About Elizabeth Shabala

Elizabeth is an ASHA certified Licensed Speech and language Pathologist who practices in Buffalo, New York. She graduated with a Bachelor of Science degree from the State University College at Fredonia in 1987. She received her Master of Arts degree from Temple University in Philadelphia, Pennsylvania in 1989.

Elizabeth gained her early experience in feeding at Children’s Seashore Hospital in Atlantic City and Philadelphia. At that time, she was a contributing author in the book, The Care of Children with Long-Term Tracheostomies. She continued her feeding and swallowing training at Children’s Hospital in Buffalo. Elizabeth has provided speech, language and feeding services in Early Intervention and Preschool in various agencies in the WNY area until starting her private practice in 2020.

In 2018, Elizabeth received certification for level 3 Talk Tools® Oral Placement therapy and received the Ace award in 2017 for 70 contact hours in the area of feeding and speech. She belongs to the ASHA special interest group, SIG 13, for swallowing and Swallowing Disorders Dysphagia. She has expertise in severe phonological impairment and motor speech disorders and a recent specialization in Tethered oral Tissues (Tots) or “tongue tie.” She has received training in Augmentative communication and sign language, but her greatest joy is in providing young children with effective care and treatment for successful feeding and improved speech clarity.

She is married to her husband Bob and they have two daughters. Hannah Grace is in her first year of Graduate school study in Speech-Language Pathology at University of Buffalo, and Emma Rose is a registered Occupational Therapist working in New York.

About Oral Placement Therapy (OPT)

Infants, toddlers and preschoolers who have a diagnosis of Hypotonia, Down Syndrome, Developmental delays, Suspected Apraxia (children under 3 years of age), Apraxia, Dysarthria, or Phonological Delay or Disorder can benefit from oral placement therapy. Children who have low tone or other muscle-based problems often have significant difficulty with speech production due to overall impaired muscle function. Clear speech requires rapid and precise movement of very fine muscles working together simultaneously. The muscles of the ribcage, jaw, tongue and lips along with the valving action of the larynx and vocal cord vibration work in harmony to create sound which the articulators shape to form speech.

Various Talk Tools® used in therapy

Various Talk Tools® used in therapy. Kaufman Speech to Language Protocol Treatment Kit 2 card also pictured.

There are no hammers or wrenches used here. T and P shaped fun colored “tools’ such as chew tubes can be used to make muscles of the jaw more stable and increase the range of movement for functional skills such as chewing. It is important to know that muscle tone cannot be changed but strength and accuracy of muscle movement can be changed. Other tools such as Bubble bear, look like toys, but like the Chew tubes, have very specific steps to follow in a hierarchy to achieve success of a specific feeding or speech movement. Talk tools does use a drill type format, meaning many repetitions are required in order to achieve success.This is a basic foundational principle of motor learning which has been around for years. All exercises are functional in nature, meaning that they are executed in order to improve movement patterns which improve feeding skills and or speech production skills.

Yes, In 1995, Sara Rosenfeld-Johnson founded Talk Tools® as a speakers bureau and source for Oral Placement Therapy (OPT) and therapy tools. Today, Talk Tools® has a “mission to improve the lives of those facing speech and feeding disabilities through techniques which add a tactile component to treatment plans with OPT”. Talk Tools® has instructors who train SLP’s in this a levels therapy program all over the world!

An OMP assessment would determine if your child would benefit from a sensory-motor based approach such as Talk Tools®. Some children such as those with muscle based problems or structural problems such as Tots (tethered oral tissues) need tactile and sensory techniques to train movement for feeding, eating and or speech. Feeding therapy is sensory motor based and very young children with severe delays in speech may have underlying oral motor deficits. In looking closely at movement for feeding and speech, it can be determined skill levels mastered and what skills need further development. OPT is sequential so a child does not move up until the current step is achieved.