Therapist needs a more thorough program

My child is seeing a myofunctional therapist for tongue thrust.  Her dentist sent us to someone to teach her to swallow correctly.  They are working on having my daughter keep her tongue tip up to the spot behind her upper teeth.  She is having a lot of difficulty and they keep spending most of the therapy time on that particular activity.  It seems like they are missing something because my daughter tries hard and does her exercises, but can’t remember to keep her tongue there all the time.  Someone told me about you and said to ask you about your basic exercises to do before working on keeping the tongue up.  I would be happy to connect you with my therapist but I don’t want her to feel badly.  Can you give me some guidance how to best help my daughter?

Hi, thank you for contacting me.  I’m sorry your daughter is struggling with therapy at this point.  In our Myo Manual Program, we have a sequential way of addressing what used to be called “tongue thrust.”  (I refer to it as an orofacial myological disorder).  First we eliminate any barriers to success such as sucking habits, certain orthodontic appliances such as rakes and cribs, airway issues that make it difficult or impossible to nose breathe consistently (allergies, obstructions, enlarged tonsils or adenoids), and ankyloglossia (tongue tie).  Once we are sure that none of the above are present, we then make sure that the tongue can move and do various actions within the oral cavity.  Only after the first section, called Proficiency Exam #1 (basic lingual skills) do we then start to work on tongue tip to “spot.”  Many years ago, when this was a relatively new specialty area called myofunctional therapy, we began with the tongue tip to spot and progressed rather rapidly into the “swallow” training.  We know much more today and we address the smaller issues first, well before focusing on the resting position of the tongue, lips and jaw; and way before talking about the swallow pattern.  I hope this helps you get a better idea of the sequence that works most often and addresses each step along the way from “basics to habituation,” which is the phrase I use to describe our program.  I will be more than happy to talk with your therapist and I promise I will let her know that you are pleased with her and just wanted to make the introduction to me in case I can contribute in any way with my long time experience in orofacial myology.