Ask A Therapist: Tongue Thrust Therapy versus Appliance Use


I am a speech language pathologist who has attended one of your presentations. I see an 8 year old girl who has a tongue thrust.  She has had a habit breaker that she has been wearing for a few years (the device that she wears on her front teeth and it stops the tongue from coming out of the mouth).  Lately though she reverted back to her habit of having her tongue come out of her mouth  even though the orthodontist tried to make the habit breaker a bit sharper so that the it would stop the tongue from sticking out of the front of the mouth.

When I assessed the child, she had perfect motor strength and movement of her tongue, and neither was her tongue inordinately large as not to fit inside her mouth.   Also when she speaks she is able to say her /s/ and /h/ sounds in words and sentences.  However the mother states that once the child has to work very hard and be very mindful to keep her tongue from sticking out.  The mother states at night she sticks her tongue out and does the suckling movements like she is trying to lick something off her lips.  It seems to me that since the child has no motor issues in her tongue muscles, this problem a habitual one that she has developed over the years and into the present.

Do you have any recommendations or suggestions on what techniques I could utilize with this client to help her with the frontal tongue thrust (the child is able to carry on a conversation without having a tongue thrust as long as she is extremely mindful of each word she says).

Thank you so much for all you help.

I am just receiving this email and will be happy to help. Appliances do not correct the tongue thrust, they just change where the thrust occurs. Most kids that wear these appliances develop lateral thrusts as opposed to interdental ones, and the interdental returns when the appliance is removed. There was a great article written years ago on this topic and here is the link.
My suggestion is that this child be engaged in a myofunctional therapy program which will correct the root of the speech issues. There are 3 I like:
2- Roberta Pierce Swallow Right
3- Swalloworks
The difference with my program is you work on speech, OPT and swallowing simultaneously.
Hope this helps and thanks for your interest in TalkTools!
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