Digging Into Stability and Mobility with Char Boshart - Ep. 79
Episode 79 is an interview with Char Boshart. Char is the president of Speech Dynamics, an author of several books, and a presenter. Char has a deep understanding of the fundamentals of oral motor movement. If you know oral motor techniques work but are at a loss to explain why, Char has the answers. In this interview we discuss:
- stability and mobility
- the human tongue
- oral resting posture
- carryover of articulation
- a new way to categorize phonemes
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Music: Simple Gifts performed by Ted Yoder, used with permission
Transcript
Denise: Hello, welcome to episode 79 of The Speech Umbrella podcast. Today we are in for a real treat because my guest is just fantastic. Char Boshart is joining us today and I'm so excited. I've admired her from afar for many years, especially for her work in the oral motor aspects of speech. Today's episode is called Digging Into Stability and Mobility With Char Boshart and we are going to learn so much from her. But before I bring Char on, I need to give you a bit of background on her.
Char Boshart, M.A., CCC-SLP, is a therapist, seminar presenter, president of Speech Dynamics, and a published author of several practical books, including The Easy R and The Key to Carryover. In addition, she has several CEU videos at speechtherapypd.com, is host of The Speech Link podcast and writes an idea oriented blog called Therapy Matters.
She recently started a vlog called Seven Minute Speech Solutions. Char graduated with her Master's in Speech Language Pathology from Western Michigan University under the tutelage of Dr. Charles Van Riper, who we like to call the father of articulation. Since that time, she has been an assistant professor and department chair of the Speech Language Department at Loma Linda University in Southern California, and worked several years in the public schools and in private practice.
In addition, she's presented hundreds of well received one and two day speech, sound, and language seminars through state associations, school districts, private companies, the Bureau of Education and Research, as well as through her own company Speech Dynamics. Currently, Char and her husband live in the beautiful mountains of North Georgia in a little cabin by the river. It's pure peace. Out of everything, however her passion is doing therapy and talking about it, and that's what we're gonna talk about today. Thank you so much for joining us, Char, on The Speech Umbrella.
Char: Ah, thank you.
Denise: As I was looking at your blog, before I invited you to do this podcast, you had a really great story there about how you walked across campus to find someone who knew about muscles, the muscles of the mouth. Would you share that story with us?
Char: Yes. Yes. Well, this, this took place actually, and thank you so much for having me. I'm excited about being a guest on your podcast and, and hopefully sharing some good information. I try to keep it practical. Um, but yes, thank you for asking about this little story. this happened years ago when I was actually teaching at Loma Linda University, La Sierra campus, and I was teaching a, an articulation disorders course, and that's when it was called Articulation Disorders. It wasn't yet, uh, speech sound disorders. And so I had a book and that I was using with, with the class. And it was the Bern Solan - Bernthal and Bankson artic book. And I, you know, I was, pretty young at that time. I was actually under 30 years of age and I was, looking at the book and thinking about lectures and so on. And I thought, you know, the thing to really focus on with articulation disorders is the tongue. And so I looked through that book and lo and behold, there was actually exactly one half page on the tongue.
And uh, you know, and it was mostly just, oh, here are the intrinsic labels, the names, and the extrinsic names. And I thought, well, that really doesn't help me much when I'm doing therapy. But that's kind of where we all start with the muscles, but it doesn't usually, go much further than that.
And so I really wanted to know about tongue muscles and so I started asking people within the, the, the department and I really didn't get too far there. And, uh, so I drove over to Loma Linda University, 'cause the two campuses were separate actually. And so I drove over there and I walked around and there was a, a school there within the Loma Linda University campus and it was called the School of Physiology and Pharmacology.
And I always thought, oh, that's a little weird. You got muscles and drugs right there in one, one school, one department there. But, I walked in, and, you know, I'm young and basically naive, but also quite desperate to learn about tongue muscles. And so I walked into this very old science building, and maybe you can relate, you know, it, it kind of had this smell to it, this scent. And, and there was absolutely not a stitch of material anywhere. There was no carpet, you know, no curtains, nothing. And it was just this really big, big building, big hallways, linoleum. So I walked in and there was a lady sitting at a desk there in front. And I thought, oh, they, they've got a receptionist. This is pretty cool.
And so I walked up to her and I said, I'm a speech language pathologist and I'm really interested in learning about tongue muscles. Is there someone here that wouldn't mind talking with me about that? And she, she kinda looked at me a little strangely and, which is fine. And she picked up the phone and she called Dr. Raymond Hall and, and he was kind enough to humor me. And, uh, so she says, well just go down to his office. And so I did, and he walked out into the hallway and had this big smile and extended his hand. And I thought, oh, this is just a great guy, you know? And so I walked in and he really was. And so I walked into his office and there was, if you think of the absent-minded professor and, and their environment, there was Dr. Hall's office with I am, I am totally serious that he would have stacks of papers, maybe a foot to a foot and a half high, and his books were stacked around, and, and you know, but you know what? He knew where everything was. And so we sat down and we talked for a good hour. And, you know, basically I started off and said, I really would like to know about tongue muscles. You know, can they be strengthened and you know, what really is the role in speech and how do they move and all of that. And he sort of looked at me like, oh boy, you know, I've, I've got some, you know, some explaining to do. But that really began the beginning of our relationship. Um, it was a two year relationship when I would go over to the campus and, and the school of Physiology and pharmacology and, and, uh, go and sit in his office and he would show me books and, and then I'd go check 'em out there at the Dell Web Library.
