4-24MNRI 3.m4a

The two reflexes I'm going to talk about are the ones you should know and should do, not all of them, but at least two out of all these, every time you do an oral-facial protocol. So you do your greeting, you do your oral-facial protocol, then you'll do two of the reflexes out of the ones I'm going to talk about right now, because they couple together. And whenever I can, I will tell you some of the little things that are along with it, okay? So before the oral facial, or after? After, after. So your oral facial, creating the oral facial, prepare them for these reflexes. Does that make sense now? Okay. First one, ATNR. We all know this one. Head turn, arm extend, leg extend. This is our ATNR.
我要談的兩個反射是你應該知道並且應該做的，不是全部，但每次進行口面部方案時，至少要做其中的兩個。所以你先進行問候，然後做口面部方案，接著從我現在要談的反射中選擇兩個來做，因為它們是相互配合的。只要有可能，我會告訴你一些相關的小細節，好嗎？那麼是在口面部之前還是之後做呢？之後，之後。所以你的口面部方案，準備好口面部，為這些反射做準備。這樣明白了嗎？好的。第一個，不對稱頸張力反射（ATNR）。我們都知道這個。頭轉向一側，手臂伸直，腿伸直。這就是我們的 ATNR。

And originally, it's a vestibular-only reflex, meaning that it's the head turn that produces the extension of the arm and the leg. Very quickly, it became auditory-entrenched also, okay? Which means when you're doing this exercise, it's head rotation first. Unless you want to do mouth-spine rotation, that's a different thing. Mouth-spine rotation has touches and visuals and all that. That's different. Always lead first, then you can add the center. Okay, so the response is an extension of the arm, same time as the head, and the extension of the leg on the same side. Okay, oh I forgot to say that's also bending on the other side; opposite side is bent and the leg is bent. The reason why I didn't even mention it is a lot of times we're having a hard time just doing this right side.
最初，它僅是一種前庭反射，意味著頭部的轉動會引發手臂和腿部的伸展。很快地，它也變得與聽覺緊密相關，明白嗎？這表示當你進行這個練習時，首先要做的是頭部旋轉。除非你想做的是口-脊柱旋轉，那是另一回事。口-脊柱旋轉涉及觸覺和視覺刺激等等，那是不同的。總是先引導頭部動作，然後才能加入中心動作。好的，所以反應是手臂的伸展，與頭部同時進行，以及同側腿部的伸展。對了，我忘了提到另一側也會彎曲；對側是彎曲的，腿部也是彎曲的。我甚至沒有提及這一點的原因，是因為很多時候我們光是做好這一側就已經很困難了。

So it functions here. Key thing for oral facial is differentiation of the head. Yes, differentiation. So we can turn and look. As the head turns, the eye, the vision changes. Also, for the ears, who knows about binaural hearing and monaural hearing; hearing on one side and being able to hear with both ears. Binaural hearing means if I have a sound here, I know it's from the right side because there is a difference between the sound going to my right ear versus my left ear. So I know the difference, so I know it's from the right side. Okay? If you don't have binaural hearing, you're just going to find that you can hear a sound because you have no idea where it came from. Okay? Think about this. Okay? That's attention and memory.
所以它在這裡發揮作用。口腔面部的關鍵在於頭部的分化。是的，分化。這樣我們就能轉頭看東西。當頭部轉動時，眼睛的視野也會改變。另外，關於耳朵，誰知道雙耳聽覺和單耳聽覺；用一邊耳朵聽和用雙耳聽的能力。雙耳聽覺意味著如果聲音在這裡，我知道它來自右邊，因為聲音傳到右耳和左耳是有差異的。所以我能夠分辨，知道聲音來自右邊。明白嗎？如果你沒有雙耳聽覺，你只會發現自己能聽到聲音，但完全不知道聲音從哪裡來。懂嗎？想想這一點。好嗎？這就涉及到注意力和記憶。

Foundation for language development. This is its development. It appears at 13 months in the utero and integrated between 6 to 7. Routine. Stroking on the baby's cheek. The baby turns. You saw that I used this when I was doing the exercises. Oh, I really forgot to ask you something. Let's go back to 18 and 4 real quick. What did you learn in oral facial technique that would help the TNR? Happy, for sure, yes? What else? Plutus mass stretches, because you're very technical in your head, excellent. Also the head traction, I told you how to turn, right? If I could carry an extra spare of hands on my back when I do a menorah, I would want that hand to do traction all the time. I am deep convinced it's the traction that allows the memory.
語言發展的基礎。這是它的發展過程。它在子宮內的第 13 個月出現，並在 6 到 7 個月之間整合。例行程序。輕撫嬰兒的臉頰。嬰兒會轉頭。你們看到我在做練習時用了這個方法。哦，我真的忘了問你們一件事。我們快速回顧一下 18 和 4。你們在口面部技術中學到了什麼對 TNR 有幫助的？快樂，當然，對吧？還有什麼？普魯塔斯質量拉伸，因為你們在腦子裡非常技術性，很棒。還有頭部牽引，我告訴過你們怎麼轉動，對吧？如果我在做燭台時能在背上多帶一雙手，我會希望那雙手一直做牽引。我深信是牽引讓記憶成為可能。

It's the activation of the pendant guard that teaches movement and memory. So I want to hold all the time. Sometimes I have parents hold it. The least is to roll up something in the back of their head, but it's not quite the same because then they tend to be. This is also when the child is able, I do a lot of oral facial this way. And I would be, oh baby, you don't have a head. So if the baby picks up their head and I do that, I put a mirror here and I do oral facial this way. Because when they pick up their head themselves, they are doing head writing themselves. I don't even have to need an extra hand. And if they're mad, that's even better because their head is up.
是吊墜守護的激活教會了動作與記憶。所以我想要一直握著它。有時候我會讓父母握著。最不濟的是在他們後腦勺捲起些東西，但這不太一樣，因為那樣他們往往會這樣。這也是當孩子有能力時，我這樣做很多口腔面部動作。我會說，哦寶貝，你沒有頭。所以如果寶寶自己抬起頭來，我就這樣做，我在這裡放一面鏡子，然後這樣做口腔面部動作。因為當他們自己抬起頭時，他們自己在做頭部書寫。我甚至不需要多一隻手。如果他們生氣了，那就更好了，因為他們的頭抬起來了。

So one thing you have to learn, and it does take some time, it took me a while, is to understand the different baby cries. When is it I'm annoyed, I don't want to do this. Or I'm losing and I'm going to be hysterical. I think that something comes with experience and also your intention. One thing I do love about babies is that although they don't speak, they know what I'm about, who I am. Usually I put them there the first couple of sessions and then they're done. They will be like, eh, eh, and they'll push things away, but they rarely will lose their temper at me unless they're sick. There are other reasons. So something that you'll learn to develop as you grow.
所以有一件事你必須學習，這確實需要一些時間，我也花了一段時間，就是要理解寶寶不同的哭聲。什麼時候是「我煩了，我不想這樣做」，或是「我受不了了，我要崩潰了」。我認為這需要經驗的累積，也需要你的用心。我喜歡寶寶的一點是，雖然他們不會說話，但他們知道我的意圖、我是誰。通常我在最初的幾次課程中把他們放在那裡，然後他們就完成了。他們會發出「呃、呃」的聲音，還會把東西推開，但除非他們生病了，否則很少會對我發脾氣。還有其他原因。所以這是隨著成長你會學會培養的東西。

Okay routine stroking and yes, this is actually also mouth searching along spine rotation What do you think that you have in your facial that helps with this? This, even this The circles, they all could be helpful, yeah? And then also as the participants already know that we have to turn left, right? So don't think that you're just going there and then you are feeding into reflexes, yeah? Okay, so here's just the, this is a really interesting part. According to Dr. Nuskatova, because rooting is searching, it supports Kavala. Interesting. So this is his development. He's rather late to completely mature. Interesting, right? Active from birth until three to five years. Very, very, very good. Puckering. Puckering reflex. So, the leg moves forward and closes. You need to know the puckering reflex cannot occur without a proper backhand. Because if your backhand is open, it can't pucker. Right? The proctoring reflex is not just for speech, but also for learning to blow. And later on, proctoring reflex evolves into playing the instrument. It's not, it's actually as interesting as hands grasp, yeah? Because we could play musical instruments. I don't know any other animals that can play musical instruments with their mouth. Yeah?
好的，例行撫摸，是的，這實際上也是沿著脊柱旋轉進行的口腔搜尋。你認為你的臉部有什麼有助於此？這個，甚至是這些圓圈，它們都可能有所幫助，對吧？然後，正如參與者已經知道的，我們必須向左轉，對吧？所以不要以為你只是去那裡，然後你就在激發反射，明白嗎？好的，這裡有一個非常有趣的部分。根據 Nuskatova 博士的說法，因為尋覓就是搜尋，它支持 Kavala。有趣。所以這是他的發展。他相當晚才完全成熟。有趣吧？從出生到三到五歲都非常活躍。非常、非常、非常好。噘嘴。噘嘴反射。所以，腿向前移動並閉合。你需要知道，沒有適當的反手，噘嘴反射就無法發生。因為如果你的反手是開放的，它就不能噘嘴。對吧？監考反射不僅僅用於說話，還用於學習吹氣。後來，監考反射演變成演奏樂器。它其實和手的抓握一樣有趣，對吧？因為我們可以演奏樂器。 我不知道還有其他動物能用嘴巴演奏樂器。是嗎？

