Why Am I Coughing?

17-year-old Betty was referred for speech therapy by her otolaryngologist because she had a hoarse voice and was coughing whenever she ate. Inspection of the vocal cords by her doctor revealed that everything looked normal.

When I met Betty, her voice sounded normal. It was not hoarse. I asked her to describe to me her major complaint about anything from the neck up. She quickly answered, saying that when she raises her tongue up and when she swallows, there is a sharp pain at the back of her tongue. This was an unusual symptom of something, but I didn’t know what. Time to discover what it was!

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In 1994, I opened an outpatient speech therapy clinic in Asheville, N.C. I started getting referrals for children who had tongue thrust. These were school-aged children so why weren’t they receiving speech therapy in the school? I learned that tongue thrust is not treated in the schools because it is not an educational problem. This meant that parents had to pay for private speech therapy and make arrangements for a weekly appointment.

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