Speech Archives - West Texas Rehab

Down Syndrome Explained: Rocking an Extra Chromosome

Down syndrome is a genetic disorder caused when abnormal cell division results in extra genetic material from chromosome 21. Instead of the typical 46 chromosomes, people with Down syndrome have 47 chromosomes. Having an extra chromosome changes brain and body development resulting in physical and cognitive differences. 

There are three different types of Down syndrome

  1. Trisomy 21 is the most common and accounts for 95% of the cases. It is caused by an extra copy of chromosome 21. 
  2. Mosaic is when there is a mixture of cells with the normal 46 chromosomes and those with 47 that have an extra chromosome 21. 
  3. Translocation is when there are the normal 46 chromosomes but then an extra copy of chromosome 21 attaches to another chromosome; usually chromosome 14.


Common characteristics: 

While characteristics vary from person to person, these are some of the most common:

Physical Features Cognitive/Social Features Developmental Delays
  • A flattened face, especially the bridge of the nose
  • Almond-shaped eyes that slant up
  • A short neck, fingers, and toes
  • Small ears
  • Short attention span
  • Poor judgment
  • Impulsive behavior
  • Slower learning
  • Delayed language and speech development
  • Gross motor skills
  • Fine motor skills
  • Speech and language skills

Myths vs. Facts

Myths  Facts 
Down syndrome is a rare disorder. 

Most children with Down syndrome are born to older parents.

All children with Down syndrome have a severe cognitive disability.

People with Down syndrome cannot be active members of society.

It is the most commonly occurring chromosomal condition. Approximately 1 out of 772 babies in the United States are born with Down syndrome.

More children with Down syndrome are born to parents younger than 35 but the likelihood of having a baby with Down syndrome increases with age. 

Most people with Down syndrome have a mild to moderate cognitive or intellectual disability.

People with Down syndrome participate in a wide range of activities in their communities.  


What can I do to help? 

Talk to your child’s pediatrician about services, equipment, and community resources in your area for support as they learn new skills.  Examples that may be appropriate:


Healthcare Equipment/Devices Community Resources
  • Medical Specialists
    • Pediatrics, Orthopedics, Neurology, Genetics, and others as appropriate
  • ECI (Early Childhood Intervention, 0-3 years)
  • Pediatric Outpatient 
    • Physical therapy, occupational therapy, and speech therapy
  • AAC (Augmented/Alternative Communication)
  • DME (Durable Medical Equipment)
    • Orthotics
    • Standing frame
    • Gait trainer
    • Walker 
  • Daycare settings for children with special needs
  • School-based therapy and accommodations
  • Adaptive Sports (Challenger League, etc.)
  • Upside Down Club of Abilene (or local chapter in your area)
    • Annual Buddy Walk event


Organizations and Websites that offer Support 

This website has resources and programs; education for parents as educators; supports for advocacy; an annual convention; and Down syndrome news stories and events. Each state also has various links to help at the state level. 

This website has resources and support by age and by topic. It also has help with advocacy and policy. 

This website offers resources, programs, research, and events specific to individuals with mosaic Down syndrome

This website offers resources and support, events, and even a shop for Down syndrome awareness 

This website has programs and resources for people with down syndrome and their families. These resources/programs include apps, a magazine, workshops, and podcasts. These resources are also available in Spanish. 

This website was created to help people with intellectual disabilities with advocacy and policy and helps to connect families with local agencies that can help with these areas. 

This website offers information about research and medical care; offers programs and events; advocacy; and news about people with Down syndrome. The foundation helps to fund the  Linda Crnic Institute for Down Syndrome which is committed to research and medical care for people with Down syndrome. 

This website offers resources, events, and personal stories for families in the Big Country area.

To learn more about all of the services we provide, click here.

Oral Motor Approach to Feeding and Speech

Oral Motor function and skill is something you may hear your Speech-Language Pathologist talk about in reference to your child’s speech and feeding therapy. What does Oral Motor mean anyway? Oral motor refers to the movement patterns and muscles of the mouth. So it makes sense that Oral Motor function and skill are important for speech and eating. Therefore, when we look at speech and feeding delays through the lens of oral motor functioning, we are able to more specifically identify and serve those patients whose speech and feeding skill delays are a result of an oral motor function deficit.

Oral motor function impacts five major areas:

  1. Awareness of pressure and movement – The body’s automatic response to sensory input i.e.(trigger of swallow or cough to protect the airway)
  2. Control of Secretions – swallowing saliva, adequate lip closure to prevent drooling
  3. Coordination for eating, drinking, talking, and facial expressions- just like we need coordination to walk and ride a bike, we need motor coordination to eat and drink a variety of consistencies safely and efficiently, and to coordinate speech movements along with breathe.
  4. Knowledge of the environment-sensory receptors (taste and touch) give information about objects within the environment i.e.( when babies mouth and chew to find out more about things around them)
  5. Control of movements for talking – early developing sounds require slower, larger movements for cooing (vowels) and as development progresses and muscle skills improve new sounds emerge with the vowel sounds i.e. babbling (bababa, mamama). Once coordination increases sound combinations become more complex i.e. (first words -> phrases -> sentences).

