Hey there! We are pediatric occupational and speech therapists who specialize in tethered oral tissues, feeding, lactation, and infant massage. We are also mothers who have experienced feeding difficulties due to tethered oral tissues with our children. The recent New York Times article discussed lip and tongue ties as a trend, causing fear-mongering with the most severe outcomes and monetizing procedures. It is important to take into consideration the facts from trained medical professionals who specialize in this area, as this can continue gaslighting mothers who are attempting to advocate for their children in times of distress. We are here to untie the knot. 

Preferred providers consist of a team approach. This team will assess oral function, feeding, swallowing, speech sound disorders, and muscular tension. Pre-op care is 

 in order to rule out alternate factors including reducing fascial restrictions, training caregivers, avoiding oral aversions, and establishing clinical baselines (Walsh, 2023). The following are considered preferred providers as a part of the multidisciplinary team.

It is critical to not only look at structure (frenulum or the “string” under your tongue) when diagnosing tongue ties. Function must be assessed in order to make a differential diagnosis. For example, 

 is the structure functioning in the presence of tight tissue impacting feeding, speech, body tension, breathing, sleep, etc? The structure 

 have a negative impact on function to warrant a diagnosis (Bulkin, 2023). This is typically first noticed in infancy; however can later be identified in children, adolescence, or adulthood.

In an excerpt from Dr. Richard Baxter’s response to the NYT’s article, 

This pre-procedure therapy accomplishes many objectives: “It allows the professional to assist in preparation for the procedure (what to expect, common troubleshooting issues, red flags, etc). If you think about knee replacement surgery, we want a strong calf and a strong hip to support that new structure.  

with tongue tie release.  We want to work on the jaw, lips, cheeks, etc.  Think about who heals better: An Olympic athlete or someone who does no physical activity?  We want to work to tone, strengthen, coordinate, and sequence patterns while inhibiting compensations prior to a procedure”   (Henning, 2019). 

Rushing a release can lead to suboptimal outcomes and it’s critical to wait for the optimal timing of release per your providers’ recommendations and child’s readiness. The body needs to be properly prepped: including a full-function oral motor assessment combining desensitization for oral aversion, decreasing tension patterns or discomfort, and regulating the nervous system.

“Due to wound healing principles, any wound left open post-procedure will try to contract and stabilize by reattaching. It is highly important for patients/parents to be instructed on active wound management techniques. The time to learn this is prior to the procedure for the best success” (Henning, 2019). 

 change in symptoms immediately after a release, however, continued improvements are observed after completion of post-op therapy to retrain the orofacial muscles on how to function with their 

“The goal is to gain and/or restore optimal function so you or your child can thrive” (Bulkin, 2023). As healing continues and skills increase, you may notice: Quiet nasal breathing, closed mouth posture with lingual palatal suction, improved sleep, infants who are 

 with decreased colic-like symptoms, quicker feeds, weight gain in infants, less grazing in children, increased speech intelligibility, decreased gagging/choking, and reduced hiccups, reflux, and constipation.

I decided in my pregnancy that I wanted to breastfeed for as long as possible with a personal goal of 1 year. I decided that I wasn’t going to check for ties until I noticed signs. I wanted an unbiased opinion so I could relate to my families at work on a more personal level. Unfortunately, these signs came earlier than anticipated. My son immediately demonstrated difficulties latching, regardless of position. I’ll never forget the overwhelming emotions I experienced- I felt anxious, defeated, like a failure, or at fault. I began hand-expressing colostrum and syringe feeding until he could latch successfully. I received lactation support in the hospital (it is difficult to be a mom

 therapist), however the possibility of ties was never discussed. We finally got a latch, and although it was shallow and painful, we powered through. He was 7lbs 7oz at birth and 7lbs 1oz at discharge. My anxiety then quickly transformed into concern. After a few days at home, I started experiencing significant discomfort including nipple trauma, painful latch, and vasospasms. I remember holding my breath, clenching my toes, and dreading each feeding. At this point, I knew there were ties and it was time to check. Sure enough, my son had upper and lower lip ties, buccal or “cheek” ties, and a tongue tie. I got established with an IBCLC, CST, and chiropractor. My team addressed compensatory patterns, strengthened oral motor skills, and released body tension. Once therapeutic readiness was identified, we scheduled with a pediatric dentist for releases at 3 weeks of age. My son latched 

 after his procedure. The pain had diminished and he was transferring more volume at the breast. It was amazing the difference- even I couldn’t believe the change! We continued seeing our team to ensure appropriate wound healing and retraining of orofacial muscles. Now, my son is 1 year old and we are still breastfeeding. I am forever grateful for this team who helped us navigate through this feeding journey and supported us along the way. Advocate! Breastfeeding 

