Functional Assessment of Tethered Oral Tissues (TOTs)
0.6 ASHA CEUs • 0.6 AOTA CEUs - click through for more info on our CEU Policy and Process
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. While not a new condition, the term TOTs was coined by Kimberly Benkert, RDH and later by Dr.
Kevin Boyd in 2014 to describe restriction of the frenula in the tongue (ankyloglossia),
lip (lip-tie) or buccal frena. While there are respected assessment protocols that look at the structure of the tissues, there is yet to be a detailed functional assessment that
looks at the impact of TOTs on oral motor, feeding and speech skills. Lori and Robyn
have done extensive literature review on TOTs and have collected several years’ worth
of clinical data in preparation of this course.
This course provides participants with a “Task Analysis” of a TOTs assessment. Robyn
and Lori have created case history forms for infants, children and adults that will reveal pertinent developmental and medical histories that look for red flags of both structural and functional TOTs issues. Then they will walk you through craniofacial /structural assessment of TOTs including what tools and cues will help assess structure. For the second part of the course, participants will be taught the functional markers of TOTs, with: breast, bottle, cup, and spoon, solid and straw feeding (s). Oral placements required for speech clarity will also be covered on how to assess errors that are typically associated with TOTs. Finally ethics, scope of practice and creating a “TOTs Team” will be explored.
- Participants will be able to list at least 2 assessment protocols for TOTs.
- Participants will be able to identify at least 3 ways in which TOTs can impact
feeding and /or speech.
- Participants will be able to describe at least 3 techniques to assess structural
and/or functional implications of TOTs.
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)
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.
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