Ask A Therapist: Straw Length

Hi Guys!

I have a couple of questions. First of all, I am utilizing Sara Rosenfeld-Johnson’s Drooling Remediation Program and OPT on a 2.2 year old for drooling. Dad is a dentist and is totally on board. Their little guy is a twin and has three other siblings. The little guy has progressed to straw #5 and although he struggled with horn #4, he has now successfully moved on to horn #5. Mom is very unhappy with the length/height of the straws … I have explained ‘calibration’ of each straw to her. Is there anything else I can say to appease this busy mom? We are also needing some help writing up the report for insurance purposes. I purchased the “Forms for Oral Placement and Treatment” CD, thinking that it would contain that type of helpful information. Insurance can be so persnickety!

I am also trying to get insurance to cover services for a 10 month old with Down Syndrome that I have screened for services. He is being seen through ECI, has not feeding issues currently but would benefit from OPT!

I have been working with a 27 year old with Down Syndrome very successfully! Her parents are amazed and thrilled!

Thank you for any information you can provide that will assist me in helping my clients!



Hi Kellie,

It sounds like you have done a great job explaining the straws and how to use them to this mom. The only other idea I have would be to encourage her to put the straw in the large TalkTools cup with lid and have the curly part of the straw under the lid. That sometimes helps if it is tipping or they are playing with it. I just try to explain that the straw is working on tongue retraction in the mouth at different levels. It is important that they are that particular length because that is what makes them more difficult and requires more work for the tongue and lips.

As far as the insurance billing, I personally do not bill insurance but there is a CD called “OPT Goals & Objectives for IEPs and Insurance Reimbursement” that will help with goals and objectives for insurance reimbursement and IEPs. It does not include coding but it should help with what you are talking about. It sounded like it was more of what you were looking for than the CD you mentioned.

Good luck with the mom you are working with and please let me know if you have any other questions.



Elizabeth Smithson, MSP, CCC-SLP is a Speech-Language Pathologist who has over 10 years of professional experience working with infants, children, adolescents and adults. She earned her Master of Speech Pathology at the University of South Carolina. Liz is also a Level 5 TalkTools® Trained Therapist. She has received specialized training in Oral Placement Therapy, Speech, Feeding, Apraxia, Sensory Processing Disorders, and PROMPT©. Liz works with clients with a wide range of disabilities including Cerebral Palsy, Down Syndrome, and Spinal Muscular Atrophy. She works through her own private practice Elizabeth Smithson Therapy, LLC in the home setting and in the TalkTools® office in Charleston, SC.

Talktool admin 18 Jul 16

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