 be painful and reaching your feeding goal 

Sitting in the hospital bed after my baby was born, I remember thinking when latching my son for the first time “ Am I doing this right?”.  I was a first-time mom. The overwhelming emotions of welcoming a child into the world, doctors and nurses in and out of my room, and my body aching from delivery heightened all my sensations. I made sure to check with lactation several times in the hospital to ensure our breastfeeding journey would be successful. Our first night home, my son cried the ENTIRE night. He nursed all night and wasn’t satisfied. His latch was completely shallow. I immediately knew something was off and made an appointment that week to meet with lactation from the hospital. At our appointment, she agreed his latch was very shallow and he was not transferring enough ounces to feel satisfied. She suspected ties and recommended seeing a speech therapist who specializes in feeding. My son was colicky, gassy, had horrible hiccups, constantly fell asleep at the breast, and had a poor latch with the bottle. We tackled triple feedings via breast, bottle feeding, and pumping around the clock every 2 hours. Sure enough, when our appointment arrived, we discovered he had a tongue and lip tie. I made sure to set up the necessary steps for pre-care therapy including a chiropractor, physical therapist, and speech therapist. My son had his release by a pediatric dentist at 3 weeks of age and we continued to work with our team for post-care and body tension.  At 6 weeks old, I made the decision to change course from breastfeeding to exclusively pumping and bottle feeding until my son was 12 months old. He is now a healthy thriving 5 year old! After my son was born, I knew what signs and symptoms to look for. I delivered a daughter 22 months later and my third child, another son, two years after her. Both of which had difficult feeding journeys after birth. Both of these two would latch at the breast; however, struggled to gain weight, were colicky, gassy, did not sleep well, and required triple feedings. With my two youngest children, we moved to Kentucky from a different state. Knowing the process, I scheduled appointments with a team of providers for consultations. Both my daughter and youngest son were diagnosed with bilateral buccal, tongue, and lip ties. We set up care with an IBCLC, CST, chiropractor, and speech therapist. My daughter had her release by a pediatric dentist at 6 weeks old and my youngest son had his release at 5 weeks old. With these two, I made a personal goal to try to breastfeed as long as I could. I wanted to try again after my first! I successfully breastfed both my now 4-year-old daughter, and 2-year-old son for 14 months each. My experience as a mother of three with feeding difficulties has inspired me to educate families on the benefits of therapy and establishing success for functional feeding. Let us be a part of 

In efforts to discontinue the spread of medical misinformation, here are some helpful resources. Families deserve to thrive! 

Helping your family build skills for life is our priority.  

 with one of our expert therapists if you have concerns about your child or want more information about the topic of tethered oral tissues! 

All Tied Up: Lip & Tongue Ties from Professional and Personal Perspectives

Flashcards have been a classic tool for building children’s vocabulary but did you know that this teaches children memorization rather than functional communication? We want children to be motivated and engaged in language. Flashcards are fun to look at a few times but end up getting tossed to the back of a shelf because your child thinks it's “boring”. 

When flashcards are used correctly, they can be a great on-the-go tool that strengthens your little one’s language skills. 

Try one of these activities next time you pull out the deck!

As parents, we strive to make every learning moment memorable and effective for our children. From object matching to scavenger hunts, describing details, and the thrill of hide-n-seek, these activities not only make language acquisition fun but also foster generalization and deeper understanding. So, let's redefine the way we utilize flashcards – not just as a tool but as a gateway to a world where language becomes an exciting journey for our little learners.

Helping your family build skills for life is our priority. If you are looking for personalized tools to build your child’s vocabulary and communication skills, 

 with one of our expert speech and language pathologists. They will provide you with creative games and activities that will engage your child while strengthening their speech and language skills!

Are Flashcards Outdated? 

When most people think of healthy vision, they typically think of getting their eyes checked by their regular optometrist to make sure they can see clearly and that their eyes are free of disease.  While this is a very critical and important thing to do as a part of overall wellness, this isn’t where the road ends. There is SO much more to healthy vision than seeing 20/20.

 Getting an annual eye exam is not the end; it is just the beginning!

 help to emphasize the relationship that the eyes, brain, body, and mind all have with one another. We have worked closely with the NVPI team to provide our families with a helpful snapshot of some information regarding the visual system and overall eye wellness. 

Kids (and adults) go through life working so much harder than they have to because the optometrist tells them they see 20/20, YET they still have trouble seeing …the words are still blurry, they get frequent headaches, and their eyes always feel fatigued. This is because their eyes are not working together as a team to gather information. The structure is there but the function is not.

70-90% of what we learn and perceive is actually processed through our visual system. It also takes from birth to age 15 for our visual skills to process. 

