Tagged "tongue movement"


Ask a Therapist: SMILE protocol for Severe Diagnosis

Posted by Deborah Grauzam on

Hi,

I would like to know if your SMILE program would help someone who is not a tongue thruster but has other abnormalities like a restricted tongue movement because of extra frenulum material, a malformed tongue, and a cleft (somewhat repaired). In other words I already know that programs can reach a variety of patients. Mine is an adult with not only all of the above problems but has just had teeth implants top and bottom. Her tongue and its relation to the teeth, and cleft (nasality) are her problems. I listened to a recording of her voice before implants and it sounded somewhat more clear but not substantially.

Thank You,

Thank you for your question. If this client does NOT have VPI and the nasality is the result of the tongue tip being poorly elevated then YES. I have treated multiple clients with nasality issues because the tongue was low or the tip was anchored due to restricted frenum. What is very important is that the client has the mobility to execute the program. If there is a severe tongue tie surgery may be needed prior to implementation.

Thanks for your interest,

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Ask a Therapist: Tongue Placement

Posted by Deborah Grauzam on

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

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