All of these areas are vital in the development of normal speech and feeding abilities. If there is significant weakness or deficit in oral motor function, feeding and speech development may be delayed or disordered for a child’s age i.e. (problems with drooling, tongue thrust, gagging, poor suck, poor eating, poor food texture grading, limited food preferences, and poor speech production).

What’s the next step? A Speech-Language Pathologist will do a comprehensive evaluation to look at all areas of speech, language, and/or feeding abilities. As a part of this evaluation, the SLP will determine if oral motor assessment is indicated. If oral motor assessment is warranted, the SLP will measure your child’s oral motor function and determine if oral motor intervention is indicated as an appropriate approach for speech or feeding therapy sessions.

Don’t we need to work on actual speech or eating tasks to improve these areas?

YES, in order to improve/develop adequate speech and/or feeding skills, the main target of therapy will be to practice speaking and/or eating. However, there is more than one way to build muscle strength, control, and coordination. Just like there are many different exercises to increase core strength i.e. (crunches, sit ups, plank). If we incorporate a variety of different ways to work and provide input to the muscles used for speech and feeding, the greater the functional strength and coordination outcome.

Will Oral motor intervention magically produce speech or increased feeding skills?

Not on it’s own. However, when paired with targeted speech or feeding intervention tasks, oral motor exercises can increase awareness and sensory input to the muscles which impact muscle activation, planning, programming, and execution. We need all of these components for everyday speech and feeding tasks.  To find out more information contact our Speech Therapy department in San Angelo or Abilene.  https://westtexasrehab.org/services/


Beckman, D. A. (1986 Rev. 2007) Beckman Oral motor Assessment and Intervention.

Published by Beckman & Associates, Inc.

620 N Wymore Rd STE 230, Maitland, Florida 32751-4253.


Written by:

Kalee Rupe M.S. CCC-SLP

May is Stroke Awareness Month

May is Stroke Awareness Month, a time dedicated to increasing awareness about stroke, its causes, and its impact on individuals and families. Stroke is a leading cause of death and disability worldwide, and it is important to understand its warning signs and risk factors.

A stroke occurs when blood flow to the brain is disrupted, either due to a clot blocking a blood vessel (ischemic stroke) or due to bleeding in the brain (hemorrhagic stroke). When the brain is deprived of blood and oxygen, brain cells start to die within minutes. This can lead to permanent brain damage, disability, or even death.

According to the American Stroke Association, someone in the United States has a stroke every 40 seconds, and someone dies from a stroke every four minutes. In addition, stroke is a leading cause of serious long-term disability, with more than 6.5 million stroke survivors currently living in the U.S.

While stroke can affect anyone, certain risk factors increase the likelihood of having a stroke. These include high blood pressure, smoking, diabetes, high cholesterol, obesity, and a family history of stroke. People who have had a previous stroke or transient ischemic attack (TIA, or “mini-stroke”) are also at higher risk.

Recognizing the warning signs of stroke is crucial for getting prompt medical attention and preventing long-term damage. The acronym “FAST” is an easy way to remember the signs of stroke:

  • Face drooping: Does one side of the face droop or feel numb?
  • Arm weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • Speech difficulty: Is speech slurred or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.”
  • Time to call 911: If someone shows any of these symptoms, call 911 immediately.

Getting to a hospital quickly can make a big difference in a stroke patient’s outcome. Certain treatments, like clot-busting drugs or mechanical thrombectomy, are time-sensitive and can only be given within a few hours of the onset of symptoms.

Stroke Awareness Month is an opportunity to spread the word about stroke prevention, recognition, and treatment. By raising awareness, we can help more people understand the risk factors, warning signs, and actions to take in the event of a stroke. This knowledge can ultimately save lives and improve outcomes for stroke survivors.

Source: https://thestrokefoundation.org/stroke-awareness-month/

Sensory Defensiveness and Anxiety

Usually when you think of sensory defensiveness we do not think of anxiety as a part of “sensory issues”. However, many times when children have difficulties with sensory modulation disorders, they will also have anxiety due to either over responding to sensory input.

When sensory integration is working…

A child can attend to tasks

Change routines without stress

Can tolerate touch, sounds and can listen

Tolerate transitions in activities

Tolerate most textures with feeding and touch

Tolerate movements

Tolerates most visual input as well as auditory

Can play, and vary types and intensities of sensory experiences.

Have the ability to conceptualize, organize, and execute non-habitual motor tasks (praxis)

Children with sensory modulation disorder may demonstrate behaviors appearing “over-responsive” or have a low threshold (takes little sensory input to set them off. Winnie Donn, Ph.D.,OTR, FAOTA). “These children can be fearful of movements, defensive to touch, certain textures, have feeding problems or be sensitive to sounds.  They appear to have anxiety, and can often have behavioral outcomes.

