Traditional speech therapy often looks at the problem as a behavioral issue - i.e. the child cannot make this sound, so we will teach the behavior (the sound). There absolutely are "typical" speech sound disorders where the child's only issue is the sound production, but very frequently, there is a missed etiology, or at the very least, contributing factors to the problem. Many children who struggle with speech do have tethered oral tissues and/or an orofacial myofunctional disorder. This is why, at Little Loon Pediatric Therapy, LLC, we believe in looking at the child as a whole.

Any evaluation for speech includes the following when appropriate:

• Case history collected via intake paperwork and parent (and child) interview

• Traditional articulation testing involving standardized testing and spontaneous speech sampling

• Assessment of the orofacial complex including appearance and structure of the face/dentition, airway, swallowing, and tongue within the speech-language pathology scope of practice

Tethered oral tissues and orofacial myofunctional disorders do not always cause problems with speech. These issues can manifest in any or multiple of the following ways as well, though this is not an exhaustive list.

A myofunctional assessment may be beneficial if your child suffers or has suffered from any of the following symptoms:

• Nursing or bottle feeding issues (shallow latch, poor weight gain, poor milk transfer, lip blisters, milk leaking from the mouth, gagging, excessively long feeding times, poor suction, maternal nipple pain, misshapen nipples, low milk supply, recurrent clogs/mastitis, etc.)

• "Colic" as an infant

• Trouble transitioning to solids (excessive gagging, vomiting, etc.)

• Picky eating/food texture preferences

• Disordered/tongue thrust swallow

• Poor chewing, stuffing the mouth, messy eating, chewing with the mouth open, etc.

• Noxious oral habits such as thumb sucking, nail biting, pencil chewing, etc.

• Open mouth rest posture/mouth breathing

• Dental malocclusions

• Poor dental health

• Temporal mandibular joint dysfunction

• Chronic neck/back tension and/or pain

• Sleep issues including snoring, upper airway resistance syndrome, apnea, restless sleep, frequent waking, etc.

If your child is found to present with dysfunctional symptoms related to their airway, hearing, oral ties, dental health, body tension, sleep, or other areas of concern, Little Loon will make the appropriate referrals to additional professionals in order to ensure your child is getting the help they need in all areas.