Myofunctional Therapy

Speech

Tongue & Lip Tie Support

Feeding

Swallowing

Oral Motor

Myofunctional Therapy

Speech

Tongue & Lip Tie Support

Feeding

Swallowing

Oral Motor

Myofunctional Therapy

Myofunctional Therapy Speech Tongue & Lip Tie Support Feeding Swallowing Oral Motor Myofunctional Therapy Speech Tongue & Lip Tie Support Feeding Swallowing Oral Motor Myofunctional Therapy

My goal is to empower children, adults, and their families with the knowledge and support they need to thrive in a medical system that fails to dig deeper and find the “why” behind dysfunction.
— Carly

Our Services

Orofacial Myofunctional Therapy

1:1 Parent Coaching

Tongue & Lip Ties (Pre and Post Support)

Feeding & Swallowing Therapy

Speech/Articulation Therapy

Meet Carly Welsh, MS, CCC-SLP, QOM-TC

I’m Carly! I’m an ASHA-certified Speech-Language Pathologist (CCC-SLP) and Qualified Orofacial Myologist-Track Candidate (QOM-TC) in Chesapeake, Virginia. I specialize in identifying and treating myofunctional disorders including tongue thrust, open-mouth posture, low tongue posture, oral habits (like finger sucking or extended pacifier use), restricted tongue mobility (TOTs), oral muscle weakness, and sleep-disordered breathing patterns. I hold advanced training in Chrysalis TOTs Training®, Orofacial Myology: From Basics to Habituation, Feed the Peds, The Swallow Treat Retreat and Beckman Oral Motor, I take an evidence-based yet compassionate approach to help families address the root cause of challenges. My goal is to empower children, adults, and their families with the knowledge and support they need to thrive in a medical system that fails to dig deeper and find the “why” behind dysfunction.

More About Us

FAQs

  • Treatment can range from 30, 45, to 60 minutes depending on the individual and service needed.

  • Visit our Contact page, or click one of the services above and it will bring you to the Contact page. Please be detailed when responding! Every detail matters 🫶

  • We see children 4+ and adults for myofunctional therapy, speech therapy, feeding and swallowing.

  • Many children benefit from both! Speech therapy focuses on how your child produces sounds and uses language to communicate. Myofunctional therapy focuses on how the muscles of the mouth, tongue, and face work together for breathing, chewing, swallowing, and speech.

    If your child struggles with things like mouth breathing, open-mouth posture, tongue thrust, picky eating, or unclear speech that hasn’t improved with traditional therapy, myofunctional therapy may help address the root cause. During your initial evaluation, I’ll take a close look at your child’s overall oral function to determine which type of therapy—or combination—is the best fit for their needs.

  • A comprehensive evaluation is the first step in understanding how your child’s mouth, tongue, and facial muscles are working together. During this visit, I look closely at things like breathing patterns, tongue posture, swallowing, chewing, speech clarity, and oral habits (such as thumb sucking or pacifier use).

    The goal is to identify why certain challenges may be happening, not just what they are. This helps create a personalized treatment plan that targets the root cause and supports long-term progress in speech, feeding, and overall function.

  • Yes, virtual sessions are available for certain types of therapy depending on your needs and the therapist’s clinical judgment. Some goals, especially those focused on oral motor patterns, muscle function, or hands-on exercises, are best addressed in person.

    During the evaluation, I’ll determine whether teletherapy is appropriate and effective for your child’s specific goals. If so, we’ll create a plan that ensures virtual sessions are just as engaging and productive as in-person visits.

  • At this time, To The Top Myo & Speech is a private-pay practice and does not bill insurance directly. However, many families are able to receive partial reimbursement by submitting a superbill (an itemized receipt) to their insurance provider for out-of-network benefits.

    Payment is collected at the time of service, and I’m happy to provide the documentation you need to request reimbursement. This approach allows me to provide individualized, evidence-based care without the limitations or restrictions that often come with insurance.

  • Yes! Parent involvement is a key part of your child’s success. I encourage parents to stay in the room during sessions so you can observe, learn strategies, and feel confident supporting your child at home. My approach is built on teamwork and consistency — the more we work together, the more progress your child will make!

  • For the initial evaluation, please bring a crunchy food (such as pretzels, crackers, or veggie straws) and a straw cup of water — these help us assess oral function and feeding skills. For the first therapy session, just bring your child, an open mind, and a willingness to learn! We’ll spend time getting to know your child, discussing your goals, and setting the foundation for successful therapy.

  • Yes! I believe the best outcomes happen when we take a team approach. I often collaborate with dentists, orthodontists, ENTs, and other specialists to make sure every aspect of your child’s care is aligned. Open communication between providers helps us get to the root cause of issues and create a plan that truly supports your child’s growth and overall health.

  • Absolutely! It is never too late to begin treatment for an orofacial myofunctional disorder (OMD). Many adults come to therapy after years of compensations related to mouth breathing, tongue thrust, TMJ pain, or sleep-disordered breathing—and find incredible relief and improvement through targeted myofunctional therapy. Treatment can help improve oral function, facial balance, and overall wellness at any age. Whether your goals are to improve breathing, sleep, speech, or posture, we’ll create a plan that supports lasting, whole-body change.

  • At To The Top Myo & Speech, I believe real progress starts with education, communication, and teamwork. From day one, it’s a partnership between you, your child, and me. I’ll teach you the why behind everything we do so you feel confident supporting your child outside of sessions, because that’s where the real change happens.

    I’m a licensed Speech Language Pathologist and Qualified Orofacial Myologist Candidate (QOM-C) with advanced training in myofunctional therapy, tethered oral tissues (TOTs), and pediatric feeding. Before opening my practice, I worked in two private practices that specialized in OMDs and feeding, which gave me a strong foundation and a passion for helping families see lasting results.

    What makes my practice different is my focus on true function and progress. I’m not here for quick fixes. I’m here to help your child breathe, eat, speak and thrive the way their body was designed to, while helping you understand every step of the process.

  • I’m so happy you’re here! Head over to our Contact page, OR select the “Get Started” button below. There you will answer a few questions, press submit, and waa-laa! We will reach out to you ASAP. See you at the top ⛰️

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