So this is the popcorn reflex starts at 16 weeks, active throughout life, so you can blow kisses and get kisses all right. This is the part about the auditory, okay tactile information and all facial reflexes. Um, if I say general tactileity area, do you know what I mean? Who knows when I say general tactileity area. General tactileity is here. It's a part of the neural tactile. So the reason why I brought this out is if you're in speech pathology, you're going to listen to this very carefully. Oral defensiveness, oral sensitivity in MNRI is considered a manifestation of a fully established general tactileity. To establish general tactility, it should have established, I think, 727 days post-life. So, if a child shows hypersensitivity or hyposensitivity, sensory regulation issues, they are most likely, the way to address it, you have to address it through the limbs.
所以這是爆米花反射，從 16 週開始，終生活躍，這樣你就能飛吻和接收親吻了。這部分關於聽覺的，好的觸覺信息以及所有面部反射。嗯，如果我說一般觸覺區域，你知道我在說什麼嗎？誰知道我說的「一般觸覺區域」是什麼。一般觸覺就在這裡。它是神經觸覺的一部分。我之所以提出這一點，是因為如果你從事語言病理學，你會非常仔細地聽這一點。在 MNRI 中，口腔防禦性、口腔敏感性被視為完全建立的一般觸覺的表現。要建立一般觸覺，我認為應該在出生後 727 天內建立。所以，如果一個孩子表現出過敏或低敏感性，感覺調節問題，最有可能的解決方式是，你必須通過四肢來解決。

You have to address it from the big, skin first. The general tactility is here. When you do the neuro-tactile protocol, you go through there. That's why I borrowed it from my art group. Right? I stole it and stuck it in the reading here and I teach it to you. Otherwise, a regular reading wouldn't have that part and I put it in art protocol here. So you're working on the general tactility. So, if you're really dealing with a lot of picky eaters, sensory issues, You should do minimally breathing and stroking before you go into the mouth. Even if you think the problem is just in the mouth, it usually isn't. And a lot of the children also have hand sensitivity. Like when they vacuum, they don't want touches at all.
你必須從大的、皮膚的部分開始處理。整體的觸覺在這裡。當你進行神經觸覺方案時，你會經過那裡。這就是為什麼我從我的藝術團體借用了它。對吧？我偷了它並把它塞進這裡的閱讀中，然後教給你。否則，一般的閱讀不會有那部分，而我把它放進了這裡的藝術方案中。所以你在處理整體的觸覺。因此，如果你真的在處理很多挑食者、感官問題，你應該在進入口腔之前先做最少的呼吸和撫摸。即使你認為問題只在口腔，通常也不是。而且很多孩子也有手部敏感。比如當他們吸塵時，他們完全不想要被觸碰。

They have this sensitivity, so they need to do vacuum reflexes. So just a little tidbit for you. If you press a child's hand and they won't let you press because they have hypersensitivity, one of the quick ways to do this. Same thing we do here. This is actually fear paralysis. And I know our fear paralysis has several points. This is one of the points, and this is one of the points. And this is very effective. This is actually one of the quick ways to get a child out of that decelerated, decorticated posture from brain injury. We do this all the time. Sorry, tech time. Can you repeat the sentence? The very first one you said, general tactility and oral facial. What did you say?
他們有這種敏感度，所以需要進行真空反射。給你一個小提示。如果你按壓孩子的手，而他們因為過度敏感不讓你按壓，這是其中一個快速方法。我們在這裡做的也是同樣的事。這實際上是恐懼麻痺。我知道我們的恐懼麻痺有幾個點。這是其中一個點，這也是其中一個點。這非常有效。這實際上是讓孩子從腦損傷導致的減速、去皮質姿勢中快速恢復的方法之一。我們經常這樣做。抱歉，技術時間。你能重複那句話嗎？你一開始說的，一般觸覺和口面部。你說了什麼？

Oral sensitivity or oral defensiveness is often a result of poorly developed general tactility. And general tactility is supposed to develop in the first, I think, don't quote me, somewhere like 7 to 20 days. Very short. And this begs the question, I mean, it's great we're doing like kangaroo care, we're putting babies on mommies and all that, but if you're thinking about MNRI, babies should and can be doing skin-to-skin the first year of their lives because they are still continuing to develop. So here begs the question, our cesarean babies, our babies that are unvacuumed, our baby who maybe was brought out but was pulled in the wrong place, their general tactility area does not establish well. They're actually often traumatized when they were taken out of the room. So that's what Dr.
口腔敏感或口腔防禦性往往是全身觸覺發展不良的結果。而全身觸覺理應在出生後，我想大概是 7 到 20 天內發展完成，時間非常短暫。這就引出了一個問題，我的意思是，我們現在做的袋鼠式護理很棒，讓寶寶貼在媽媽身上等等，但如果你考慮到 MNRI（反射整合神經運動療法），寶寶在生命的第一年其實應該並且能夠進行肌膚接觸，因為他們仍在持續發展中。這就帶出了另一個問題，我們的剖腹產寶寶、未使用真空吸引的寶寶，或是可能被拉出來時位置不對的寶寶，他們的全身觸覺區域沒有建立得很好。實際上，他們被帶離產房時經常受到創傷。這就是 Dr.

Muscatola is saying, is that that is why, like, Isabel is going to Hong Kong to teach DMP. She's big, and she teaches the infant class. She and Dr. Muscatola, I mean, I am also a supporter. I'm just not running in front of that. They were hoping that the neonatal nurses can be trained to do basic [checks], for example, or reflexes, so that these babies can be done there and then, regardless of their family situation, or can be taught to parents so a parent can do it, so that before they leave the hospital, A, their reflexes are checked, and their tactile is established. Because there are circumstances where a baby has to be taken out quickly, right? Is it like body awareness? It is the foundation of body awareness.
穆斯卡托拉說的是，這就是為什麼，就像，伊莎貝爾要去香港教授 DMP。 她很有影響力，教授嬰兒班。 她和穆斯卡托拉博士，我是說，我也是支援者。 我只是沒有衝在最前面。 他們希望新生兒護士能接受培訓，進行基本的[檢查]，例如反射測試，這樣無論家庭情況如何，這些嬰兒都能在那裡完成檢查，或者可以教給父母，讓父母來做，這樣在他們離開醫院之前，A，他們的反射得到檢查，觸覺也建立起來。 因為有些情況下嬰兒需要迅速被帶出來，對吧？ 這就像是身體意識嗎？ 這是身體意識的基礎。

But that you have to ask Dr. Ms. Okutoba because I don't quite know why she picked these words. So she's saying that sensory integration in the OT is a joke if it doesn't understand the general fatality it has established first. It's like asking somebody to do algebra but they don't even know the symbol addition and subtraction. So besides, you mentioned this is general fatality, what can be done on the brain? Stroking. Just stroking generally. What? Huh? What is it? That's ridiculous? No, no, no. It's a reticular function. Reticular function? Yeah. Like monkeys, if you don't stroke them right away, they cease. In 30 seconds, in climatary in 30 seconds, but if you don't stroke them. 30 seconds? Yeah. If you don't stroke them, then they can take off.
但你得去問奧庫托巴博士女士，因為我不太清楚她為什麼選這些詞。所以她說，如果 OT 中的感覺整合不先理解它所建立的一般致命性，那就是個笑話。這就像要求某人做代數，但他們甚至不知道加減符號。此外，你提到這是一般致命性，那對大腦能做什麼？撫摸。就是一般性地撫摸。什麼？嗯？那是什麼？太荒謬了？不不不。這是網狀功能。網狀功能？對。就像猴子，如果你不馬上撫摸牠們，牠們就會停止。30 秒內，在 30 秒內的氣候中，但如果你不撫摸牠們。30 秒？對。如果你不撫摸牠們，牠們就會離開。

