Tethered Oral Tissues (TOTS)
INFANT / TODDLER PROGRAM
Infant Massage:
Integrated craniosacral fascial therapy
Body input to bring baby to midline
Facial input with palpation of muscles, fascia, and interrelated orofacial complex
Chewing and Swallowing Reflex activities to promote integration
Oral Motor, Oral Sensory, and Oral Phase Swallow:
Tongue lateralization focus for tip and body movement
Suck training hierarchy to strengthen negative pressure/latch and increase endurance
Desensitization input to lips, gums, tongue, inner cheek, and palate o Oral play for increased use of untethered structures for exploration/breastfeeding
Functional movement activities
Recommended Collaborative TOTs Care:
Whole Body Manual Therapy
Chiropractic Care
Craniosacral Therapy
Occupational Therapy
Lactation Consultant – IBCLC
Speech/Feeding Therapy
SCHOOL AGE / ADULT
Facial Massage, Posture, and Breathing:
Facial input with palpation of muscles, fascia, and interrelated orofacial complex
Chewing and Swallowing Reflex activities to promote integration
Head & neck posture with activation of dynamic diaphragmatic nasal breathing patterns
Oral Motor, Oral Sensory, Oral Phase Swallow, and Speech Sound Production:
Desensitization input to lips, gums, tongue, inner cheek, and palate
Patterned use of oral structures for increased use of untethered structures for function
Oral dissociation skill development
Chewing, food collection, and swallowing skill development
Targeted speech sound remediation if warranted
Recommended Collaborative Post Revision Care:
Whole Body Manual Therapy
Chiropractic Care
Craniosacral Therapy
Occupational Therapy
Airway/Sleep Consultation
Orthodontic Consultation
Speech/Oral Phase Swallow Therapy