And, um, the first day he actually, um, explained to me a new, or actually had the, um, the journal articles there. And there was two articles that came out in 1985 and 86 by Smith and Kier and then Kier and Smith. And it was, they were basically called Trunks, Tongues and Tentacles. And he said, you know what? This is going to revolutionize the way we look at muscles. And, uh, you know, to me it really should have been, um, you know, headline news in the speech language pathology field, but it hasn't been. And, uh, there's, you know, two or three people that I have read that have actually mentioned, the tongue as a muscular hydrostat, which was what the whole topic was about.
And it wasn't just about the tongue, it was about the muscular hydrostat and how elephant's trunks are muscular hydrostats and octopus arms and insect tongues and the human tongue are all muscular hydrostats. And that's basically how they move. And, and you contract one area and that enables the adjacent part to move, which is pretty much what happens during speech production. So I've seen, Dr. Raymond Kent repeat, you know, some information and talk about it and, you know, and a few others, but it really hasn't, made a huge impact in our field. but that's kind of where I started. And so over two years time, I really got to know Dr. Hall and bless him, he hung in there with me. I'm not a physiologist. I'm a speech language pathologist and not one that is totally focused on the science-y words and the terminology. So he would take time to explain things to me about strength, tone, and endurance and, and I just learned a ton about muscles, more than I actually needed. But that was, that was the beginning. And that really set me off, you know, on, on my quest to learn more about the tongue and how it interacts with the mouth, and especially what happens intraorally, you know, not just the sound that emits, but to really learn more about muscles and, really how speech is movement. And, yeah. So that was kind of the beginning, my impetus.
Denise: Yes, speech is movement made audible. One of my favorite quotes of all time.
Char: Yes, it is. It absolutely is. And I know that Pam Marshalla said that and, and I have a book here. It's, um, I love this book and I know you can't see it, but it's called Motor Phonetics, A Study of Speech Movements in Action. And it's by R H Stetson and it's a 1951 edition. And he was a researcher over in Amsterdam, and he is one of the first ones that coined the term that speech is movement.
And I like to interject in there that speech is interactive movement. And you know, and that kind of revolutionized my world because when I was at Western Michigan University, you know, and I learned from Dr. Van as he was called there, Dr. Van Riper, and really he talks about, you know, speech placement and, and how you go from auditory training to, you know, speech stem and then kind of looking at the placement of what, where the tongue is or the lips or whatever parts are being used for that sound. And so there it's sort of a still representation, but through the years I really enjoyed that concept, that speech is movement.
Denise: We tend to separate movements that shouldn't really be separated, and as speech therapists sometimes we're really focused on telling a child how to move the tongue, and if we don't understand how the jaw is interrelated, how the lips and the labo facial muscles work together, they're not gonna succeed and we just get frustrated. We're like, well, what am I doing wrong? Why can't they move their tongue the way I want them to move their tongue? So with that in mind, let's talk about stability and mobility and what that means, and, and what does stability and mobility look like from a whole body perspective?
Char: Mm-hmm. Mm-hmm. And that's a really good place to begin, and when you think of movement, we're talking movement, whole body movement, leg movement, you know, arm movement, hand movement, down to the refined interactions of what's going on intraorally. Movement is all about stabilization, mobilization, and you know, just to make sure that I wasn't like making this up, you know, or, oh, this seems logical.
I mean, I have read books, oh, I've got 'em here somewhere. I've read, oh, here's a couple of 'em over here. One's called Human Motor Control. There's another one called Motor Control and Learning. And they all talk about stability. Now, they don't always use that term. They talk about the, the tonus of the muscles and how they contract and they hold on and it provides anchorage and so on.
But it's all about stability. And if you think of, you know, someone that's skiing down, you know, shushing down the, the slopes. you know, you have that inner core that is contracted, there's stability there, obviously your thigh muscles, et cetera. You've gotta have some stability and you have your positioning and all of that is your internal stabilization, your muscle contractions.
And then your external is really how your arms are placed. And you have your, your poles placed and so on. And that's more your external. So for everything, you have internal stabilization and external stabilization, and that's an important piece to remember as well. And all of that really provides your ability to move with control, with control. Now I wanna put that there, come back to it, but I do wanna emphasize kind of where all of this came from. You know, I, I was a Van Riper fan and learned from him. I even had him as a, a supervisor, uh, an advisor in my clinic, which was humbling. Very humbling.