Three to six months when I'm on the tree. Because it's the stroking that activates the reticular formation, which then creates the body awareness, me versus you, which creates the separation of self. Those who are taking Refresh Recovery, what's reticular formation? What is reticular formation, Vanessa? What's reticular formation? What does reticular formation made of? Reticular formation in the brain stem. What is it made of? What kind of cell is it made of? Interneurons. Interneurons. But not everything is coming together. That's really cool. All right. So it's the stroking and then the squeezing. That's the Guili part of the Guili. It connects the entire body together. The general and then stroking. Squeeze. Squeeze. So, each primary reflexion has its own designated receptor field relying on a tactile system to bring it to the brain.
當我在樹上的三到六個月。因為正是撫摸激活了網狀結構，進而創造了身體意識，即我與你的區別，這形成了自我的分離。那些正在進行 Refresh Recovery 的人，什麼是網狀結構？Vanessa，網狀結構是什麼？網狀結構是什麼？網狀結構由什麼組成？腦幹中的網狀結構。它由什麼組成？它由什麼樣的細胞組成？中間神經元。中間神經元。但並非一切都結合在一起。這真的很酷。好的。所以先是撫摸，然後是擠壓。這就是 Guili 的 Guili 部分。它將整個身體連接在一起。先是整體的撫摸。擠壓。擠壓。因此，每個主要反射都有其指定的感受野，依賴觸覺系統將其傳遞到大腦。

Think about sucking and back in. So here's just a little diagram for you. I just want to point out how the tactile system on the face is a little different than the rest of the body so that you are aware. Although it still has the same structure, the difference is it has more nerve endings. Our face is very sensitive. It can heal faster than the rest of the body. It's also more sensitive because you also have the mucosal inside. There are certain parts of the receptors that are denser, like our fingertips. Our fingertips are actually a very precise receptor. It can feel different textures. Meet things, the rest of our body, like our back. The receptors are further apart, so you can't tell.
想想吸吮和收回的動作。這裡有個小圖示給你看。我只想指出臉部的觸覺系統與身體其他部位略有不同，讓你能注意到。雖然結構相同，但差別在於臉部有更多的神經末梢。我們的臉非常敏感，癒合速度比身體其他部位快。同時也因為口腔內有黏膜，所以更加敏感。某些部位的受器密度較高，像是我們的指尖。指尖其實是非常精密的受器，能感受不同的質地。相較之下，身體其他部位如背部，受器間距較遠，就無法如此精確辨識。

You know that little test where they prick your back and you say, is it one point or two points? At one point, when you go close, you can't tell. Our fingers aren't like that. Our fingers are a lot more sensitive. The skin on the face is also thinner than the rest of the body. So when you're touching the face, you have to be a little more aware of this, okay? So when you stop tapping on the fingertips, that means they are sitting something on the face. So, in NMRI we understand the fingertips particularly is, how do I describe this? So, we in NMRI, we do a lot of finger pairings, right? You're hearing this, okay? We typically start from the tip and then we go down.
你知道那個小測試嗎？他們會戳你的背，然後問你是一個點還是兩個點？當點靠得很近時，你就分不出來了。我們的手指可不是這樣。我們的手指敏感得多。臉上的皮膚也比身體其他部位薄。所以當你觸摸臉部時，必須更加注意這一點，好嗎？所以當你停止在指尖輕拍時，就意味著他們正在臉部做什麼。那麼，在 NMRI 中，我們特別理解指尖是，我該怎麼形容呢？所以，我們在 NMRI 中做了很多手指配對，對吧？你聽到了嗎？我們通常從指尖開始，然後往下進行。

And the reason is because this activates which part of the brain? Cortex. Which part of the cortex? You're right. Prefrontal cortex. And inside there is a little structure. You can look it up. The insula. Insula. Insula is the name. It creates here and now. It is believed to be the area in the brain that understands here and now. So what they're doing is, I think even with some people when we are thinking we do this, yeah? That's because the area of the brain is being activated, it's right out here, and that anchors our existence, so to speak, okay? Alrighty, so there are many different sensory systems, but in MNRI we have, we're looking at all sensory systems, visual, auditory, olfactory, vestibular, proprioceptive.
原因是因為這激活了大腦的哪個部分？皮質。皮質的哪個部分？你說對了。前額葉皮質。而在裡面有一個小小的結構。你可以查查看。島葉。島葉。島葉就是它的名字。它創造了此時此刻。被認為是大腦中理解此時此刻的區域。所以他們所做的，我認為甚至有些人在思考時也會這樣做，對吧？那是因為大腦的這個區域被激活了，就在這裡，可以說是錨定了我們的存在，明白嗎？好的，那麼有許多不同的感覺系統，但在 MNRI 中，我們關注所有的感覺系統，視覺、聽覺、嗅覺、前庭覺、本體感覺。

However, in MNRI it believes that tactile is the king of all these sensations and there is a reason now there's some supporting uh evidence to that you know you can ignore this you can look at Dr. Google here's just to show you look at where the palm and the wrist you see here this is the sensory cortex in the brain this is the palm this is this is the hand right hand hand wrist wrist palm okay What's F5? Small fingers. Okay. And then? Look, look, look. This is the palm. Okay. This is the hand. This is the fingers. Now look. What's F1? What's this? Chin. What's this? Chin receptors. Yes. Mandibular. Lip. Lip. So the sensory cortex. The receptor for hands is sitting right next to face.
然而，在 MNRI 中，我們相信觸覺是所有感覺之王，現在有一些支持性的證據可以說明這一點。你可以忽略這個，你可以看看 Google 博士這裡只是為了展示給你看，看看手掌和手腕的位置，你看到這裡，這是大腦的感覺皮層，這是手掌，這是手，右手，手腕，手掌，好嗎？F5 是什麼？小手指。好。然後呢？看，看，看。這是手掌。好。這是手。這是手指。現在看。F1 是什麼？這是什麼？下巴。這是什麼？下巴的受體。對。下頜的。嘴唇。嘴唇。所以感覺皮層。手的受體就緊鄰著臉部。

That's why in the past, it always had happened, the children with speech delays, if they have OT, they actually can speak better. Nobody knew why. And they were not treating their speech. So in MNRI, we want speech to be better. We also are working on the hands. Initially, I didn't realize it was this. I thought it was just because we were hands crossed, hands pulling back from a posture. And which is still true, but down here comes the differentiation of the fingers corresponds to the differentiation of the tongue. Let's say that again. Differentiation of the fingers, finger pyramids, when I can do one, two, three, four, five, one, two, three, four, five, that reflects the differentiation of the tongue. That is why children who have poor speech often have poor fine motor.
這就是為什麼過去總是發生這樣的情況，有語言發展遲緩的孩子，如果他們接受職能治療（OT），實際上說話能力會變得更好。沒有人知道原因。而且他們並沒有針對語言進行治療。所以在 MNRI 中，我們希望語言能力能有所改善。我們同時也在進行手部訓練。最初，我並沒有意識到這一點。我以為只是因為我們雙手交叉，從某種姿勢中把手拉回來。這仍然是事實，但在這裡，手指的分化對應著舌頭的分化。讓我們再說一遍。手指的分化，手指金字塔，當我能做一、二、三、四、五，一、二、三、四、五時，這反映了舌頭的分化。這就是為什麼語言能力差的孩子通常精細動作也較差。

Whether it was weak grip, too strong grip, no differentiation, and it reflects their speech level as an articulation. So you connect. So that's why when they can start to open individual fingers, they can differentiate in a sentence, rather than everything's one time. I also think the differentiation of the fingers allows the differentiation of concept. Understanding different groups. Cars, bus, and trucks are vehicles. Monkeys, ducks, and cows are animals. The differentiation of concepts. Categorization. Categorization. Categorization. Cementing association. So, indirectly. And this is an easy one you can do in sitting. But before you do it, I highly, highly, highly recommend you to do finger payments and do your just general facial stroking. Just that first 10 techniques you got. You learn from this before you move on to the next. It would be great because now you are working on this strip completely and you have the motor with it.
無論是握力過弱、過強，還是缺乏區分能力，這都反映了他們言語層面的清晰度。所以你將它們聯繫起來。這就是為什麼當他們能夠開始獨立活動每根手指時，他們就能在句子中進行區分，而不是一次性表達所有內容。我也認為手指的區分能力促進了概念的區分。理解不同的群體。汽車、公車和卡車都是交通工具。猴子、鴨子和牛都是動物。概念的區分。分類。分類。分類。強化關聯。因此，這是間接的。而且這是一個你可以坐著輕鬆完成的練習。但在進行之前，我強烈、強烈、強烈建議你先做手指支付和一般的面部撫摸。就從你學到的那前 10 個技巧開始。在進入下一步之前，先從這些練習中學習。這樣會非常好，因為現在你正在完整地練習這條肌肉帶，並且已經具備了相應的運動能力。

