MYOFUNCTIONAL SPOT - WHO ARE WE?

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Hello! My name is Dena Freedman-Muchnick, M.S., CCC-SLP, CLC and I am the Clinical Director and Owner of Myofunctional Spot. We provide individualized services to treat myofunctional (pediatric and adult), speech, feeding and voice disorders. We are a small concierge clinic that focuses on an integrated "whole person" approach treating the root cause of dysfunction.

Choosing the right provider can be the single most important decision when pursuing Myofunctional Therapy. Our highly skilled and experienced team of Speech Language Pathologists will assist you in building your Myofunctional Team, and guide you through the entire process from the time of your first call. We limit the number of clients that we work with, to assure that each client receives the highest level of care. We will collaborate with the other skilled providers/physicians on your team to assure the best possible outcome for you or your family member. We pride ourselves on our individualized holistic approach, and would love the opportunity to help you achieve your myofunctional goals.

As a Speech Language Pathologist (SLP) who specializes in Infant Feeding, Lactation and Orofacial Myofunctional Therapy (OMT) I diagnose, treat and prevent feeding and swallowing disorders, specifically Orofacial Myofunctional Disorders, in patients from infancy to adulthood. My work centers on empowering my clients with tools and strategies to encourage healthy facial and airway development and teaming with other practitioners to see the greatest health outcomes. I also provide oral habit elimination intervention (e.g. thumb and digit sucking). 

My services:

Effective EVALUATION that identifies the root cause of impairment.

Integrative INTERVENTION that treats the root cause of impairment.

Interdisciplinary COLLABORATION that supports the whole patient.

Preventative EDUCATION that empowers the patient and the public.

Speech & Myofunctional Early Intervention through my TINY MYO PROGRAM for children ages 1-5+ years.

What are Orofacial Myofunctional Disorders (OMDs)?

Orofacial myology, a specialty field in speech pathology, focuses on nasal breathing and appropriate resting postures of the tongue, lips, and jaw. Common disruptions, known as Orofacial Myofunctional Disorders (OMDs), include sucking habits, tethered oral tissues, and the familiar "tongue thrust" all of which can greatly impair facial, dental, and airway development. In order to properly speak, breathe, and swallow, the muscles in our face, mouth, and throat need to be structured in the correct position and coordinate as they move together.

Few people know exactly what a Speech Language Pathologist (SLP) does. We wear many hats in medical, academic and outpatient settings. My scope of practice includes speech, myofunctional, language, voice, feeding, swallowing oral motor, fluency and cognition.

According to the American Speech-Language and Hearing Association (ASHA), Orofacial myofunctional disorders (OMDs) are “patterns involving oral and orofacial musculature that interfere with normal growth, development, or function of orofacial structures, or call attention to themselves.”

Here are a few examples of Orofacial Myofunctional Disorders (OMDs):

• Reverse Swallow/Tongue Thrust 
• Mouth Breathing (during day or night)
• Jaw malocclusions (such as an overbite, underbite, or open bite)
• Ankyloglossia (tongue or lip ties)
• Negative Oral Habits
• Sleep Apnea/Sleep Disordered Breathing
• Temporomandibular Disorders (TMD/TMJ)
• Chewing/Feeding/Swallowing Dysfunction
• Issues with Early Feeding Skills/Oral Motor Development

OMDs can be caused by a combination of Structural, Functional or Habitual etiologies and their impact on the mouth and facial muscles over time. 

Causes include:

• Genetics
• Orthodontic issues
• Thumb or finger sucking habit
• Prolonged use of sippy cups/pacifiers
• Structural abnormalities (oral restrictions/tongue tie etc)
• Incorrect Oral Postures
• Neurological disorders
• Obstructed nasal passages (for example, due to enlarged tonsils or adenoids, or allergies), causing the tongue to be in an improper position.

Myofunctional therapy is a program used to correct/retrain oral dysfunctional patterns of the tongue and lips, and facial muscles.  It involves strengthening of the tongue and orofacial muscles by teaching individuals how to engage the muscles and improve range of motion, mobility and coordination. Myofunctional Therapy targets proper function of the orofacial musculature at rest, during eating and swallowing, and optimal breathing patterns. 

Many symptoms of OMD can appear "typical" and even common. Things like mouth breathing and snoring are just accepted or joked about, even when they are extremely disruptive to one's life. Even migraines, TMJ and Obstructive Sleep Apnea (OSA) have become more of the norm. However, oral dysfunction is never normal. When structural issues such as oral restrictions (tongue ties) go undiagnosed and untreated, it can lead to a cascade of other issues and symptoms. 

According to the Academy of Oral Myofunctional Therapy, “Orofacial Myofunctional Therapy is neurological re-education to assist the normalization of the developing, or developed, craniofacial structures and function. It is related to the study, research, prevention, evaluation, diagnosis, and treatment of functional and structural alterations in the region of the mouth (oro), face (facial), and regions of the neck (oropharyngeal area).” 

There is a growing body of evidence based research that demonstrates how atypical orofacial developments and swallowing patterns (often observed in patients with OMD) are correlated with disordered-sleep breathing, obstructive sleep apnea and/or pediatric obstructive sleep apnea. Breathing and swallowing are the first and most important actions an infant takes when entering the world. Breathing and swallowing (up to 1000 times a day) are the body’s way of establishing a state of homeostasis. Treating OMD with Myofunctional Therapy not only improves tongue posture and swallowing but also supports healthy airway and facial development. Myofunctional Therapy has also been shown to support patients with  sleep-disordered breathing and sleep apnea.

