Functional Assessment and Remediation of Tethered Oral Tissues (TOTs) - TIME AGENDA

8:30AM-12:00pm (15 MIN. BREAK at 10:30AM)
  • What is frenula?
  • What is TOTs?
  • What is the controversy?
  • Theoretical Foundations - the importance of a functional assessment and task analysis
  • Current Assessment Protocols
    • The Kotlow Rate Scale
    • Hazelbaker Assessment Tool for Lingual Frenulum Function
    • Lingual Frenulum Protocol for Infants by Martinelli
    • Lingual Frenulum Protocol by Marchesan
  • Merkel-Walsh and Overland TOTs Protocol: Using a Task Analysis to assess
    • Case History
    • Structure (Hard and Soft Tissue)
    • Breast
    • Bottle
    • Spoon
    • Solids
    • Cup
    • Straw
    • Speech
Lunch 12:00PM- 1:00PM
1:00PM-4:00PM (15 MIN. BREAK AT 2:45PM)
  • Pre-Op Goals, Surgical Procedures and Post-Op Considerations
  • Neuromuscular re-education of:
    • Breast
    • Bottle
    • Spoon
    • Solids
    • Cup
    • Straw
    • Speech (bilabials, alveolars, palatals, labiodentals)
  • Wrap-up/Q&A
  • Support
  • Activities to Improve Lip Movements for Feeding and Speech Clarity: Closure, Rounding, Retraction and Lower Lip Dissociation
  • Activities to Improve Tongue Movements for Feeding and Speech Clarity: Retraction, Lateralization, Elevation/Depression and Back of Tongue Side Spread for Co-Articulation