Tongue Lateralization and Protrusion

Posted by Debra C. Lowsky, MS, CCC-SLP on 26th Sep 2011

Question:  Do you have a tool to increase tongue protrusion and tongue lateralization?


We do!  ARK's  Oro-Navigator was specifically created to help individuals "get" the concept of tongue lateralization.  It's very easy to use.  Simply place the cuff on the side of the tongue and guide the tongue from one side of the mouth to the opposite side.  Then repeat on the other side of the tongue.  This allows the individual to feel what their tongue should be doing.  Use a mirror for visual feedback so that they can see what their tongue is doing as well.

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Tongue Lateralization & Protrusion

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To establish the concept, you can also do trunk turning exercises.  Sit on the floor with the child between your legs.  Place items to the right and left side of the child (within their reach).  Have the child take their right hand and reach over to the left side to get the item.  Repeat to the other side.  Have the parent do this with the child for home practice.

You can also stroke the sides of the tongue with the Probe or Z-Vibe to stimulate lateralization.  Stroke one side five times, then the other.  Or, you can alternate sides to simulate lateralization. 

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Another exercise for tongue lateralization:  place the tip of the Probe or Z-Vibe inside the cheek area to one side.  Have the child touch it with the tip of their tongue.  Repeat to the other side.  Do about 5 sets. 

For tongue protrusion: if the tongue is too far back in the mouth, stroke the tongue from front to back to relax the tongue and have it come forward slightly.

All that being said, the need to increase both tongue protrusion and tongue lateralization raises a red flag for me.  It sounds as if there is a larger problem at hand here, possibly ankyloglossia (tongue tie).  A few factors to consider are the following:

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•  Can the individual extend his/her tongue OUTSIDE the mouth to lick an ice cream cone or lollipop?  Or, does he/she position the food inside the oral cavity, compensating for the inability to extend the tongue for licking?

•  Have the individual open his/her mouth wide and position the tongue tip up to the alveolar ridge (the piece of skin behind the upper front teeth). Can the tongue reach that spot?  Is the individual closing the mouth in order to reach it?

•  Is the individual speaking with a more closed mouth?  Elevating the tongue to the alveolar ridge is how we produce the tongue tip sounds t/d/n/l/s/z.  If an individual cannot properly elevate the tongue, his/her speech will be affected.  Observe carefully, as the individual may be compensating by making these sounds with the tongue tip behind the bottom teeth instead.

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Without seeing the child, it's difficult for me to accurately assess the situation.  I would refer to a medical doctor such as a dentist or ENT, who can work in conjunction with an SLP to diagnose this case.  If there is ankyloglossia, the parents will ultimately decide what they want for their child.  I hope this information points you in the right direction.

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All my best, 

Debbie

Debra C. Lowsky, MS, CCC-SLP

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