uses different movements of her jaw, tongue, lips and 
cheeks with the different utensils.  If she is tipping her head back and 
using less skillful movement with the sipper cup, you will want to phase 
it out gradually and give her more opportunities to drink from the straw 
or open cup.  It is wonderful that you already have introduced her to so 
many different ways of drinking. 

The most important thing at this point is that she is able to get the 
amount of liquid she needs to prevent dehydration and that she be as 
independent as possible with her peers at school.  These aspects always 
take precedence for me over fine-tuning oral skills.  You can help her 
move toward more mature drinking skills with the help of the therapists 
you are working with.

Suzanne Morris
New Visions
http://www.new-vis.com

>I have read with great interest the discussion on sippy cups.  I would like
>to ask your opinion on my specific child's situation.  She is 6 years old,
>was born with congenital dysphagia (severe), was exclusively g-tube fed for
>4.5 years, and is now completely oral after e-stim treatments (g-tube
>removed 6 months ago) --mostly still eating soft purees and drinking, but is
>chewing some small amounts of other food.  She will drink from an open cup
>and uses straws, both small and large in circumference.  She often uses a
>sippy cup, especially at school.  I send her drink in a cup because I add
>duocal to it for calories, so I need to mix it in something.  The cup I use
>is an older First Years cup with a clear top.  When she first started
>drinking I thought it was hard for her to suck out of the lid, and I did not
>think it was necessarily good for her to be doing that-- oral-motor-wise.
>So, I punched a hole in the lid so that the liquid essentially pours out of
>the spout.  What do you think of this?  Should I abandon the sippy cup
>altogether?
>
>I want to promote her oral motor development as much as possible.  She is
>also hard of hearing and signs for communication, but is very motivated to
>vocalize and pretend to talk on the phone, etc...  If she has any chance at
>some speech those oral motor skills need to develop...obviously!
>My point is that she isn't using her mouth to speak, so right now her best
>chance at developing skills is with feeding.
>
>I will gladly accept any and all suggestions regarding any of this.
>Thanks.
>--Andrea
---------------------------------------------------------------------
To UNSUBSCRIBE from this list, please send an e-mail message to
majordomo@medonline.com with the following text as a message:
unsubscribe dysphagia
---------------------------------------------------------------------