Carryover reminder for lip closure

I have a client that I have worked with for about a year – for some time he seemed that he was almost ready to graduate.  I have worked with him on his lisp and his major tongue thrust.  He is now in 4th grade, and I think we have hit a plateau.  I think he is stressed, busy, and tired from 4th grade, and his mom said that his mouth is open more often now than it was before (not before therapy, but before when he was doing so well).  We have tried everything I can think of including: penny/check game, making a poster, putting reminders in his house, checklists at home and school for lips closed, chin ups during the night, reinforcement charts, special pencils, special bracelets, praising, sticky spot…  Do you have any other ideas??? We are now going to go once every 3 weeks or so for the sessions, in order to encourage independence.  He is getting annoyed when his mom reminds or even praises him. He may subconscioulsy be rebelling.  We are not sure.  I decided to have a celebration with him tomorrow (our last session before our first 3 week break – I have been seeing him weekly up to this point) and tell him that he has done such a great job and he is ready to do this all on his own – he will just check back with me every few weeks. I will give him some sticky spot so it can be his physical reminder and we will make a list of other tricks.  Do you have any other ideas for the carryover of lips closed? He can breathe through his nose fine…

Keep in mind that it is not any particular exercise or activity that works miracles and you can keep coming up with ideas until you are blue in the face.  This young man has “had it” with therapy and with his parents’ nudging.  You have made the wisest decision…give him sort of a clinical break, a reward per se for having gotten this far, and do exactly as you described. I have some ideas in the back of the Myo Manual, which I think you own, that might be appropriate if you want a few more ideas…but remember what I wrote above that it isn’t any particular exercise that he needs now.  He needs a break!