Kamdyn's Story
Three years ago, I was seeing a little boy named Kamdyn. He had just turned 2 a couple of months prior, through our state's early intervention program. I received some general background info — scores, family goals, and his limited verbal productions.
He also had 18 documented ear infections! All signs pointed to a typical late-talking boy who had endured infection after infection.
When he turned 3, he began seeing his local school district for therapy services. I said my goodbyes and wished him and his family well on the journey ahead.
Fast forward 14 months. I had immersed myself in motor speech and feeding therapy and had opened my own private practice.
Then, in May of 2016, I got an e-mail from Kamdyn's mom, Ashley. She told me he had recently been diagnosed with severe Childhood Apraxia of Speech (CAS). Childhood Apraxia of Speech?!
I know CAS is very difficult to diagnose before age 3. Still, I was dumbfounded — and, to be honest, disappointed in my clinical skills. I had worked with this boy every week for over a year and never once thought CAS was on the radar.
After all, he had 18 ear infections! Even so, there was no time for self-doubt. It was time to get Kam into therapy.
A Different Kind of Evaluation
I had never worked with a child with a sole diagnosis of severe CAS. However, I knew that the trainings I had completed over the past year gave me something valuable to offer. Kamdyn came to his initial evaluation reluctantly.
This kid had been through assessment after assessment. Understandably, more speech testing was not his idea of fun. My evaluation, though, was different from the others.
Specifically, I examined his mouth and assessed motor responses of his tongue, jaw, and lips. As a result, I found asymmetry in his jaw strength and stability, poor lip rounding, and poor lip closure for his /m/, /p/, and /b/ sounds.
In addition, I found a high palate, a moderate tongue tie, and a reverse swallow. While Kamdyn had no history of feeding difficulty, he was chewing and manipulating food in a very unorganized way.
Building the OPT Program
To address these challenges, we started the TalkTools Straw Hierarchy (straw #2), the bite tube hierarchy, Bite Blocks (the ultimate jaw exercise!), the Horn Hierarchy, and bubble blowing. Gum chewing and the slow feed technique were addressed as well.
Alongside these tools, we began targeting the reverse swallow. I explained to his mom that this looks different from traditional speech therapy. Even so, a strong oral motor foundation is essential for speech clarity — whether a child has CAS, Down syndrome, or another motor-based diagnosis.
If the jaw is not in a stable position, the tongue and lips will struggle during speech. Think of it like a pyramid of cheerleaders.
Without the stable base — the cheerleaders firmly on the ground — the one on top cannot perform. The tongue is like that top cheerleader. Its fine motor movements determine whether Kamdyn says "Tam" or "Kam".
Because of his CAS and reverse swallow, Kamdyn wasn't using his muscles optimally for speech. That is where the weakness came in.
It was mild, but it was there. During speech, he clenched his jaw tightly to create stability — and that left his tongue with less freedom to move.
How Sessions Were Structured
As a result, I saw Kamdyn twice a week from May through August, alongside his traditional speech therapy. Each session included about 30 minutes of oral placement exercises and 15 minutes of speech drills.
Crucially, we did not complete all OPT exercises first and then switch to speech. That approach does not support motor pattern generalization. Instead, I chained each OPT exercise directly to a functional speech sound or drill.
For example, Kamdyn struggled significantly with lip rounding. To target the /o/ and /w/ sounds, we used this sequence: a sensory motor warm-up with a Z-Vibe, fish lip pops, straw drinking, then mass practice in CV or CVCV formations. The key is linking OPT from sensory, to feeding, and finally to speech.
Remarkable Results
Within just two months, his family noticed clear gains — not only in his speech, but in his confidence. The first video shows Kamdyn during his evaluation. The second was recorded just two months after starting the OPT-based program.
The difference in how he moves his lips, cheeks, and jaw is astonishing. It is an honor to be part of his therapy team and to see firsthand that OPT benefits far more than feeding difficulties alone.
Most importantly, Kamdyn is living proof that speech is motor. When you pair sensory, feeding, and speech work together, the results can be remarkable.
~ Vanessa Anderson-Smith
Vanessa Anderson-Smith is a Speech-Language Pathologist born and raised in South Dakota. She earned her Bachelor's Degree at Augustana University and her Master's Degree from the University of South Dakota.
In 2013, she founded Anderson-Smith Speech Therapy, LLC. Her practice focuses on motor-based speech and feeding disorders in children and adults.
Vanessa lives in Canton, South Dakota with her supportive husband, Ryan.