WEBINAR | TOTs and the "Terrible 2's": Frenectomy Care with Toddlers [August 18, 2020] [10:00AM-12:00PM EASTERN]

WEBINAR | TOTs and the "Terrible 2's": Frenectomy Care with Toddlers [August 18, 2020] [10:00AM-12:00PM EASTERN]


Date: August 18, 2020

Location: Webinar (10:00AM-12:00PM EASTERN)

Presenter: Robyn Merkel-Walsh, MA, CCC-SLP, COM®️

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Course Description

Tethered Oral Tissue (TOTs) is often being discussed in the fields of dentistry, otolaryngology, speech pathology, lactation as well as occupational and physical medicine. While many agree on the impact of TOTs on breastfeeding, some professionals debate, or do not understand the functional impact of TOTs across the lifespan. Often babies seemingly improve with functional skills after a release in relation to breastfeeding, but as they advance to solids and age appropriate drinking, vessel problems arise. There are also toddlers who are picky eaters or have unintelligible speech, and the TOTs diagnosis was missed in infancy. While some argue that a toddler cannot undergo a frenectomy or engage in pre- and post op care, this is a myth. Many toddlers have successful TOTs release outcomes when therapists combine oral sensory motor techniques with behavior management strategies. This course will outline the functional symptoms of toddlers with TOTs and the clinical parameters for treatment.

Learning Outcomes

  1. Participants will be able to list at least three red flags of TOTs in toddlers.
  2. Participants will be able to list at least 3 problems that may arise in TOTs if not addressed in the toddler years.
  3. Participants will be able to initiate at least 2 techniques that can be used with toddlers for pre- and post-op care.

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 0.2 ASHA CEUs (Intermediate Level; Professional Area)(see TalkTools 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 2 self-study contact hours or 0.2 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.

Webinar Details


Schedule (10:00AM - 12:00PM Eastern)

  • 10 minutes: Speaker intro & why this webinar is important
  • 25 minutes: What is TOTs and what problems can arise from TOTs in the toddler years
  • 35 minutes: Toddler tantrums and tribulations in therapy
  • 40 minutes: Tackling the terrible twos in TOTs pre and post-op care
  • 10 minutes: Q&A


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

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