Tongue Thrust and Speech Development
Tongue thrust is a swallowing pattern in which the tongue pushes against or between the teeth. Accordingly, this type of swallow pattern is also referred to as oral myofunctional disorder or infantile swallow pattern.
The most visible characteristic is tongue protrusion during the swallow and at rest. There are other muscles that function incorrectly but are not easily seen. The incorrect resting position of the lips, tongue and jaw impact both swallowing and speech sound production. Additionally, parents frequently report issues with breast or bottle feeding from birth or express concern that their child has a lisp.
Tongue Thrust Eating Pattern
Characteristics of tongue thrust eating pattern:
- A lack of facial muscle usage or tensing of facial muscles
- Food particulates through-out the oral cavity after the swallow
- Incorrect tongue seal against or through the teeth
- Molars not making contact during the swallow
- A suckling pattern with cup or straw drinking
Common Behaviors
There are behaviors/etiologies that frequently occur with a tongue thrust. It is necessary to address these behaviors early in treatment. If behaviors are not addressed, it is likely progress will be impeded. Behavoirs include:
- Sucking habits; primarily thumb, finger, and extended pacifier sucking
- Open lip posture
- Mouth breathing
- Enlarged tonsils/adenoids
- Lip or tongue weakness
- Miss aligned teeth
- Allergies
Does My Child Need Treatment For Tongue Thrust?
Firstly, treatment focuses on obtaining normal action of muscle groups related to tongue movement and swallowing. This includes identification and elimination of unwanted oral behaviors, exercises specific to the patient, correcting resting tongue position, and teaching a correct swallow. In addition, a home-based program is a necessary part of treatment. In order to see success, the program must be completed several times per week (preferably daily).
The consequences of not correcting a tongue thrust pattern include:
- Speech problems
- Dental/orthodontic issues
- Appearance issues (open mouth posture, tongue protrusion, drooling)
- Lowered self-esteem due to poor eating habits (poor table manners/messy eating, taking extensive time to finish a meal, teasing by peers).
- Nutritional issues and health issues (limited food selection, poorly chewed food, digestive disturbances)
- Difficulty with oral transit leading to choking, aspiration
A child with incorrect speech sounds due to a tongue thrust will not correct error sounds without eliminating the tongue thrust pattern. For that reason, a speech-language pathologist can complete an assessment to determine if a tongue thrust is causing current sound errors or may cause future speech errors. Treatment to correct tongue position and movement can then be initiated to correct sound errors and/or prevent future speech difficulty.