Orofacial Myofunctional Therapy with Lily: Myo Week 1

Hey, guys. All right, so it looks like a lot of you are interested in following Lily's MYO journey. So maybe what we'll do is. Okay, I have to ask Lily her permission for this, but I think she'll be totally down. Is maybe we'll record us doing a MYO session with Lily every week so that you guys can actually observe myofunctional therapy with my child, who is four and a half. She. I would say cognitively, she. She might be a little bit ahead of a four and a half year old. She is pretty pretty with it. So, you know, I haven't officially tested her. I will say I have done assessments on her in the past because I was curious, and I have them here since I have private practice. But I've not tested her cognition anytime recently. So I can't say for sure that she's cognitively ahead of a four and a half year old, but the girl's pretty with it. So we're doing MYO with her. And we typically say that myofunctional therapy is best done with a child who is at least four years old cognitively. We say that because there are certain parts of the program that require the child or adult or person who's participating in MYO to understand and grasp what they need to do both cognitively and then physically. Right. Carry that out with the anatomy that you have in place. And that can be challenging sometimes. You know, MYO is not just wagging your tail side to side, sticking it out, elevating it up and down. There is much more that goes into mayo. And I'm going to explain the program that I use. And it's actually not a program I've created. It is somebody else's program. So we'll jump into that in a second, but. And I'll kind of break down the three phases. I'm going to make it very simple for the purposes of this video and kind of give you an idea of what I do, how I do it, and why I like the program that I use. That said, there are people who feel you can do myofunctional therapy with younger children. I will admit that in my practice, we modify our MYO program for younger children and have them participate even around, like, the age of two, in certain activities. But some would argue that that's more oral motor work. And so I don't get too much into, hey, guys. Hey, everybody. Who's joining? Ivana. I see tiny, mighty voices. And Barbara. Hey, Gu. I don't get so much into what I Call it per se, personally, that's my own thing. But I will tell you that when I'm doing oral motor work with a preschooler or a child who's able to imitate and copy, I am, hey, thanks for the waves. I am modifying things from my MYO program. And so one could argue that it's more oral motor work or it's modified. I like to call it modified myo. And then when we're talking about babies and those little, little ones, you know, it's often there are a lot of things that we do passively for them, but there's also things they can do actively. And so, depending on your approach and what you're using and what other methods are combined in the therapy you might be doing, you know, some will argue that you can do MYO with infants. So I'm not here to have that debate for purposes of this video. And what we're planning to do is I want to show you guys myofunctional therapy with Lily. Hey, my MYO health. And Ivana said she just listened to the podcast with Michelle and she's mind blown. That's awesome. Michelle is so easy to talk to. I love her dearly. She definitely does. You know, baby MYO and MYO for toddlers, toddler MYO and all that fun stuff. But, you know, I think it's really interesting to hear her approach and hear how she's approaching the MYO from her end of things before we kind of start to get into that debate of like, oh, is MYO for babies or toddlers, or is it just for four and up? And so my whole point of the intro here is just that. Hey, my whole point is that what I'm doing with Lily is my traditional MYO program. She is four and a half. She's had an ALS device in her appliance, I guess you could call it, in her mouth since August when she turned four. We put it in. I have a super awesome doctor, Dr. Jennifer Tippograph, gonna give her a little shout at Natural Dentist Associates in North Bethesda, Maryland. And we figured, you know, let's give it a try. Let's see what happens. And so, because she is so young, we've actually noticed that she's making really great movements anatomically. We're seeing that palate widen. The tongue is. Has got more space, you know, to rest in the top of her mouth. But she's got a lisp. And I don't feel that a lisp is a lisp. Is a lisp or something. That we can traditionally treat in speech therapy without myofunctional therapy. I said it. So it is my belief that a lisp happens because there is an orofacial myofunctional disorder and OMD in place. There's a reason why that tongue is pushing forward. And I also want to clarify that a lisp is different than that tongue forward posture that you want for feeding. When it comes to infants who are breastfeeding or bottle feeding, right when their tongue comes forward and rests here, because that's where it needs to be, and it cups to, you know, then pull and draw in a bottle nipple or a human nipple. That's a whole different discussion. But I'm not talking about that. That's very different than a child whose tongue, even in infancy or at birth, is here or here between the lips or here, or the mouth is open, the tongue is down, and when they speak their, you know, the tongue is coming forward for S's and, you know, it's supposed to go between your teeth for th, but not for any other sound. And that even is the case in early development. So I want to kind of clarify that, you