Language part, right? I have children do this. Monday, Tuesday, Wednesday, Thursday, Friday. So, do it together, and we sing, and we do lots and lots of stuff. And that's why I think their language goes so fast. I'm not going to write them all the day. This is crazy. Anyway. Alright. So dysfunctions of the tactile system relate to delayed oral motor, where I don't need it to say. Okay, this is the part I wanted to show you, and after this, we're gonna talk about tongue type, or we can go straight into practice. All right, so this is the part I wanna talk about. This is the function of the ears. You already understand that there is cranial nerve seven that, not seven, cranial nerve eight. There was a mistake there. Finger nerve auditory is a pure sensory and the motor responses is for facial nerve.
語言部分，對吧？我會讓孩子們做這個。星期一、星期二、星期三、星期四、星期五。所以，一起做，我們唱歌，做很多很多的事情。這就是為什麼我覺得他們的語言進步這麼快。我不打算把每一天都寫下來。這太瘋狂了。總之。好。觸覺系統的功能障礙與口腔運動遲緩有關，這部分我就不多說了。好，這是我想要給你們看的部分，之後我們會討論舌頭的類型，或者我們可以直接進入實作。好，這是我想要談的部分。這是耳朵的功能。你們已經知道有第七對腦神經，不對，是第八對腦神經。那裡有個錯誤。聽覺神經是純感覺神經，而運動反應則是由顏面神經負責。

Let's talk about acoustic reflex. Acoustic reflex is an involuntary response of the stapedius membrane when a sound is perceived to be too high. It will contract to protect the ear from going deaf. Right? But it's a perception. Okay? And it is activated in low frequency. It means that the low intensity, it's not loud, but the body perceives it as loud, then we have a hyperacusis. Right? So this is the study that I was telling you about before, about the discovery of classical and non-classical. That's about the experiment. We found out that children under the age of 10 are still perceiving sound. It goes through thalamus first before it reaches cortex. Does this sound familiar, like Luria, right? And they were able to distract the child. They distract through a tactile stimulus, which is an electrical stimuli.
讓我們來談談聽覺反射。聽覺反射是當聲音被感知為過高時，鐙骨肌膜的一種不自主反應。它會收縮以保護耳朵免於失聰，對吧？但這是一種感知。明白嗎？而且它在低頻時被激活。這意味著低強度，聲音不大，但身體卻感知為大聲，這時我們就有了聽覺過敏。對吧？這就是我之前告訴你的那項研究，關於古典與非古典的發現。那是關於實驗的。我們發現 10 歲以下的兒童仍在感知聲音。聲音在到達皮質之前會先經過丘腦。這聽起來熟悉嗎，就像 Luria 說的，對吧？而且他們能夠分散孩子的注意力。他們通過觸覺刺激來分散注意力，這是一種電刺激。

They can stop it from happening and the child's brain can behave more like an adult. So now, a subsequent study on the classical and non-classical pathway. This is the original data. I can send it on the WhatsApp. They found that a lot of children on the spectrum, their auditory system behaved like someone who had PTSD. Meaning that information comes in, it was held ransom, it was traveling through non-classical pathway and held ransom at the thalamus amygdala level. There's not enough release to the cortex. The problem is the cortex sitting there waiting, hey, where's my little minion? Are you going to send me some language, some speech? But it gets nothing because everything is hogged at the amygdala, non-classical. The child is busy deciding, do I run away?
他們可以阻止這種情況發生，讓孩子的大腦表現得更像成人。現在，接著進行一項關於經典與非經典路徑的研究。這是原始數據，我可以透過 WhatsApp 發送。他們發現許多自閉症譜系的孩子，他們的聽覺系統表現得像是有創傷後壓力症候群的人。意思是信息進來後被扣留，通過非經典路徑傳遞，並在丘腦杏仁核層級被扣留。沒有足夠的釋放到皮質。問題在於皮質在那裡等待，嘿，我的小助手在哪？你會給我一些語言、一些言語嗎？但它什麼也沒得到，因為一切都被杏仁核、非經典路徑佔據了。孩子忙著決定，我要逃跑嗎？

If I can't run away, do I sit here and check out? So the cortex is thinking, wait, wait, wait, nobody's teaching me anything. So how does the child learn to speak? It can't. Well, there is input, but it's not receiving. The child is not receiving the input into the place it's supposed to be, which is the cortex, but it's being held ransom because it's traveling in the non-classical path. So Dr. M's belief is that our work, especially auditory reflexes, will help maturation move on from the non-classical to classical. Remember, the non-classical to classical: It started to show some signs at six months, and by 12 months, it will start to have some dominance shift. It just doesn't complete until 10. It doesn't mean that before 10 years, it won't; it just has varied dominance.
如果我無法逃離，我是否就坐在這裡等待結束？所以大腦皮質在思考，等等，等等，等等，沒有人教我任何東西。那麼孩子是如何學會說話的？它不能。嗯，有輸入，但它沒有接收。孩子沒有將輸入接收到它應該去的地方，也就是大腦皮質，但它被挾持了，因為它在非典型路徑中傳遞。所以 M 博士的信念是，我們的工作，特別是聽覺反射，將幫助成熟從非典型轉移到典型。記住，從非典型到典型：它在六個月時開始顯示一些跡象，到 12 個月時，它將開始有一些主導權的轉變。它只是直到 10 歲才完成。這並不意味著在 10 歲之前它不會；它只是有變化的主導權。

That's all. And what's interesting to see is, if you ask Dr. Lialai, she'll tell you this. Dr. Lialai is our audiologist who is a core specialist, also an instructor in auditory-visual. She is saying that in early stages, which is under 10 years old, tactile and auditory and visual are intertwined together. If I don't hear well, if I can't process well, I don't see well, I don't touch well. Same thing, if I can't tell texture-wise, I don't have body awareness, I can't tell my tactile is not developed well, I don't hear well. I can hear, but I don't hear well. Accurately, but I can't differentiate. And I can't see such. The three are connected together. Because of non-classical time. And this is what you call visual processing. Well, this article is about auditory processing. But this is the thing about science and scientific principle is that if it can be proven in one modality, same principle can apply to other modalities. So this is what it's saying right now. If you can find non-classical pathway in auditory processing, you should be able to find non-classical pathway in tactile and visual.
這就是全部。有趣的是，如果你問李阿萊博士，她會告訴你這些。李阿萊博士是我們的聽力學家，也是核心專家，同時是聽覺視覺領域的講師。她說在早期階段，也就是 10 歲以下，觸覺、聽覺和視覺是交織在一起的。如果我聽不清楚，如果處理不好，我就看不清楚，觸摸也不靈敏。同樣地，如果我無法分辨質地，我就沒有身體意識，無法判斷我的觸覺發展不良，也就聽不清楚。我能聽到，但聽不清楚。準確地說，但我無法區分。我也看不清楚。這三者是相互關聯的。因為非經典時間的緣故。這就是你所說的視覺處理。這篇文章是關於聽覺處理的。但科學和科學原理就是這樣，如果能在一個模態中證明，同樣的原理也適用於其他模態。所以這就是目前所說的。如果你能在聽覺處理中找到非經典途徑，那麼你也應該能在觸覺和視覺中找到非經典途徑。

Subcortical structures such as thalamus in the middle. Classical goes straight to the cortex. But we know more. No, that's not the same as nociceptor. So, the reason why we know more about the classical, and we call it a classical because we discovered it first because we're looking at the dog brain. And then the children ended up being called non-classical because they were discovered second. But really, the pediatric developmental should have been the classical pathway, and then you should read an advanced or mature pathway; but this is how science works out, yeah! So this is why our children who are failing to learn to speak are also so sensitive to sounds, and therefore they spend all their energy trying to escape sound.
皮質下結構如位於中央的丘腦。經典路徑直接通往大腦皮質。但我們知道得更多。不，那與傷害感受器不同。所以，我們之所以對經典路徑了解較多，並稱之為「經典」，是因為我們最早發現它，因為我們研究的是狗的大腦。而後來發現的兒童路徑就被稱為非經典路徑，因為它們是第二個被發現的。但實際上，兒科發展路徑本應是經典路徑，然後你應該讀到的是進階或成熟路徑；但科學就是這樣發展的，沒錯！這就是為什麼我們那些學習說話有困難的孩子對聲音如此敏感，因此他們耗盡所有精力試圖逃離聲音。