Denise: I love, I love to read the books by Van Riper. Um, they're old, but there's gems in them. I'd have a highlighter in my hand.
Char: Definitely, definitely. definitely. I, yeah. Uh, he is, he was a character. And, you know, and, and you know, I, I know we don't have time to, you know, to tell all the details, but at the end of every semester, he would, invite all of his, class, all of us students, out to his farm. And I went, you know, out there a couple times and you'd get to, to meet his wife, he called her the madam. And, uh, I have this visual image of him rocking in his chair, in, in his rocking chair in front of his fireplace, smoking his pipe. And, uh, he, you know, and, and then he would take us out and we would walk among the, the rows of corn and the stalks of corn. And he would just, you know, he was just full of wisdom and humor and logic and he was just an amazing man.
So we were so fortunate to have him as the, you know, the initiator really of a lot of, of, you know, where we began, basically, in our field.
Denise: A lot of what we do. Yeah.
Char: Yeah. And he really does, he still in, he still has a, an influence in a lot of what we do. And, and that's kind of where I'd like to, you know, one aspect that I'd like to talk about here that, you know, we all sound stem, you know, we do sound stem, you know, here honey, here, you know, here's, here's the sound. Listen to it. And I remember I get down on my knees and, you know, really next to the child's ear and here's the sound. And I want you to, to, you know, say it just like this. Make it sound just like this.
So we all do sound stem and we all do here, look at my mouth kind of thing. And that's kind of what we do. And that really comes from Van Riper. But here's the key. As an SLP stems the target sound auditorily, and then also visually. Okay? But typically we don't go inside the mouth, but it's more auditory, visual.
The child translates that, interprets that, and then translates that into an experiment of trying to find the positioning in their own mouth, okay? To generate a close acoustic result. All right, so the kid's kind of on their own in there. All right. I mean, we, we give, you know, some clues and cues, but the kid is definitely on their own. And then when there is a perceived acoustic match, then the child advances to the next production level. And, you know, I have heard of and seen some therapists that, you know, if the kid has some S issues, no matter what it is, I don't care if it's a frontal or a lateral or they're omitting or they're, they're stopping or whatever they're doing.
You know, a lot of times the child will put their teeth together, clamp their, their teeth together or, and get a sound. And I have seen therapists time and time again say, oh, that's really good. That's good. Okay, let's keep that one. Now, let's say it maybe consonant vowel or maybe moving into just a, you know, a one syllable word or something. And so we'll take that, that that sounds better. I'm gonna say we get in trouble right there. And you know where we get in trouble? We get in trouble not only with, with advancing, you know, the higher phonemic load, but we get in major trouble with carryover because if you don't have the appropriate, okay, the appropriate stabilization and mobilization, you are not going to be able to fit a teeth closed, um, sort of, you know, S.
Denise: They're clenching sometimes.
Char: They're clenching. Yeah. You're not gonna go 'silly Sally set on the doorstep', you're not gonna do that. It has to be, you have to have that appropriate stabilization mobilization. So now the question is, you know, what is the appropriate stabilization mobilization? And, um, you know, one other thing that I want to mention to sort of go back and, and really address in, in your question, which is more of the larger stabilization mobilization, that also has to do with positioning as far as the overall body position in therapy. That has such an influence on the head positioning, which has an influence on the jaw positioning. And we know that wherever the jaw goes, so goes the tongue. And that that's going to impact the tongue's interaction with the alveolar ridge hard palate, the soft palate, and the, cutting surfaces of the teeth for th. So it's going to impact.
So this is if you, if you're doing therapy in person or if you're doing therapy online, I want that child upright. I want a series of, of right angles, and I want the feet anchored on the floor. That's the beginning of your stabilization, whether you have to put a stool under there, or you know, two or five or 10 phone books, whatever. But I want the kids feet anchored on the floor. I want the trunk upright. I want even the arms anchored, if you have arms on the chair, that's very unusual, but bless you. Okay. Which is a good thing to have. Or just have the child fold their arms in front of them, you know, and anchor on the table in front of them. And I want-
Denise: And the head. The head so often is they, when they attempt to sound, they tilt their chin up and they get tons and tons of tension in their neck, in their jaw, and until you can get that head level and release some of that tension, sometimes they're so locked. Their muscles are, well, I think it being really stiff and locked, they can't do anything.
Char: Yeah. Yeah. That's not, yeah, that's counterproductive, big time. So yes, you want everything, you want the head upright and you want the neck muscles relaxed and you want everything in just good positioning so that the child can appropriately, you know, work with the jaw, lips, and the tongue, just as you say.
