Question
I work with a 4th grader who has the most serious case of misaligned and protruding teeth I have seen. His mother tells me that the dentist will work with his teeth after his lower jaw grows, which they expect to be when he is 15. He of course has troubl
Answer
It is apparent from your description, that your client has upper lip incompetence from his "misaligned and protruding teeth." I am going to assume that his only misarticulations are bilabial-stop plosives. Without medical/dental intervention, working on improving the range of motion (ROM) of his lips and working on compensatory strategies is the path to take. We need to remember that the primary purpose of the respiratory, articulatory, and laryngeal systems is breathing and feeding. The speech mechanism is able to generate much more force and structural displacement than is necessary for the production of speech, and it is capable of making significant compensation for structural and functional insufficiency (Peterson & Marquart, 1994). So you may be able to help him improve intelligibility with ROM exercises and compensatory strategies. Personally, I would look for a second opinion from another dentist--age 15 just seems a little late to me.
References
Peterson, H. A., & Marquart, T. P. (1994). Appraisal and diagnosis of speech and language disorders (3rd Ed.). Englewood Cliffs, NJ: Prentice-Hall.
Dee Lance is an Associate Professor at the University of Central Arkansas where she teaches classes in articulation development/disorders and child language disorders. She has worked as a speech-language pathologist with pre-school and school-age children for the past 18 years.
Dee Lance, Ph.D,CCC-SLP
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