Since it is my philosophy that only children who really want to stop sucking and are ready to stop sucking be taken into The Thumbsucking Elimination Program, success is fairly high in the Thumbsucking Elimination Program. In the past 15 years, my exit surveys indicate that the VAST majority (90-95%) significantly alter or stop their thumbsucking habit in the first 24-48 hours. It is also my feeling that a child who is not ready to stop thumbsucking will not stop, no matter what program they are placed in, nor what tool they are given to assist them.
Will a child ever be a participant in The Thumbsucking Program if they are not ready?
I can count on the fingers of my hands just how many children have been admitted to the Thumbsucking Elimination Program who were "on the fence". They were exceptions because a pediatrician felt it was a dire necessity I work with that particular child on their thumbsucking habit for a significant medical reason (severe dermatological or systemic infection that the doctor had diagnosed and was traced back to the thumbsucking). In those instances, it was only upon a physician's referral. I really need a "spark of readiness" from a child...but I will address this question more below...
We have tried EVERYTHING to help with their thumbsucking...what makes you think YOU can succeed?
Almost all of my families in The Thumbsucking Program have tried on multiple occasions with multiple modalities to help curb their child's thumbsucking habit with limited success. Some children have had multiple failures that have caused them to feel severely defeated and may have even challenged their self-esteem. The norm in my office is the child that has tried and tried again and again, feels sad or frustrated or discouraged from their unsuccessful attempts, but is willing to come for help or even excited and renewed and actually looking forward to meeting someone who can help. A third party who is skilled in this process can make all the difference...I truly believe that it is the fact that I am an outside resource with expertise in thumbsucking elimination that makes the difference and helps a family move forward. If I feel I cannot help your child with their thumbsucking, I will not put you and your family into a situation of potential failure or frustration. That is not what I am all about...that is not what the thumbsucking program is all about. It is about helping a family SUCCEED and not helping a family to TRY to succeed. I will tell you honestly and candidly at that initial appointment if it is not the best time to do this, but that I would like to leave the door open to revisit the option to stop thumbsucking in a few months, etc. If you are open with me, and are able to explain your circumstances succinctly, I am usually a very good judge of being able to tell if a child is ready to stop thumbsucking, and if a family can work together successfully in this endeavor...after 15 years I stake my reputation on it. And, although it has happened, it is rare a child is referred to my office by a health provider unless they are in a "good place to succeed". I have been doing this work for 15 years successfully. I have a plan that works for the VAST majority of families. It will NOT work with a child or family who is not ready or not in a good place physically or emotionally to stop. But when your child is ready, it is my passion to see your child succeed...it is my life's work. I promise you I will give you and your family my all, my energy, and my expertise to help you and your family succeed. If I don't think I can succeed, I will not waste your time.
When is a good time to work on the thumbsucking habit?
When your child is displaying signs of readiness. You may see beginning efforts of your child to cut back on their thumbsucking. You may hear statements such as, "I'm trying to stop...It's just so hard", or "I really want to stop thumbsucking but I just can't"!. These are usually indicators that your child may be open to success. I need a "spark of interest" and a child to be in a developmental place where they are able to postpone gratification. For most children that may occur between ages 4-5 years. I encourage you to call me and discuss readiness. I am always happy to receive this type of call.
When is a BAD time to address thumbsucking and finger sucking elimination?
Any recent major life change can be a potential issue... A new or upcoming new baby, new move, death of a pet or a loved one, severe illness in the family, divorce or separation, or if the child is struggling with other issues of concern usually indicate a poor time to start their process of thumbsucking elimination. If a child has to face any major life challenges, it is often not the best time to concurrently address a thumbsucking habit. I want to work with your child at the most opportune time, not "throw spaghetti at the wall and see if it sticks"...
What if my child has a "lovie" along with their thumbsucking?
Sometimes that beloved item is an integral part of the process, other times, we may consider a more modified approach. Either way, I will know once I sit down with the family and talk more about their thumbsucking habit, and will proceed from there with suggestions.
My child is starting to pull their hair and suck their finger/thumb. Will the thumbsucking program help?
It is NOT my position nor place to treat hair pulling. I help eliminate ORAL habits. However, the children that have been referred to my practice by their concerned health care providers that have this concomitant habit along with their thumbsucking habit do extremely well by addressing the thumbsucking or fingersucking as the primary habit. Research has shown that if you address thumbsucking elimination in a child who also concomitantly pulls the hair, the secondary habit of hair pulling will usually subside.
