Straw drinking is an oral motor exercise frequently incorporated into speech therapy, moving beyond its function as a simple feeding skill. This activity is utilized to develop specific muscle control and coordination within the mouth, a process that lays a foundation for both clear speech and safe swallowing. The training focuses on improving a tight lip seal, building tension in the cheeks, and promoting appropriate tongue positioning. A successful straw drinking pattern requires the coordinated effort of many small muscles.
Therapeutic Rationale for Oral Motor Skills
Drinking through a straw engages the musculature necessary for generating negative pressure. The orbicularis oris muscle, which encircles the mouth, is activated to create a firm, rounded seal around the straw’s opening. This exercise strengthens the lips, promoting the necessary closure for producing bilabial speech sounds like /p/, /b/, and /m/. Strengthening the lip seal also helps prevent drooling and supports a resting mouth posture that is closed.
The buccinator muscles, which form the fleshy part of the cheeks, must be tense and drawn inward to prevent them from collapsing during the sucking process. This development of cheek tension contributes directly to stabilizing the jaw and cheeks, which is important for lateral tongue movements required for chewing and for managing food in the mouth during a mature swallow. Furthermore, the act of sucking requires the tongue to retract and elevate toward the roof of the mouth, a movement pattern that is preparatory for correct tongue positioning during the production of sounds like /s/, /z/, and /sh/. This tongue retraction, involving the suprahyoid muscles, encourages a more efficient, wave-like swallow pattern, moving away from an immature tongue-thrusting swallow.
Assessing Readiness and Selecting Tools
Before commencing straw training, a child should demonstrate adequate head and neck stability, as proper posture is needed to manage liquids safely. The child must also show an ability to tolerate different textures and understand cause and effect, connecting the action of sucking with the reward of liquid. Starting with a slightly thicker liquid, such as a thin milkshake, applesauce, or a smoothie, is beneficial because increased viscosity slows the flow and requires greater muscle effort.
Specialized tools help isolate the specific oral motor movements being taught. Devices like the “Honey Bear” cup or similar squeezable bottles allow the caregiver to gently push liquid up the straw, rewarding the child immediately without requiring a strong initial suck. Using a straw that is both short and narrow is also helpful; a short straw minimizes the distance the liquid must travel, and a narrow diameter encourages a tighter lip seal.
Sequential Training Method
The initial step is the “dip and sip” or pipette method, which introduces the child to the concept of liquid coming from the straw. The caregiver places the straw into the liquid, covers the top opening with a finger to trap a small amount, and then presents the straw to the child’s lips. Releasing the finger allows the trapped liquid to flow into the child’s mouth, providing an immediate, passive reward that demonstrates the straw’s function. This step is repeated until the child anticipates the liquid and begins to close their lips around the straw.
Once the child understands this basic principle, training progresses to encourage active sucking using a very short straw. The straw should only enter the mouth by approximately one-quarter of an inch, just beyond the lips, to encourage a strong, independent lip seal and discourage jaw movement. The caregiver can provide physical cues, such as gently pressing the child’s chin up with a finger, to help stabilize the jaw and promote lip rounding. The goal is to see a fish-mouth posture, where the lips are tightly pursed around the straw.
After the child successfully sucks from the short straw and thicker liquid, the difficulty is gradually increased. This involves decreasing the viscosity of the liquid, moving from a thick smoothie to milk, and eventually to thin water. The length of the straw is also slowly increased to require more sustained suction effort. The final step involves transitioning the child to a regular, full-length straw and standard cup.
Troubleshooting Common Motor Difficulties
A frequent challenge is tongue thrusting, where the tongue pushes the straw out of the mouth. To address this, the straw should be significantly shortened so it only reaches the very front of the tongue, making it physically harder to thrust forward. Biting the straw for stability signals poor jaw control. Using a chewable tool, such as a chewy tube, before drinking can help the child organize jaw muscles and establish stability before the straw is introduced.
A child may also suck with collapsed cheeks, showing a lack of buccinator engagement and resulting in an inefficient suck. Encouraging the child to make an exaggerated “ooh” sound before placing the straw can help activate the correct lip and cheek muscles for rounding and tension. If the child exhibits excessive jaw sliding or up-and-down movement while sucking, the jaw needs stabilization. Gently cupping the chin with a hand during the practice sip offers a physical cue to limit movement, promoting isolated and controlled lip and tongue action.