Hi,

I am an SLP in an elementary school in Virginia. I have been recently viewing your course A Three-Part Treatment Plan for Oral Placement Therapy. I have found your information to be extremely fascinating and, although I have 2 more hours, I have learned so much through your training. I do have a question. I have a 3rd grade student that is considered having a frontal lisp. He fronts many sounds. He is able to accurately produce the /s/ in conversation, when structured and prompted. However, in the course a child was mentioned that was able to accurately produce the /s/ in the structured setting, but once the setting was relaxed, she reverted back to her resting/comfortable position  of frontal sounds. Being that he is a typically developing child (9 years), would the bubble blowing and/or horn hierarchy be appropriate?

My thoughts would be that I need to work on establishing tongue retraction. I am just wondering what your professional judgement would be, considering he sounds a lot like  the girl that played "golf-ball air hockey" against Sara's daughter. I appreciate any thoughts you may be able to share! Thank you so much for your time and expertise!

School-Based Speech-Language Pathologist

Hi,

I am so pleased you decided to contact us as the Horn program has been very beneficial for so many of our child clients with muscle-based articulation disorders.

The question you asked is an interesting one.  I will try to answer it with as much information as I can.  The TalkTools Horn Hierarchy was developed, with the help of an engineer and palatograms, to address the following speech systems: grading in the muscles of the abdomen, velum, jaw lips and tongue.  So, you can see that one horn will not correct a phoneme error such as the one you mentioned.

The hierarchy then addresses all of the muscles in the tongue needed for standard speech sound production on the conversational level and is only one technique used to treat the /t/ and /d/ placement errors.  In most cases for those phoneme errors I would use the Horn Hierarchy in conjunction with the TalkTools Straw Drinking Hierarchy.

Because you seem to be interested in using Oral Placement Therapy (OPT) I would encourage you to attend a class or watch the video of my our 2-day class:  "A Three Part Treatment Plan for Oral Placement Therapy."  In it you will learn how this therapy works and step-by-step instructions for how to implement the Horn and Straw Hierarchies in addition to numerous other techniques to improve speech clarity.

I hope this has answered your question,

Sara Rosenfeld-Johnson

Hi, I am hoping you can offer a suggestion.

I am an SLP and see a 2 YO child who began sucking on his tongue and had a forward tongue posture before I started seeing him. Once I started working with him I had the family switch to straws only and eliminated the sippy cup. They did that and he continued to have tongue sucking behaviors. Now, he has switched to twisting/turning his tongue around his mouth and it is interfering with his speech sound productions.

I tried to introduce vibration to provide sensory stimulation, but he does not tolerate that in his mouth. I also gave him a chewy tube as a substitution and he will tolerate it, but it is not eliminating the problem.

Do you have any product suggestions? I would greatly appreciate it. He has no drooling, no muscle weakness, and no feeding difficulties. I have never seen a child do this before.

Thank you in advance for any suggestions or product recommendations!

I have a few thoughts on this to help you:

1. Make sure there is not a structural or physiological problem, for example enlarged tonsils and adenoids. If the tongue must be displaced forward for breathing for example it could start these odd habits. Look for a tongue tie.

2. The sensory-motor systems cannot be separated. Though you say there are no feeding issues, I suspect there may be some breakdown in oral-motor development. Look carefully at developmental norms. This will soon be available in the feeding book Lori and I wrote, or you can look into taking Lori's feeding class if you have not already. If this child sucks his tongue at rest, there may be similar patterns on the straw.

3. Use of chewy tubes and sensory motor activities are most useful when you work from the outside of the mouth to the inside of the mouth and the therapy is led by the therapist. So I would not recommend handing the chewy tube to the child, but rather follow Lori's pre-feeding Chewing Hierarchy.

4. Finally, for the tongue sucking, I would recommend tasks that work on tongue retraction. The TalkTools Straw program and TalkTools Horn program, when executed by the directions on the tools kits would be excellent, as would TalkTools Bubble Kit. If you wanted to learn more, we have self-study courses for each of these kits!

Thanks for your interest in TalkTools!

Robyn Merkel-Walsh