Hey Sandra, Hope all is well. Question : had  call from mother with a 3 year old who’s SLP diagnosed child with apraxia and is a mouth breather. Also had sleep study and has mild apnea. They are planning on tonsil/adenoid removal for apnea. Is this a case Myofunctional should be included ? Thanks, John W DDS

Wow John, You DO get difficult cases!   Is he “just” three or nearly “four”?  He isn’t a candidate for typical myo, but after the T & A, there might be a few very simple exercises that an older three year old could do just to get used to having a good airway and a tongue that doesn’t have be held forward or out to help him breathe better.  Being that he has apraxia, he might not be able to do anything you ask or demonstrate, unfortunately. Without apraxia, I would I would attempt only what a three year old could do:  Open mouth and hold it open as he touches the lip corners, trying not to move mandible (might be difficult for a young three year old); try to touch upper teeth on inside or even the cutting edges; transfer food (could be a malted ball or something similar) from one side to the other; lick around lips, etc.  Not much else you can do If he is seeing an SLP for the apraxia, I hope she/he would be one that has some oral motor background and can work with him in ways that involve his mouth and tongue and lips. If he has a cooperative therapist, you could speak with her or have mom do so to encourage oral movement, chewing, etc. That’s about all I can contribute with this particular kiddo.  I hope it is at least a bit helpful. Be well,