Hi, I am hoping you can offer a suggestion.
I am an SLP and see a 2 YO child who began sucking on his tongue and had a forward tongue posture before I started seeing him. Once I started working with him I had the family switch to straws only and eliminated the sippy cup. They did that and he continued to have tongue sucking behaviors. Now, he has switched to twisting/turning his tongue around his mouth and it is interfering with his speech sound productions.
I tried to introduce vibration to provide sensory stimulation, but he does not tolerate that in his mouth. I also gave him a bite tube as a substitution and he will tolerate it, but it is not eliminating the problem.
Do you have any product suggestions? I would greatly appreciate it. He has no drooling, no muscle weakness, and no feeding difficulties. I have never seen a child do this before.
Thank you in advance for any suggestions or product recommendations!
I have a few thoughts on this to help you:
- Rule out structural/physiological issues.
For example, enlarged tonsils and adenoids. If the tongue must be displaced forward for breathing, these odd habits can develop. Also screen for a tongue tie. - Consider sensory–motor development, not just “feeding.”
Though you note no feeding issues, there may be a breakdown in oral-motor development. Look carefully at developmental norms. This will soon be available in the feeding book Lori and I wrote, or you can take Lori’s feeding class if you haven’t already. If this child sucks his tongue at rest, there may be similar patterns on the straw. - Use therapist-led tools from outside to inside.
Use of bite tube and other sensory-motor activities are most useful when you work from the outside of the mouth to the inside, and when you lead the activity. I would not recommend handing the bite tube to the child; instead, follow Lori’s Pre-Feeding Chewing Hierarchy. - Target tongue retraction with structured programs.
The TalkTools Straw Program and Horn Program, when executed per the tool-kit directions, are excellent, as is the TalkTools Bubble Kit. If you want to learn more, we have self-study courses for each of these kits.
Thanks for your interest in TalkTools!