Assessment of Tongue Thrust
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www.speech.com
Who?
A diagnosis can be made by any of the following:
· Orthodontist
· General dentist
· Pedodontist
· Pediatrician
· Otolaryngologist (ENT)
· Speech therapist
(ASHA, 2013 )
A diagnosis can be made by any of the following:
· Orthodontist
· General dentist
· Pedodontist
· Pediatrician
· Otolaryngologist (ENT)
· Speech therapist
(ASHA, 2013 )
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When?
Diagnosis is generally made when a child displays a dental or speech problem that needs correction. In many instances, an orofacial myofunctional disorder may not be diagnosed until the patient is under orthodontic care.
How?
A basic assessment includes an evaluation of:
Pertinent questions regarding these focus areas are addressed:
2. Oral-Facial Examination
3. Swallowing
People with tongue thrust will present with one of the following characteristics:
a) Tongue will come forward and make contact with the front teeth
b) Liquid will spill out the front of the mouth
c) Patient will throw head back to initiate the swallow
d) Patient will be unable to swallow without closing his/her lips (in a normal swallow tongue is placed on the alveolar ridge
to complete the seal)
4. Articulation
(Lee‐White, 2010)
Assessment Tools:
Ø Orofacial Myofunctional Exam with Scores (OME-S)
Diagnosis is generally made when a child displays a dental or speech problem that needs correction. In many instances, an orofacial myofunctional disorder may not be diagnosed until the patient is under orthodontic care.
How?
A basic assessment includes an evaluation of:
- Case History
Pertinent questions regarding these focus areas are addressed:
- respiratory issues: Is there any history of asthma, allergies, snoring?
- miscellaneous medical history: Is there any history of frenectomy or pressure equalization tubes?
- dental issues: Did this patient have premature loss of teeth or wear an kind of orthodontic appliance?
- eating habits: Is the patient a messy eater
- oral habits: Does this patient have a history of thumb/finger sucking, extended bottle/pacifier use? Is s/he a mouth breather?
- previous treatment: Was this patient ever treated for articulation or other speech impediments?
2. Oral-Facial Examination
- Structural assessment – observation of face, jaw, lips, tongue, teeth, hard and soft palates, pharynx. Digital pictures may be taken to record dental structure.
- Perceptual and instrumental measures – to assess oral and nasal airway functions as they pertain to orofacial myofunctional patterns (enlarged tonsils/adenoids)
3. Swallowing
- Complete swallowing evaluation – patient is observed while swallowing solid foods and liquids.
- Squirt a little bit of water in the patient’s mouth and part the lips with your fingers just as the swallow begins. In a normal swallow there will be posterior tooth contact, relaxed lips, and the tongue placed on the palate. Most abnormal swallows have the teeth apart with hyperactivity of the orbicularis oris and mentalis muscles in an attempt to create an anterior seal. The tongue may come forward over the posterior teeth.
- Payne technique – place fluorescent Orabase paste on the tongue at the dorsum, tip and both sides. Have the patient swallow. Using an ultraviolet light you can easily see the spots which the tongue has contacted. To make this more effective you can distract the patient and check them a second time so that you get a true unconscious swallow.
People with tongue thrust will present with one of the following characteristics:
a) Tongue will come forward and make contact with the front teeth
b) Liquid will spill out the front of the mouth
c) Patient will throw head back to initiate the swallow
d) Patient will be unable to swallow without closing his/her lips (in a normal swallow tongue is placed on the alveolar ridge
to complete the seal)
4. Articulation
- Speech evaluation - as a result of tongue thrust, some patients incorrectly articulate sounds like /s/, /z/, “sh”, “ch”, and “j” because their tongue slips out between the teeth. Other sounds like /t/, /d/, /n/, and /l/ may also be produced incorrectly because of weak tongue muscles.
- Observation – the SLP will evaluate production of normal conversational speech.
(Lee‐White, 2010)
Assessment Tools:
Ø Orofacial Myofunctional Exam with Scores (OME-S)
![](http://www.weebly.com/weebly/images/file_icons/pdf.png)
OMES Protocol | |
File Size: | 224 kb |
File Type: |
Ø Nordic Orofacial Test Screening (NOT-S)
![](http://www.weebly.com/weebly/images/file_icons/pdf.png)
NOT-S Protocol.pdf | |
File Size: | 100 kb |
File Type: |
Ø 3D Ultrasonography – provides an objective assessment of tongue posture