Facial-Oral Tract Therapy (F.O.T.T.)

Book excerpt: The book offers a comprehensive approach to the assessment and treatment of disturbances in facial expression, oral movement, swallowing, breathing, voice and speech production caused by developmental and acquired neurological conditions. The principles outlined are used in patients with different etiologies (e.g. stroke, tumors, traumas). F.O.T. T., developed by Kay Coombes, is a hands-on approach based on an understanding of neurological functions and the way we learn from experience. The approach aims to give the patient experience of physiological posture and movement using facial-oral functions in normal activities of daily living (ADL). Rather than mere “exercises”, F.O.T.T involves meaningful activities aiming to promote participation, according to ICF criteria. Four main areas are covered: nutrition, oral hygiene, nonverbal communication and speech. Each chapter summarises the problems of severely ill patients and shows the clinical reasoning behind the solutions offered. Separate chapters discuss tracheostomy management and the training of the carers involved, including relatives. The chapter authors are experienced specialists (physio-, occupational- and speech-language therapists and physicians), whose contributions aim to provide interdisciplinary perspectives and translate latest research into clinical practice.