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Note: The month of May is Better Speech and Hearing Month. As speech/language pathologists, it is our commitment to educate our community to issues relating to speech and language.

Several years ago, a fellow speech therapist and I were beginning to see more and more toddlers with poor speech and oral motor skills. The children had poor lip closure and had a prominent tongue thrust. After attending an intensive Oral-Motor/Speech Training about how the muscles for eating and talking relate to speech development, we made the connection between the use of sippy cups as the leading culprit for the lack of lip closure and tongue thrust, which can lead to poor speech skills.

The sippy cup is a plastic cup with a tight lid and a protruding bill-shaped spout. It is the spout that causes the child to maintain the baby-like suck or suckle rather than developing a mature swallow with strong lip closure and good tongue retraction.

Today's toddlers are rarely seen without a sippy cup in hand — it seems to go everywhere. The cup has become the cell phone of the toddler world. However, when a child uses the sippy cup, they are still using the same muscle action they did when they were on the bottle. Sucking or suckling causes the tongue to protrude 75 percent of the time. When we talk, the tongue is retracted 98 percent of the time. The only speech sound that requires the tongue to protrude is the "th" as in "the" or "teeth" — all other sounds are made with the tongue retracted. Drinking from a regular cup or a cup with a straw develops a more complex mature swallow. The cheeks and lips suck the liquid onto the tongue, and then the tongue squeezes, lifts and propels the liquid down the throat. This action helps build the muscles required for proper speech.

In an article written by Jonathan Eig of The Wall Street Journal, he reported that there has been a noticeable decline in the articulation skills in preschools.

"What we've noticed in the past five or six years is that articulation for young children has totally disappeared," said Gail Smith, director of the Gingham Giraffe Preschool in Chatham, N.J. "I directly attribute it to the use of sippy cups."

Further concerns are coming from pediatric dentists as they are beginning to see more cavities among children who use sippy cups filled with juices and other sweet drinks. Children often suck on the cup for hours at a time, and sometimes even while they sleep. An article from the Academy of General Dentistry says, in part, "that the long-term and regular use of sippy cups puts children's growing teeth at an increased risk for tooth decay."

Sara Rosenfeld Johnson is a leading speech pathologist in the area of oral motor and speech development. She said, "It's just like sucking your thumb all the way up until you're 5 or 6 years old."

Charlotte Boshart, another speech pathologist reports, "It is wreaking havoc on tongue positioning."

What's a parent to do? Don't panic … remove the lids for your old sippy cups and use them for regular cup drinking. Then start using cups with straws. What you do not want is a cup with a wide flat spout. There are many cups on the market which promote lip closure and tongue retraction leading to a mature swallow. The use of a regular cup is great when they are at the table. For the mobile times, any cup with a straw helps to create good oral motor development. Many of the straw cups can be flung across the room with little or no spillage.

Darci L. Truax is a pediatric speech language pathologist at Deaconess Billings Clinic.

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