A lot of them so because the sound goes to the tenderness, they cannot organize the sound and filter the sound. And the worst thing is amygdala does not have the function to differentiate. So, the people say, I don't understand. You are bad. Go away. All right. That's it. Let's go to this. We do 10 minutes of this, and then we can do exercises. I'm sorry? Thank you so much. All right. This is an embryonic tongue formation, as you can see my friend here. So, initially the genoglossal is attached to the floor of the mouth. And it's supposed to differentiate. And so there was almost like a web, I guess you could understand it more like a web. As the fetus grows, it's supposed to release from the front and so that you will have your tongue develop.
他們很多人因為聲音觸及了柔軟處，無法組織和過濾聲音。最糟糕的是，杏仁核沒有辨別的功能。所以人們會說，我不明白。你很壞。走開。好吧。就這樣。我們來做這個。我們做十分鐘，然後可以做練習。抱歉？非常感謝。好的。這是一個胚胎舌頭的形成，如你們所見，我的朋友在這裡。所以，最初舌根是附著在口腔底部的。它應該要分化。所以那裡幾乎像一張網，我想你們可以更理解為一張網。隨著胎兒的成長，它應該從前端釋放，這樣你的舌頭才會發育。

Okay? A lot of us have some feathering, you know, but I still have it. So, well, I had it revised, but I didn't have all the things taken out, okay? It shouldn't be restricting. A lot of us will have a little piece. And here's the funny thing, though. When it doesn't completely release and has some attachment, it actually helps with the postural control. Remember? We did the exercise today that the tongue and the position of the tongue can really help you to maintain posture. So anyway, so the lingual frenulum is a layer. So the frenulum underneath it, the problem is when you release, if it doesn't completely release, the tongue tight, is dependent on how bad the leftover is, isn't it? Right? So how much is attached.
好嗎？我們很多人都有一些舌繫帶的殘留，你知道的，但我仍然有。所以，嗯，我曾經修正過，但我沒有把所有的東西都移除，好嗎？它不應該造成限制。我們很多人都會有一小部分。不過這裡有個有趣的事情。當它沒有完全釋放並且有一些附著時，實際上對姿勢控制有幫助。記得嗎？我們今天做的練習顯示，舌頭和舌頭的位置真的可以幫助你維持姿勢。所以無論如何，舌繫帶是一層組織。所以下面的繫帶，問題在於當你釋放時，如果沒有完全釋放，舌頭的緊繃程度取決於殘留的嚴重程度，不是嗎？對吧？所以附著的程度有多少。

So there are many different ways of classifying tongue tie and lip tie. But I actually prefer Dr. Cutlow's way. This is an American doctor. Dr. Cutlow is well known by the medical insurance company because they actually use his articles. Although he never had a PhD, I think he should have a nominal one. But, so, basically, is, hang on, let me go to his classification first. So, let's look at a simple, the old ways I learned it when I was a student was, if you look, this is the bottom of the mouth, this is the tongue. So if you pick up your tongue and you see this. This is the submandibular saliva gland. Everybody has this. And so this is the floor and mouth, and this is the base of the tongue.
因此，有許多不同的方式來分類舌繫帶過短和唇繫帶過短。但我其實更喜歡卡特勒博士的方法。這是一位美國醫生。卡特勒博士因為他的文章被醫療保險公司實際採用而廣為人知。雖然他從未獲得博士學位，但我認為他應該有個名譽博士。不過，基本上，等等，讓我先看看他的分類方式。那麼，我們來看一個簡單的，我學生時代學到的老方法是，如果你看，這是口腔底部，這是舌頭。所以當你抬起舌頭時會看到這個。這是下頜唾液腺。每個人都有這個。而這裡是口腔底部，這是舌頭的基部。

If the tether starts from here and goes to here, this is the front-facing part. It's called anterior tongue tie. And if it's in the back here, it's called posterior tongue tie. That's what I learned. I'll just look at anterior and posterior. That's all we have. But Dr. Kahlok gets more specific. So this is the way he looks at it, okay? Because it's supposed to release from the front. If it's completely shut, this is one and this is two. Anything that's before the gland is type one or type two. And type two means it's halfway. Okay, so if the tether is all the way, this is type one. And if it ends halfway, it's type two. Simple? And it follows the embryology. Okay, so here is some of the picture of the tongue ties, okay?
如果繫帶從這裡開始延伸到這裡，這是朝前的部分，稱為前舌繫帶。如果它在後面這裡，就稱為後舌繫帶。這是我學到的。我只會看前和後，這就是我們所有的分類。但 Kahlok 醫生分得更細。這就是他的看法，懂嗎？因為它應該從前面釋放。如果完全封閉，這是一型，這是二型。任何在腺體之前的都是一型或二型。二型表示它只到一半。好，所以如果繫帶一直延伸，這是一型。如果只到一半，就是二型。簡單吧？這跟胚胎學是一致的。好，這裡有一些舌繫帶的圖片，懂嗎？

Which was what I call an old anterior ties. What I want to impress on you is if you see this, then you know when they go to cut it, they need to cut all the way because when you see it, this is just the front of the fanfare, but the back is completely tethered, yes? The problem is it depends on the expertise of the doctor and their beliefs. They may not cut all the way. So this is the posterior, right? This is type 3, and that's type 4. So this is what we call the posterior ties. Clinically, I can tell you that as long as it's not a tight tether, usually, as long as it's pliable, a 3 and a 4 may not cause too much issue with breastfeeding.
這就是我所謂的舊式前繫帶。我想強調的是，當你看到這個情況，就該明白在進行切割時必須徹底切斷，因為眼前所見只是表面的華麗裝飾，但後方卻完全被束縛著，明白嗎？問題在於這取決於醫生的專業知識及其信念，他們可能不會徹底切斷。所以這是後繫帶，對吧？這是第三型，而那則是第四型。這就是我們所稱的後繫帶。臨床上我可以告訴你，只要不是緊密的束縛，通常只要具有柔韌性，第三型和第四型可能不會對哺乳造成太大問題。

The more it's tethered and more anterior, the more likely it will affect breastfeeding. It's not to say that this child will be fine. It depends on the overall presentation and the skill level. What you need to know is when we go to assess and we go across, when we can feel something, it's not by looking, it's actually by feeling, especially in infants. We feel and not look. The reason is because of these looks. You can't tell, but there's a submucosal tie here. But if I feel this, I probably will feel it. I'll feel a tightness right at the floor because you can't see it. The older the child is or the adult, you can have them open their mouth and lift up their tongue because you have a tongue problem.
束縛得越緊且位置越靠前，就越可能影響哺乳。這並不是說這個孩子會沒事，這取決於整體表現和技術水平。你需要知道的是，當我們去評估並進行觸診時，能感覺到某些東西，不是靠看，而是實際靠觸摸，尤其是在嬰兒身上。我們是靠觸摸而非視覺。原因在於這些外觀。你無法看出來，但這裡有一個黏膜下的繫帶。但如果我觸摸這裡，很可能會感覺到。我會在底部感覺到緊繃，因為你看不到它。孩子或成人年齡越大，你可以讓他們張開嘴巴並抬起舌頭，因為你有舌頭問題。

You don't. But the younger they are, the harder it is to see. You have to actually feel it. So for infants under the age of about 10 to 12 months, we still have to do our classic assessments. Just put the baby this way, and you run your mouth underneath the tongue. You see if there's restriction or not. You can feel it, because you should be able to go all the way across. So this is a basic tongue type classification. I feel like I was forgetting something. I think there's a slide that I went too fast. So I mentioned it before, is Dr. Mascadova do believe that a tethered tongue can affect oral reflex development, because it can't perform sucking and swallowing reflex properly.
你不會。但年紀越小，越難看出來。你必須實際去感受。所以對於大約 10 到 12 個月以下的嬰兒，我們仍然需要進行經典的評估。只要把寶寶這樣放，然後你在舌頭下方移動你的手指。你看是否有受限。你可以感覺到，因為你應該能夠完全移動過去。所以這是一個基本的舌頭類型分類。我覺得我好像忘了什麼。我想有一張幻燈片我講得太快了。我之前提到過，Mascadova 博士確實認為舌繫帶過緊會影響口腔反射的發展，因為它無法正確執行吸吮和吞嚥反射。

