We take for granted the value of breath.
The role it plays in optimising everything we do.
And for Isaac the conscious act of breathing,
Particularly taking inhalation upon request,
And proving an even more challenging thing to teach,
Despite both his Prompt Speech Therapy and Feldenkrais sessions working collaboratively to demonstrate the principle.
For the more Isaac’s drive to talk becomes apparent,
So does the restrictions placed on its progress due to lack of breath.
His body becomes tight and constrained,
And fluidity in facial movement,
And body function,
As the effort to speak without breath dominates his system.
In order to produce words,
One relies on the cutting off of air flow,
In conjunction with tongue, jaw and lip movement.
Yet for Isaac he’s relying virtually solely on the jaw,
With some tongue,
And a slow increase in lip involvement,
But almost no airflow.
It isn’t a new phenomenon for us,
We’ve seen it developing since speech for him began,
Although it’s become more obvious,
As he tries desperately to expand his vocabulary.
Ideally we want to begin exploring inward and outward breath without sound,
Or excessive body movement,
To begin to help Isaac feel where the breath comes from,
And how the breath isn’t an act of efforting,
But the concepts are currently far too advance.
And as a result it becomes apparent that we must first support the current position,
Or his systems current utilisation for speech,
In order to first limit the effort within his chosen approach,
And then work towards changing his positioning/body’s response,
To optimise talking.
But it cannot happen all at once.
In lying him down we are able to first simply take the load off,
To allow Isaac to feel that the jaw is separate from the neck extensors (which shorten the neck),
And rest into a comfortable position conducive for exploring this,
Once it is acknowledged that his go to position of head dropped back,
Chin stuck out,
In he attempts to speak isn’t either helpful,
Or his only option,
Then we move to next progression,
Of limiting the head throw back,
Tucking the chin,
And lengthening the back of neck,
While hopefully maintaining his new understanding of how his jaw and lips can work,
In other positions like sitting or standing.
Possibly trying with hands above head while lying may also be of benefit,
To free up the body,
Allow weight-shift to occur,
Just like we see when walking with Isaac,
If we remove the pulling or squeezing through his arms, neck and shoulders,
He actually begins to utilise his legs more effectively.
Same may occur in allowing him to truly use his jaw, tongue and lips,
By eliminating the possibility of him using his whole upper body,
In an attempt to talk.
When it comes to incorporating word practise,
Some words are easier to focus on,
As the sound in themselves requires airflow without active breath –
“Up” is ideal,
For the voice is already exhaling somewhat to create the “ahhh” sound,
Followed by the sudden lip closure cutting air off for the “p”.
The same concept applies for other words,
“Out”, “hat”, “hot”,
But in contrast it’s the tongue responsible for cutting off the air to create the “t”.
We also begin to introduce other fun games,
To explore breath,
Like blowing empty patty-cakes across water,
Or making bubbles in water with a straw.
The challenge is that very few games have a cause-and-effect,
For the inward breath,
But all these activities only work if there is air in the lungs to exhale.
So all very worthy exercises to embark on.
So we will endeavour to facilitate Isaac’s understanding of breath,
And optimise positioning to greater his ability for speech,
While remaining mindful of fatigue,
For challenge is beneficial in producing progress,
But only without threat,
Which simply hinders development.