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 Thrust Following the Swallow
By Pam Marshalla
Q: My friend’s daughter has a tongue thrust (the tongue pushes forward after the swallow). The orthodontist gave her one technique–– holding gum on the roof of her mouth while she swallows. Do you have any other ideas for tongue thrust techniques for a very typically developing 2nd grader?
First a few words about the general nature of this question: Asking someone for ideas about teaching a correct swallow is like asking someone for techniques to fix an articulation error. There are many interwoven ideas that work together, it is not always a quick fix, and a professional should do the work. A professional who does swallowing therapy should do this work. Thrusting the tongue after the swallow may only be the tip of the iceberg for this child. She may have a forward tongue carriage all the time, she may be avoiding certain foods, she may be munching instead of chewing, she may not transfer food from side-to-side correctly, etc…. the list goes on and on. Her swallow should be evaluated and a treatment program should ensue.
But let’s assume that it is true that all she does wrong is thrust after the swallow 🙂 Then all she needs to do is learn NOT to do that.
Get her in front of a mirror and show her what she is doing that is different than most. She doesn’t need the gum if she is only thrusting at the end, but it makes for an amusing activity. The piece of gum needs to be very small, and you have to make sure that the presence of the gum is not throwing everything else off–– lip position, jaw position, etc. I would prefer to use something much smaller: Like a piece of knotted dental floss situated between the upper central incisors so that the knot sits right behind the teeth at the alveolar ridge. Another tiny tool to use would be a dental pick.
Basically the child needs to learn to go from oral rest position to a correct swallow, and then go back to oral rest position again. If you understand the correct mature swallow, then you are teaching her that. Use the knotted dental floss or dental pick to teach her to keep the tongue-tip in the right position.