Orofacial Myofunctional Therapy with Lily: Myo Week 2

Alright, so we are doing our exercises. Nice job, Lily. Lily was being silly, but now she's doing it for real. And you'll see that her face is nice and relaxed. There's no tension in her forehead or her cheeks or anywhere. Drop your shoulders down. Now you're just kind of pushing up on my legs. But we want to make sure the whole body is relaxed when doing orofacial myofunctional work, because the whole goal is that the tongue is working independently of everything else at the moment at least, Lily's goal is that. And we have to make sure that there's no tension carried anywhere. And that includes everything from the face, the neck, the shoulders. Put your shoulders down. Thank you. Okay, so she's doing that on purpose because you think she's funny. But we want to make sure that they have nice posture, that their shoulders are down, and that the face is nice and relaxed. So that's very important while we're doing our exercises. Right, so she's showing you how she can suction her tongue and hold it. And she can hold that for probably a good two minutes, which is awesome. Nice work, kiddo. All right, so the next thing we're going to do is we're going to see how that tongue is working independently of the lips, the jaw, the cheeks. So what we're going to do, Lil, is we're going to. You ready? We're going to stick our tongue out, but we're going to open our mouth wide first and then stick it out without it touching. Good. You got it. So that was really hard before. She can do that 10 times. But for the purposes of this video, we're just going to do it the one time. Really proud of you, kiddo. Now the next one we're going to do is a little tricky last time, and we haven't practiced this one that much. So we'll see what happens. But we want to see. When we open the mouth, can we get the tongue to lateralize side to side without the jaw moving? We have to keep that jaw in place. So first open. Wait, stop, stop, stop, stop. Open your mouth wide. Hold it open. And now do it so we can see. It's still challenging for her. And again, we have not practiced this one. So I'm going to help you. Mama's going to hold it. You move your tongue. Ready? So she's fighting me. She's trying hard to move that shot. Really doesn't want to move. It really wants to do it again. Show us how you do it. So it really wants to move all as one unit. And that's how you can see that the tongue is still not working independently of everything else. Because you see the tongue here is moving together with the jaw. That is our cue that we have some more work to do there. So this week Lily and I will be working on taking what she's doing and trying to transform it into this. Alright. First we'll give chin support, then we'll back it off and just see if we can do it without it. All right, girlfriend, stop chewing on your tongue. Alright, so now what's the next thing that we need to work on? We did tongue out last week. We showed them how you can go up and down. Can you show us tongue the spot? Uh huh. And then drop it down behind your bottom teeth and up. So you can see she actually is able to do that really well without using her jaw. So that she's stabilized the jaw there. So we're getting there. We'll get there with the lateralization too. Lateralization tends to be pretty hard for a lot of the kiddos that I work with. I'm sorry, I wasn't really hitting you. I'm just tapping your leg because I'm proud of you. Lateralization tends to be really hard for a lot of the kids that I work with. And they're so used to putting food in on one side of their mouth and biting down and just chewing and chewing and chewing and keeping it there and then. Or mashing. They might not even be doing a real chew, but mashing and swallowing back foods that are just easy to mash and mix with their saliva, they're able to carry back. The reason I say that is because so many of my mayo kids have limited diets and eat foods that are easier to break down occasionally. We have an anomaly in there where like mom will say, oh, they love carrots or oh, they love, you know, certain crunchy foods. But they're often a lot of my kiddos. You like carrots? Yes. They often don't like, like grilled chicken or grilled beef because it's harder to chew and it takes a lot of work and it's very fatiguing to your oral structures if it's something not easy to do. So it almost seems like it's not worth it. But I do have some kids who power through or parents who just cut the small to make it easier for them to eat. All right, so what else, Miss Lily? The bowl. Let's see your tongue. Bowl. There we go. Nice job. So she is shaping a better bowl show us that again. Uh huh. And we're getting the front of the tongue to come up. It's a little tense. I would like to see the sides come up a bit more. Show us that one more time. Uh huh. Good job. So that is making nice progress. We will work on that for the next week because I would like for the tongue to be a little bit more relaxed so that when she makes the ball the. It's not. I actually do it when I'm five. Oh, you're gonna wait. Well, you're not till five, till August. So we're gonna work on that now. That's four. Count your fingers. Yeah, that's five. So she's doing more of this and I want her to do more of this. So we want the tongue