TeamHope Speech & Pediatric Therapy Center

For those who celebrate!

IT'S NOT ABOUT THE AIRWAY, IT'S ABOUT THE OMD=OROFACIAL MYOFUNCTIONAL DISORDER. Airway is a marketing term. There is no designation within the ADA for a specialty called "Airway". A more appropriate description is OMD, Orofacial Myofunctional Disorder. These are the disorders that Speech Pathologist diagnose, treat, and make referrals for when appropriate. That is the diagnosis under which symptoms which include "airway" or disordered breathing falls. So tongue ties, difficulty feeding, speaking, breathing, enlarged tonsils/adenoids, needing ear tubes, etc are all symptoms of OMDS. The causes are multifactorial as everyone compensates differently for how their craniofacial development progresses under these conditions, and are influences by age. The orthodontist typically should be looking at the development of the upper and lower arches whether the upper and lower jaws are growing appropriately to create enough space for the teeth and tongue to fit properly in the arch. Dental crowding, crossbites, having teeth pulled (no one should be doing this anymore) are all indications that expansion is necessary. How expansion is achieved and what device is used is based on the age of the patient and the expertise of the provider.

So thankful for the invitation to join Drs. Marianna Evans, Kevin Boyd, and Meryl Baurmash this weekend in advancing knowledge on the importance of early expansion. Here in New Jersey, Dr. Baurmash and I have being at it for the past 3 years developing protocols, expanding littles and seeing great successes.

This is great article. What's best for baby is a healthy mom.

I Always Pictured Breastfeeding My Kids. Then My Psychiatrist Recommended Against It. I was never taught about the mental health risks of breastfeeding—until I had to live them.

With credit to the artist. Happy Labor Day.

Great overview which explains airway disorders.

Sleep-Disordered Breathing: The Hidden Sleep Problem Linked With ADHD and Even Orthodontics If your kid still wakes up in the middle of the night or is irritable during the day, they may have an underlying breathing issue. Treatment can help them get the rest they need.

I'm a little late in getting to this, but what a great conference. From instructors, to supervisors, to mentors, to colleagues, to friends it's been an evolutionary journey for us all. There's more than a few missing here, Nancy Fitzgerald Calamusa, Carole Kornsweig, Melissa Goldstein, Deidre Beglan et al. But just an unimaginable amount of talent all gathered in one place.

Thank you for this explanation Robyn Merkel-Walsh MA, CCC-SLP, COM®️ . It helps to repeat this. This is a specialty of Speech Language Pathologists, who are trained in the diagnosis of OMDs (orofacial myofunctional disorders) and their treatment. Unfortunately there is a tremendous amount of confusion amongst consumers regarding who to seek for care resulting in many patients spending unnecessary dollars and undergoing unnecessary treatments. This becomes of even greater concern when we think about our most vulnerable patients infants, toddlers, and older adults.

Professional Ethics lesson of the week ........

Orofacial Myofunctional Therapy is not a business model or a way to get clients to make money . It's a scientific , evidence based treatment modality to help patients who present with disorders of sleep, swallowing , airway , speech , muscle dysfunction, tethered oral tissue , dental malocclusion , noxious habits and more . In addition :

✅It's a treatment modality by a licensed professional , that uses that license because the method is within their scope of practice . Generally this is an RDH or SLP with a state license and accreditation from their national organization. Other professions treat various aspects of an OMD for example , an IBCLC supports the breastfeeding dyad and OTs and PTs support posture and alignment. It's a team model based on presenting symptoms.
✅ It takes a lot of training beyond your degree(s) . It can be costly and takes dedication. Continuing education , mentoring by a seasoned clinician , more learning , exams , clinician lessons and more . It's not "take this class like magic you too can be a Myofunctional therapist !"
✅If you focus your OMT training on how to make your business boom with clever marketing and ways to build referral networks , you are missing the most critical aspect - the assessment and treatment of these complex disorders . Your expertise as a well trained clinician who facilitates progress in patients is how to build your referrals and reputation.
✅ Speaking of "Myofunctional therapist "....... that's a questionable term . Your profession and how you sign your name is based on your degree and license. When patients call as say "I'm looking for a Myofunctional therapist " I reply "I'm a speech and language pathologist who is trained in Orofacial myology and can assist you with Myofunctional therapy ".
✅ It takes liability insurance . Chewing . Swallowing . Speech . Airway. TOTs care ...... you are in person's mouth and tapping into their sensory motor system, motor planning and ex*****on and need knowledge of medical issues associated with OMDs. There are safety protocols and CDC / OSHA standards . A patient gets injured or chokes ? Where is your insurance ? You only obtain insurance through your license and scope of practice .
✅ It may be covered by medical insurance when performed by a licensed speech pathologist in relation to a feeding , speech or swallowing disorder. Many state laws have specific disclosures regarding the assurance that patients know they may be able to have services covered through their medical coverage, so making this a "cash business" could be a violation of license guidelines and insurance laws in certain states .