Otherwise, things are skewed, that that intraoral interaction is going to be skewed. And I have seen, and people send me videos and we talk about and whatever, and it's like, okay, especially in 2020, you know, you've, bless their hearts. I mean, and here are the kids all over the place, or he is leaning off, or he is sliding down in his chair, or, you know, or he is standing up and he is bouncing all over the place.
And there's, I'm gonna say there's no way to really get intraoral focusing, because half the time I have my kids close their eyes so they can focus intraorally so that you can focus on that proprioceptive sense intraorally. So as to what they're doing with their stabilization mobilization, there's got to be stillness.
I mean, I'm, I'm not talking like, you know, we're working with kids here, but you know, you gotta have at least 50% stillness in, you know, during your therapy sessions or you're sunk, there's absolutely no way.
Denise: You have to have moments of stillness. So moments of stillness when they are so focused, uh, I think it takes a lot more focus than we realize. And get some repeated moments of stillness. They can have a little bit of fun, then you can return back to stillness so they don't have to be, you know, still the entire session.
But, but you can't have, you have to have those, I love that word, stillness. Yeah. You have to have, I call it mindfulness, whatever, focusing in, uh, before you, um, let 'em move around a little bit and then let's come back.
Char: Mm-hmm. Exactly, exactly. Because when you're moving around, and also, you know, when you're moving around, you're, you're not focused on your mouth. And also when you are looking at something, you're looking at something. You're not thinking and focusing on your mouth intraorally. So that's why I have the kids close their eyes.
So that kind of helps with the stillness piece. And, and also sometimes if the child is, you know, rather, and I used to say, okay honey, we need to stop moving and be still, and, and I, I learned to use the word freeze. I want you to freeze. Okay. And that seems to work, you know, better than anything. And, and then, you know, have them focus intraorally and, you know, what are they focusing on? They're focusing on stabilization mobilization.
Denise: So now that we talked about like this sort of whole body stability and mobility, now what does it look like orally?
Char: Okay. You have external lingual stabilization and internal lingual stabilization and the external, to really get a sense of that I would recommend that, you know, you grab a pen and a paper and you write and, and you'll notice that you put the edge of your hand on the table. You are stabilized, and then your fingers are moving the pen.
So you have stabilization, and this is a, this is a major key. You have stabilization near the moving part. Yeah, we just talked about that child that bites their teeth together in an S in an effort, if you will, an effort to try and generate stabilization, but it's not close enough to the moving part. Okay. That's a form of stabilization, but it's, it's, it's not going to work because you need the stabilization. If we're doing an S then the front part of the tongue lowers and sustains itself in space while the air flows through, and so you've got to have that nearby stabilization. So that's just an example, but let's talk about the external stabilization. Just as you have your hand on the desk, on the table and your writing, that is external stabilization. Let's talk about the external stabilization of the tongue. And this has actually been studied since the 1800s, and they've been, trying to study it through palatography.
Palatography has been around a long time. And I even have a 1941 article on palatography and how they used, I think I really, I think it was like charcoal and they would put it on the edges of the tongue and then have the person say the speech sound. Then they would open and they would see, you know, the black, what it, you know, if it came off onto the, onto the teeth or onto the perimeter, the palate or whatever, you know.
So palatography has been around and then they went into electropalatography, thank goodness, where they have electrodes in the, in the palate, you know, the, this acrylic, palate that they make with electrodes in there. And then they have the individuals say the speech sounds, and then they can see, you know, on a screen, what parts of the palate that the tongue is touching.
And, that I even have a, a really, a nice current, 2019 article on, palatography so it's, it's continuing to be done, but here's the thing. the sides of the tongue on the palate is a really important thing. But also, not everybody makes extreme contact with the perimeter of the palate. A lot of times you just make contact with the sides of the teeth. Okay, so that lateral bracing, or I call it lateral margin stabilization, or bracing, which is Brian Jicks' favorite term, and he's a researcher out of Canada who's done some amazing things, and I can talk with you about, his article that he wrote, he and his, his colleagues wrote in 2017.
Bless him. He is one of the few individuals that really look at stabilization during running speech during conversational speaking, almost everybody else from Stone to Gibbons to, you know, a bunch of people that have been doing this for a long time, Hardcastle, a bunch of people that have been doing it for a long time. Palatography and the research and I mean, they've been doing some amazing things, but it really looks at the speech, sound and isolation, which is good. And that helps us, oh honey, put your tongue here to stabilize, to anchor, to give your tongue support to the part that is moving. And really that's what it's doing. Okay. And that is the external piece. There's also an internal piece too that I wanna talk about,
Denise: Okay. So the external piece is the bracing of the tongue.
Char: Right, it's the bracing of the tongue on the perimeter of the palate and the side teeth. Now the thing to remember and to know is that there are different amounts of contact for each sound, okay? Not every sound has full length of, you know, the sides of the tongue on the full length of the perimeter, the palate, and the sides of the top teeth.
