If you have a student or client with tongue thrust (as known as oral myofunctional disorder) you may need some information about the jaw.
Learn more about the jaw here and see my resources for therapy ideas on Teachers Pay Teachers.com.
The vowels are often affected by the position of the jaw. If you are teaching English pronunciation to a foreign-born speaker, they may improve their low vowels /ae/ as in /cat/, and /ah/ as in /pot/, if they open their mouth wider (move their jaw to a low jaw position).
What is tongue thrust and why is it important to correct? A heavy force such as chewing only occupies a small amount of time each day. Contrast that with swallowing at every meal, as well as the regular swallowing of saliva. Swallowing happens hundreds of times each day and night.
For some, the tongue is not positioned correctly for the hundreds of times each day and night that swallowing occurs. Instead of lifting up against the roof of the mouth as it should, the tongue stays low and “thrusts” forward, and often through the teeth. Others rest their tongue in a more forward position than expected. This constant force is tongue thrust, and creates a space between the teeth that impacts the normal development of the teeth, tongue, lips, jaw and face. It often impacts clear and understandable speech. All babies use tongue thrust as a safety mechanism when eating. But children are expected to grow out of this by age 5 – 7.
Use the search above to look for tongue thrust, also called myofunctional disorders.
When working with myofunctional or accent reduction clients, it’s important to look at tongue placement and jaw height.
I’m working with a young man who substitutes short O for short A. His Dad sounds like dodd, his sack sounds like sock, and his laugh sound like loff.
It means he uses the right jaw height for short A (as is cat) , with a low jaw, but holds his tongue too far back in his mouth and says short O (as in cot). He needs to put his tongue forward in his mouth for a correct short A sound.
The best success we’ve had is when he does minimal pairs, like
I’ve complied many of the fun and effective exercises we use in speech therapy for kids with tongue thrustinto a 4 page printable and made it available on TPT at this link. These are exercises and activities that I like from several sources including Sara Rosenfeld-Johnson at Talk Tools®, Robin Merkel-Walsh, MA, CCC-SLP and her book S.M.I.L.E. (Systematic Intervention for Lingual Elevation), and Kathy Winslow, RDH, myofunctional therapist.
SLPs – you’ll find lots of activities here.
Parents – Please consult your SLP or orofacial myologist. He or she will give you guidance on which are the best exercises for your child.
When working with kids who have tongue thrust (also called myofunctional disorders) I like to play games, and one of our favorites is Paper Suck Tic Tac Toe.
Straw practice with “oo” lips, and the straw in front of the teeth promotes the back tongue movement needed for correct swallow, and speech production.
To play you’ll need paper pieces, playing board and 2 straws. Cut out the Xs and Os and lay them on the table. Each player needs 5. Players take turns using their straw to suck up the paper piece, and place it on the gameboard (without using their hands.) Like regular tic tac toe, 3-in-a-row wins! When sucking paper:
Use “oo” lips.
Keep the straw in front of your teeth.
To make it easier use a fat straw, or cut the straw in half.
To make it harder, use a skinny straw and increase the weight of the paper pieces. You can use cardstock. You can double the paper (crimp the corners so the pieces stick together.)
I’m working with a little boy who has imprecise articulation, and speaks two languages. His speech is garbled in his native language and in English. We have worked on exercises to improve the strength and mobility of his lips, tongue and jaw. He’s a “tongue thruster” so he’s working on keeping his tongue behind his teeth for most sounds in English.
Since he’s pretty bright I thought he knew the definition of clear speech. But when I asked, he could not define it. He couldn’t define it in his primary language either. That’s when we worked on this printable “Clear Speech vs. Mumbling”. He’s learned the new vocabulary and now he responds quickly when I correct him.
Don’t be afraid to back up, if you discover you forgot to teach something!
