These exercises are designed to increase the range of movement in your tongue, lips, and

 jaw, which will help your speech and/or swallow functioning.  When doing these exercises, it is

 important to move the designated area as far as you can in each direction until you feel the

 muscles stretch.  Stop if you feel any pain, and mention it to your speech therapist or doctor.

***  Practice these exercises, once through, 10 times a day.
 

TONGUE EXERCISES

Range of Motion:
 1. Tongue Extension
  Protrude tongue between lips.  Sticking out tongue as far as you can.  Hold tongue steady and straight for 3 to 5 seconds.
  Relax and Repeat 5 times.

 2. Tongue Retraction
  Retract tongue, touching the back of your tongue to the roof of your mouth  (as if producing the /k/).  Hold for 1 to 3 seconds.
  Relax and Repeat 5 times.

 3. Tongue Extension and Retraction
  Combine the two procedures above, holding each position for 1 to 3 seconds.  Relax and Repeat 5 times.  .

 4. Tongue Tip Up
  Place tongue on alveolar ridge, (the area behind your top teeth.)  If you don't have any teeth, move your tongue tip up to your gum where your top teeth would be.  Open mouth as wide as possible maintaining tongue contact.
  Hold for 3 to 5 seconds.
  Relax and Repeat 5 times

 5. Tongue Elevation Along The Palate
  Tongue tip to alveolar ridge,  (The area behind your top teeth.)  Move in anteriorly  to posteriorly along the palate.  (Front to back along the roof of your mouth.)
  Relax and Repeat 5 times.

 6. Tongue Side To Side
  Tongue tip to left side of mouth, hold for 3 to 5 seconds.
  Tongue tip to right side of mouth, hold for 3 to 5 seconds.
  Relax and Repeat 5 to 10 times.

 7. Tongue Tip Up - Jaw Down
  If you can perform exercise #4, with your tongue touching behind your gums/teeth:   Lower your jaw as far as you can while keeping your tongue tip up behind your top gums/teeth.  Hold your jaw in that position for 3 to 5 seconds.
  Relax and Repeat 5 times.
 

Tongue Resistance:
 1. Tongue Push Forward
  Stick out your tongue   (As far as you can).  Put something flat, such as the back of a spoon or a tongue blade against your tongue.  Push against your tongue with the flat object, while, at the same time, pushing against the flat object with your tongue.
  Hold for 1 to 2  second.
  Repeat 5 times.

 2. Tongue Push Up
  Push down on your tongue with the flat object, (tongue blade or back of spoon), while, at the same time, you push up with your tongue.
  Hold 1 second.
  Repeat 5 times.

 3. Tongue Push To The Side
  Extend your tongue as far as possible to the corner of your mouth while pressing against a tongue depressor.
  Hold for 1 second.
  Repeat 5 times.
  (Repeat for each side of the mouth unless instructed otherwise).

 4. Tongue Inside Push
  Put your finger against your right cheek about 1" to the side of the corner of your mouth.  From the inside, push your tongue against your cheek where your finger is touching.  Push as hard as you can.
  Hold it for 1 to 2 seconds.
  Relax and Repeat 5 times.
  (Repeat for each side of the mouth unless instructed otherwise)
 
 

JAW EXERCISES

Range of Motion:
 1. Jaw Opening
  Open your jaw as wide as you can until you feel a stretching, but no pain.  Hold this furthest open position for 5 seconds then relax and close your mouth.
  Repeat this open posture 5 times.

 2. Side-to-Side Movement
  Move your jaw to the right side as far as you can until it pulls but does not hurt.  Hold it there for 5 seconds then relax.  Move your jaw to the left side as far as you can until you feel a stretch but it does not hurt.  Hold it there for 5 seconds then relax.
  Alternate this right to left movement 5 times.

 3. Increasing Circular Jaw Movement
  Move your jaw around in a circle making it move as far in each direction as you can until you feel a stretch but no pain.  In this circular movement you will be increasing range of motion in all directions. When you have completed a full circle relax.
  Repeat the circular movement 5 times.
 

LIP EXERCISES

Range of Motion:
 1. Lip Retraction
  Smile.  Hold for 5 seconds.
  Relax and Repeat 5 times.

 2. Lip Protrusion
  Pucker your lips as if you were going to give someone a kiss.  Hold for 5 seconds.  Relax and Repeat 5 times.

 3. Lip Retraction and Protrusion
  Smile then pucker your lips.  Use exaggerated movements.
  Relax and Repeat 5 times.

Closure:
 1. Lip Press
  Press lips tightly together for 5 seconds.
  Relax and Repeat 5 times.

 2. Lip Press on Tongue Depressor
  Tightly press lips around tongue depressor, while the clinician tries to remove it.
  Perform for 3 to 5 seconds.
  Relax and Repeat 5 times.

 3. Puff Cheeks
  Fill cheeks with air, move air from one cheek to the other 5 to 10 times.
  No air should escape from around the lips or the nose.
  Relax and Repeat 5 times.
 

BOLUS CONTROL EXERCISES

 1. Licorice Stick Chew
  Clinician holds one end of licorice stick and places the other end between the tongue and hard palate of the patient.  The patient is then instructed to move the candy for midline to left side of oral cavity.  Repeat at least 10 times.  Next, have the patient perform same activity on right side.

 2. Oral Preparation With Pudding
  Clinician administers small boluses (approximately 1/3 teaspoon) of paste consistency.  The complete oral cavity is examined after the swallow for residue.  If patient is successful at manipulating paste, liquids may be introduced.  (To be attempted only if the patient can tolerate paste consistency).

 3. Fruit Juice On Gauze Squeeze
  (Use only if the patient can tolerate small amounts of liquid without aspirating.)  Take a long piece of gauze, roll it up and soak it in fruit juice.  Place gauze in patients mouth at midline, and ask the patient to push upward and backward with his tongue.  This action will squeeze juice from the gauze.  This will aid in bolus propulsion, and allow the patient to practice small swallow while manipulating solids.