to be a bowl shape and we want that bowl to be pretty even around the lateral edges up to the point the tip of the tongue. Yeah, show me. Uh huh. And she's getting there. She's definitely getting there. We want to relax the sides of the tongue. So one trick that we can use is you can take your finger and sometimes just help to shape it a little bit or a tongue depressor. And of course I don't have one with me right at the moment downstairs, but a tongue depressor, you can take it and I like to take it and I just push down on an angle like this with a tongue depressor and have them shape that bowl around it. And after we do that, take the tongue depressor out and see if they can hold it and maintain. So she and I will be trying. Let's see, did that work? Oh, there we go. There you go. You're getting a better one. There we go. We got more lateral borders rising on the side there. And that's really, really common that when they take typically start. I see this, they bring it up in the front, but those sides don't come up. So we were often working to get the sides of the tongue up too. Nice job. And the reason that that is important is because when we prepare a bolus, which is our chewed food mixed with saliva, it's supposed to be in the middle of the tongue, Right. Once it's prepped and ready to swallow, we put it into the meliton. We basically make a bowl. But then we suction that bowl to the top of our mouth to our palate. And when we do that, we need enough room for the food in the middle. That's where you get that bowl shape. But the sides of the tongue need to Come up, and they need to make contact, not just the front of the tongue, because it has to create that negative pressure. So we can swallow, and we can push the bolus back. Right. It kind of does this little. It's like this peristaltic movement, but it's hard to show here with my hands in this format. So the important thing to note is that. That you made a house nice job. The important thing to note is that if those lateral edges of the tongue do not come up and make contact, you're not going to get that negative pressure, and the tongue is going to continue to push forward. We're going to get that nice tongue thrust that everybody sees in a lot of these kiddos, right? They're doing. Yeah, they're doing a. Some people call it a backward swallow, a tongue thrust swallow, a tongue forward swallow. I see. The important thing is that the tongue is either pushing against the upper or lower dentition or between the teeth. And that's not what we want. Right. We want the tongue up in the palate and suctioning, making nice contact, suctioning to the palate for that swallow to make sure that we can clear the bolus with no more than one cleanup swallow afterwards. So that's a little bit about what we're working on and why we're working on it. I will say there's no one program for everybody in terms of. Of, like, I don't have a prescribed set of exercises that everybody gets. I do have a program that I use that I pull exercises from. However, I do that based on the child's goals and what they need. And while some kids might do this for a couple months, others might need it for a year. It really depends on the case, the child's needs, and what else we're working on. So Lily's having fun making faces at you guys. She and I are going to keep working on more exercises. Hey, Lily, can you do this one? I want to give you a new one this week. You ready for a new one? Usually I give my. My patients. Oh, depending on how many you're still working for. I don't love to give them more than, like, three to work on for any given week. But a lot of the exercises that we work on and the goals that we're working towards tend to build on each other over time as well, depending on what they're able to do already or what they. What we still need to work on. So I try not to overwhelm, because I find overwhelm means they don't do Any homework, I'd rather give them three and have them move through therapy faster when they're super focused. And sometimes in doing those three, it actually helps us achieve other things that we try to work on in our sessions, which also changes the homework that I was maybe planning to give from one week to the next. So it's a very fluid process. Lily, try this. Try this one. All right, so she's doing a click. What I want you to do is you're going to do your click, but at the end, you're going to push the tongue, the front of the tongue, up into the top, up into that spot. Okay? And don't let it fall down ever. We're going to keep it for the whole time. Watch. See, when mine popped off, the front stayed up. It's a little tricky, right, Cara, Close. Now let me show you. We're going to break it down. Do a click. No, do a click silly. Can you do a regular click, please? Thank you. And then stop. Do one click and then go tongue to spot. No, tongue to spot silly. Now click. Tongue to spot. Click. Tongue to spot. Cut time. Spot. All right, so she and I are going to work on this. I have some other tricks on how to achieve this as well, but we will work on it and see what she needs to. What she needs to achieve this over the next week. And we'll report back on our next video. Hope this was helpful. Maya with Lily. Say bye, everybody. Bye, everybody. Oh, you're a baby now. All right, guys, chat soon.