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
Related Courses
1https://www.speechpathology.com/slp-ceus/course/treatment-approach-considerations-for-school-9472Treatment Approach Considerations for School-Aged Children with Speech Sound DisordersThis course will address the theoretical underpinnings and research base related to differential diagnosis and treatment of articulation and phonological deficits in children with speech sound disorders. Special considerations for how to tailor evaluation and intervention to meet the needs of school-age children will be discussed.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comTreatment Approach Considerations for School-Aged Children with Speech Sound DisordersThis course will address the theoretical underpinnings and research base related to differential diagnosis and treatment of articulation and phonological deficits in children with speech sound disorders. Special considerations for how to tailor evaluation and intervention to meet the needs of school-age children will be discussed.9472OnlinePT60M
This course will address the theoretical underpinnings and research base related to differential diagnosis and treatment of articulation and phonological deficits in children with speech sound disorders. Special considerations for how to tailor evaluation and intervention to meet the needs of school-age children will be discussed.
2https://www.speechpathology.com/slp-ceus/course/ripple-effect-stuttering-community-based-9217The Ripple Effect of Stuttering: A Community-Based ApproachThis is Part 2 of a four-part series. The stuttering experience has a ripple effect that extends far beyond the child who stutters. Parents, teachers, peers, and others must possess both knowledge and skills to best support children who stutter. This course will highlight new clinical tools and resources to provide a community-based treatment approach for stuttering. (Part 1 - Course 9278, Part 3 - Course 9301, Part 4 - Course 9304)auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comThe Ripple Effect of Stuttering: A Community-Based ApproachThis is Part 2 of a four-part series. The stuttering experience has a ripple effect that extends far beyond the child who stutters. Parents, teachers, peers, and others must possess both knowledge and skills to best support children who stutter. This course will highlight new clinical tools and resources to provide a community-based treatment approach for stuttering. (Part 1 - Course 9278, Part 3 - Course 9301, Part 4 - Course 9304)9217OnlinePT120M
This is Part 2 of a four-part series. The stuttering experience has a ripple effect that extends far beyond the child who stutters. Parents, teachers, peers, and others must possess both knowledge and skills to best support children who stutter. This course will highlight new clinical tools and resources to provide a community-based treatment approach for stuttering. (Part 1 - Course 9278, Part 3 - Course 9301, Part 4 - Course 9304)
3https://www.speechpathology.com/slp-ceus/course/behavioral-frameworks-for-dementia-management-9473Behavioral Frameworks for Dementia ManagementThis course will focus on cognitive-communication intervention strategies for various dementia presentations and will provide a review of evidence-based treatment. Behavioral frameworks along with their rationales will be introduced and applied across several dementia types and mild, moderate and severe levels of impairment.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comBehavioral Frameworks for Dementia ManagementThis course will focus on cognitive-communication intervention strategies for various dementia presentations and will provide a review of evidence-based treatment. Behavioral frameworks along with their rationales will be introduced and applied across several dementia types and mild, moderate and severe levels of impairment.9473OnlinePT60M
This course will focus on cognitive-communication intervention strategies for various dementia presentations and will provide a review of evidence-based treatment. Behavioral frameworks along with their rationales will be introduced and applied across several dementia types and mild, moderate and severe levels of impairment.
4https://www.speechpathology.com/slp-ceus/course/20q-infection-control-strategies-for-972920Q: Infection Control Strategies for SLPsSpeech-language pathologists are expected by policy authorities to apply appropriate measures to protect patients, co-workers and themselves in clinical situations that may expose individuals to infectious microbes. This article provides practical guidelines for implementing infection control principles within the context of the COVID-19 pandemic, including discussion of personal protective equipment (PPE) and disinfecting and cleaning products.textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.com20Q: Infection Control Strategies for SLPsSpeech-language pathologists are expected by policy authorities to apply appropriate measures to protect patients, co-workers and themselves in clinical situations that may expose individuals to infectious microbes. This article provides practical guidelines for implementing infection control principles within the context of the COVID-19 pandemic, including discussion of personal protective equipment (PPE) and disinfecting and cleaning products.9729OnlinePT60M
Speech-language pathologists are expected by policy authorities to apply appropriate measures to protect patients, co-workers and themselves in clinical situations that may expose individuals to infectious microbes. This article provides practical guidelines for implementing infection control principles within the context of the COVID-19 pandemic, including discussion of personal protective equipment (PPE) and disinfecting and cleaning products.
5https://www.speechpathology.com/slp-ceus/course/thickened-liquids-in-clinical-practice-10497Thickened Liquids in Clinical Practice: The Plot “Thickens”Clinicians who utilize thickened liquids in their clinical practice are aware of their benefits, but what about the risks and contraindications? Advantages and disadvantages of thickened liquids are reviewed in this course with a focus on clinical outcomes, including impacts on medication administration, lung health, and hydration. Product types are evaluated to facilitate appropriate choices for individual clients.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comThickened Liquids in Clinical Practice: The Plot “Thickens”Clinicians who utilize thickened liquids in their clinical practice are aware of their benefits, but what about the risks and contraindications? Advantages and disadvantages of thickened liquids are reviewed in this course with a focus on clinical outcomes, including impacts on medication administration, lung health, and hydration. Product types are evaluated to facilitate appropriate choices for individual clients.10497OnlinePT60M
Clinicians who utilize thickened liquids in their clinical practice are aware of their benefits, but what about the risks and contraindications? Advantages and disadvantages of thickened liquids are reviewed in this course with a focus on clinical outcomes, including impacts on medication administration, lung health, and hydration. Product types are evaluated to facilitate appropriate choices for individual clients.
