Hi Sandra! It was great catching up with you last week! Glad to hear you are doing well. I have a client question for you. I recently picked up a six year old boy who has been in speech therapy for years for production of velars. He consistently fronts /k,g/ and is not stimulable for the sounds. He has a slight Class III malocclusion and a low and forward tongue resting position. He inconsistently rests with his lips closed throughout the day; he typically sleeps with his mouth open at night. Mom says he “sometimes” snores. He has an extremely hypersensitive gag reflex. His tonsils appear enlarged. He recently had a physical and his pediatrician stated that his tonsils appeared WNL. I am currently working on the basic lingual skill exercises and improving tongue-jaw dissociation. He is progressing with these. I introduced exercises to encourage tongue retraction; he is progressing through the SRJ straw drinking hierarchy. I am also having his gargle water (this is extremely difficult for him). Additional articulation errors noted include w/r. He doesn’t have a frontal lisp. Could his improper oral rest postures/enlarged tonsils/inconsistent mouth breathing completely inhibit his ability to produce /k,g/? Should I push for an ENT consult even though his pediatrician was not concerned with his tonsils? Thanks for your time and input!