And don't forget, you remember earlier this morning, you saw the swallowing process, the tongue goes back, and the epiglottis here, the tongue goes back, the epiglottis gets flipped. So if I'm tethered here, I can't go. Somebody is stopping. It depends on how much force is being pulled and how much space that it determines how far I could go back. So I had my tongue tie revised when I was 14 years old. It's almost a joke when it was done, and the doctor just said, I'll do one for you for free. I went to see a client that had the procedure. Because I was referring older children who already had quite, I mean, so when I see a client for two years and they are not making the changes I'm expecting, I'm bored.
還有別忘了，今天早上早些時候你看到的吞嚥過程，舌頭往後縮，這裡的會厭，舌頭往後，會厭就會翻轉。所以如果我被拴在這裡，我就動不了。有人在阻止。這取決於被拉的力量有多大，以及空間有多大，這決定了我能往後退多遠。所以我 14 歲時做了舌繫帶修復手術。當時幾乎是個笑話，醫生只是說，我免費幫你做一個。我去看了一個做過這個手術的客戶。因為我轉介的都是年紀較大的孩子，他們已經有相當的...我是說，所以當我為一個客戶看了兩年，他們卻沒有做出我預期的改變時，我就覺得無聊了。

I have to find something else to do. So when I realize I chopped out everything, the child is, okay, it's making these little mediocre changes, and I know that there's something else going on. And that's how I started to get to know about tongue-tie and lip-tie. So, I was sending older children, like four-and-a-half and five, six years old, who have speech disorders. When I prompt them, when I train them, they can talk beautifully. When they see me, they talk beautifully. When they turn their back, it's gone. Or when they're talking to their mommy and daddy, each gets slurry and they have those sound errors. So, I started to understand about tongue-tie and lip-tie. So, I tried on a couple clients, and they actually had great results. So, I wanted to go see.
我必須找些別的事情來做。所以當我意識到我砍掉了一切，孩子卻只是做出這些小小的平庸改變時，我知道還有其他事情在發生。這就是我開始了解舌繫帶和唇繫帶的過程。於是，我開始送一些年紀較大的孩子，像是四歲半、五歲、六歲，有語言障礙的孩子來。當我提示他們、訓練他們時，他們可以說得很漂亮。當他們看到我時，他們說得很漂亮。但當他們轉身，一切就消失了。或者當他們和爸爸媽媽說話時，話語變得含糊不清，出現那些發音錯誤。因此，我開始理解舌繫帶和唇繫帶的問題。於是，我試著幫助幾個客戶，他們實際上取得了很好的效果。所以，我想去看看。

So, I went in and saw it. And I said to the dentist, I was like, because she was explaining to me what she's doing. And I said, I have one of those. She goes, come here, open your mouth. And I open my mouth. She goes, oh, yeah, you do have one. And I said, what do I do? She goes, I can do one for you. I said, really? Are you free next week? And she goes, yeah, just come. I'll do it for you. Mine is a half release. But I didn't know any better. I didn't know I had one on that point. So I'm older, so she has to numb it, because it can be painful now since you're older, and she cut it with a laser, waterless laser.
於是，我走進去看了。我對牙醫說，因為她正在向我解釋她要做什麼。我說，我有一個那樣的。她說，過來，張開嘴。我張開嘴。她說，哦，對，你確實有一個。我問，那我該怎麼辦？她說，我可以幫你做一個。我說，真的嗎？你下週有空嗎？她說，有，直接來吧。我幫你做。我的是半釋放的。但我當時不知道更好。我不知道在那個點上我有一個。因為我年紀大了，所以她必須麻醉它，因為現在可能會痛，她用無水激光切開了它。

I'm going to tell you, because I was on the pain medication, when I was driving home, I was elated. I was never aware that swallowing can be so, so deep. And every time I swallow, it makes me happy. It's like a euphoria. Well, I didn't tell you about it. When I get home, there's no more anesthesia. You're supposed to exercise on yourself every four hours. Otherwise, you will be attached. And one time, the alarm went off. I just turned it on and went back to bed. And when I woke up, I detached myself. Oh, that was not fun. That really was not fun. But I never knew. I didn't know better. But I had a lot of soft signs. So I didn't go; I tell as a joke.
我要告訴你，因為當時我在服用止痛藥，開車回家的路上，我感到異常興奮。我從未意識到吞嚥可以如此、如此深刻。每次吞嚥都讓我感到快樂，就像一種欣快感。嗯，我之前沒告訴你這件事。回到家後，麻醉效果就消失了。本來應該每四小時自己練習一次，否則就會被黏住。有一次警報響了，我只是把它打開就又回去睡覺。醒來時，我把自己解開了。哦，那感覺一點都不好玩，真的不好玩。但我當時不知道，我沒有更好的認識。不過我有很多軟性徵兆，所以我沒去；我只是當笑話講講。

But I did have signs that she asked me a few things. Like, I have headaches. I have not just, I have migraines, and my migraines are so bad that I have aura. So I see aura first, then I have headache. She goes, hmm, I have shoulder pains, I have reflux, but I thought I had reflux, I had reflux as a child. I mean, sometimes I get without taking care of what I eat. I never thought about it. But after the revision, I don't have the same headache anymore. I still do get headache here and there, but it's usually when I overexert myself. But I never, I never. I know that I missed it, but I don't remember the aura anymore. And I don't get the headache on the side of the migraine anymore.
但我確實有一些跡象顯示她問了我幾件事。比如，我有頭痛。不只是普通的頭痛，我有偏頭痛，而且我的偏頭痛嚴重到會有先兆。所以我會先看到先兆，然後才頭痛。她說，嗯，我有肩膀痛，我有胃酸逆流，但我以為我有胃酸逆流，我小時候就有胃酸逆流。我是說，有時候我不注意飲食就會這樣。我從來沒想過這個。但經過調整後，我不再有同樣的頭痛了。我還是會時不時頭痛，但通常是在我過度勞累的時候。但我再也沒有，再也沒有。我知道我錯過了，但我已經不記得先兆了。而且我也不再有偏頭痛那一側的頭痛了。

It's really, really strange. But anyway, so this is what tongue-tie is. So you have to decide. And I was going to tell you this also, is that there are other ties. I'm going to introduce it, and I'll show you a picture of the tongue ties. There are lip tie. Some of you are very familiar. You just lift it up. And the problem with lip tie is one of the funny things about lip tie, when you lift them, you see it. The tie is actually not just on the top. It goes right under between the front teeth. And if you lift up the lips and you see a lip tie, there's 1 in 50% chances that person will have a tongue tie because it's the same. It's like a guitar string from the front to the back.
這真的、真的很奇怪。但無論如何，這就是所謂的舌繫帶過短。所以你得做出決定。我本來還想告訴你的是，還有其他類型的繫帶。我會介紹一下，並給你看一張舌繫帶的照片。還有唇繫帶。你們有些人很熟悉。只要把它掀起來看。唇繫帶的問題中，有一個有趣的地方是，當你掀開嘴唇時，就能看到它。這個繫帶不僅僅在頂部，它會一直延伸到前牙之間的下方。如果你掀開嘴唇看到唇繫帶，有 50%的機率那個人也會有舌繫帶，因為它們是相同的。就像從前到後的一根吉他弦。

Bucal tie. Go see the picture. Or you can see here. This is a bucal tie. But this is a single buccal. Sometimes you will see the whole entire membrane get stuck. Yeah, yeah, this is the buccal type. This is the buccal type. This. This thing. Like side. No, no, no. No, no, no. This. This one. This one. This one. So when you go, remember your zygomatic stretches? If you have a tight, it will be tethered. You can't form the sinuses. Yeah. And I'm going to tell you, if you have a membrane type, like which is the whole thing gets tethered in, this is your picky eaters. Picky eaters. A lot of them have these. It has to do maybe the increased surface. Do you see what I'm saying?
頰繫帶。去看圖片。或者你可以在這裡看。這是一個頰繫帶。但這是一個單側的頰繫帶。有時候你會看到整個膜都被黏住。對，對，這是頰型。這是頰型。這個。這個東西。像側面。不，不，不。不，不，不。這個。這個。這個。這個。所以當你去的時候，記得你的顴骨伸展嗎？如果你有一個緊的，它就會被束縛住。你無法形成竇腔。對。我要告訴你，如果你有一個膜型的，像是整個東西都被束縛住，這就是你的挑食者。挑食者。很多挑食者有這些。這可能與增加的面積有關。你明白我在說什麼嗎？