You know, there are varying degrees because the front tongue lowers. So like the sound that has the greatest level of external stabilization is really the N. Okay? And then the next one is the T. So if you do these mm yeah, you feel, you know, complete contact there. The tongue is above the horizontal midline of the mouth up within the dental arch.
And I'm not talking hard palate, that's a vertical arch. I'm talking the horizontal arch of the dental arch. Okay, so the tongue operates up within the dental arch most of the time, except for low vowels, low fronts, and low back vowels and the ths, all the other speech sounds are up within that dental arch.
Okay, so bottom line, if you see a lot of the surface of the tongue when a child is talking, then that tongue is not up within that, that dental arch. Okay? You shouldn't really see the surface of the tongue when a person is talking except for low vowels. Okay? Maybe they'll open up for low vowels.
Denise: That's a really good practical cue to watch for. I love that. Just observe.
Char: Yes, exactly. And that tongue that is up within that dental arch is achieving, you know, full surface to surface, you know, full contact on the sides there for your, for your ends. a little less contact because the front part of the tongue mobilizes and releases for the T's and the D's. Then a little bit less for the S's, the S and the Z, then a little bit less for the sh and, and the ch, you know, and so on, and, and because the front part of the tongue is lowering more and more and more, see, and so you're going to see less contact or you're going to feel less contact on the sides, but it's still, you still need that stabilization.
Now here's the interesting piece with the internal stabilization, and that is that stuff that I learned back in the eighties from Dr. Hall, okay. This stuff has been around a long time and what is happening and to make this, you know, kind of a short explanation, you have the tongue that is contracting in the center and making like a little tongue bowl, b o w l bowl.
Denise: Yes.
Char: And that provides the anchorage one for the front tongue to move. And it also shortens the muscles so that the front part of the tongue does move. There is no way to move, to curl, to lift, to elevate the front part of the tongue without contracting the center. There's no way. Okay, so if you have a kid that has this flat tongue and it's moving horizontally, cuz you see all speech sounds, except those goofy th's all speech sounds are vertical, front tongue, vertical, and then back tongue, vertical, all speech sounds. And then th is that horizontal tongue moves down, you know, basically within the cutting surfaces of the top and bottom back teeth and moves horizontally. Totally different than all the other consonants. it's just goofy.
Denise: That's a really useful way to categorize sounds as opposed to what I learned in, uh, what I learned in grad school about the different categories we have for sounds. We call these liquids, we call these bi-labials. Well, actually bi-labial is a really useful way to think about it, but others not so much because they don't really describe the manner, place, manner, voice. And that's what we all used, you know? Yeah, is not as helpful as looking at it from a stabilization and mobilization perspective. And how the tongue is vertical. I really love that. I think it would be so valuable to teach our kids in, kids. I think it'll be so valuable to teach our students, a new way to look at sounds.
Char: Yes, yes. Yeah. And they can understand this and they do. They absolutely do. And you know, as I think about our field, you know, we, we went through the whole distinctive feature thing, you know, with the binary and, the, the P is a plosive and it's puff plus plosive and it's a minus plosive. And you know, that's what I kind of, you know, was taught there at Western Michigan University. And I have to say, I just thought it was a ridiculous way of, of looking at sounds, cuz it did not help me at all when I would go into the clinic. Okay. It did not help me at all. It was purely just a way of categorizing things for researchers, which, you know, bless them, which, you know, was a good thing.
But, and then we went into, place, manner, voice, and then also the phonological processes, which phonological processes to me, you know, and there are supposed to be things that a lot of kids do as they develop. but you know, it's kind of telling me what the kid is not supposed to do.
Denise: Yes, it's not, it doesn't tell us what they need to do. It tells us what we don't want them to do, not what we want them to do. That's what I came to realize about phonological processes. But you something here, you said, um, I had to find it here. Your observation on one of your blog posts. Children don't learn sounds, they learn movements and the sounds emerge.
Yes.
I just love that. That's what the baby does. They're playing, they're not trying to make certain sounds. So the speech that develops naturally and ordinarily and correctly is from the child learning how to move all their articulators in their jaw and.
Char: Yeah.
Denise: And then the sounds emerge. And if sounds don't emerge correctly, well, what do we look at? We need to look at movement first and foremost. And I will say that some children after they get really good movement, do have phonological awarenesses who stacked on top.
Char: Sure. Sure.
Denise: But, the motor is, if, if you're not looking at the motor you could be missing a huge piece of what is keeping that child from progressing.
Char: Yeah. Yeah, I totally agree. I mean, the mouth is kind of important. You know, the mouth is the source. It's the source, and, and that's not to say that the whole phonological piece is not important because oh, wow. It sure is. But we need to look at the whole system.
Denise: The whole child, Not cut it in half.
Char: And, you know, the phonetic piece, the sensory motor, yeah. Yeah. Not just the cognitive language piece.
