**SOLD OUT**  | The Functional *REMEDIATION* of TOTs (Tethered Oral Tissues) [VIRTUAL][September 26, 2020]

**SOLD OUT** | The Functional *REMEDIATION* of TOTs (Tethered Oral Tissues) [VIRTUAL][September 26, 2020]

Date: September 26, 2020

Location: VIRTUAL (8:30AM - 04:00PM)

Presenter: Lori L. Overland MS CCC-SLP, C/NDT, CLC, FOM & Robyn Merkel-Walsh, MA, CCC-SLP, COM®️

The TOTs course is now being offered as 2 days. Click here to save by purchasing both days.

Course Description

Tethered Oral Tissues (TOTs) is the restriction of the frena or frenulum, which are small folds of tissue that connect bone to tissue and support or limit movement. The term TOTs is used to describe restriction of the frenula in the tongue
(ankyloglossia), lip (lip-tie) or buccal frena. Robyn and Lori created a detailed functional assessment protocol that task the impact of TOTs on oral motor, feeding and speech skills. From this assessment, goals are established and a treatment protocol can be generated.
This course provides participants with specific neuromuscular re-education tasks that will assist with the functional impact of TOTs on pre-feeding, feeding and speech. Robyn and Lori will teach participants specific passive and active exercises for breast, bottle, cup, spoon, solid and straw feeding in addition to the oral placements required for speech clarity. Pre and post-operative considerations as well as surgical procedures will be discussed. Neuromuscular re-education of the cheeks, lips and tongue will be presented and numerous demonstrations, practicums and video slides will teach participants to execute a functional remediation program. Techniques learned may be executed in the school, hospital or clinic based settings. This course is rich with evidence based practices and will address many of the controversies that make TOTs a “hot topic” (e.g. who is the team leader?)

Learning Outcomes

  1. Participants will be able to list at least 2 red flags for TOTs.
  2. Participants will be able to identify at least 3 ways in which TOTs can impact feeding and/or speech.
  3. Participants will be able to execute at least 3 neuromuscular education activities for pre and post op TOTs. 


 30 Min

  • Theoretical Foundations
  • What are TOTs
  • The importance of pre-and post-Op therapy

45 Min:

  • The variations of feeding and orofacial myology when treating TOTs
  • Passive bs Active
  • Active wound management vs. neuromuscular re-education
  • Who makes a TOTs team
  • Scope & Licensure

30 Min:

  • Laser release
  • Scissor/Scalpel release
  • Risk factors

75 Min: Neuromuscular re-education for pre-feeding with practicum

  • Buccal
  • Labial
  • Lingual

15 Min: Morning Q & A

75 Min: Neuromuscular re-education for feeding with practicum

  • Buccal
  • Labial
  • Lingual

75 Min: Neuromuscular re-education for Speech with practicum

  • Bilabials
  • Alveolars
  • Back Tongue Side Spread
  • Velars
  • Labiodentals
  • Lingua-dentals

15 Min: Afternoon Q & A

Target Audience: SLPs, OTs, IBCLC, dentists, surgeons, ENTs and RDHs. 
While TalkTools welcomes all to attend and learn the course content, it is the responsibility of the professional to determine if applying the techniques fits within the scope of their practice. 

Instruction Level: Intermediate. The learning outcomes and objectives are relevant for inter-professional practice and education (IEP) programs; and can be applied across the client's lifespan in a variety of settings (schools, private practice, clinics/hospitals)

Content Disclosure: This presentation will focus on treatment methods related to the use of TalkTools® OPT resources. Other similar treatment approaches will receive limited or no coverage during this lecture.

This program is offered for 0.6 ASHA CEUs(Intermediate Level; Professional Area). (seeTalkTools ASHA CEU Policy and Process for more information). 

TalkTools®️ is an AOTA Approved Provider of continuing education. Provider #: 4782. This self-study course qualifies for 6 self-study contact hours or 0.6 CEUs in the Category of Occupational Therapy Process. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA. Course Level: Intermediate.

Workshop Details

PLEASE READ THIS INFORMATION carefully before you submit your payment. Once we ship supplies you cannot be refunded. If you cannot attend the Zoom virtual workshop for any reason, you can attend an in-person workshop anytime at no additional charge. You will need to bring the materials provided


Registration Rates

$199 Early Bird Rate - until 07/26/20

$259 Standard Rate - 07/27/20 to 09/11/20

$289 Late Registration - 09/12/20 to day of

  • Registration Only Includes: 0.6 ASHA/AOTA approved CEUs, course supplies,and certificate of completion.
  • Registration + Textbook Includes:
  • 25% off TOTs Book
  • (book received at workshop location)

**Course supplies will only be shipped within the United States**

Instructor Bio

Lori L. Overland MS CCC-SLP, C/NDT, CLC, FOM Bio and Financial Disclosure

Robyn Merkel-Walsh, MA, CCC-SLP, COM®️ Bio and Financial Disclosure 

Recommended Tools

  • Sensi and Tips
  • Throat Scope
  • Straw Kit
  • Bite Blocks
  • Horn Kit
  • Pre-Feeding Kit
  • Feeding Kit
  • Tongue Tip Lateralization Tool
  • The Liper Device