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TOTs are restrictive tissues in the mouth that limit the movement of the tongue, lips, or cheeks. These restrictions can affect breastfeeding, bottle feeding, chewing /swallowing or speech development. We assess tethered oral tissues and create treatment plans for infants and children to improve feeding and speech skills, ensuring optimal timing and results for surgical releases if needed.

Dysphagia refers to difficulty swallowing, which can lead to coughing, choking, or food getting stuck. A swallow study may be needed to identify the cause, and therapy will focus on improving swallowing safety and efficiency.

When a child isn't gaining weight or growing as expected, it may indicate they aren't receiving enough nutrition to support their physical development. This can be linked to feeding difficulties such as trouble with sucking, chewing, swallowing, or sensory aversions.

Pediatric feeding disorders include challenges like difficulty sucking, chewing, swallowing, or accepting certain foods. Sensory sensitivities to texture, taste, or smell are common. Defined by the ICF, pediatric feeding disorders involve disturbances in nutrient intake that last at least two weeks and impact medical, nutritional, feeding skill, or psychosocial areas.

Tube/G-Tube dependency occurs when a child relies on a feeding tube for most or all of their nutrition. While feeding tubes are essential for ensuring proper nutrition, they can delay the development of normal eating and drinking skills. We assess and treat underlying feeding, swallowing, or GI issues to help your child gradually transition to eating by mouth, building confidence and enjoying mealtimes.

Children with limited diets may only eat a few foods, refuse entire food groups, or show sensitivity to textures or colors. Often linked to sensory sensitivities, oral motor difficulties, or past negative experiences, selective eating requires addressing underlying challenges to increase food variety and make mealtimes more enjoyable for the whole family.

Mouth breathing, caused by nasal congestion or enlarged tonsils, can lead to oral health issues, speech problems, and sleep disturbances. Addressing the underlying cause and retraining breathing patterns can support better oral function and development.

OMDs involve improper function of the muscles in the mouth and face, affecting growth, development, speech, and swallowing. These disorders can occur at any age and often co-exist with speech or swallowing issues. Therapy targets correcting these patterns for better oral function and development.

Oral habits like thumb sucking, nail biting, or prolonged pacifier use can impact jaw development, teeth alignment, and speech. Early intervention helps prevent long-term effects on oral health, and myofunctional therapy retrains proper oral habits for healthier development.

Oral motor delays affect the strength, coordination, and movement of the tongue, lips, and jaw, which are essential for feeding and speech. Signs include difficulty chewing, excessive drooling, or trouble managing liquids. We work to improve muscle strength and coordination for better feeding and speech outcomes.

If your child has a tongue tie, it is important to have therapy before and after surgery. Starting therapy before a release provides an assessment of baseline oral function, and also gives us a good idea of what we must work to improve, and whether all of those things are related to a tie or not. It allows the therapy team to determine optimal timing of release, reduce oral aversions, and reduce stress for the child and family. Additionally, therapy before the release also helps to prepare the muscles and begin teaching new muscle patterns and reduce tension in the surrounding muscle tissue. The release will "free" tight tissue, but it will not train the muscles of the mouth to do new things. Sucking patterns are learned in utero, so habits and movement patterns are often already established at birth (muscle memory). For optimal results retraining these patterns should start before the release, and continue post operatively until client and family goals are achieved Oral motor therapy and Myofunctional Therapy before and after a release is a lot like physical therapy before and after an orthopedic surgery; it helps to establish strength and teaches a new motor plan so the body has a better idea of what to do with the new range of motion after the procedure.

Aftercare stretches and follow-up visits are important to help the tissue heal properly and maximize tongue movement. If the tissue heals too quickly, reattachment of the tissue can occur.  It is important to find a release provider and therapy team with specific training in oral ties and function in order to provide you and your child the right aftercare and limit reattachment.

Children with sensory aversions often react negatively to certain textures, tastes, smells, or even the sight of food. Therapy focuses on reducing stress around new foods and broadening your child’s comfort level in a non-threatening way, making mealtimes a positive experience.

Children may struggle with speech clarity due to articulation disorders, motor planning issues, or oral motor delays. Our personalized approach identifies the root cause and enhances communication skills, improving speech clarity and boosting confidence.

The tongue can have a profound impact on the development of both the mouth and the teeth. For optimal orofacial growth and development, the whole tongue should be resting on the roof of the mouth, with the tongue tip 2-3 mm behind your top front teeth. When the tongue cannot fit in the roof of the mouth, or teeth are crowded/crooked, orthodontic treatment is often recommended. Typically, myofunctional therapy will improve the lasting outcomes of orthodontics by retraining oral rest posture, chewing, swallowing, and breathing patterns that were likely dysfunctional pre orthodontic expansion. Myofunctional therapy can support and improve the oral space. Starting Myofunctional therapy pre orthodontic treatment provides a baseline of oral function, and helps direct the type of orthodontic treatment your child may need. It can also help decrease oral aversions and prepare the child and family for the changes that orthodontic treatment may bring to the oro-facial complex. Basic lingual and labial skills, articulation, and jaw stability can be targeted while going through expansion. Generally we want to be working before the orthodontics are removed to ensure that the changes made with the expander will be maintained once the expander is removed. It is determined on a case by case basis to continue Myofunctional therapy with orthodontic treatment or not. Your therapist will help determine what is right for your child.