UTT open bite how long to wait for tx

HI, Sandra – I am working with a 7 year old with an anterior open bite. …..background:  Referred to me for tongue thrust by her SLP who cannot make progress on her frontal /s/.  This girl started with me 3 months ago in November.  Evaluation revealed open mouth posturing, forward tongue resting position, drooling, tongue thrust on swallow, and large tonsils.  She admitted being a thumb sucker, but said she had stopped several weeks earlier and mom had not seen her do it at night or day.  I referred her to ENT b/c of large tonsils and we missed about 3-4 weeks of therapy due to healing and Thanksgiving holiday. We started up again in December and have been working on the prep skills (pre-test 1), lips, and resting position; suctioning, etc….I was SURE she had to be sucking.  She admitted to sucking her coat “only at recess” (hmmm?) and mom checked on her numerous times at night.  We BOTH learned a lesson when mom decided to feel her thumb – which was wet.  She checked again later, same thing.  Child admitted to sucking.  So….we are doing Unplugging The Thumb program…..she is excited and doing well.  My main question:  I just viewed a DVD by Rosemarie VanNorman and she says she waits for 6 months after stopping of thumb sucking to see if any other/additional therapy (e.g. thrusting) is needed……is this your stance?  (This little girl does WELL with resting posture and lips closed now, but her open bite is prominent). J

Hi J, Be sure to take into consideration that a precise /s/,/z/ might not be possible due to the open bite.  Open your mouth the approximate amount as hers to be certain you are asking something fair of her….and check what can be reasonably expected with that measurement of open bite.  Are you saying that the tonsils have been removed?  Adenoids also? I’m not sure how much therapy Rosemarie did beyond offering thumb/finger sucking elimination programs, so maybe that’s why she waited to see.   She’s was known for sucking habits and has been active for many years. Rosemarie was not a speech pathologist and therefore she would have to find someone else to complete the work once the sucking habit is eliminated.  Your situation and credentials are entirely different from Rose’s.  Your patient has already been through a lot and needs a fighting chance asap to correct the speech problems, which cannot be corrected until the other areas are okay.  It would appear that you are following the right path with her.  I have just completed a 6 year old and an 8 year old with UTT (Unplugging the Thumb) and both worked like clockwork.  It really does work nearly 100% of the time for therapists.  If you are not experiencing that level of success, we can talk some more or role play, whatever you need.  We have the “Special Edition for Therapists” so that instead of the parent guide, you would have the therapist’s guide.  Therapists are often the key to success with the program, and I prefer to target them as well as parents since the level of success  for therapists is known whereas the success rates vary more from parent to parent.     Keep in touch and let me know how it’s going and what I can do to add my input as needed. Sandra