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  • By Joanne Summer, MA, CCC-SLP

Speaking of Tongues: Orofacial Myology


Every so often I would receive a call from a parent regarding her child’s inabilty to produce some speech sounds “due to tongue thrust.” Generally, I would probe further and discover that what the parent was calling a “tongue thrust” was a frontal lisp, which I would successfully treat. However, sometimes it sounded like the child was thrusting his or her tongue forward when swallowing, in which case I would refer the parent to a speech-language pathologist who was trained in orofacial myology.

One day, however, a 16-year-old girl walked into my office with the worst production of the “r” phoneme I had ever heard. When her appointment had been booked, her parents said they were looking to improve her articulation of the “r” sound; I had thought I was going to be doing a simple articulation evaluation and following up with articulation therapy, if needed. Fortunately, during the appointment, her mother told me that her daughter had just been released from speech in her school, after receiving services to improve her articulation therapy for the past two years. When asked why she was released, the mother responded: “They said she is finished. We don’t think she is finished.”

Serendipitously, the mom also said that the girl had seen the orthodontist the week before our appointment to begin the process of straightening out her teeth. The orthodontist noticed that the girl was not swallowing properly. She was considering putting on a “rake” device, which would prevent the girl from thrusting her tongue forward when swallowing. Fortunately, upon hearing that the girl was scheduled to see a speech-language pathologist the following week, the orthodontist decided to hold off installing the device until I saw her patient.

Although I had no experience at the time with a tongue thrust, I did remember from graduate school that there is therapy available to correct this aberrant swallowing pattern and other Orofacial Myofunctional Disorders. I realized that if the orthodontist installed this rake, it may have prevented the girl from thrusting her tongue forward while she was wearing the orthodontia; however, after it was removed, her tongue thrust could in time push her teeth forward and undo her orthodontic treatment. In other words, it was a quick fix that would do nothing to train the tongue. I also remembered from graduate school that speech-language pathologists and dental professionals who were trained in orofacial myology could correct problems such as these.

I then located a speech-language pathologist who is certified in orofacial myology to treat this young lady. This same SLP who accepted my client invited me to take the Sandra Holtzman’s 28-hour course, “Orofacial Myology—From Basics to Habituation,” which I completed a few weeks ago. I have now entered the world of “myo” and am looking forward to helping clients with tongue thrusts, post frenectomy and articulation errors that don’t resolve with traditional articulation therapy—because something else is going on.

#orofacialmyology #OrofacialMyofunctionalDisorders #tonguethrust #frontallisp #swallowing

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