Denise: Because then, because then we cut half the picture out, they're all important. But in our profession, in recent years, there's been a tendency to, uh, sort of disregard the motor piece, at least by some people. Yeah.
Char: Oh yeah. Big time. Big time. Yeah. That's a whole nother podcast, Denise. Yeah, that's really is a whole nother podcast. Yeah. And, uh, and that is just way unfortunate, because it really has set many, some, some of the new therapists off on the trail that, you don't focus on the sensory motor piece.
And, and I'm, I'm giving equal weight to the sensory piece as to the motor piece because, you know, as we have mentioned, there is interaction going on, and you can't see it. You are totally relegated to the proprioceptive, tactile information that you're receiving inside of your mouth. And it doesn't become auditory until you say it, and then it's too late. Okay. So, yeah. Yeah, I mean, it's good for feedback and, oh, okay. Let me see. How did that sound? Well, let me think and I'll see if I can adjust, but I'm not sure. So focusing on the sensory piece, the propreceptive and tactile piece, I think is really important.
And it's unfortunate that in our field in America, and I've done a, a, you know, ton of investigating, I'm gonna call it. And I, I have a gazillion articles and whatever, but, um, and I love to, to read most of them. Okay. But most of the sensory information is being done outside of the United States. I'm talking Sweden, Japan, Brazil. Okay. Outside. You don't see a lot happening in America, and that's kind of too bad. One last thing that I'd like to say about this phonological piece, it's so very important, but I was around when the phonetic piece, you know, the emphasis on the oral involvement was being, overshadowed, I'm gonna say was, you know, this new phonological piece came in and I've gone back and looked at articles that were being written at that time and many, many of the researchers, and number one was, was Mark Fey, f e y. And he wrote a really good article on phonology is really important, but the phonetic piece is just as important and we can't give up the phonetic piece, the oral sensory motor piece and just go into phonology but then that's kind of what we did. And he wrote that back, I think it was in the eighties. And, from that time on, we just have pretty much ignored, and then especially when Dr. Loff(?), brought his information in and, you know, I would love to talk about all of that, but.
Denise: We might have to do another podcast.
Char: And that was, we could do another podcast. I, I would really like just to sort of plant the seed. And, and really the article that just kind of sent it over the cliff was, Dr. Loff's(?) Article, I think it was 2008. And, he and Watson did a survey and he concluded that, that what people were doing what they were using and so on was not working. And if you actually take a good look at that article, I would've concluded much differently. Just reading you a little bit here, let's see if I can find it. 85% of the SLPs that filled out the survey, 85% of the respondents reported using oral sensory motor tasks to deal with children's speech sound problems as being positive. 85% of them. Okay, and yet the conclusions, the conclusions that he came up with was exactly opposite. So and you kind of have to read through the whole thing. And I wrote a blog on this and it's my number 55 blog and it's called Read the Whole Journal Article, Not Just the Conclusions.
And then I have another article there, Speaking Tongues Are Actively Braced, and that was number seven article, on my website, speech dynamics.com. And that's the Jick article, the 2017 article on, the lateral margin stabilization, the bracing piece. So, I'm just glad that, you know, Dr. Jick and several other people have been continuing to focus on research about stabilization and so on, verifying that working with the mouth is important. So I'm hoping that things will begin to sort of swing around and if we can come back to a balance.
Denise: And I think this is why we had to take statistics. I, I hated every bit of it, but we, I can read a journal article and I can kind of remember that because we do, you need to not just read the abstract or what someone says about it. You need to be able to read the whole article and say, okay, so this is how they set up this study and this could be why they drew this conclusion and maybe why I would draw a different conclusion. So to me, that's the value of statistics. I would never actually do a statistical analysis myself.
Char: Well, you don't have to, you have to work with those kids. Remediate those kids. Yeah. Yeah. We're on the front lines.
Denise: We are, um, let's, let's kind of move into carryover and oral resting posture because this is huge.
Char: It is huge. and you know, not everybody is looking at resting postures, okay. But it is something that, that I started looking at right out of the gate. Even I actually was a student at Loma Linda University and, my professor, Dr. Fletcher Tar, wrote a little book on oral resting postures.
And this was back, oh yeah, it was back. It was just back. Okay. It was just back in the seventies basically. And, I remembered that it, he was so excited about that and it made such sense. And he was saying things like, oh, the, you know, the, the lips are gently closed and the tongue is up on top with the front fourth to third of the surface of the tongue on the alveolar ridge, or just on part of the hard palate, you know, however your intraoral hard tissue is, is shaped and, that your jaw is just gently relaxed. And he had a little book on that, and then he said, that is the central operating zone for your speech sounds. And I never forgot that. And so then I went from there to, you know, Western Michigan University, and I'm talking with people about resting postures and lo and behold, nobody's talking about them. And so really resting postures has not, ignited in our field. but really it establishes the zone. And I tell my kids this, it's, it, it establishes the neighborhood where speech sounds are made, and so your tongue is up within that dental arch. The sides of your tongue at rest are just gently, touching the sides of the teeth.