know, a lisp is a symptom of an orofacial myofunctional disorder. It's a symptom of something else. Something is causing that lisp. And I'm going into this because Lily has a lisp. And every. Even though my little Lily has amazing speech and she was producing speech pretty clearly as a infant going into toddlerhood, to the point where the University of Maryland I sent one of my instructors because she came over and taught and did a CEU event for my team. She heard Lily speak and she commented on how clear Lily's speech was. And I was actually testing out the new Golden Fristo for my own purposes. And so I offered to test to give Lily the Golden Fristo and record her saying the words so that students could transcribe her because she had some sounds we would not yet expect for a two year old at that point. Or maybe she was 18 months old. Gosh. Yeah. I mean, this was probably three years ago. And so we recorded her because she actually had a lot of advanced sounds, but then she also didn't have other sounds that she shouldn't have had yet. And so it was just a really cool opportunity to record her. I'm sure I have that recording somewhere. But she's always had very advanced speech and language skills. And so. And yes, I have done language testing on her so I can say that poor child was getting like the Pls and the Rossetti and all those things done to her like way early on. And I was doing it like once a year. And I have not done it recently. But she's got pretty advanced skills, which is. It's fun as a mom, right? But then you see this kiddo who's got an OMD and a lisp. Haha. Jokes on me, right? Tongue tie and picky eating for the mom who's a feeding therapist. Now I'm a myofunctional therapist, which I got into because of her. And now she, you know, we've corrected that tongue tie. We are doing expansion. She's got a nice closed mouth, you know, oral rest posture when she's not sick. If she has a cold, obviously she starts to do a little mouth breathing when she's congested. But she doesn't get sick as often anymore, which is interesting. With that ALF in her tonsils have gone down in size. They do flame up a little bit when or flare up, I should say get inflamed when she has a cold, but much less frequent than in the past. And that could be a combination of, you know, I can't say that's definitely because of the alf, but it could be a combination of. This is her third year in preschool and so she's developed a lot of immunity, Although we all know there's different strands of illness that goes around every year, especially with flu and all that fun stuff. So I will say that we are thankfully pretty healthy over here. Just a little cold that doesn't last too long, thankfully. And yeah, so my goal with her is really to get that tongue right. Like I tell. This is what I tell my patients. There's two main goals for us in our myofunctional therapy program. And that is one, oral rest posture. Right. We want correct oral rest posture. And two, we want correct posture, oral postures for swallowing and so. And some could argue. Okay, speech as well. I'm going to tell you, I do not typically treat speech directly until we get to the second phase if it is still an issue. And my program is three phases. Thanks for all the hearts, guys. I love it. So I use Sandra Holtzman's program. I studied with her when she was still part of the iaom. She is no longer. She is now out on her own and still teaches. So if you're interested in learning, the IAOM is who certifies me. But I did learn through Sandra. And so, you know, two really great avenues you could go to get your. Your Learning on, from, from like an intro to myo standpoint. There's also, you know, some other wonderful teachers who are teaching courses in the iaom. But I use Sandra's program, and I love her program because I have a rule of three. I like to break things down in threes because I think that it makes it very easy one, for our patients to remember. Okay, there's three things I need to remember. And I actually used to tell them that there were three goals for myofunctional therapy, and I kind of nar it down to two. But, you know, it doesn't really matter, matter how you pose it, as long as they understand why they're there and what the goals are, Right? And obviously, when I write out goals that they might be submitting to insurance because we're private pay, but they might submit their super bill and their treatment plan and our weekly notes and their assessment, you know, the report, there's more goals broken down in there from an insurance and treatment standpoint. But from what I tell our families, I basically tell them like, this is a three, three phase program. Phase one, we're breaking everything down. We're making sure everything can work independently and properly. And if you saw my posts last night that are still up in my Instagram story right now, and we'll save that to one of the Instagram folders, I don't remember, like, I am so, like, not like a social media guru, guys. So bear with me because you will see me all over social media. I'm getting better at it. But my lingo, I make up my own words. So I will save those though, because I think they might be helpful. And we'll, we'll do like a. Maybe we'll do like a week one, week two, week three, and kind of put it all in one folder so you guys can kind of see her progression that we share in Instagram stories. So highlights. Thank you, Lola. Yes, the Instagram highlights. I told you. I told you. I just got an Instagram, like this summer. I had an account, but I've really only been posting things since, like, I don't know, August, when I started, when I was on