Talk tools is an approach to improve speech clarity and feeding skills as well as to improve
things like drooling in children with and without autism.
Hi, I'm Dr Mary Barbera, autism mom board certified behavior analyst online course creator
and bestselling author of the verbal behavior approach.
Each week I provide you with some of my ideas about turning autism around, so if you haven't
subscribed to my youtube channel you can do that now.
Today I'm sharing a small excerpt from podcast number 30 which is an interview with Mags
Kirk, who's both a speech and language therapist in the UK for many years and a newly minted
board certified behavior analyst.
Mags is an expert on talk tools and she's certified in this approach and she shares
with us some of the benefits of using talk tools as one of the tools in our tool bag.
If you'd like to check out the full episode on the podcast, you can go to marybarbera.com
/30 at or you can click the card on the screen right now.
I remember when I spoke in the UK I think it was 4 years ago, um, Skybound Therapy,
um, brought me in for a 2 day workshop I believe, and that's when we met in per person, but
you are already a part of my online community.
Um, and one of the things that really struck me was you and others, there were a handful
of you that were talk tool certified.
And, um, I had written actually about talk tools in my book in chapter 6, the non-vocal
to vocal chapter.
Um, Lucas, my son was always very vocal, but there were other kids that, um, their speech
therapists used talk tools or some kind of, you know, talk tools, procedures, and those
moms really felt like, um, that resulted in better language.
So can you, for our listeners, just describe what talk tools is and tell us a little bit
about your training and certification in that area.
Sure.
So talk tools is, um, an approach that’s very structured, um, and it's looking at how
the muscles, um, function in order to move to the correct postures for speech.
So a fundamental concept in talk tools is the importance of the jaw.
Um, which actually going back into my speech therapy training was an area which wasn't
really covered very much in detail.
It was all about what are the lips do, what did the tongue do to make the speech sounds,
but actually the jaw wasn't really mentioned.
But if you actually think about how much the jaw is moving every time we're speaking, it's
going up and down, um, all the time, all these different jaw heights.
Um, but what you'll find with the children who've got very unclear speech or perhaps
the ones that are not speaking at all yet, is that they've got a very unstable jaw.
They're not able to hold their jaw in the postures that are needed for different speech
sounds.
Um, so the fundamentals of talk tools and the basic, um, exercises that that child will
be doing is probably going to be doing, um, jaw stability.
And so talk tools adopts what we call a tactile approach to teaching children.
So most children who are typically developing will be able to perhaps look at the adult
to understand, um, how their lips and their tongue and their jaw are moving and then they'll
be able to imitate that.
But we do know that a lot of children with autism don't have that imitative ability at
first.
Um, the other thing that children typically developing will do with speech development
is to listen to, um, how the sounds are made and they'll work out how can I make that sound
and replicate it.
But again, we know with children with autism, they will often have the auditory processing
difficulties, which means that they find it very difficult to attend to speech, to work
out what is speech versus what's background noise, how to tune out that background noise
so that they can really focus.
Um, and so talk tools will go to the tactile because they can then actually feel what is
needed to make the speech sounds so in talk tools, we'll be using equipment to, um, help
them feel.
Um, oh, my jaw needs to be, um, at this opening of height to make this sound.
So for example, we're working with bite blocks.
Um, so those are little plastic sticks that will be put in between their teeth and that
will help them to hold their mouth in the posture that we would need for an e sound
or if we use a slightly bigger bite block than we'd been making the sound for Ah, and
that would learn, they would then be learning.
I've got to open my jaw to that height and to make that sound.
Another thing that we might do in talk tools is using chewy tubes.
So, um, obviously to achieve, it’s very commonly used as a sensory strategy for children
with autism, but in talk tools, we're using it in a very structured and hierarchical approach.
So we'll be working with the red chewy tube, which the easiest one to chew and getting
them to bite on that up to 10 times and making sure their jaw is staying very aligned and
so that then they are strengthening their muscles, which is what is needed for speech.
And then gradually we'll move through to the harder textures all the time, strengthening
their jaw so that they're able to hold it in different postures for speech sounds.
Um, another thing that we might do in talk tools is working on air stream control.
So a lot of the children with autism perhaps haven't got adequate air stream to actually
get vocalization going.
So we're going to be teaching them, this is how we breathe from the diaphragm and we might
be using bubbles, um, to get them to, um, use an outgoing airstream.
So, um, they got that automatic reinforcement.
I've blown the bubble, therefore I see the bubble and that's going to then reinforce
me to try that again.