Did you know that there are actually a total of 17 visual skills and generally ONE of those (Central Distant Acuity), is tested on most eye exams? NVPI actually tests all 17 skills to ensure proper results and diagnosis.

 seeing objects at the sides when continuing to look straight ahead

 understanding whether seen objects are close to or far from each other

 both eyes working together to achieve clear, comfortable vision

the eyes’ ability to quickly move or “jump” between different focal points

 both eyes’ smooth movements tracking a moving target

both eyes working together, toward each other, to focus on a nearby object

 the eye continues to change its focus between near and distant objects

the eyes’ ability to maintain focus on close-up activity

an analysis of the information about an image (visual/spatial learning or picture thinking

employing visual information to direct the body’s movements in a coordinated way

employing visual information to control the movement of hands, fingers, and feet

understanding what is being seen and using cognition to process this information

using vision together with other senses in order to perform complex tasks

The two videos below from Dr. Graebe at NVPI help to best explain what Vision Therapy is, as well as best explain the correlation between one’s vision and learning. It is very often that the school struggles your child might be experiencing, go hand-in-hand with vision-related concerns. 

Healthy Vision - More Than Seeing 20/20

Nearly 1 in 5 Americans will be diagnosed with a mental health condition at some point during their life. A large majority by the young age of 14.

As Licensed Mental Health professionals, we are seeing the numbers of those diagnosed with a mental health condition or even seeing signs rise in our children, youth, adolescents, and teenagers, especially following the unprecedented events of Covid. The reality is: life is hard, it is challenging, and we are not meant to do it alone. We all need a support system. We need access to helpful resources and reliable professionals to navigate our mental health journeys.

There are numerous resources out there that can help to minimize the severity of a mental health condition(s), including that of individual and family/group counseling sessions. We must work hard to ensure that these resources are easily found, known and that we are supporting one another.

, we can help to break the stigma that follows Mental Health. Mental Health is just as important as our Physical Health. Just like experiencing a physical illness that might be more apparent or obvious, being able to identify and treat mental health conditions earlier on can prevent something more serious from developing.

Some of the more or less “common” mental health conditions or experiences warranting professional support:

Knowing the “warning signs” to watch for:

Mental Health Therapy visits focus on providing encouragement and support in order to create a more balanced, loving, and overall successful home life. By working with both the child and the family using proven psychological methods, Mental Health Therapy can help manage and even eliminate a variety of mental illnesses and emotional difficulties.

Our goal is to provide parents with the confidence and best possible resources available to understand, manage, and prioritize their family's mental health.

 through both individual and family counseling sessions. A referral is not required for this discipline, and we work with many 

insurance providers, including Kentucky Medicaid

. Our clinicians are knowledgeable about clinical excellence in all disciplines.

Mental Health Matters! 

As clinical experts and many of us parents ourselves,

we resonate with the fast-paced life you live and the immediate concerns that come with experiencing the uncertainty of receiving an unexpected diagnosis. Not knowing what direction to turn, oftentimes blaming yourself, wondering who will be the most reliable (and immediate) source of help, and ultimately, what is going to make things "normal" the fastest way possible. 

If you're reading this, there's a pretty high chance that you know exactly what we are describing to be similar to your personal testimony. We hope that you have found the most reliable therapy team to care for your child and equip you with all of the things that you not only need but that you deserve. 

If you have not yet established that foundation, the Marshall team wants to encourage and remind you that through our multidisciplinary approach to treatment, we are able to really cover all of the bases. We fight behind the scenes every single day to ensure you are cared for in the most comprehensive manner. From an initial evaluation, through the insurance/payment parameters, to community partners to advocate on your behalf, we want you to feel empowered on your therapy journey. 

The overall effectiveness of therapy goes far beyond what goes on solely in the clinical setting. By actively using the 

, techniques, and tools provided by one’s therapist and through credible Autism materials, you are helping one achieve milestones faster.

 might look differently for an autism diagnosis. Through therapy and time spent in multiple learning environments, the child is becoming more proactive, self-aware, and stronger both mentally and physically. The caretaker is also able to learn more tips and tricks to handle particular situations with confidence. This education then becomes a helpful asset to share with other families. Suddenly, a bonding community is formed and is more impactful than it has ever been before. 

Therapy, most of the time, can be hard work and challenging to overcome specific obstacles, but it certainly does not have to be super expensive or time-consuming! There ARE definitely ways that you can implement FUN activities into the mix of play at home or even on the go for your child regardless of their condition. Most of the time, these are even fun for the entire family!

Our Marshall Pediatric Therapy Clinical Experts want to introduce you to three affordable "do it yourself" activities inclusive of some shoppable links that are also educational and therapeutic.

Sensory boxes help children with autism relax and be able to concentrate. Sensory boxes are also great for learning new vocabulary words and exploring different textures. Sensory boxes are often times more manageable when it comes to sensory processing.

2. Playdough stamping with Legos or household items like a kitchen whisk or pasta

https://thecraftathomefamily.com/2-ingredient-cloud-dough/

We hope you enjoyed reading this post and are inspired to make some unique activities at home! If you're looking for a consistent therapy basis or need help in any way, we want to be an extension of your team! Make sure to visit our 

From Our Experts

All Tied Up: Lip & Tongue Ties from Professional and Personal Perspectives

Are Flashcards Outdated?

Healthy Vision - More Than Seeing 20/20

Mental Health Matters!

Three Simple DIY Activities for a Child Diagnosed with Autism