Friman and Hove, (1987) , Knell and Moore (1988), Watson and Allen (1993), Van Noman (1997), Green, (2009).
What is the cost of the Thumbsucking/Fingersucking Program?
The cost of The Thumbsucking Program is based on a comprehensive fee of five visits. Please call the office for further information. I would be happy to discuss this with you.
What about other habits?
Certified Orofacial Myologists, C.O.M.'s, work on a variety of other oral habits, such as nailbiting, inanimate object biting and chewing, tongue sucking, lip biting, pacifier sucking, cuticle chewing, toe sucking, and tongue thrusting. Some habits are more challenging than others, and require more time to assist, but can be improved and impacted with similar techniques and strategies from the core program, with the exception of tongue thrusting. Tongue thrusting requires a more comprehensive approach.
What about tongue thrusting or other tongue and open lip issues?
Inappropriate oral resting postures of the tongue, lips, and jaw, and tongue thrust swallow patterns are some of the most common oral habits the certified orofacial myologist works with. Tongue thrust is an issue that requires more extensive visits... anywhere from 12-20 visits, given no medical or learning challenges and a dedicated practice routine, and due to its' more complex nature, is considered a completely separate entity from the Thumbsucking Elimination Program. Muscular behavior patterns are addressed and oral exercise strategies are required to help the client improve or remediate this particular issue. The majority of our tongue thrust clients are referred by orthodontists, pediatric and general dentists, allergists, pediatricians, speech pathologists, and ENT's. Again, tongue thrust remediation requires daily exercise and tasks, weekly to alternate weekly visits, and the ability for the client to replicate activities appropriately within a framework of skillsets. A client must possess adequate space to train the tongue in, a tongue that is physically able to lift vertically, and also must be able to demonstrate the ability to physically breathe through the nose, as determined by their physician. In addition, the better a client is able to learn and practice their exercise skills, the better the outcome. In regards to the nose, for example, if a client cannot physically breathe through the nasal cavity, or in regards to the tongue, if a client cannot physically lift their tongue adequately, such as in the case of a tongue tie, it would be very difficult to remediate a tongue thrust, as the tongue has to be elevated in the hard palate while the lips are closed gently at rest. One of the main causes of a tongue thrust is the difficulty to nasal breathe for a variety of reasons. Often times it is a client who has had a history of a nasal or tonsil/adenoid challenge that encouraged the open lips rest posture and low postured tongue to coexist, and that issue may have been successfully addressed or controlled by their health care team, but the tongue thrust habit or low rest posture of the tongue and open lips rest posture remains long after the initial nasal or tonsil/adenoid issue has dissipated. The same holds true for the client who may have had a prior tongue tie that was addressed, but the low rest posture of the tongue persists. I work with individuals of all ages with tongue thrust, and my patients have ranged in age from 4-70 year olds.
Do children who demonstrate thumbsucking or fingersucking or have other oral habits usually have a tongue thrust?
Unfortunately, this is usually the case. The percentage of clients with a history of extended thumbsucking is quite high...Anything that encourages the tongue to seat low, such as a thumb placing downward pressure on the tongue, has the potential to encourage incorrect rest posture and inappropriate behavior patterns of the tongue to persist. That is why there is a brief introduction to tongue and lip rest position in The Thumbsucking Elimination Program. The benefit is that not only are we addressing the pressure a thumb can potentially exert on the dentition when a thumbsucking habit occurs, but we are addressing the issue of a tongue potentially pushing or exerting unwanted pressure against the teeth at rest as well. The exercises also provide another benefit. They keep the tongue busy and help with habit elimination...it would be nearly impossible to do the tongue activities with the thumb, finger, paci, etc. in the mouth!
How do I know if I make an appointment I will actually see you personally?
Easy...I do ALL my own appointments. No interns, no assistants, no trainees...When you make an appointment to work on your habit, or for a consultation, I will be doing the work. No one else.
Will appointments infringe on school time?
Since our initial meeting is lengthy, it is often difficult to find that block of time available for the first visit in an afterschool or afterwork slot. This is especially true in the case of the Thumbsucking Program. Occasionally it does happen, such as in the wintertime, but it is rare. Usually that means a weekday morning or mid day appointment time. The good news is that after that initial visit, time is almost always available later in the afternoon for follow ups. The initial visit is generous for a reason. I do not want you or your child to feel rushed. I want to be able to answer all your questions fully.
Do you see adult clients, and if so what is their experience?
