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Using a Rake to Treat Tongue Thrust

Lesley Mangus, Ph.D

July 10, 2006

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Question

I have a 9 year old child at school who is on his Second Rake for his tongue thrust. He demonstrates a resting position of the lower lip under his upper teeth (f) placement when he is at rest. Mom is concerned with his having these appliances in his mouth

Answer

Do they really still use Rakes for tongue thrust! Personally, I feel that children with tongue thrust have sneaky compensation techniques hence the need for a "second" rake. They just learn new ways to circumvent the appliance. The reverse swallowing patterns and some of the newer, yet un-researched oral motor techniques do yield favorable results. What it comes down to though is the child's motivation. At 9 years old, the child needs to start taking on more responsibility for the behavior. If he is only going to rely on an appliance, then he won't ever learn to develop the kinesthetic awareness of what needs to be done to 'fix' the pattern. Somehow the tactile, visual, and auditory cues of what he is doing and what he needs to be doing to correct the pattern needs to be taught. Awareness of when he is thrusting and when he shouldn't be thrusting needs to be incorporated into the treatment protocol. Without the child's motivation though, therapy will not be successful. Eventually, he will have to decide if he needs or wants to change the behavior. Good luck.

Lesley Magnus received her Bachelor of Science in Education from Minot State University in 1985. She completed her Master of Science in Speech-Language Pathology from Minot State University in 1986. After 15 years of clinical work in Pediatric SLP, Dr. Magnus returned to Wichita State University to complete her Doctor of Philosophy in Communication Disorders and Sciences in 2000. Her doctoral dissertation focused on phonological aspects of children born with Clefting anomalies. Magnus is a certified SLP in both Canada and the USA. In addition, she is past president of the Saskatchewan Association of Speech Language Pathologists and Audiologists. Magnus' professional interests and work lie in the areas of phonology, clefting, and language disorders in children.

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