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Resources for Feeding, Eating, Drinking, Speech, and Mouth/Airway Function


Question & Answer - Development

What are some simple, easy strategies for respiratory development?

July 2014


ANSWER BY Eileen Richter, MPH, OTR/L, FAOTA, from Stillwater, MN (

Addressing respiration is one of the most effective ways to improve postural control. This is because the muscles and structures of posture and the muscles and structures of respiration are the same. Hence, postural dysfunction often results in respiratory limitations and vice versa; they are inextricably linked. But, improving respiration can go well beyond improving postural control. Good respiratory function also supports modulation in the body, self-regulation, sensory motor function, and psychosocial development. It is needed for good feeding and speech development. A complete explanation of the connections between respiration and the many body functions listed here can be found in the book MORE: Integrating the Mouth with Sensory and Postural Functions (Oetter, Richter, & Frick, 1995).

There are many ways to improve respiratory function including strategies to release fixed musculature, breathing exercises, remediation of delayed reflex development, etc. These are complex therapeutic techniques that require training to implement. However, many functional activities (found in the lists below) can be useful for improving respiration. These activities engage the muscles and structures in typical use to encourage strengthening and grading for skill development (Note: grading means that muscles move a structure “just enough” for a specific activity). Such activities may involve the use of breath for voicing, humming, singing, making animal sounds, and/or blowing on whistles, blow toys, or musical instruments.


Blow toys are a good example of simple, inexpensive therapeutic tools with multidimensional value. Because they provide multiple sensory motor experiences, whistles offer opportunities for integrating oral, ocular motor, eye-hand, and auditory functions, as well as opportunities for developing improved respiratory and postural outcomes. These toys may be used to grade respiratory challenges at various levels (Oetter, Richter, & Frick, 1995). The following are some suggested blow toys to achieve various respiratory outcomes. Many of these may be obtained from Therapro, party stores, etc.

For beginning blowing:

Soft Toot Train

Mini Harmonica*

Mini Bird Whistle

Siren Whistle

Magic Flute Straw

Two Tone Trumpet

Lips Siren Whistle

Rubber Razzer

Rooster Whistle

Riverboat Whistle

*Also for grading

For power breath (invites explosive breath that often results in the release of a fixed diaphragm):

Blow Darts (of any kind)

Whistling Balloon Copter*

Train Track Whistle*


Duck Whistle

Merry-Go-Round Whistle*

Trumpet Whistle

Airplane Whistle*

Space Whistle*

Race Track Whistle*

*Also for grading

For resistive blowing (strengthens a weak diaphragm):

Whistling Balloon Copter

Blow Fish


Inflatable Tongue

For graded breath:

Canary Whistle

Slide Whistle

Bird Water Whistle

Singing Bird Whistle

Magic Ball Pipe

Animal Eye Poppers

String Bottle Pipe

Rainbow Pipe


Wooden Ball Blower

Harmonica (any kind)

Round Kazoo

Kazoo (any kind)

Bubbles (any kind, including Bubba-loon)


Typical respiration is essentially a rhythmic function that is adaptable to variations in physical, emotional, and communication demands. The ability to return to respiratory rhythmicity following these adaptations, along with the ability to change the depth of breathing, contributes to its regulatory effect on the nervous system. Individuals with respiratory/postural challenges often demonstrate arrhythmic respiratory patterns that make attention and behavioral organization difficult. External rhythms via sound and music played in the background, such as drumming or Baroque music, have been shown to support rhythmic respiration through nervous system entrainment.

Auditory support for respiration:

Baroque for Modulation

Vivaldi for Modulation

Spirit Drums

Drum Medicine

Mozart for Modulation & More Mozart for Modulation

Musical Playground

It is rare to find a collection on one CD that offers the range and variety of rhythms, instrumentation, and musical expression found on A Musical Playground. The music is engaging, the rhythms are grounding, and the arrangements are inspiring. Selections range from quick and intense (a good match for the kids with fast “engine speeds”) to soft lullabies that sooth and calm (good for winding down to sleep). This music appeals to all ages, so adults won’t get bored playing it again and again for the children.


It is important to recognize that respiratory/postural functions are complex. Children with significant problems in this area should work with a trained occupational or physical therapist for treatment to resolve them. However, the functional activities described above will augment and help to maintain gains made through therapeutic intervention.


Eileen Richter co-authored the book MORE: Integrating the Mouth with Sensory and Postural Functions (1995) which has long been a “go to” reference for parents and therapists who want to address motor, oral, respiratory, and eye-hand function in a systematic way from a sensory-motor perspective using fun tools found in many homes and clinics. This book also contains excellent information on suck-swallow-breathe synchrony and the many other aspects of respiratory function including respiration for speech production.


Oetter, Richter, & Frick (1995). MORE: Integrating the Mouth with Sensory and Postural Functions. Stillwater, MN: Pileated Press, LLC.


This article was originally published on 6/1/14 by Richter Active Integration Resources. Permission to reprint this article on the Ages and Stages website was granted by Eileen Richter.