Myofunctional Spot offers therapy to treat Orofacial Myofunctional Disorders (OMDs), which is an umbrella term that includes various disorders of the muscles and functions of the face and mouth. Myofunctional therapy is based on a series of exercises that help patients learn to change bad habits. Our treatment programs are aimed at helping our clients live a pain-free, healthy life by regaining the joy of eating, speaking, breathing, and sound sleep.

Our therapy corrects issues that include the following:

• Thumb or finger sucking habits
• Oral rest posture
• Mouth breathing
• Dysfunctional swallow patterns (reverse swallow/tongue thrust)
• Sleep Apnea
• Functional Oral Restrictions/Tongue Tie
• Pre/Post Frenectomy (tongue/lip ties)
• Voice/Resonance Therapy for Professional Singers undergoing Frenectomy
• Fluency/Stuttering Therapy
• Feeding Issues (oral preparatory phase)
• Chewing/TMJ
• Early Feeding Skills
• Speech & Myofunctional Early Intervention through my TINY MYO PROGRAM for children ages 1-5+ years.
• And so much more….

Myofunctional therapy is all about changing habits and strengthening muscles to improve the way we breathe, speak, chew and swallow. It’s possible to have life-changing results from a myofunctional therapy program, such as eliminating a mouth breathing habit or easing sleep apnea symptoms, but it’s worth bearing in mind that every patient is different. Some OMDs are strictly habitual, and will require less treatment, and can be resolved by therapy alone. Other OMDs require multiple physicians working together to resolve symptoms. If structural issues are involved, such as enlarged turbinates or tongue ties, your myofunctional team may include a dentist, ENT or oral surgeon among others. 

Speech therapists offer complimentary myofunctional therapy as part of your overall treatment plan. Most physicians/surgeons will not conduct certain procedures (such as a lingual frenectomy), without simultaneous pre & post-surgical myofunctional therapy to assure that the behaviors and patterns are corrected along with the structures. Every situation is different. Most of our clients have been to multiple specialists, explored various treatments for their lifelong symptoms - oftentimes myofunctional therapy is the "missing puzzle piece". 

Proper oral rest position during the day and while sleeping includes the lips sealed together, the tongue pressed up against the palate, and nasal breathing. Due to various reasons (structural and habitual), many people breath through their mouths instead of their nose. Eventually, this turns into an open mouth habit with a low resting tongue. Once this pattern becomes habitual, it persist throughout one's life because the muscles of the face and tongue never learn to function correctly.

If we were to take a closer look at the tongue and where it rests in the mouth, often we won’t find it in the correct place at the top of the mouth, pressing against the palate. Instead, it will rest low in the floor of the mouth and push forward against the teeth when swallowing. This is known as a reverse swallow or tongue thrust swallowing pattern. The reverse swallow then causes a loss of muscle tone in the muscles of the tongue leading to all kinds of problems ranging from digestive issues to sleep apnea, as well as dramatically changing the shape of the face.

Myofunctional therapy programs focus on four main goals. If you are able to accomplish these four goals, it will lead to a healthier, happier version of you!

THE 4 GOALS ARE:

These goals may sound simple, but for people with dysfunctional oral, facial, breathing and swallowing patterns, they can be quite challenging....requiring intensive treatment to retrain the various systems to work functionally. 

Myofunctional Therapy vs. Speech Therapy

It’s important to clarify that myofunctional therapy and speech therapy are not the same thing. Orofacial Myofunctional Therapy (OMT) is a type of therapy that certain Speech-Language Pathologists (also known as Speech Therapists) specialize in. Not all speech therapists have pursued the additional training and experience necessary to become proficient in assessing and treating OMDs. 

Myofunctional therapy exercises can be considered a foundational treatment when approaching speech problems. However, speech therapy will NOT resolve an Oromyofunctional Disorder. Some children receive speech therapy for years, with no progress. Some people carry their speech articulation errors into adulthood. I am sure we can all think of an adult that we know who has an obvious "lisp" or who pronounces certain sounds differently. Oftentimes in these cases, there is something deeper going on that has been overlooked. 

How Can Myofunctional Therapy Help With Speech?

What’s great about myofunctional therapy exercises is that they can be used as a foundational treatment when addressing speech problems. Myofunctional therapy programs can teach both adults and children precise movements and placement of the tongue, along with the muscle control that can address functional problems related to speech. Speech & Myofunctional Early Intervention is extremely proactive for eliminating potential issues in small children ages 1-5+ through my TINY MYO PROGRAM.

Just like physical therapy, some patients will need more exercises over a longer period of time, while others are fine with shorter treatment programs. It all depends on the individual patient’s presentation and symptoms. For example, a seven-year-old girl with a thumb-sucking habit will require a vastly different treatment plan than a 46-year-old male who has been diagnosed with sleep apnea due to lifelong improper tongue position and swallow patterns.

This is why I offer a variety of Myofunctional Therapy Treatment Plans ranging in price and duration, all of which are tailored specifically to your unique needs. To learn more about my programs (click here).

ALL ASSESSMENT AND THERAPY SESSIONS UTILIZE A TELEHEALTH SERVICE DELIVERY MODEL AND ARE PROVIDED FROM THE COMFORTS OF YOUR OWN HOME. 

Please be advised: due to licensing restrictions, any Telehealth sessions with participants outside of the state of Florida or California can only be provided within a consultative or "coaching" capacity and therefore are not eligible to receive superbills or insurance reimbursement. 

For additional answers to Common Questions as it relates to Myofunctional Therapy, please visit our FAQ  page.

I'd be happy to discuss your specific concerns. Contact me for a free consultation to see how Myofunctional Therapy can help you.