Yes, yes, yes! My oldest tongue thrust client was in her 70's! As far as thumbsucking elimination, I have had clients into their 20's, and nailbiting into their 50's. It is never too late to work on an oral habit. And, my adults are some of my best clients! They work hard, they are very motivated to succeed for a variety of reasons, and they are wonderful to work with. In fact, over the past 14 years, there have been times when my practice has actually been made up of almost 30% adult clients!
Why do the majority of people seek your thumbsucking elimination services?
Basically, they have tried so many other techniques and have met up with frustration. Some parents report that they are concerned about their child's socialization and self esteem changing due to the extended thumbsucking, some have noticed bite changes or report their dentists have mentioned bite changes, some parents notice speech issues and "lisping", some see drooling or poor eating habits and noisy or messy chewing at the dinner table, and some parents feel that there is a stigma attached to their older child still thumbsucking or fingersucking and want to address the issue. Whatever the reason, when their child is ready, I welcome their dentist's, physician's, or speech pathologist's referral for help! Often a speech pathologist has referred a child to the office because without eliminating a thumbsucking habit (or a tongue thrusting habit, for that matter), appropriate speech attainment would be challenging. Basically, many speech pathologists report to me that they have referred their client because I have to do my job successfully so they can do their job successfully. It really is a team effort.
What do most thumbsucking children tell you when they come in?
Of course, I cannot share that private information. But, what I can say is that most children who get to the point of walking through my door for thumbsucking REALLY REALLY REALLY want to stop deep down. They are usually just frustrated. And defeated. Some hang their head low out of embarrassment, some walk in feeling a weight has been lifted off their little shoulders now that they have a plan of action. Many children have been teased or bullied about thumbsucking and have never shared this with their parent until the day we meet. Sometimes my job is heartbreaking. But the heartbreak is quickly replaced with joy by the smiles on the faces of the children that return next visit thumbsucking and fingersucking free. Sometimes the hardest thing to do as a parent is make that first call to the office. It is okay for you as a parent to ask for help. It is an important lesson to teach your child. It is okay to ask for help!
We are from far away. What accommodations can be made to our Thumbsucking Program? Tongue thrust clients?
I have had clients from all over the U.S. come to the office for assistance. The official position of our professional organization, the IAOM, is that we may teleconference via Skype. I find this works beautifully for the Thumbsucking and Finger Sucking Program. For tongue thrust clients, I require a face to face initial visit, one on one, but for example, if a tongue thrust client must be away, such as a college student or traveling business person, they can still benefit greatly from a follow up visit via Skype if need be. I would still highly encourage check ins in the office when they are able.
I have more than one child that needs assistance. Will you be willing to work with them together?
Absolutely! In fact, when two or more children attend together, the success can readily multiply! A team effort, especially with the Thumbsucking Elimination Program, is very enjoyable for everyone involved. And, the fact that we can consolidate appointments allows me to structure the fee at a discounted rate!
What should I tell my child when I am considering your services?
Have them visit the website, tell them about the thumbsucking elimination program, ask them if they "want to stop" thumbsucking, and see what they say. You might be surprised at their response...Remember, many children are afraid of failing, and really are motivated deep down. They are open to help since help means they will be less likely to fail again. It is always good to teach children that it is OK to ask for help!
What if my dentist, pediatrician, or speech pathologist has not mentioned your Thumbsucking Elimination Program or has not heard of you?
I would be happy to follow up with them and introduce myself prior to our meeting, as I feel keeping the lines of communication open are essential. We really want that line of communication open and that encouragement in place! A health provider that encourages a child to visit the office is one more member of the team encouraging the child to succeed!
What are your hours?
By appointment. My schedule is very flexible. To schedule an appointment please call (847) 641-4444.
Who usually attends the initial thumbsucking visit?
For The Thumbsucking Elimination Program, the client, myself, and one parent if the client is a child. If the client is an adult, or young adult, they may bring a support person should this be desired. Throughout the process, attendance and participation by that support person is expected. Parents can count on being present with us during the entire process, and therefore the attendance of young siblings or siblings that need monitoring is highly discouraged at the initial visit. This is the thumbsucking child's special time, and having to attend to another child in the reception room can be distracting and break the flow of the process. The shorter follow up appointments are usually easier on a sibling, and more conducive to the sibing's presence.
If the client is a child, should both parents attend?
