Tongue thrust, articulation, language and /k/ommunication

Healthcare Professionals

A speech or communication impairment will affect many area’s of a person’s life. For children, a communication disorder can impact normal social and academic development. Adults will find it difficult or impossible to function independently and may be at increased risk of social isolation and depression. Swallowing disorders can be profoundly life changing, and they may even be life threatening.

Make a referral:

Download referral forms (PDF): Referral-Orofacial-Myology or Referral-general

Submit online referral form: Orofacial Myology Referral or General Referral

Pediatric referrals

According to the American Speech-Language Association, the following behaviors in children should trigger a pediatric SLP referral. By age 3 years cannot:

  • be understood by family and/or caregivers
  • correctly produce vowels and such sounds as p, b, m, w in words
  • repeat when not understood without becoming frustrated

By age 4 years cannot:

  • be understood by individuals with whom they do not associate regularly
  • be understood by family and/or caregivers
  • correctly produce t, d, k, g, f
  • be asked to repeat without becoming sensitive

By age 5 years cannot:

  • be understood in all situations by most listeners
  • correctly produce most speech sounds
  • be asked to repeat without exhibiting frustration

Some of these challenges can be related to orofacial myofunctional disorder. Others can be associated with speech sound disorders or expressive or receptive language delays.

  • A disturbance in neuromuscular control causes difficulty in learning to produce sounds appropriately. Speech is usually slurred; there is difficulty in controlling respiration for speech; and there may be abnormal loudness, rhythm, or vocal quality.
  • A disturbance in programming, positioning, and sequencing of precise muscular movements will lead to sound errors that are prevalent but variable (i.e., “dog” could be produced “dog,” “tog,” “gog,” “god” by the same child).
  • A disturbance in performing voluntary movements with mouth and vocal mechanism prevents an individual from producing the precise movements necessary for sound production, or may cause the sounds they make to be produced in a whisper.
  • Deafness or severe hearing loss can cause severe prosodic disturbances in intonation, duration, and rhythm in addition to sound errors.
  • Autism, emotional disturbance, and/or intellectual disabilities may cause very unusual prosodic variations, including intonation and/or rhythm of connected speech that may sound abnormal; and speaking volume may be consistently or intermittently too loud or too soft.

Make a referral:

Download referral forms (PDF): Referral-Orofacial-Myology or Referral-general

Submit online referral form: Orofacial Myology Referral or General Referral

"Laura, my son is doing great and hardly drooling two weeks post tonsillectomy and adenoidectomy. Thanks so much for working with us and leading us to the right diagnosis!”,

Pediatrician with Seattle Children’s

Adult referrals

According to ASHA, the following conditions and behaviors in adults should trigger an adult SLP referral. The links will take you to related additional information on this website.

Make a referral:

Download referral forms (PDF): Referral-Orofacial-Myology or Referral-general

Submit online referral form: Orofacial Myology Referral or General Referral

Is therapy with Laura right for my patient?

Laura S. Smith, MS, is a certified orofacial myologist (COM) as well as a certified speech-language pathologist (CCC-SLP). She has an unparalleled depth of experience working with children and adults in both acute and clinical settings. In her earlier work, she performed numerous swallowing evaluations, which have given her the knowledge and observational skill in how to adjust for swallowing various liquids and solids, modifying diets to meet the needs for her patients, and training them to use optional seating and positioning strategies to maximize their safety and nutritional needs. Her quest for more knowledge and precision skill in tongue thrust, swallowing, and related disorders, led her to pursue extensive training and research. Therapy with Laura encompasses a range of cognitive, expressive, and receptive language challenges. She is effective at helping individuals with oral-motor, speech, and orofacial myofunctional disorders. Her work also addresses social communication disorders, stuttering, augmentive alternative communication, and neurogenic disorders. She also offers coaching for business communication and accent modification, and can assist transgender individuals with voice therapy. Her compassionate, fun, enthusiastic, and motivating personality delivers results for adults as well as children. For more information about Laura and the work that she does, please read her many client testimonials.

Contact Laura and TALK SLP

If your patient needs specialized help with a speech, language, communication, or orofacial myology issue, please contact us via phone, fax, or email: (206) 228-8530 phone (206) 568-8530 fax TALK SLP’s offices are located in the Northgate area of Seattle and on Mercer Island, allowing us to serve individuals and families throughout the greater Seattle region of Washington state. Telepractice appointments are also available, where clients can receive consultation and therapy services from a distance via Skype or other online tools.