What is a “Tongue Thrust”?

Webpage.4 with icecream

YES, tongues need to pass beyond your lips to reach the ice-cream, but NOT in every day swallowing, eating or drinking!

A Tongue Thrust, or reverse swallow pattern, is referred to as an Orofacial Myofunctional Disorder (OMD) 

Lori Savage Grayson, MMSc, CCC-SLP provides Consultation, Diagnostic Evaluations, and SLP Intervention for OMD at Children’s Communication Center.

Q: What can a Speech-Language Pathologist (SLP) do for someone with an Orofacial Myofunctional Disorder (OMD)?

A: A Speech-Language Pathologist who has been trained and has experience with OMD is able to conduct an evaluation and determine the course of appropriate intervention strategies, goals and objectives. This SLP may also make referrals to a dentist, orthodontist and/or physician for related concerns.

Q: What evaluation/intervention strategies does Children’s Communication Center use for OMD?

A: Lori Savage Grayson, MMSc, CCC-SLP was trained specifically for OMD during her graduate studies at Emory University and has successfully treated hundreds of children, adolescents and adults over her 36 years in practice with a adapted version of this OMD program

Q: Can you explain more about an Orofacial Myofunctional Disorder?

A: Simply stated, this is commonly referred to as a “tongue thrust or reverse swallow”. This occurs when one’s tongue moves forward in an exaggerated manner during swallowing and/or during speech sound production. A person with a “tongue thrust” may notice that their tongue rests or goes beyond their teeth when speaking, when swallowing or when they are “resting”. Many people with tongue thrusts may also be mouth breathers.  

Q: Why do people have a “tongue thrust”?

A: This forward movement during swallowing is typical in infancy, think about how an infant pushing the food out of his/her mouth when just beginning to be fed solid foods. But eventually and in most instances, this forward swallow pattern decreases and it is replaced with a more mature swallow pattern.

Q: Why do some people retain their forward swallow pattern, also known as a tongue thrust?

A: There is no one specific answer, but there are factors which seem to be associated with a “tongue thrust”.  Remember, any behavior that increases or maintains the “sucking” pattern may contribute to OMD.

In toddlers or young children:

  • Excessive thumb, finger, or lip sucking, nail or lip biting behaviors.
  • The presence of an ankyloglossia, tongue tie, which limits the mobility of the tongue.
  • The overuse of sippy/spouted cups rather than progressing to an open cup for toddlers.
  • Continued use of spouted cups, sports bottles, or straws by children, adolescents or adults limits the use of open cups and may decrease the development and use of a mature swallow.

NOTE: A sippy/spouted cup is meant to be a transition from the bottle to an open cup.

In children, adolescents or adults:

  • Allergies leading to open mouth posture where the tongue rests more forward.
  • Enlarged tonsils often associated with allergies which increase mouth breathing and a more forward tongue position.
  • Nasal congestion which contributes to mouth breathing & the associated forward tongue position.
  • The presence of an ankyloglossia, tongue tie, which limits the mobility of the tongue.
  • An enlarged tongue due to heredity, allergies, or other factors.
  • Teeth clenching or grinding.

NOTE: Hereditary factors can be involved in determining the size of one’s mouth, the arrangement and the number of teeth, and the strength of the lip, tongue, mouth, and facial muscles.

Q: What are the negative effects of a “tongue thrust”?

A:  The presence of a “tongue thrust” may create facial asymmetries, speech sound production challenges, eating/swallowing problems (including difficulty handling one’s own saliva, “loud” chewing, poor chewing), and dental issues such as an open bite or other misalignments.

Due to the precise nature of speech sound production, some children, adolescents, and adults may also experience speech articulation problems in conjunction with their OMD. The speech sounds often affected are: /s/,/z/, “sh”, “zh”, “ch” and “j”, /t/, /d/, /n/, and /l/. These speech sounds may be produced incorrectly because of oral motor weakness/incoordination associated with the OMD.  However, not everyone with OMD presents with speech articulation (speech sound production) challenges. 

Q: How is OMD diagnosed?

A: OMD can be diagnosed by a Speech-Language Pathologist (SLP), dentist, orthodontist or physician. Many parents are the first to notice, have concerns and bring the concerns to the attention of professional(s) for evaluation.

Q: What professionals can help someone with OMD?

A: A Speech-Language Pathologist, trained and experienced in OMD will assess and treat the effects of OMD on speech sound production, rest postures, and swallowing. Lori Savage Grayson, MMSc, CCC-SLP has this training and experience and offers a successful OMD program.

Dentists and/or orthodontists are able to determine the presence of a constant, continued tongue pressure against the teeth and the interference on normal tooth eruption and alignment of the teeth and jaws. Excessive thumb/finger sucking may change the shape of the child’s upper/lower jaws and their teeth. This may require team involvement with an SLP, dentist and orthodontist.

Physicians are able to determine the presence of a blocked airway from allergies, enlarged tonsils or adenoids which often causes open mouth breathing and a subsequent forward tongue posture. Open-mouth breathing over a long period of time may decrease lip and tongue strength/tone further promoting a “tongue thrust”. Medical factors are usually addressed prior to or in conjunction with the SLP’s treatment.

Contact us to learn how we may be able to help your family! 

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