I have found from experience, it is best if only one parent attend the initial along with the child and myself. There will be ample opportunities in the future for the other parent to be actively involved in the process, future visits, and at home. It really does take a village. However, I find that if both parents attend the initial, for some reason, for some children, it just seems overwhelming.
If I attend tongue thrust sessions, rather than thumbsucking sessions, will there be homework?
Yes. Daily homework for both issues is required. The tasks for each are just very different. Planning any sessions at a time when you can commit to regular attendance and choosing a time to be able to accomplish consistent daily tasks is crucial.
Can siblings attend tongue thrust appointments?
Yes. Also, parents are expected to be present for tongue thrust appointments, but usually a sibling who is able to sit and do homework, read, or play nicely in the reception area is not an issue. This is true for the initial visit as well. However, good decorum is expected.
What if i absolutely need an afterwork or afterschool time for the initial?
There are certain times of the year that make attaining an initial appointment at a requested time more likely than others, such as winter, school holidays, breaks, late arrival, conference, or inservice days, etc. Some parents are just willing to wait a very long time and schedule way in advance to come in at those specific late day hours. My feeling is that it is better to address the thumbsucking issue as soon as the child is excited to be attending, rather than waiting weeks on end to come in at a more convenient time in their day. Sometimes the momentum and excitement can dissipate, and it is important that spark of initial interest remain ignited. Children will be more receptive when they are ready and excited, and more alert in the earlier day hours than late in the evening or afternoon when they have had a long day at school or sports practice/camp. The end of the day is not the best time for an initial visit for the thumbsucking program, and is never my first choice! It is rare that I cannot offer someone a mid day or early day appointment within a few days of their initial phone call. If you are asking me to advise you on optimum times for your child to attend, it is absolutely as soon as possible after you have discussed the program with your child, and logistically in the earlier part of the day when they are most receptive, and as soon as they have decided they are ready to go for it!
What if we get to our appointment and the timing for thumbsucking elimination just doesn't seem right for myself or my child, or my child seems unsure or uncommitted and we are unable to move forward? Will I be charged for the appointment?
The Thumbsucking Elimination Program is designed for children who want to stop. It would be frustrating and difficult to move forward if the motivation is not right, or the timing is poor. As far as the fee, you will not be charged a comprehensive fee, but rather a consultation fee that can be applied to future attendance in the Thumbsucking Elimination Program. I will tell your child I am ready whenever they are, and would like to meet again in a few months, etc. or as soon as they decide they are ready to stop thumbsucking. They are to call me or you are to call me as soon as you feel the timing is right. My quickest turnaround occurred several years ago when a child who came to see me one morning for the initial thumbsucking visit said she was not sure if she was really ready. My gut feeling was that she was ready to stop, but needed to feel she had some control in the decision making process. Sometimes, a child just needs a moment to let the acceptance settle in... And, that's okay. I suggested she think about it and her and her mom could call me when they are ready. They went to lunch and then called me after lunch when the child had a chance to think about it further and decided she would like to return to the office and stop the thumbsucking that day! I had time after lunch in the schedule, and they came back that afternoon. She stopped their fingersucking successfully that very day!
What are some new developments that we are now discovering about thumbsucking?
Right now, the research community is working on exploring the role that a narrow structure, low tonus of the facial and oral muscles, and tongue thrust may play in the development of functional breathing problems, especially at night. There have been dozens of new emerging research projects coming out of the US and the internationally on how a narrow roof, (which thumb sucking and low postured tongues may contribute to), may be involved in this process.
How? If a roof is growing narrow and vertically from a tongue thrust or a thumb habit, researchers speculate so is the soft palate, nose and even airway. According to new research, a child who does not sleep well can show poor school performance, issues with alertness, and may go on to develop sleep disorders. We always knew the thumb and tongue could impact the growth of the roof, but these new studies show that even more concerning issues may develop over time as well. Scientists continue to study these concerns at a rapid pace. Several of these studies point to learning proper rest postures and tongue activity with orofacial myofunctional activities taught by a properly trained therapist and proper childhood screening for tongue thrust and oral habits early in life as a way to encourage proper growth and development as part of team approach. (Guillimianault, 2013, 2014, Pia Villia et al, 2014, Sheldon and Boyd, 2013).
An excellent website that explains some of these concerns is www.brianpalmerdds.com Dr. Palmer was a dear friend and colleague who passed away yet left his website as a legacy in which to obtain further information on the importance of childhood airway and palatal development, the role of breastfeeding in an infant's oral development, and the importance of early childhood screening and prevention of oral maladies.