And that's where your tongue needs to anchor for most of the front tongue vertical speech sounds. And it's in the zone. Okay? It's, it's contacting the alveolar ridge where it's going to be interacting for Ns and Ts and Ds and S;s, and Zs and, and so on. And it's just, it's right there. and there's the positional piece, and then there's also the muscular piece to, to put your lips closed, your tongue up, and you're joly relaxed. You are in essence, exerting what's called mild tonus, t o n u s contraction, where you're putting out a little bit of effort to maintain that position. Okay. And I mean, it's like at night you go to bed and maybe you put your thermostat down to, you know, maybe 68 or something, and then the next day you put it back up to 72 or 73.
You don't just turn off, you know, your heating. You don't just turn it off because then the next day it's gotta come all the way from what you know, 42 all the way up to 73. So your muscles are at the ready, to move into speaking, chewing, and swallowing at a moment's notice. So not only is it important for positioning, it's important for muscle activation, if you will.
Okay. And especially for, you know, that's one of the things through the years, just ask the kids, you know, where do you keep your tongue when you're not using it? And if you have a child whose tongue is low, or low forward, well they're out of the zone. Okay. And, and getting that tongue up within the zone, as you're working on the speech sounds and building capability and so on, that is going to help you with your carryover because the tongue will be, I'm gonna say used, used to being in that zone.
Denise: It will always be positioned, it'll all be be in the right from the get-go. And, and so they don't have to think about, oh, now I gotta put my tongue in the right position so I can make this sound correctly. Cuz who does that in running speech? Nobody does that in running It has to already be there that it can function quickly and accurately.
Char: Oh, you got it. You got it. it's in the neighborhood. You're not gonna head out of the neighborhood and then go back, you know, have to, drive home to pick up something and then go back. I mean, it's,
Denise: And that's why some of our kids will succeed at the single word level or maybe two words level, because they have the cognitive capability to carry that load to think about just that single sound and get their tongue in the right position, even if they don't have a good oral resting posture, they can do that. Then you try and move on to carry over and everything just falls apart.
Char: Yeah. Yeah, because they're, they're not going to, they're, if they're lips, tongue, and jaw are in the good resting position. That is the necessary piece, so that that tongue puts out as little physiological movement as possible to access the speech sound. So if their tongue is resting on the bottom, they're probably not gonna say, Hey, I gotta elevate my tongue up here to make my S and s H and c h. They're just gonna stay down because that's most physiologically economical.
Denise: So we do really make minimal movements with our, when we speak, the movement really is minimal. cuz our bodies don't wanna be efficient. They wanna be efficient.
Char: Oh, I like that word. Yeah. Yeah. It's movement efficiency. It's movement refinement. Yeah. And it's all based on that external stabilization and internal stabilization.
Denise: One more thing. It's a, it's really eye-opening how many of our clients don't have a good oral resting posture, and after I started focusing on this, and I was still working in the schools, and every time I pulled up the child's, file to work on the REP or whatever, their little school picture would show up, and I started looking, oh my goodness. That child doesn't have a good, that child doesn't have a good oral resting posture. That child, it's, so, it affects a huge number of our clients that we work with. This is just not a small section or it's just not applicable to kids who have some other kind of motor disability, like cerebral palsy or something, although you certainly see it in that population too, but just your garden variety, if I can use that word, child who's coming to work with you for S or R, whatever, you know, their oral resting is probably involved.
Char: Yeah, for, for multiple. Yeah. Yeah. It's across the board. This, this all is another, you know, podcast. But, I use the term obstacles because there are obstacles that impede the appropriate stabilization and mobilization and impedes the, appropriate lips, tongue, jaw resting positions. So those obstacles can be, nasal obstruction. So the, you know, the, the jaw is lowered. The tongue is lowered, so it's out of the zone, right there out of the gate. Sometimes you end up with, from a jaw that is lowered excessively and chronically during the first years of life, like the first nine years of life, you can, the, the face can be altered so that you end up with a lower third face, and then it makes it more difficult for the lips to close.
So you end up with, I'm gonna say maxillary excess, and it lowers, the jaw lowers and, and it's difficult to close lips and then to elevate the tongue because when lips are open, the tongue is down, then you can have a narrow dental arch that can impede the positioning of the tongue for your stabilization mobilization in your resting positions.
Or you can have a restrictive lingual frenum or you know, I mean your labial frenums can restrict labial closure, which can impacts when lips are open the tongue is down, bottom line for wherever the lips are open. Okay. maybe lips are open because you know, you have an overjet, you know, whatever. But you look at those options and how they potentially influence your bracing, your stabilization, and then also the potential for the mobilization of the speech sounds, and also ultimately your resting positions.