vacation at the beach, that's how I got into Instagram. So anywho, I tell them three phases, right? And so phase one, we're breaking it down. And that's what you saw me doing with Lily, was starting to break down those individual movements. We want to make sure that the tongue can work independent of the jaw, independent of the cheeks, the lips. Everything is working independently of each other and that once the tongue is working independent of the lips, the jaw, the lips, the jaw, the cheeks, and even the neck and the shoulders, right? We want to make sure everything's working independently of each other. That's phase one. That's why we break things down. Phase two, we pull it all back together, we make sure everything is working functionally and then we start to reintegrate like food and water into so that it is truly functional. And at that point, if a family is very adamant about working on certain speech sounds, because I'm a speech pathologist, I might then add in some speech sound work. Now I get, if you're an RDH or DDS or somebody who is not a speech pathologist doing myo, that's going to be out of scope for you. So you likely will not do that. The good news is a lot of my kids who have lisps or who have, who have other speech sounds that may be tied to what's going on, you know, as an OMD or a tongue tie or whatever the case may be, a lot of them have improvements in their speech as a result of the MYO program. Right? Because then I tell parents, you know, once we get to phase three, we have, there's no new exercises or anything. It's, it's habituation. We are looking to habituate. And again, guys, I learned this from Sandra Holtzman. This is her program that I use and it works beautifully. So I love it. And while it is a program and there are phases and there are, you know, MYO exercises that you do throughout, not everybody gets the same exercises. Not everybody gets does that same program. I have adults who have graduated in six weeks. I have adults who, you know, teens who have graduated in 12 weeks or 16 weeks. I have some that have tape, you know, I've got some younger kids that have as well and I've got some that have taken a year. It really depends on what you're coming to me for. What else is going on? Like what, what therapy have you had in the past or not had? How old are you? You know, how cognitively with it are you? Because obviously my AD who are far beyond the age of a 4 year old cognitively are able to very quickly see what I'm doing. It might be kind of strange or hard to do the first time they try, but even within that session they might be able to get something. I might give it to them for homework to reinforce something. But I'm not always doing that because I realize, well, wait, they already have the skill or they are able to get it really quickly. Let me get them something else that's a bit more challenging for them to work on at home. That reinforces what we just worked on and what I just tried to elicit from them that they were eventually able to get within the session. But. But for time purposes, it's not a cookbook recipe. It's not like, oh, hey, this week you get these three exercises, and next week you get those three, and the week after that you get those five. That's not how my therapy operates. My therapy operates on. What are we looking at? What is our end goal? What's the fastest way to get you from point A to point Z without necessarily doing everything in the program? Right. It's all here because it can be used, but it doesn't mean everybody needs it. It's not a cookbook. But what we're doing in that third phase is habituating. Right? We want to make sure that whatever you have learned, all of those newly learned skills are now becoming new habits. Because if we don't make it a new habit, guess what's going to happen? Everything you learned is for nothing. You're just going to go back to, you know, that frontal, lateral, whatever the lisp is that you have in place or swallowing with a forward. A forward swallow. Some people call it a backward swallow. I actually say the tongue is coming forward because you're pushing it. It's protruding or it's pushing against the teeth, whether it's the top or going in the middle or pushing against your lower, you know, central incisors or whatever. The whole purpose here is habits. New habits need to be created. I actually, even though that's phase three, and that's how I pose it, I start those new habits much earlier on in the program. So by the time we get to phase three, it's like, oh, yeah, hey, by the way, we've already been doing all of this, but now, so let's work on integrating it into your daily life. Make it super functional and make sure it's something that we can habituate, you know, pretty quickly. So, you know, that's a little bit about my program. That's what I'm going to be doing with Lily. So what you saw last night was we were trying to, you know, get. Just work on tongue protrusion, make sure it goes straight out without hitting the teeth. She's got that. We want to lateralize without jaw movement. And I'd also like to see her do it inside the cheeks. Okay. We want to make sure. She can go up and down. She can do all these things. So we were kind of just doing that to show you guys the videos because we were messing around and having fun. She's got that down. What she and I are working on is trying to gain better control over her tongue and change the shapes that she's able to make with her tongues. Change the patterns, change the, you know, basically wake up those muscles and have them do some new things. Build stamina and strength. And so her two things that we're