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SLPnNYC
I'm filling in for another SLP in one of my schools and I have a student whose tongue is always hanging out, his muscle tone seems to be weak and I strongly believe that he needs oral motor exercises. When I spoke to his previous SLP, she told me she discontinued artic therapy b/c he doesn't need it dry.gif Anyway, oral motor is not my strongest suit so what exercises can I suggest to the parents to practice at home? Thanks.
Guest
I think we need more information. How old is the child? Is there a diagnosis? What's the situation with the artic? How long has he been in therapy? What exactly are the goals? Is the tongue hanging out because there's truely low tone? Are other areas weak/low tone? Is this a dysarthric speaker? Is the child a mouth-breather? Thumb sucker? Are the tonsils enlarged? Is there an ENT eval/report? If you're filling in, you're the child's SLP, so you've got to do the therapy you feel is appropriate. I wouldn't feel comfortable recommending therapy techniques for a parent to do at home that I wasn't totally comfortable with myself.
buddy
Does the child have an IEP? If there are no oral motor goals on the IEP, I would not do them. If you are only filling in, it is not up to you to change the course of his therapy program (unless you are filling in for a long period of time, like the entire school year).
I agree with the previous person, that you have to know the reason for the tongue hanging out before you decide what is an appropriate treatment.
buddy
Does the child have an IEP? If there are no oral motor goals on the IEP, I would not do them. If you are only filling in, it is not up to you to change the course of his therapy program (unless you are filling in for a long period of time, like the entire school year).
I agree with the previous person, that you have to know the reason for the tongue hanging out before you decide what is an appropriate treatment.
Guest
what is your rationale for using oral motor exercises? What are your trying to achieve? OME do not have a strong research base for many disorders...what is his DX? Also, you cannot improve "tone" from OME. How old is the child, and how is the tongue position affecting speech/language?

Does the child have a tongue thrust?
holly
Mouth breathers...oh NO! Got to get those noses and throats checked out by MD or even school nurse may be able to help parents do this. Everything you do will not matter if his mouth stays open..the tip of the tongue must have tip elevated and making contact with alv.ridge to start his swallow for oral secretions. Plenty of artic errors, like the fricatives and sibilants, and blends, etc. may be distorted due to this whole tongue thing. Artic therapy is effective, once he can keep his mouth closed. Teacher will have to help cue the child, possibly having him keep a behavior chart. The reverse swallow, tongue thrust, malocclusion/bite, enlarged lips that become droopy. Its the whole thing. Once the nose and breathing is documented medically, possible a daily medication, things will fall into a program. I would work intensely with this child. No games, just structured activities for all of his issues. I do come from the private sector, on this issue, and so have a 'can do' opinion on this.
Guest_shidelr
Hi! I'm italian; what's an IEP?
Thank you!
Guest
IEP-Individualized Education Program. Basically it is a legal document (for kids 3-21) and it states if the child qualfies for special education services in the schools here in the United States and the amount of services they are eligible for. It also states the goals that the kid is going to work on for the year in each specific area that the qualfied for. You meet at least once a year with the parents to discuss how the child is doing. Also if the child needs assistive technology or any additional modifications etc it will be listed in the IEP. Hopefully that sums it up. I am sure others can add on to what I wrote if you want more info.
SLPnNYC
The child is 10 years old and yes, he does have an IEP. There are no goals that even touch upon the issue. I know that he used to get artic therapy but his previous SLP felt he didn't need it anymore. He demonstrates with a frontal lisp which is very severe that it interferes with speech clarity.
Guest
Why would you want to use OME to target a frontal lisp? What is the rationale?
Guest
I totally agree with the previous poster. How are OME going to fix a frontal lisp? I don't even really believe in them to begin with but especially how is going to help a lisp? Shouldn't you really be working on teaching this guy appropriate tongue placement?
Kate
If this severe frontal lisp is actually a tongue thrust, it's not surprising that artic therapy didn't work. Maybe you're thinking of myofunctional therapy, which addresses the reverse swallow and might be called oral motor therapy. But it needs to be done intensively with lots of follow-through at home. You might want to have Mom go for an orthodontic consult re: tongue thrust... if that's, in fact, the case.
SLPnNYC
I apologize for the confusion. I meant tongue thrust sad.gif We did a few tongue placement exercises but he never practices at home and Mom is not compliant. Is there anything fun I can give him to motivate him?
Guest
OK, I feel better now when you said it is tongue thrust! From what I have read, and from talking to other SLPs, myofunctional therapy can be VERY difficult and does not always have success. A tongue crib is the best bet. The child should see an ortho. I have placed one of my students on consult until he gets his.
Guest
We are not even allowed to treat tongue thrusting in my school district.
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