Because they have all tethered and they can’t tell the food because it’s all tied up. Okay, so that's buccal tie. So there are many different ties. The buccal tie is the hardest one to recover from because my second son had a headache cut and he said that that's most painful. He's got lip, buccal, and tongue. I'll show you in a minute. So, sorry, I'm just curious. So if you have tongue tie, most likely 50% chance you have big tongues, but just saying. When you have a lip tie, you have more than 50% to have a tongue tie. Okay. So does it mean when you cut the tongue, you fix the tongue tie, you fix the lip tie too? Or not necessarily?
因為它們都被繫住了，所以無法分辨食物，因為全都被綁起來了。好的，這就是頰繫帶。有很多不同類型的繫帶。頰繫帶是最難恢復的一種，因為我的第二個兒子做了頭痛切割，他說那是最痛的。他有唇繫帶、頰繫帶和舌繫帶。我待會兒給你看。抱歉，我只是好奇。所以如果你有舌繫帶，很可能有 50%的機率舌頭較大，但只是說說。當你有唇繫帶時，有超過 50%的機率同時有舌繫帶。好的。那麼這是否意味著當你切割舌頭，解決舌繫帶時，也同時解決了唇繫帶？或者不一定？

It depends on the physician who sees you and their decision and overall presentation of the ties. It's not always, but yeah. When you have a lip tie, you're likely to have a tongue tie, but you could have just a lip tie. Oh, you can have just a tongue tie. It's not, um, but they're often associated together. Are you saying you can have lip tie, tongue tie, and, uh? Fugle tie, yes. Actually, that's more common, to have the whole spang. I call them the whole spang. Yes? Instead of the lip tie and the fugle tie, like tongue tie, do you see this type one, type two? No. Well, actually, there might be one in the lip tie, but I'm not aware of it.
這取決於為你看診的醫生及其決定，以及繫帶的整體表現。並非總是如此，但確實有可能。當你有唇繫帶時，很可能也有舌繫帶，但也可能只有唇繫帶。哦，也可能只有舌繫帶。不是的，嗯，但它們經常是相關聯的。你是說可能同時有唇繫帶、舌繫帶，還有...？繫帶群，是的。實際上，擁有整個繫帶群更為常見。我稱它們為整個繫帶群。是嗎？相對於唇繫帶和繫帶群，比如舌繫帶，你見過這種類型一、類型二嗎？沒有。嗯，實際上唇繫帶中可能有一種，但我並不清楚。

So from the dentist I work with, there is one that it depends on if you're just at the gingiva or if it's going under your gum. So there is a difference, but there's no classification, the judge is asking me. If you're asking, is there a classification, like a one, two, three, none. There's just two differences. Either it's wrapped all the way between the front teeth and goes through the gum behind, or it's not, and it's just between the inside, so it doesn't wrap around. There's only two types. Maybe there is a name. I'm going to ask my dentist, actually. So here, I want you to look at this. This is two different children. This is the first day after it's cut. Do you see what the difference is?
所以從我合作的牙醫那裡得知，這取決於你是只在牙齦處還是會深入到牙齦下方。所以是有區別的，但沒有分類，法官正在問我。如果你問的是有沒有分類，比如一、二、三或無，其實只有兩種區別。要麼是整個繞過前牙並穿過後面的牙齦，要麼不是，只是位於內側，沒有繞過去。只有這兩種類型。或許有個名稱，我其實要去問問我的牙醫。那麼在這裡，我要你看看這個。這是兩個不同的孩子。這是切割後的第一天。你看出區別了嗎？

This one, when it's cut, you see, it's much wider. And it has to be cut out. This is actually the Gino Hayoi presentation. No, this one is deep. This is very broad. This child has buccal tie also, but her buccal tie is what I'm telling you that's all around. So this is a huge picky eater. And she hurts herself. And her speech is slurred. Once it's cut, it's all done, no need for speech therapy. Although she's on the spectrum, but okay. But that's that. This is actually my own son. Do you see how deep this is? So I have been treating him since he was four and a half. And there are other things. He has attention deficit issues too. And I've been stretching him. So there's one thing you have to understand.
這個，當它被切開時，你看，它寬多了。而且必須被切除。這實際上是 Gino Hayoi 的演示。不，這個很深。這個非常寬。這個孩子也有頰繫帶，但她的頰繫帶就像我告訴你的那樣，是環繞的。所以她非常挑食。而且她會傷害自己。她的言語含糊不清。一旦切開，就都解決了，不需要言語治療。雖然她在自閉症譜系上，但沒關係。就是這樣。這其實是我自己的兒子。你看到這有多深嗎？所以我從他四歲半開始就一直在治療他。還有其他問題。他也有注意力不足的問題。我一直在幫他伸展。所以有一件事你必須明白。

A tie is a tie is a tie. A frenulum is a frenulum. A lung is a frenulum. You cannot loosen a frenulum. You cannot expect that child will fall and just cut it itself. But the work you can do is to loosen the compensation, the muscles around it to compensate for this time. You cannot release it. You cannot make it less tight. Is that clear? Because it's a web, it doesn't loosen. That is why Dr. Kalo is a big proponent of getting it cut. He said that this is just a tether. We have to let loose. We just have to take it away. So my son, that was when he was eight. So he had it cut at six weeks. Then he started little things as he grows.
領帶就是領帶，繫帶就是繫帶。肺就是繫帶。你無法鬆開繫帶。你不能指望孩子跌倒時它會自行切斷。但你能做的是減輕周圍肌肉的代償作用，暫時緩解這種情況。你無法釋放它，也無法讓它變得不那麼緊繃。這樣清楚了嗎？因為它是一片網狀組織，不會鬆開。這就是為什麼卡羅醫生大力主張進行切斷手術。他說這只是一種束縛，我們必須放手，必須將其移除。所以我兒子在八週大時接受了手術。他在六週大時做了切斷手術，之後隨著成長開始慢慢恢復一些細微動作。

I mean, eating is okay because I'm a feeding specialist and he loves to eat, so that way we're fine. Except that he learned chewing. A lot later. He's tuned mature later. And I, at that time, didn't realize there was a huge connection. So then, as he gets older, I worried more about his overall development. My pediatrician kept thinking that he's fine. I had to get her to write me a script that said that he has attention deficit. Anyway, so by four and a half, he's talking like this. I was like, okay. So then his attention deficit, and he's walking down the stairs. He will do like this. He didn't have one leg. I was like, I don't know what you're doing, but something is not quite right.
我的意思是，吃飯沒問題，因為我是餵食專家，而他喜歡吃東西，所以這方面我們沒問題。只是他學會咀嚼的時間晚了很多。他成熟得比較晚。而我當時並沒有意識到這之間有很大的關聯。所以隨著他長大，我越來越擔心他的整體發展。我的小兒科醫生一直認為他沒事。我不得不讓她開一張證明，說他有注意力不足的問題。總之，到了四歲半的時候，他說話是這樣的。我就想，好吧。然後是他的注意力不足，還有他下樓梯時會這樣。他好像少了一條腿似的。我就想，我不知道你在做什麼，但感覺不太對勁。

So I started looking into not having him evaluated by Dr. Moskatova, and there's other things happening. But just to beat you along, I treated him. Okay, for the S sounds and the Z sounds and the L sounds and all that. He was fine most of the time. But he has a stutter. My husband had a stutter when he was young, so I said, oh, that's just from the science. But as a speech therapist, you have to do something. So I did my things, and he was okay. But whenever he's excited, when he's upset, then it's all gone. In the end, I decided, you know what, he needs to be redone. Because I looked, and I saw that it was here. Because when he was first cut, I didn't realize that.
所以我開始考慮不讓莫斯卡托娃醫生評估他，而且還有其他事情在發生。但為了讓你了解情況，我還是對他進行了治療。好的，針對 S 音、Z 音、L 音等等。大部分時候他都沒問題。但他有口吃的問題。我丈夫年輕時也有口吃，所以我說，哦，這只是遺傳。但身為語言治療師，你必須做些什麼。所以我做了我該做的，他情況還行。但每當他興奮或難過時，這些就又全沒用了。最後我決定，你知道嗎，他需要重新治療。因為我仔細觀察後發現問題在這裡。當初他第一次接受治療時，我沒有意識到這點。

I went to a scissor, and he was cut, and everything was fine. I thought that was it. So mommy takes time to grow, I mean, as in me. So then I realized, I had a conversation with him. I go, honey, when you were eight, We have to go and get the vector to help you. So you have to almost feel cutting and all that. It was quite an experience whatsoever. But when it's cut and we took the picture, I know this is why he can't get those things done. He's not able to do his speech. Because how deep is that? That went all the way. So you have to see what's the involvement of... Does not stutter now. Does not have speech issue. Attention deficit is minuscule.
我去找了一把剪刀，他被剪了，一切都很好。 我以為就這樣了。 所以媽媽需要時間成長，我是說，就像我一樣。 然後我意識到，我和他談了一次話。 我說，親愛的，當你八歲的時候，我們得去找那個向量來説明你。 所以你幾乎得感受到剪的過程和所有那些。 那真是一次相當的經歷。 但當剪完並拍了照片后，我知道這就是為什麼他無法完成那些事情。 他無法完成他的演講。 因為那有多深呢？ 那一直深入到底。 所以你得看看涉及到什麼...... 現在不口吃了。 沒有語言問題。 注意力缺陷微乎其微。