When a child is “under-responsive” or has a high threshold, it takes a lot of sensory input to achieve the ‘just right’ threshold.  These are the children that seek out sensory input, such as running, crashing, jumping, or have lack of attending.  They have a decreased awareness of tactile or auditory input (such as calling their name). These children can also have difficulties with emotional/behavioral regulation.  Some children can fluctuate between the two extremes.  Dunn, Winnie, 1999, The Psychological Corporation.

As a therapist working with toddlers or older children, learning strategies to deal with the sensory issues as well as the anxiety is paramount. Sometimes the anxiety can manifest into sensory issues.


With toddlers there can be a wide array of sensory issues that can set them off.  I usually have parents start out by filling out the “Sensory Profile”, then as a therapist I want to know their likes and dislikes and will have the parents give a list of both. Again, working closely with parents so they may be successful at home, daycare, church or any environment that was challenging for the child.

I start out with a plan of heavy work activities that is suited for the child. Heavy work  is any type of activity that pushes or pulls against the body. Heavy work activities can help kids with sensory processing issues feel centered. Heavy work engages a sense called proprioception, or body awareness.  I also encourage parents to start working on this at home.

For Older children:

Again, we get them involved with heavy work as this is generally calming to most children in a high or escalated state.

We also work on self -awareness of the level of anxiety using charts (see below).  On this particular chart the levels are 1-5 with 1 being happy and 5 being “I feel Anxious!” or “I feel like hurting myself.”  We recognize some anxiety is healthy, however when it interferes with daily activities such as school work, relationships, performance in daily tasks at home it is no longer healthy.  I have children look at the chart 5 times throughout the day and read their levels, if they are getting to a level 3, 4, they need to address the anxiety before it gets out of control by performing heavy work activities, or favorite activities to calm them down.

My child was just diagnosed with a speech/language impairment, now what?

by Anna Nguyen, SLP

As a therapist, my day-to-day is pretty routine. Do therapy. Drink coffee. Document. Drink more coffee. Do an evaluation. As a parent, bringing your child in for an evaluation is anything but routine. I imagine there is a flood of emotions. “Is it because I put them in daycare too early?” or “Is it because I didn’t put them in daycare?” And even “Is it because 2 languages are spoken at home?”

Rest assured. None of these things are the reason. As much as I would love to think I know everything in the world, there is not always a hard and fast reason for why some children’s language develops slowly or differently than others. Sometimes it just happens.

When your child is evaluated for therapy, there will be a lot of questions we might ask. It is OK if you do not know all of the answers. Say that with me again. IT IS OK to not know all of the answers. The SLP will then make recommendations for therapy, re-evaluation, home program, or discharge.

Now let’s say your child was just recommended to receive therapy for language skills. We expect you and your family to be active partners in this process with us. We cannot fix your child. We can help your child gain new skills. But it is YOUR job to give your child experience and practice with these skills. Here are a few ways to help be a partner in your child’s road to successful communication:

1) Read with your child every day. Read interactively, do not just recite the words. Point things out in the book. Ask questions. If your child points to a picture, explain that picture to them.

2) Play with your child every day. The most important thing a child can do is play. This is where they learn vocabulary, social skills, and problem solving. You being a play partner opens up a new world full of new actions, words, and lessons.

3) Expand on what your child is saying. If you are trying to get your child to use sentences rather than just single words and your child sees a dog and says “dog” this is a perfect opportunity to fill in their gaps! “Oh look at that dog run! He is fast! Hi dog!” For older children, talk about what you know about a dog. “Our dog is brown but that dog is ____”

4) If you have a question, ask. Your SLP is your partner. Never be afraid to ask for our advice on anything. We are both working toward the same goal–increasing your child’s communication!

More about Anna…

Anna Nguyen is a speech language pathologist in San Angelo. She was born and raised in Abilene and attended Abilene Christian University for her B.S. in Communication Disorders and Psychology. She continued on to Texas Tech University Health Sciences Center to get her M.S. in Speech-Language Pathology. She has been at West Texas Rehab since 2015 and loves the patients and coworkers she sees each day. “I began to grow my knowledge with feeding disorders and feeding therapy and loved it!

I had my sweet baby boy, Oliver, in 2021 and struggled with breastfeeding. I joined different Facebook groups to get advice and, after a while, found myself trying to share my journey in order to help others be successful. It was during this

time that I realized that I had a passion for breastfeeding.” Anna explains. After completing coursework, clinical competencies, and the certification exam, she received her certification as a Certified Lactation Counselor in August 2022. “I have months of personal experience with exclusive pumping, milk storage, and weaning. I am also confident in my ability to help parents of preterm infants or infants born with differing abilities be successful in their pumping or breastfeeding journey. Breastfeeding not only allows a unique bond to form between the nursing parent and the child, but it also benefits both the nursing parent and the baby! I am excited to share my passion and expertise with parents wishing to pursue their breastfeeding journey!” Anna exclaims.