Questions about Down Syndrome and Orofacial Myology
1.In your opinion and in the research, will treating the forward resting inter dental tongue posture of an individual with Down Syndrome improve articulation? I work with a 6 yr old girl with DS and apart from all the language work, I must better address her weak oral musculature, tongue and lip and jaw posture but I’m wary of the “non-speech oromotor” exercises. Is myofunctional therapy the way to go? (I am doing a lot of language based speech work as well, I just feel that I’m leaving out a part of the puzzle).
It is my belief that the failure of some “oral motor” approaches and subsequent negativity that resulted is because various exercises are being used in a haphazard manner with no sensible direction or goals. Each patient/client has unique symptoms and abilities that must be thoroughly assessed with an excellent orofacial examination and history information. I have had identical twins with the same diagnosis and did not give them identical treatments, for example. And yes, you are leaving out a piece of the puzzle as you suspect. My goal is always to “maximize” each child, to draw the best out of them, rather than merely push in certain exercises, etc. So, yes, you can aim for improving the lingual rest posture with this patient but the goal would be to maximize her in many areas prior to even thinking about lingual resting posture or lingual position during speech. Please see the very important article at the following like specifically related to children with Down Syndrome and what are and are not reasonable expectations.https://orofacialmyology.com/wp-content/uploads/2017/10/orofacial-myology-wheter_or_not_to_treat_children_w_down_syndrome.pdf
2. I’ve been incorporating some old “tongue-thrust” techniques somewhat randomly (e.g button pull, tongue tip “on the spot”, mother’s delight) I’d like to feel a bit more steady- how can I learn more?
It is frustrating, I know, to present the exercises randomly. I have created the Myo Manual, not as a cookbook, but as a sensible reasonably sequential program that takes the client from maximizing the excursions of the tongue; separation/differentiation of the tongue from mandible and from lips, suctioning, which is necessary for lingual posture, successful bolus collection, and speech production; separation of the inter-lingual muscle movements; and increasing stability of the lateral borders of the tongue for purposes of bolus control and sealing of bolus to prevent loss into the sulci as well as other factors related to speech…..this falls under the Myo Manual’s proficiency exam #1…….to then maximizing the labial functions and buccinator function and more…..to developing the full suctioning ability….to then introducing various Quiet Time activities which I developed from the former Mother’s Delight….we also do certain exercises that coordinate the prior training as we go along the way through treatment, some of which are meant to detect any areas that may have not be addressed enough or thoroughly enough. In essence, they are taken from maximizing the areas of “weakness” or below normal range functioning as determined by the thorough orofacial examination…to coordinating the excursions of the improved areas/musculature, to suctioning training, to habituation into everyday life.
3. How does this field (orofacial myology) differ from “oromotor exercises” (ala blowing horns using straws etc.)in terms of remediation of forward tongue posture? Any studies? Orofacial myology is a special area within the speech pathology and dental fields that covers many fascinating areas such as mouth breathing, open mouth posture, sucking habits, tongue tie determination and post surgery treatment, articulation disorders resulting from orofacial myology symptoms (in my personal opinion, this is probably 95% of articulation errors..but others might miss what I can detect, due to my years of specializing in this area), open bites as well as other malocclusions; and so much more. Even certain types of voice differences are related to orofacial myology disorders. I’m not familiar with any studies about the horns and straws, but I think that company might claim to have them…you’d have to check with them. But the horns or straws or individual oral motor exercises should be considered unrelated to an orofacial myology program.
4. How can I learn more? You can follow the link to find course information. https://orofacialmyology.com/seminars-shop/