Nobody would know if I say it. Between 9 and 10, everything just squared out, and then he has his braces, which makes it even better. So you don't know. That's what I'm trying to explain to you is you don't know what's behind that tie until you get a tie. Even the doctors won't know. And he has a good range of motion. He has, because I trained him. He could do it, but out of our resources. Out of our resources, this is the funny thing. So this is why now, this is the latest about Tong Thai, is that Tong Thai can be nothing, which is you don't have a Thai, or it could be just a web. So it's right here, that's all. And they, when they go to do it.
如果我說出來，沒有人會知道。在 9 到 10 之間，一切都剛剛好，然後他還戴著牙套，這讓情況更加完美。所以你不會知道。這就是我試圖向你解釋的，在你得到一條領帶之前，你不知道那條領帶背後有什麼。甚至醫生也不會知道。而且他的活動範圍很好。他有，因為我訓練過他。他可以做到，但超出了我們的資源範圍。超出我們的資源，這是最有趣的地方。所以這就是為什麼現在，關於 Tong Thai 的最新情況是，Tong Thai 可能什麼都不是，也就是說你沒有 Thai，或者它可能只是一個網。所以就在這裡，僅此而已。而他們，當他們去做這件事的時候。

Look like this. They just have to cut here, right? And then we're all hunky-dory. They're just to take away the excess tissue, and we are done. But it could be this. That's my son. It could be this. So this has a risk, and I'm so glad that we are okay because there's a lot more blood vessels and nerve endings in there, and you could hurt the tissue and the muscle, and you can wind up having facial palsy by nipping it. That's the problem. But the thing is, we don't know until we open it up. And I suspect that I have a deep one too. And mine wasn't cut all the way through. It's because I was a little nervous. And because I'm an adult, I can move my tongue.
看起來是這樣。他們只需要在這裡切開，對吧？然後我們就一切順利了。他們只需去除多餘的組織，我們就完成了。但也可能是這樣。那是我兒子。也可能是這樣。所以這是有風險的，我很高興我們沒事，因為那裡有更多的血管和神經末梢，你可能會傷害組織和肌肉，甚至可能因為夾到而導致面癱。這就是問題所在。但問題是，我們不打開就不知道。而且我懷疑我也有一個深層的。我的沒有完全切開。那是因為我有點緊張。而且因為我是成年人，我可以移動我的舌頭。

When she's cutting it, she goes, 'How do you feel? Is this okay?' So she only cut half. If she had gone in, we call it diamond shape, she probably would find that my tongue type is like my son's. But thank God my son has it done when he was younger. If he had had it done in his 40s, I don't know something would happen to him. So that's why you have to consider, and nobody knows, maybe in a few years, because dentists make so much money, maybe they can come up with an ultrasound that they can scan and they can see how deep the environment is. But right now we don't know. We can only hope. But it doesn't change your age, right? No. It is what it is, right?
她剪的時候問：「你感覺如何？這樣可以嗎？」所以她只剪了一半。如果她剪得更深入，我們稱之為鑽石形狀，她可能會發現我的舌頭類型和我兒子的一樣。但感謝上帝，我兒子在年紀較小的時候就做了這個手術。如果他在 40 多歲時才做，我不知道會發生什麼事。這就是為什麼你必須考慮，而且沒有人知道，也許幾年後，因為牙醫賺很多錢，也許他們可以發明一種超聲波，可以掃描並看到環境有多深。但現在我們還不知道。我們只能希望。但這不會改變你的年齡，對吧？不會。事情就是這樣，對吧？

Yeah. And the good news is, before I was 40, I was still, I was a speech therapist. I can talk. I make money. I have children. I have friends. Does that mean I'm all right? No. And afterwards, my quality of life is better. But I'm just saying the majority of us can compensate. But as a therapist and as a parent, I look at my child and I say, 'Why do I want them to compensate?' I want them to have a better quality of life. I want them to have more confidence. I used to think that is just a simple thing. Humbly, but now that you mention that, I don't, and you see it could be Type A, so you can't even tell. No, A is when you don't have.
是的。好消息是，在我 40 歲之前，我仍然是一名語言治療師。我能說話。我賺錢。我有孩子。我有朋友。這代表我一切都好嗎？不。之後，我的生活品質更好了。但我只是說，我們大多數人都能彌補。但作為一名治療師和家長，我看著我的孩子，我說：「為什麼我要他們去彌補？」我希望他們有更好的生活品質。我希望他們更有自信。我以前以為這只是件簡單的事。謙虛地說，但現在你提到這點，我不這麼認為了，而且你也看到了，可能是 A 型，所以你甚至無法分辨。不，A 型是指你沒有。

Oh, when you don't have. A is when you don't have. So really it looks like the one that should go for a surgical procedure is this, but we don't know until we open it up, so it's very hard to say. All right. So does it really matter? Here's just a little slide for you to consider. Things to consider have to be discussions between the practitioner, the dentist, and the parents. If it's worth cutting it or not. My general rule is always try with non-invasive first. See if it changes. And if the change is sufficient enough. And then think of the risk factors. Right? MNRI is non-invasive. Osteopathic work is non-invasive. Myofunctional therapy is non-invasive. Speech therapy is non-invasive. But if you have a young man, I got a young man who had speech therapy since five years old.
哦，當你沒有的時候。A 就是當你沒有的時候。所以實際上，看起來應該進行手術的是這個，但我們在打開之前並不知道，所以很難說。好吧。那麼這真的很重要嗎？這裡有一張小幻燈片供你參考。需要考慮的事情必須是從業者、牙醫和父母之間的討論。是否值得進行切割。我的一般規則是總是先嘗試非侵入性的方法。看看是否有變化。如果變化足夠大。然後再考慮風險因素。對吧？MNRI 是非侵入性的。整骨療法是非侵入性的。肌功能療法是非侵入性的。言語治療是非侵入性的。但如果你有一個年輕人，我有一個從五歲就開始接受言語治療的年輕人。

All the way, he came to me, he was 18. Young man, smart, intelligent. But I tested him, his gland is all this, paresis off, had a huge tongue tie, has allergies, headache, and all these things. I suggest he get it done because he had, I mean, he's too old. Speech therapy. The parents didn't want to think it was a surgical procedure, and they came from D. C. I don't live in D. C., so I recommend him to an MRI specialist in D. C. She gave him some exercise, and through Zoom, work with him doing the exercises. In two months, he was speaking a lot clearer, no stutter, and he is happier. But then the parents said that either they didn't follow up or he didn't continue.
一路走來，他來到我這裡時已經 18 歲。年輕、聰明、機智。但我測試了他，他的腺體狀況如此，部分癱瘓，有嚴重的舌繫帶過短，還有過敏、頭痛等問題。我建議他接受治療，因為他已經——我是說，他年紀太大了。言語治療。父母不願認為這是個外科手術，他們來自華盛頓特區。我不住在華盛頓特區，所以我推薦他去見一位當地的 MRI 專家。她給了他一些練習，並通過 Zoom 指導他進行這些練習。兩個月後，他說話清楚多了，不再口吃，人也更開心了。但後來父母要麼沒有跟進，要麼他自己沒有繼續下去。

And then a month later, the parents wrote to me and said, he's doing terribly, he was doing so great in the two months, and now he didn't have the exercise for one week, so for one month, he's deteriorating, what should they do? What should you do? Do the exercise for them, no, so they said, does this mean that he needs to exercise the rest of his life? I said, if you don't want to get it cut off, of course he's going to need it for the rest of his life. What do you want me to do? But you see the parents don't understand this. They don't want to be non-invasive. Then you need to have the discipline to keep up with the exercise for the rest of your life. What do you want me to say? Yeah? So every individual is on case. All right. Two minutes bathroom break when you need it. Clear off your table. We're going to go do our exercises. Okay?
一個月後，父母寫信給我說，他表現得很糟糕，前兩個月明明做得很好，現在因為一週沒做運動，一個月來狀況惡化，他們該怎麼辦？你能怎麼辦？替他們做運動嗎？不行。所以他們問，這是否意味著他需要終生運動？我說，如果你不想前功盡棄，他當然需要終生運動。你想我怎麼做？但你看，父母不明白這點。他們不想採取非侵入性方式。那麼你就需要有紀律地終生堅持運動。你想我說什麼？對吧？所以每個案例都是獨立的。好了。需要時可以上兩分鐘廁所。清理好你的桌子。我們要去做運動了。好嗎？