And what we can do with our airstream is then to get them to vocalize at the same time.
So we might be pressing on their diaphragm perhaps, and then the airstream comes out
and then we might open their mouth and they'll be saying now ah as they're vocalizing, and
then that can, um, teach them to make other sounds.
So there's lots of different things that we're doing in talk tools using the tactile approach
to teach them how to speak.
Okay.
So, um, that was helpful.
And I'm familiar with talk tools.
So, um, so some of the equipment, the talk tools, equipment and hierarchy include things
like bite blocks, chewy tubes, but it's not just handing a kid a chewy tube and having
them chew on it.
It's very specific.
They have to be sitting up straight.
You have to be, um, supporting their jaw jaw in some situations supporting their head alignment.
It's very, um, controlled and hierarchical.
What I find is the kids, um, that we have, you know, that the parents and professionals
have in my early learner course and toddler course.
If they are not talking, if they're non vocal, they're also usually having eating problems,
drinking out of a bottle or a sippy cup or uh, using a pacifier.
They also might have trouble with drooling.
So drooling, feeding, talking.
Um, it's all intertwined and, and talk tools does have, um, the equipment and the care
to deal with all those issues.
Is that correct?
Sure.
So yeah, talk tools can be quite misleading with the name talk tools.
It implies that actually it's all about talking, but actually talk tools has a lot of activities
that we can use to help with the drooling with the feeding, um, as well as just the
talking.
So one of the main things that I noticed with these children that are non-vocal at this
point is that oftentimes they will be drooling as well.
They might have this open mouth posture and very often it's related to their muscle function
that they actually haven't had the muscle strength to close their mouth properly.
So they might be, um, going around with their tongue hanging out.
And so a lot of what we're doing with talk tools is helping with that jaw stability so
that they can put their tongue back in their mouths.
And the tongue posture is really important for feeding as well because what you'll often
see is children that are primarily just using a forward tongue posture will only be doing
a sucking posture in their feedings.
So that's why they're still on a bottle.
While they can't drink from an open cup, why they're having difficulty chewing food.
And what we see is those children very often turn into very picky eaters or even really
restrictive feeders simply because they can't physically manage to chew the food.
And so they then develop all these behaviors around it to avoid the food and avoid that
negative experience of not being able to chew the food.
Um, and that's where talk tools really helps with feeding as well as speech.
So we would be looking at perhaps how to develop the tongue lateralization skills through chewing
and for that we will be using real foods.
So if you're working on feeding, you would be using real food.
So, um, we will very often using some stick shape foods perhaps, and we'll be putting
those to the side of the mouth to encourage the child to chew better on them.
And also particularly looking at how they're swallowing.
So we might be using the straw hierarchy in talk tools.
And that is, um, a series of straws that get harder and harder to suck through.
So all the time we're working on retracting the tongue, putting the tongue back in the
mouth, but also at the same time we're going to be looking at can they round their lips
to suck through the straw and where do they put their tongue when they're swallowing.
So we'll see, um, when they move through the straw hierarchy that they're starting to move
their tongue up to the bump just behind the top teeth, the Alveolar Ridge.
And as they do that more and more, their time is going to start staying in their mouth,
which in turn will improve their chewing skills, their swallowing skills.
And um, we'll have a carry over effect on speech as well.
So I've been amazed actually how um working on feeding development's has an improvement
on their speech as well.
It just really carries over and it's, it's brilliant.
Just say a parent is listening and they really want to know more about talk tools and you
know, how would they get started?
And I can't imagine that you have a ton of time for distance consulting and that sort
of things, but like how would they find somebody certified?
Maybe in their area or how would they proceed?
Yeah, so if they were go to the talk tools website, so I think it's talktools.com.
Um, we can, um, there's a database on there that has all the level 3 plus certified practitioners
on there so you can do a database search there and to find someone.
What I would say is if you can find a consultants at that level, that's brilliant, but you will
find really good practitioners and as well, um, anybody who's kind of level 2 and above
will be really brilliant to work with.
They'll have all done the certification training and will be able to run a program for you,
but it might just be worth getting a level 3 to oversee it.
It's a very similar kind of thing to working at the BCBA and then perhaps having an RBT
do the, um, the ground work hours or an ABA to, to do the, the work with your child.
Similar kind of structure.
Yeah.
I hope you enjoyed this short snippet from the podcast.
If you want more content, check out the podcast at marybarbera.com/podcast wherever you're
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