Finally ......

Taking an OMT class doesn't allow you to change the name of your profession and / or add made up credentials to your signature . Don't believe me ? Run it by your licensing board or national organization before doing so. Don't do this because your instructor said so , fact check with the governing body that maintains your professional code of ethics .

What a great piece of research. Much thanks for sharing Morgan Warnier.

Assessment of mouth breathing by Speech-Language Pathologists: an international Delphi consensus ABSTRACT Purpose mouth breathing (MB) has detrimental effects on children’s growth. Diagnosis of...

The evidence continues to grow. Thanks for sharing Robyn Merkel-Walsh MA, CCC-SLP, COM®️ .

Obstructive sleep apnea and anatomical structures of the nasomaxillary complex in adolescents - PubMed The aim of the present study was to reveal the associations between skeletal and soft tissue features of the nasomaxillary complex and development and severity of obstructive sleep apnea (OSA) in adolescents. A total of 100 adolescents (mean age, 14.9 ± 1.4 years; age range, 13-17 years) were enrol...

Very interesting piece.

Central pattern generation involved in oral and respiratory control for feeding in the term infant Drinking and eating are essential skills for survival and benefit from the coordination of several pattern generating networks and their musculoskeletal effectors to achieve safe swallows. Oral-pharyngo-esophageal motility develops during infancy and ...

Thank you so much for sharing Walt Fritz.

Somatosensory Contribution to Motor Learning Due to Facial Skin Deformation | Journal of Neurophysiology Motor learning is dependent on kinesthetic information that is obtained both from cutaneous afferents and from muscle receptors. In human arm movement, information from these two kinds of afferents is largely correlated. The facial skin offers a unique situation in which there are plentiful cutaneou...

Thank you Diane Bahr for sharing. Very encouraging piece of research.

Bottle-feeding and gastroesophageal reflux disease improvement after restrictive tethered oral tissues release - PubMed This study confirms the need for functional assessment of tongue and lip movement for this significantly affected cohort when surgical release is proposed. Laser surgical release (frenotomy) of tongue-tie, lip-tie, buccal-tie resulted in significant improvement in I-GERQ-R outcomes were found for co...

Everyone has a frenulum. In fact these are found throughout the body and in most cases are perfectly normal. Having a tongue tie is unrelated to the presence of "unintegrated reflexes". Tongue tie is an anatomical variation, not an indication of neurological status. Indeed, we retain numerous reflexes across the lifespan, these are normal and in many ways protective. The interpretation of the significance of their presence or absence is best left to those with the clinical expertise to do so. Hope Fernicola, M.A. CCC-SLP, COM, CBS, CPRCS.

Interesting article, worth the read.

Tooth-Bone-Borne Vs. Bone-Borne Palatal Expanders: A Systematic Review The aim of this review was to evaluate the current evidence regarding post-treatment effects of tooth-bone-borne vs. bone-borne expanders. A search was conducted in MEDLINE via PubMed, Web of Science, Scopus, Cochrane Library, Google Scholar, and Open Gray; in addition to a hand search in reference....

This study seems to have confirmed what may of us suspected, there are numerous postural variables that impact the findings on CBCT. I don't believe this makes the tool useless, but as the paper suggests protocols are needs. And primarily asking the subject not to swallow while the image is being taken should be one of them.

Does Head and Neck Posture Affect Cone-Beam Computed Tomography Assessment of the Upper Airway? Radiographic analysis is often used as a screening tool to assess for risk of sleep-related breathing disorders. This study aimed to address 2 questions: (1) Does head posture significantly affect the minimum cross-sectional area (MCA)? and (2) Is the NBC3 (nasion-basion-C3) angle a reliable measure...

Can't wait to see the full text. Some fabulous work by Dr Yoon, et al. on the role of Orthodontics in treating breathing disorders.

A Roadmap of Craniofacial Growth Modification for Children with Sleep Disordered Breathing: A Multidisciplinary Proposal - PubMed Craniofacial modification by orthodontic techniques is increasingly incorporated in the multidisciplinary management of sleep disordered breathing in children and adolescents. With increasing application of orthodontics to this clinical population it is important for healthcare providers, families,....