working on right now this week are creating that tongue bowl and then also skinny wide tongue. Okay. And I've been doing this for a long time. Skinny white is really hard for a lot of people. So it's something a lot of people go, I can't do that. Do I have a tongue tie? No, it doesn't mean you have a tongue tie. What I often tell parents of kids in my programs too is you might try to do some of these exercises to help your child. And it's. You might have a hard time doing it because one you. If you don't have a functional impairment, you don't need to break things down into these movements that we're doing right now. That's not important. Not everybody needs to be able to do that. So I put that little disclaimer in there. The last thing I'll say is that Lily's a super trooper and she's willing to try and do anything. So we're gonna have fun with this. And we're. Another thing I'm thinking about doing is, you know, while we'll have some like, myo Mondays, maybe Tots Tuesdays, and thinking about throwing in like a little what would Hallie do Wednesday? I'm coming up with this off the top of my head as I'm speaking right now. Maybe we'll even do like a foodie Friday because we try to. I try to integrate something new also, food wise, into her diet because that's part of her profile and part of the functional impairment is that she's a pretty picky eater. She's. I don't like to use the word picky. You'll see me use it a lot because that's what a lot of parents will use. And so that's what resonates with them. But she's pretty selective. And while she does eat a variety of green vegetables, we cannot get her to expand her proteins very easily. That's something that we're working on and, you know, and breaking out of her current, you know, set of foods that she would literally eat every single day of her life if we let her without, you know, so anyways, we'll. We'll probably post some fun things that I do with us cooking in the kitchen and just trying new things and adding one new thing, you know, so you guys can get some ideas of what I do. Because I, as a mom and not your. I don't. I don't know how I come off because I do have people helping me online. But I will tell you, we are messy. We are. We are real. We don't have time to be those Pinterest moms who create these fancy, beautiful. Or, you know, we eat organic. I will say that. But, you know, when we're in a restaurant, we eat in restaurants, so we do do that. But when we're at home, we eat organic most of the time. It's gotta be functional. It's not, you know, you're not gonna see me creating these fancy Pinterest meals and everything. So if I'm sharing things about, like, Foodie Friday, you know, it might be like a foodstirs organic box mix and. Or we might be making a pizza with some organic naan that we're spreading some sauce onto, some organic sauce onto. I'm not making all that homemade, so just know, like, if you're following me, this is real life and I'm using organic things. They're not all homemade. But we will show you what we do here. You can do what works for you, and hopefully it gives you some good ideas because part of, you know, her expansion goals and her myofunctional goals are to, you know, we want to make sure we also expand what she's eating at the same time. So, you know, join us for that. And I will even say, like, she's a kiddo who used to love pizza and now in a lot of restaurants does not like the red sauce. We try. She did try one the other day here. I think it was like the organic pizza sauce from Whole Foods, and she liked that. So we maybe will make some pizza with that this week and share that. But yeah, I, you know, my goal is to keep it real. So if you guys have any. I don't know if there's any questions. I do have to hop off in a few minutes to get on a training call in about eight minutes. Thank you. I love the podcast too, so I'm so happy to hear it's so well received. I was just looking, and I think we have, like, over 21,000 downloads since, you know, I Launched it, which is super exciting. I don't know what normal podcasts get. I have no idea if that's like, you know, a good number or not a good number or whatever. But for me, I would like to know that we have 34 episodes that have been downloaded 20,000 times or 21,000 times. Like, holy cow, guys, that's awesome. So thank you guys for your support. If you and tiny mighty voices, us moms, you know, we got to stick together. Yeah. Our kids definitely challenge us. You know, it's like, raising a kid is hard enough, and then you add on the additional levels of things like eats and speaks. Hey, girl. Thank you. Yes. Speaking truths. Totally speaking truths. And when it comes to the podcast, guys, if there are people you want to hear on the podcast, can you let me know? Can you drop your. You know who? I wish you had X, Y, and Z people on the podcast, or if you've got a story to share or you're like a fellow myofunctional therapist or feeding therapist or somebody who would love to, you know, ENTs, dentists. I'm forgetting a whole slew of people. But if you want to be on the podcast, if you've got a message or a story to share or you think there's something that people need to hear, you know, it's. It's a platform, and I want to share information that people are seeking because that's the whole purpose of why I started. It was like, one to educate and get that information out there to make sure that it's easier for people to access this information and not make mayo and tongue tie such, like, a taboo topic. Right. I want it to kind of be more mainstream and something that people realize, like, hey, yes, there's a