I have a question regarding treatment. I am working with 14 year old twin boys and have almost completed phase I. In our initial assessment they had a normal bolus collection and swallow. Do I still work through phase 2? The issues that they had were open mouth posture and some mouth breathing. They are keeping their mouths closed and making a habit of nasal breathing. They worked through difficulties with lingual mandibular differentiation and have progressed well. I’m not sure what to do from here?
That’s an infrequent situation but I’ve seen it among those who have had frenectomies for example so it’s not entirely unusual.
I suggest you have them demonstrate that they can do Knotty Straw exercise so you know that they are indeed suctioning acceptably; if so, then jump ahead to the soft food swallow because that activity is really an assessment up to that point. I’d make sure they know the locations of the elastics for Quiet Time and I would be sure they can play a quiet game with you for 15 minutes or so as you frequently say “check” and check the elastic locations.
Do you have the 2nd Edition of the Myo Manual? It has the criteria to pass each exercise and the recommended times per day to practice them. Also, there is a section to assure that each patient has the elastics in the right number and locations on the tongue for exercises. I wasn’t sure if you had the older version or newer one. Also, don’t forget that we are still trying to fit in one past VIP grad per upcoming classes, so if you want to update yourself, let me know in plenty of time.
Keep in touch and let me know if this was helpful,