This is a new post on more exercises we do in the clinic for kids who are coming to speech therapy for tongue thrust. Next I’ll compile a pdf of all my exercises, so stop back and look for it under “FREE PRINTABLES at the top of the page. See my earlier posts on tongue thrust exercise here and here and here.
Tongue thrust (also known as Myofunctional Disorder) is the forward movement of the tongue (often through the teeth) for swallowing. It’s a natural posture for babies (it serves as a protection from choking). Most children outgrow it, but a number of children still “tongue thrust” at age 7 or 8 and often need therapy to correct it. Some adults have tongue thrust. Children or adults who lisp (for example use TH for S) probably have a tongue thrust and can benefit from speech therapy. Remember when we talk about “the spot” we meant the alvealor ridge, or bumpy spot right behind the upper front teeth.
Exercises to help tongue strength –
Hold tongue up in the “resting position” for 5 minutes, working up to 30 minutes at a time – tongue tip on the spot, mid tongue and back tongue up high against the roof of the mouth. Click for a free printable of the “resting position“
Tongue Trace – with lips closed, student licks the inside of the lips around in a circle. You can also left to right and right to left, on the upper and lower lip
Water pump or Water swishy – with a small amount of water, student swishes the water around in mouth, like mouthwash, for 1 minutes then gathers it all on top of the tongue (I call it “big gather”) and lifts it up for the swallow
Tooth Cleaners – use the tongue to “rub” the back molars, several times, upper and lower
Exercises to help lip strength
Tongue depressor with pennies – tape pennies to both ends of a tongue depressor. Student uses lips only to hold the center of the tongue depressor. Hold for 25 seconds, x3. Start with 2 pennies and work up to 16
Tongue trace – close the lips and trace around the inside of the lips with the tongue, keeping the lips together. Can also trace right to left, and left to right, on the top and bottom lip
Exercises for jaw strength
Watch the muscle – with a mirror, have the student bite down and watch the masseter muscle move or bulge (the muscle on the side of the face connecting jaw to
skull). Bite 5 times and then rest
One of the best ways to get kids to practice is by singing songs. I want my tongue thrust students to get muscle memory for tongue placement for T, D, N and L. All these sounds have the tongue tip lifting up to the “spot” (the alveolar ridge or bumpy spot behind the upper front teeth). Have kids sing a common song but instead of the lyrics, for every syllable substitute the sound “LA”. (You could also have sing the other phonemes) Start with Happy Birthday. Everyone knows that song. Make sure they keep their tongue behind their teeth. They could watch in a mirror to check how they’re doing.
Happy birthday to you…
should sound like
La La La La La La….
Change it up so your student won’t get bored. Here’s a list of songs to practice LA LA songs. Click here for the free printable.
Kids love to play games in speech therapy. Lately we’ve been playing a lot of air hockey using our breath to push the ping pong ball across the table. I’m following the ideas in Talk Tools’ Oral Placement Therapy for Speech Clarity and Feeding. This photo is from page 51 of their book, and shows the position of players at the table, and the field of play.
With the student’s head at table level, they use a puff of breath to move the ball. No using hands or bodies to block the ball! Not much air is needed, but what is needed is abdominal grading and controlled oral air flow. Abdominal grading is a skill kids need to control the air flow for speaking. With normal speech production, we inhale a large breath quickly and then use that breath to speak, exhaling it in a slow and controlled manner. If a student is having trouble with controlled airflow, this is a fun and effective therapy activity.
Lip rounding is also targeted with a blowing activity like this. You can tell your student to use “oo” lips when they blow. Some students may need to use one hand to block goals. Others will be able to block by blowing.
Reluctant players like to choose which color ball to use. Any time you can give an A – B choice, a reluctant student will participate better. Yes – No choices can be a big shut down of activities!
“Do you want to play air hockey?” “No.”
“We’re gonna play air hockey. Do you want a red or white ping pong ball?” “I want a red.”
Ping pong balls are inexpensive, and a game of air hockey doesn’t even feel like work, even though everything your student does will be good for him during this activity!