When more INFO is needed

I started working with a client who has: an anterior and posterior crossbite, an everted lip, jaw sliding when talking and high narrow palate.  I now know to take her through phase I, II and III.  But the one thing I am not sure what to do with is that I could not see her uvula/tonsil upon phonation of ah.  Should I recommend a visit to an ENT? Needless to say she is a mouth breather and rests her tongue on the bottom of her mouth.

Here are my thoughts:  Who sent her and for what purpose?  You didn’t say and that is critical since an orthodontic referral might have different answers to that questions than a child you see for speech in a school setting.  Is she seeing an orthodontist?  Did they send her?  With regard to the uvula/tonsils, that would depend upon your case history in part.  Does she have symptoms of sleep apnea, for example?  There are some therapists who send everyone who comes to their office for ENT exams.  I never did that and most people do not.  I don’t have enough information to give you more suggestions. Please do present this to Myo Masters because there is likely to be a lot of back and forth questions….since I’ll be teaching this week, I don’t want you to be on hold again.