problem, but, hey, there's something we can do about it. Right. And it's not. It's not that big of a deal. Like, let's, you know, early intervention. Let's start earlier. Or, you know, it's never too late. Like, yeah, if you're an adult or you're a teen, we can still help you, too. So, yes, I have asked some Ents, and to be honest with you, I've asked a couple Ents, and they are so busy that they have turned me down. So if you know of any Ents that could be on the podcast or, you know, Ents that, you know, and. And I'm really looking for those, like, airway centric Ents who get it, who, like, totally get Tots on a certain level. So, yes, definitely, you know, send me some more suggestions and we will, we will ask if we get enough people asking for one particular person. I'll also forward a screenshot to them and tell them that they're being highly sought after and they should definitely hop on the podcast. But yes, I've only been turned down by two people and they were both ents because they say they're busy and they just don't have time to do it. And I don't have an ENT in the D.C. metro area that I work very closely with at this point. So I would love to. Would love some people to let me know who they know in entwise. And the DMV that is tot savvy and airway centric, you know, definitely share that too. Yes, Ivana, absolutely. But I think with the level of like, research and everything he has going on right now, he said he didn't really have time to record a podcast, but I will ask him again because I asked him last summer and maybe things have changed. Let's see. My myo health says how to speak out, despite the cynicism, how to stay thick skinned. I'm gonna snap a screenshot of this right now. Perfect. Okay. That way I can remember. Yeah, girl. I mean, it's a real problem, right? Like, you have got to speak out and you've gotta. I'm kind of of the mindset that I'm gonna come here, I'm gonna deliver what I know, I'm gonna deliver what I see clinically. I'm gonna deliver what I do on a daily basis. And I'm gonna do that despite what all the naysayers say. And I just, I don't care what other people think of me. There, we've said it. I don't really care so much. What. I mean, here's the thing, right? I know what I'm doing is I'm helping people. Whether it's helping a patient improve their life and their, you know, the issues that are caused by their OMD or the ties or speech issues or feeding issues or whatever. Whether I'm helping other professionals by creating a course that we're working on for feeding therapists or offering a free tool like offering that fee, the free feeding screener that I have. And I'll link that too. So you guys have access to that if you haven't seen it yet. Whether it's hopping on here and just, you know, sharing my journey with my own daughter as a mom of a patient of a child, sharing my journey as a mom, which I haven't done much of lately, but maybe I should as a mom and a patient because I'm also undergoing expansion and I've shared my tongue tie journey, but I haven't shared much on many updates on my own dental work as of late, so I can definitely do that too. But I'm real. This is me. You get me. I always say to my child, you get what you get. You don't get upset. Okay, yeah, whatever. Like, you can get upset if you want, that's your choice. But it's also what I tell my child. You have a choice. You can be upset if you want. But I'm real, guys, this is the real Hallie. What you see is the most fake thing about me is maybe the makeup I put on my face because, like, hi, I might not look this alive and awake if I didn't have makeup on, but you're getting the real me. So, yeah, I can definitely talk about that because I think for me, the benefits of helping my patients and helping myself and helping my child and helping you guys far outweighs any cynicism, criticism, naysaying, any of that stuff. And maybe I naturally am just thick skinned, but I just don't let this stuff bother me. I have had people who are big names in this space come after me for things that either I didn't say or I didn't do. And you don't see me posting that stuff on social media because I just don't care. I'm kind of like moving my attention somewhere else because there's people I can help and people who do need me. And so that's where my focus goes is on you guys and on my patients. So I hope that helps a little bit. If there's specific scenarios. Totally can answer questions. So you guys can always send me a DM with your questions or if you have questions or topics you want covered on the podcast. Like I did two recently, which actually I think you guys really enjoyed because there seemed to be. And I have to hop off in like one minute. But I shared one about my process from like getting somebody in the door as a referral to graduating them. Like kind of what that process looks like from a myofunctional standpoint. Just like the processes themselves from like a business side of things. And I also shared what was the other thing I shared. Oh, I talked about like snoring and airway and sleep and all that. And I love doing that stuff because this is stuff I do with my patients all the time. So if there are topics you want to hear me speak on. I don't have to have a guest on the podcast to speak on these topics. I can totally do more episodes for you guys, just answering questions and focusing on topics that are of interest to you. So drop that here or send me a dm. We'll work on more of that. I gotta hop off because it's 4 o' clock and I have a training call that the zoom that I need to get on from my own personal development kind of stuff. Love you guys and we will chat soon.