I really appreciate the thorough dedication the authors have put into this valuable book. They have described the current classification systems, combined the valuable features those systems offer, created a massively detailed chart for each type of tethered oral tissue (buccal, labial, lingual) that has sections for skill/muscle function, impact on appearance, impact on feeding, and impact on speech. So incredibly useful and I feel like I can use my client observations and measurements and compare them with the chart to really tease out what I'm seeing--and even what I missed but the details within each chart assist you in further defining your clinical observations. There is also a chart section about speech sounds and how the oral placement may be affected by TOTs. So useful!

I really appreciate the guides on assessing skills in clients that can voluntarily follow directions as well as those clients who cannot voluntarily perform requested tasks. Additional guides for exercises are included throughout the book, which I have not finished reading through yet. It is a goldmine! Some nuggets I am flipping through include: a guide to preparing the oral musculature from passive to active program planning; discussion of the chewing hierarchy, postoperative feeding therapy and pre-feeding therapy, postoperative speech therapy exercises with a muscle-based approach and description of oral placement therapy, appendices including forms, TOTs protocol, oral sensory-motor cookbook, and more! Finally a great place to have written guidance on exercises and how to elicit movements in a range of clients.

Areas of improvement include increasing the quality of the photos and diagrams, many of which appear grainy; including clear, quality photos of specific types of tethered oral tissues with specific structural notes; photos with labeled features of the pertinent areas we are analyzing, such as floor of mouth with salivary ducts and other features labeled, upper central gums with different gingival areas specified so readers have immediate access to identifying the areas referred to in the text. I went on my own google sprees to find where the salivary ducts were located, but it seems that is not a common term. The different areas of the gingiva have a variety of names for the same section, and that took some sorting out as well.

I am sooooo glad I purchased this book! Merkel-Walsh and Overland are really the top experts in this area and I am grateful they spent so much time to share this wealth of knowledge with us!

As an obsessive reader, learner and research addict - to say that I have and have read almost every book ever written on TOTs and everything oral motor/oral function, written by authors far and wide, is an understatement. Out of all them however - this is one of the most clear, cohesive, complete, and comprehensive book that I have read on the subject of TOTs. The organization of the charts, pictures and content of the book and how it looks at and applies the affects of the different types of tethering on: physiology, articulation, feeding/ swallowing and orofacial myofunctional- physiological development of the person during the most critical years of development is simply... brilliance. To make it even better- it is an easy read and a book that can be used as a reference for all who are both new and old to the ever controversial topic of tethered oral tissues. Robyn and Lori, thank you for your dedication to our field and for sharing your knowledge with us all. In the Prologue, Robyn wonders if she will be remembered for their contributions in the years to come. I wholeheartedly proclaiming- at least for me- YES!!!!! Bravo ladies!

I felt like a kid on Christmas when I received this book! I have referenced, reviewed & used everyday on my clinical practice. The information in this book is fabulous!!

It’s so nice to have this information as it relates to speech. I am using with clients and for my new baby who was born with TOT’s. Can’t wait to see the course that goes along with this! A must have...

So happy to have this book! It so very clearly outlines the functional implications of TOTS. There are so many children who will benefit form Lori's and Robin's work. As an OT, this is one of those areas that I couldn't evaluate, because I didn't even know anything about! Now I do and thanks to this book, I am better able to explain the implications to parents and other professionals. Truly an excellent resource and labor of love! Thank you.