How to teach your child with Down Syndrome to drink from the Honey Bear from Talk Tools-Technique #1

Thank you once again to Sara Rosenfeld-Johnson for offering the amazing DVD classes and information offered through www.talktools.com    I received information below through the Honey Bear literature that was obtained with the Honey Bear as seen above. 

Teaching straw drinking is an important step in children with Down Syndrome.  I start introducing the straw as young as four months old.  Now I know that the little one is not going to have the skills to use proper lip rounding and lingual retraction to draw the liquid….however….I like to introduce early…while I am working on the pre-feeding exercises such as lip rounding using the Ice Stick (can be found at www.talktools.com). 

This post is going to describe technique number one for straw drinking out of the Honey Bear.  Please remember that this should be used in conjunction with the bottle or sippy cup….and that the Honey Bear can NOT be solely used until the child is able to receive adequate liquid nutrition through the Honey Bear.  When she has mastered drinking from the Honey Bear…then the sippy cup or bottle can be eliminated.

Important factors when using the Honey Bear:

Child should be in a stable posture.

Chair should encourage a 90 degree angle in the child’s pelvis, knees, ankles and chin.

Child’s hand should be midline.

Highly flavored thickened liquids are easier to control and give additional sensory information for taste and texture.

 

Once the Honey Bear has been mastered you can move on to the straw kit…following the hierarchy….I have only posted about one straw so far..there are eight in the kit….these straws can be found at www.talktools.com

The information below was taken from the Talk Tools instruction kit.  Please go to their website for additional information:

Technique Number One:

Fill the Honey Bear with a favorite, highly flavored, slightly thickened liquid.  Leave 1/2 inch of the straw exposed.  Support the child’s jaw.  Place the tip of the straw midline on the surface of the lower lip.  Assist with lip rounding as needed.   Squeeze a small amount of the liquid in the child’s mouth and remove the straw.  Support the jaw and wait for the swallow.  Assist with lip closure if needed.

Repeat this three times at the start of each liquid feed…then allow the child to drink the liquid how she typically does…from the bottle or sippy cup.  Practice one to three times a day.  As skills improve reduce the amount of assistance given to squeezing the liquid, and in the jaw and lips.  Increase the repetitions at the start of each liquid feed as the child can tolerate.

Once the child is able to draw four ounces of liquid independently through the Honey Bear, use the Talk Tools Straw Drinking Hierarchy and follow the directions. 

If your child has signficant tongue protrusion and cannot draw the liquid using the 1/2 inch straw length…use Honey Bear Technique number 2 ( I will post about this technique)

If your child is resistant or unable to drink using a 90 degree angle…and is relying on backward head tilt…use technique number three (I will post about this as well).

 

Hope this was helpful!

About Kim

My name is Kim Marino and I have been practicing as a licensed speech and language pathologist since 1993. I work on Long Island providing diagnostic evaluations and services to children from birth to age 21. My experience is vast and am proud to say that I work with children that may present with articulation and phonological concerns, oral motor feeding concerns, Down Syndrome feeding, cognitive rehabilitation, auditory processing delays, receptive language delays, cleft palate feeding and sound development and expressive language delays. Most importantly, I am the mother of four amazing children and am happily married to my childhood sweetheart. I feel blessed to have my four children and so lucky to share this journey in life with my husband. I always had it somewhere in my head that I wanted to develop a blog or a website of some sort so that I could provide families with an additional resource....so that parents could help their little ones become a better communicator. And as I was developing this blog....I realized that I also needed to share the stories about my life and my children....and the funny things along the way that help to keep me smiling. Whether you are a working mother or not...finding balance between home, children and life can be a challenge....I hope that my blog helps to bring a smile to your face..and also some tools to help you help your little or big one. I hope you enjoy! Kim
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2 Responses to How to teach your child with Down Syndrome to drink from the Honey Bear from Talk Tools-Technique #1

  1. Jenny says:

    Hi Kim,

    Thank you for creating this blog. I’ve been getting wonderful useful tips for my little 3 yo who has DS. He had a pretty rough start to life. During one of his hospitalizations when he was less than a year old, he was diagnosed with silent aspiration. He used an NG tube for about 8 months. Getting enough calories into him has always been an issue, but he has been stable for several months now.At his last video swallow earlier this year, he showed no aspiration. Over the years we have tried several oral motor and feeding techniques; oral beckman, talk tools, kinesio taping. He still uses a bottle with milk thickened to nectar consistency, and mainly eats chunky pureed foods. He is just now accepting and tolerating meltable veggie/fruit sticks without having to mix it with pureed food and showing a nice rotary chew pattern. I have been using the honey bear straw drinking, nosey cup, and z-vibe. I can’t totally take away the bottle because I’m afraid his caloric intake will significantly drop. BUT, I feel that continually using the bottle negates all the feeding therapy, i.e. I’m trying to reduce his suckle pattern but just give it right back by giving him the bottle. Is working with both the honey bear and open cup drinking too much?

    Thanks in advance

    • Kim says:

      Hi Jenny…I am so glad that you have found my blog helpful. Nutrition is always the most important component with regard to feeding. If he is not able to get the needed amount of liquid via honey bear or straw…then giving him the bottle is a necessity. How much liquid does the pediatrician want him to have a day? How many calories does he need to have per day? Meeting with a nutritionist may be a very helpful idea. Tell me this..is he able to drink from the honey bear and nosey cup…could you possibly get the needed calories/liquid via the honey bear or nosey cup. Great that he is demonstrating the rotary chew…and eating more solid foods. There are so many ways to add calories to the foods he is eating. For example if he can tolerate mashed potatoes..adding more butter…some sour cream…even creamed cheese adds calories. Advocados mashed up are great too…they have I think almost 400 calories in one advocado..and the good fat. It sounds like your goal is to get him off of the bottle to decrease the suckle pattern. I would say yes to transition to the honey bear and the nosey cup IF and only IF he is able to get the needed calories/liquid. Maybe send me some more information…answering some questions I had…and hopefully I can help you to come up with a plan. It would be wonderful if you could reach out to the pediatrician and find out exactly how many calories he/she wants your LO to have per day. I hope this was helpful. Best, Kim

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