This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Tongue-Protrusion in Toddlers
By Pam Marshalla
Q: I work in the Early Intervention setting and increasingly encounter late talking children (frequently boys) who prefer a frontal tongue posture. What’s the correction?
In my experience, this problem does not need to be fixed in a two-year-old boy who is delayed in SL.
First, tongue protrusion is normal in two-year-olds. Second, the child is late in talking and therefore should be using the pattern of a one-year-old.
The only thing I would do over the next year is to teach him to produce a good Long E (as in “eat”).
Long E is the first phoneme of oral stability. It sets the jaw in a high position, and the tongue in a rear position with the back-lateral margins elevated. And this sets the stage for all phonemes to be produced with the jaw high and the tongue inside the mouth.
Use words with Long E as the main vowel (eat, me, see, pee) and diminutives (mommy, daddy, doggie, kitty, horsie, birdie).
(p.s. My book Vowel Practice Pictures contains carefully organized lists of Long E words to use for practice 🙂 )
Thanks for the information I didn’t know anything about jaw sliding until my grandson was diagnosed with it he’s 4 and doesn’t speak to well he’s been in speech therapy for 2yrs he didn’t start saying words like mommy and daddy until 3 I’m a concerned grandma,any suggestions?
Hello. I am the Board Chair of the Oral Motor Institute . Pam was one of my great mentors and I’ll answer this question.
Jaw instability usually has two common causes 1) structural issues or 2) muscle weakness. It’s very important to have an evaluation with an oral motor specialist that can determine the root of the issue .
I’d recommend looking at two resources for a therapist that would have the proper training. TalkTools or The International Association of Orofacial Myology. Both of these organizations have a find a therapist feature .
I have a newly turned four year old boy who has the autism diagnosis that for some reason will gag when he sticks his tongue out upon request. We had his tongue clipped, and lasered after it grew back, for tongue tie along with his lip within the first year. He sees a speech therapist who noticed it for the first time today and is not too familiar with other cases. She believes that his tongue is disassociated so that it does not manipulate food with the tongue as it normally should when eating so that is probably why he gags every now and then during meals. Has anyone experienced this before and know what it means? He seems to eat snacks just fine but has always had meal issues in which he might gag on some items like broccoli, sweet potatoes, chunks in foods, etc.. But I figured that was a texture thing and didn’t think there might be something medically wrong with his tongue.
I have been in the field for over 50 years now and have watched the changes in oral control with the development of more and more pacifiers, large spouted cups, big square straws and continued use of bottles an thumb sucking.
For the first 25 years of my practice children’s tongues rested properly because they drank from open cups and their tongue and jaw stability matured as it should. Over the last twenty five years I have seen more and more issues that people are calling normal that are not normal. A typical two year old boy should be able to have his mouth closed and tongue resting inside where it should. When parents decide that a drop of water on the floor will not destroy their house and let their children learn like they should we will again have children who look like they are supposed to, sit in class with their mouths closed and don’t need extensive orthodontic work. Classroom teachers are noticing the change it is so dramatic. Don’t let what you are seeing now make you think it should be that way.
Hi, I’m a SLP and I didn’t know that tongue protrusion is normal in two-year-olds. I thought that it was hypotonia. Can you explain me why is it normal?
Do you have articles you can recommend to me with this information?
thank you!