Do I focus on front, middle and back of tongue?What do I need to correct or review, when a patient has difficulty moving forward in treatment after the slurps followed by swallowing? Do I have to work more with the middle and the back of the tongue? Do you have any suggestion?
How far into the program are you? With the Myo Manual program, we prepare the patient first by maximizing all the functions of the tongue. Once they pass the first assessment, we work on coordinating the various tongue movements with the lips and mandible. Then we introduce sequential steps related to the swallow process. By the time we are beyond Slurp and Swallow, they are able to move forward with ease. I would not suggest jumping ahead to that exercise unless she is prepared to do that level of training. There are some exercises that are often necessary for the lateral borders of the tongue, to assure that the seal is acceptable; however, I don’t work separately with the front, middle and back of tongue. I did that many years ago, but it is more important to prepare the tongue first to be able to accomplish all of the shaping and movements needed prior to any swallowing training.
I hope this is helpful.
My best,
Sandra