Frenum Question- R: Techniques and Interventions to Correct /r/

Hi Sandra, I am taking your R course on northernspeech.com. I currently working with a 9 yr old boy who has difficulty producing /r/. I have done an oral exam and he is able to move his tongue laterally and up and down. He can even touch his nose. I want to also mention that this child is very determined to say his r’s correctly and is willing to do whatever it takes. He is very mature for his age! He told me that when he tries to create the suction against his upper palate, he feels discomfort in his frenum. He said when he touches his alveolar ridge with his tongue tip he has to consciously hold it up there. He also said that when he pulls his tongue up and back he is afraid that he will “swallow” his tongue. He said he doesn’t feel like he is going to gag but gets nervous that he will choke on his tongue. Any input and suggestions would be greatly appreciated! Thank you, L. B.

Hi L, The boy you are working with seems to have some unusual characteristics. Does he have a hyper gag reflex? If so, that might be an added psychological factor influencing improvement. If he does have a hyper gag, I have found purely by accident that an exercise I use for coordination at the end of my Myo Manual program in Phase One, has helped several of my patients to reduce their hyper gags. Let me know if that is the issue and I can direct you further re the Elevator Disk Exercise. You can see it online under our media button at the top of the first page of www.OrofacialMyology.com or at video button under the disk elevator section in our orofacial myology store. A very likely possibility is lingual restriction: When you checked his frenum, was his mouth wide open and held there. Stabilize his jaw open (I use 2Way and 3Way Mouth props) and then ask him to elevate toward the spot, etc. to give you a better view. Sometimes a frenum is not short but is still restrictive because of the attachment location on the tongue or onto the lower alveolar ridge. Sometimes it is a very inflexible frenum. Have you seen my other course on Northern Speech, Ankyloglossia 101 for SLPs? (I’m not sure if that is the exact title, but similar). I go into a lot of detail regarding what to look for and how to diagnose a restricted lingual or labial frenum in that online course. Does he have a high and narrow palate? That often interferes with improvement in /r/ production. Let me know if any of this helps or at least helps you to rule out some considerations. I look forward to hearing from you.  Sandra