So that's the connection, it's the obstacles. And then you have, like you were saying, if a child has CP, that's obviously a neurophysiological obstacle. Okay. Or maybe you have some kids that have cognitive obstacles or maybe you have a child with, with Downs Syndrome that has all sorts of obstacles. You know, the shape of their head, is different.
And so you end up with a tongue that, protrudes more than it should, or that, that you would want it to. Or maybe you have, you know, muscle issues with, you know, children with Downs Syndrome cuz they know that, where they're more hypotonic. And so all of those are issues and obstacles that can impede your stabilization, your mobilization, and your resting postures.
Those, that's how all of that fits together. So your resting postures, your stabilization mobilization for your speech production is the core and everything else dances around it because those things impede.
Denise: Yeah. So we've gotta remove the obstacles. So suppose we have an SLP listening who is not familiar with any of this, didn't get it in the university training. What could that SLP do? Where could they go to learn more?
Char: Okay. Okay. Well, there's a ton of, you know, I've got a bunch of stuff out there, you know, and all this is sort of self-serving, of course, I have been around a long time, you know, so I do have of stuff.
Denise: You have some excellent things. I'm using one of your handouts right now with one of my clients who has dysarthria and it's, it's wonderful.
Char: Good, good. good. Well, you know, I've got the website that has, you know, some books and, and things on it. There's articles. It's speechdynamics.com. And, you know, Therapy Matters is the blog. And, you know, I'm remiss, I haven't put, you know, a, a blog up there for quite a while. And then also you mentioned in the introduction, you know, the Seven Minute Speech Solutions, and I'm gonna be recording that this weekend, so I'm getting that started. But that will go out to everybody that's on the list. And so you can go and sign up for the newsletter, but if you're on that list, you'll get the Therapy Matters print, and then you'll also get the Seven Minutes Solutions audio, or the video. I'm gonna be doing video and then just sending that out to everybody. So there's that.
Denise: Will that be a link from Speech dynamics? Can people get to the Seven Minute video or the Seven Minute Speech Solutions?
Char: I'm gonna have like a, um, you know, like a script and that'll be the Therapy Matters blog. And then you can also watch, watch it it. It's gonna be an mp4 and I'll have a link on, on there as well. Um, yeah, yeah, there's that. Um,
Denise: Any links that are up that are current, I'll put them in my show notes.
Char: Okay, thank you. And then this, speechtherapypd.com. I've got a bunch of, videos there. And then I also do The Speech Link, as you know, the podcast I just did one last night, and then you can access those just, you know, on any of the, the audio podcasts that are out there, you know, apple, apple and POD being in tune in and all those. and then also, oh, you know what I'm gonna be doing, you know, someone may be interested in this new thing that Speech Therapy PD is doing. They're doing mentor courses and so my mentor course, I am doing two mentor courses, on Sundays starting February 5th, and they'll be every other week for six weeks.
And, I'm doing one on the front tongue vertical, sounds like S S H C H and so on. And then one on R and there it's like Eastern Time six o'clock to seven. And then, the R is, that'll be the S then the R is 7:30 to 8:30, and that's through Speech Therapy Pd.com. And I don't even know how much it's gonna cost or whatever, but that's, that's through them and they'll only be like eight to 10 people in there, and we'll walk. I think so too. And people can play their videos of their kids, you know, get, get a release of course. And it'll be personalized according to everybody's needs. And, you know, you'll have things to do over the next couple of weeks, then come back and say, Hey, this is what I learned and hey, do I have this question about it?
So I think that'll be kind of fun. And then also on speech therapy pd.com. That's not my website. Okay, so I'm not, you know, self-serving on that one. But there is something that's called the Community Hub, and, Margot Kinser Quarter(?) And I are doing the speech and language for the school age kids. And it's kind of like a, a Facebook, but you know, we put in topics and people respond and, and that's very personalized as well. But it's on specific topics. So that is within speech therapy pd.com.
Denise: Those are all excellent resources, so any SLPs out there who want to know more about this, you know where to go. And also, I'll put in a plug for my beloved PROMPT therapy, which also teaches about stabilization and mobilization and oral resting posture. And they actually talk about the tongue as a muscular hydrostat too.
Char: Do they?
Denise: Well, Um, so there's, there's a lot of options out there. Thank you so much, Char. we learned a lot. This has been an excellent interview and we might have I have touch bases again on a further podcast. Yeah.
Wow. Wasn't that a feast. There are a lot of takeaways here. One that I'm going to use a lot is the fact that we shouldn't see the surface of our clients tongues\ very much. Because if we do, it means their tongues aren't residing in the optimal neighborhood for optimal speech. That's a very practical, easy to implement tool we can use when we're observing our clients.
And you know how I love simple tools for optimal outcomes. Char gave us a lot of resources and I will link as many as I can. In the show notes, You can find those show notes at the speech umbrella.com/blog/ 79.
So be sure to check those out. As always, thank you so much for joining me on this podcast and see you next time.
