Children's Services : Speech

Tongue Thrust

Simply stated, it is an abnormal swallow pattern of pushing the tongue against the teeth between and while swallowing. Speech problems frequently occur with a tongue thrust due to the way the tongue is positioned and carried in the mouth. The most common speech problem is a frontal lisp that will affect the correct production of the /s/ and /z/ sounds and can affect other speech sounds that, while not obviously mispronounced, are produced in a way that will make speech sound “sloppy”. In order to correct the speech problems, the tongue thrust will have to be corrected. It is not possible to correct speech without correcting the position and carriage of the tongue in the mouth.

    Tongue Thrust Facts:
  • Children and adults swallow approximately 2,000 times per day.
  • Incorrect swallowing can exert 6 pounds of pressure against the teeth and jaw.
  • As many as 67% to 95% of children between the ages of 5 to 8 years old exhibit tongue thrust behavior that may be associated with orthodontia and/or speech problems.
  • Types of tongue thrust vary.
  • Tongue thrusting can prevent braces from effectively positioning the teeth.
  • Up to 80% of orthodontic patients have some form of tongue thrust.

Our Treatment Program:

The most effective type of therapy for tongue thrust utilizes techniques that re-educate muscles used for swallowing by changing the swallow pattern. This method is taught and monitored by a certified speech pathologist trained in the diagnosis and treatment of tongue thrust. The Swain Center offers the Progressive Tongue Thrust Therapy Program (PTTTP) that corrects tongue thrust over a period of four months.*

    Each level targets the tongue movements associated with:
  • Chewing
  • Swallowing
  • Integrating chewing with swallowing
  • Oral posture at rest

*The success of the program is based on commitment and motivation of the child, parent, orthodontist and speech pathologist.

Cleft Lip & Palate

Cleft lip and cleft palate comprise the most common birth defect in the United States. One of every 600 newborns is affected by cleft lip and/or cleft palate.

A cleft lip is a separation of the two sides of the lip. The separation often includes the bones of the upper jaw and/or upper gum. A cleft palate is an opening in the roof of the mouth in which the two sides of the palate did not fuse, or join together, as the unborn baby was developing. Cleft lip and cleft palate can occur on one side (unilateral cleft lip and/or palate), or on both sides (bilateral cleft lip and/or palate). Because the lip and the palate develop separately, it is possible for the child to have a cleft lip, a cleft palate, or both cleft lip and cleft palate.

Cleft lip and cleft palate are congenital defects, or birth defects, which occur very early in pregnancy. There are many causes of cleft lip and palate. Problems with genes passed down from one or both parents, drugs, viruses, or other toxins can all cause these birth defects. Cleft lip and palate may occur along with other syndromes or birth defects. Risk factors include a family history of cleft lip or palate and other birth defects. The majority of clefts appear to be due to a combination of genetics and environmental factors. The risks of recurrence of a cleft condition are dependent upon many factors, including the number of affected persons in the family, the closeness of affected relatives, the race and sex of all affected persons, and the severity of the clefts.

A child born with a cleft frequently requires several different types of services, e.g., surgery, dental/orthodontic care, and speech therapy, all of which need to be provided in a coordinated manner over a period of years. This coordinated care is provided by interdisciplinary cleft palate/craniofacial teams comprised of professionals from a variety of health care disciplines who work together on the child’s total rehabilitation.

    Our Treatment Program:
  • Evaluation, interpretation, and recommendations by a certified speech-language pathologist
  • Customized treatment programs based on individual needs
  • Individually scheduled therapy sessions

Swallowing Disorders

Swallowing difficulty, or dysphagia, presents itself in a variety of ways and occurs for a number of reasons. Swallowing disorders are usually related to neurologic disorders or dysfunctions. They may occur after a stroke, traumatic brain injury, neurological diseases, surgery or serious illness.

Swallowing disorders can pose safety and health risks and must be identified and treated. Sometimes a problem with swallowing can go unrecognized or undiagnosed and result in aspiration. Aspiration can occur when food or liquid enters a patient’s airway. This type of event is commonly referred to as food or liquid "going down the wrong pipe." When this happens pneumonia may result. Additional problems can include choking which can be life threatening. In order to minimize health and safety risks changes in a person’s diet may be recommended.

    Our Treatment Program:
  • Evaluation, interpretation and recommendations by a speech-language pathologist
  • Collaboration with physicians and radiology professionals regarding imaging studies
  • Development of an individualized therapy plan to improve swallowing function
  • Implementation of specific swallowing techniques to improve skills (e.g. Masako, Mendelsohn, etc)
  • Use of oral-motor exercises to improve muscle strength to support swallowing rehabilitation
  • Consultation with a dietician for development of an appropriate diet and meal planning

Very often patients with post-surgical dysphagia or swallowing problems after stroke do recover their swallowing ability and return to a normal diet.