tongue thrust
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articulation disorder
articulation disorder
articulation disorder
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tongue thrust
In recent years, the relationship between swallowing and articulation has received much attention. A pattern of abnormal swallow is called tongue thrust. Orthodontists, specialists who treat people with misaligned teeth and upper and lower dental arches, are concerned with tongue thrust because of the belief that tongue thrust works against orthodontic treatment. While the orthodontist tries to move the upper dental arches back, tongue thrust is supposed to move it forward. Some speech-language pathologists are concerned with tongue thrust because of its potential association with articulation disorders, especially the frontal lisp. In the normal swallow, the tip of the tongue is placed against alveolar ridge, which is that portion of the inner gum ridge behind the upper central incisors. The body of the tongue then pushes the fluid or the solid into the back of the mouth and the upper throat. From then on, swallowing is mostly reflexive. During deviant swallow, the tip of the tongue is supposed to push the front teeth, often the upper central incisors. But the tongue tip may protrude between the upper and lower teeth and thus come in contact with the lower lip. During speech production, the tongue also may exert some force against the front teeth. Even at rest, the tongue may be carried more toward the frontal portion of the mouth. There is no satisfactory explanation for tongue thrust, though both bottle-feeding and thumb sucking have been blamed for it. There is controversy about whether deviant swallow causes articulation problems and whether correcting deviant swallow is the work of speech-language pathologists. Orthodontists often refer children with deviant swallow to speech-language pathologists for myofunctional therapy, which is treatment aimed at correcting tongue thrust. Some speech-language pathologists provide myofunctional therapy. However, there also are myofunctional therapists who are not speech-language pathologists. Many speech-language pathologists accept a referral from an orthodontist only when the client has a speech sound disorder, which they treat. Other speech-language pathologists may treat speech sound disorder and tongue thrust. More research is needed to determine the exact relationship between deviant swallow and speech disorders. Although finding causes of disorders is an important task for clinical scientists, speech-language services cannot wait until the scientists have completed their task. Therefore, when a child needs help with speech sound productions, the clinicians makes a thorough assessment of the kinds of problems the child has and designs an intervention program based on the results of assessment. Fortunately, a child's speech sound errors may be clinically corrected even if the original cause of the disorder remains obscure. Any obvious organic deviation, such as a cleft of the hard and soft palate, may be surgically repaired prior to, or along with, clinical speech services.
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