Strong gag and NOT stimulable for the /k/ and /g/ sounds

Have you worked with clients that have NOT been stimulable for the /k/ and /g/ sounds?  I have come across 1 in my 12 years and have now been approached by another parent.  Her daughter has quite a gag reflex and it has been difficult for SLPs up to this point to stimulate that sound…do you have any suggestions?

How old is this child?  And is she developmentally where she should be?  Unless she’s very young, she might benefit by one of the Myo Manual exercises that was not intended to reduce gag, but has proven to do so with some of my patients.  I discovered purely by accident that the Disk Elevator exercise is effective with some clients with hyper-gag difficulties. If she does have a strong gag, then she should be able to make the /k/ and /g/ even more easily.  I usually have them make a strong gutteral sound, like a Middle Eastern ccccccccccchhhhhhhhhhhhhh  and work from there, having them repeat the end portion of it over and over, shaping it into the /k/.  Also, if you have the 2 or3Way mouth props  to maintain oral opening, that helps very much.  Otherwise, they tend to close the mandible and mess up the chance of making the /k/.  You want lingual/mandibular separation here so the tongue is all they use for the /k/.  The video link that follows has exercises with the  mouth props and it will give you the idea.   Click onto the 2 way and then the 3 way mouth prop videos.        https://orofacialmyology.com/myo-media/ Sandra