F.O.T.T. Concept

Premise, view and procedure in the treatment of the Facio-Oral Tract - F.O.T.T.®

  • The facial-oral functions of breathing, salivary ingestion, food intake, speech, oral cleaning movements, etc., alternate permanently and in a coordinated manner. This is the whole body involved.
  • Central perturbations often affect all of these areas, i. Dysphagia rarely occurs in isolation.
  • The basis of the procedure is the knowledge of physiological movements and the resulting fazio-oral activity and action sequences as well as the exact analysis of the occurring pathologies. The total body disorders are considered in connection with the existing illness and the resulting problems in everyday life.
  • The basis is also the knowledge of how we learn in childhood and all our lives. (1), (2)

The F.O.T.T.®
... was developed by Kay Coombes, English speech therapist and Bobath Tutor, in the 1970s together with her colleagues and has emerged from the eponymous neurophysiological treatment approach established by Berta and Karel Bobath.

The F.O.T.T.®
... is being continuously developed, integrating aspects of the Affolter model and current neuroscientific models such as the principles of motor learning and neuroplasticity.

The F.O.T.T.®
... provides an ICF-oriented, structured and targeted approach to the assessment and treatment of neurogenic disorders of swallowing, oral ingestion, facial expression, and the range of breathing, voice, and speech in patients of all ages.

The F.O.T.T.®
... helps patients with neurogenic disorders to have as normal a movement experience as possible in an individually stimulating everyday context. Lost or impaired functions are thus initiated and (re) achieved on the basis of sensory-motor perceptual learning.

"Children with brain damage, unlike adults, can not rely on previously learned movement experiences (implicit body knowledge) and learning processes. This results in sensory-motor deficits with multiple developmental disorders and effects on the fazio-oral tract. In the therapy with children development-dependent everyday situations are selected, in order to promote the situation understanding, the curiosity at the experimentation and developing a strategy. Largely normal and safe movement behavior should be developed hereby. Feeling or "feedback" to the position of the body in the room and the movements should help to prevent aspirations-favorable head postures and other unhelpful learning experiences. "(2)

The F.O.T.T.®
... uses meaningful, individually and therapeutically varied, everyday ones in the treatment
Activities instead of standardized exercises. Movements and actions are facilitated and, where necessary, work is done at the body structure level to re-direct the movement processes to minimize restrictions on the mobility of the nervous system, contractures and fascial blockages of the target tissue. (1)

The F.O.T.T.®
... begins as early as possible, with the aim of helping the patient to use his fazio-oral functions as efficiently and effectively as possible in everyday life and to avoid the development of secondary problems. With early adaptive structure and regularity of therapeutic-nursing measures, a deprivation of the oral cavity with the problems of hypersensitivity and phasic biting up to the impossibility of adequate oral care is counteracted.

The F.O.T.T.®
... is integrated into a multi-and interprofessional, everyday-oriented and everyday 24-hour concept. The continuity of the therapeutic-nursing measures is made possible by the interdisciplinary cooperation of the various occupational groups. Relatives are, as far as they wish and can, guided thereby.

As of: 08-04-2020

(1) Müller-Busch, R (2015) The F.O.T.T. Concept: Functional-complex-everyday-related, in: The therapy of the Facio-Oral Tract, edited by Müller-Busch, Springer-Verlag Berlin-Heidelberg
(2) Elferich, B (2011) F.O.T.T. -Therapy of the Facio-Oral Tract, in: Pediatric Dysphagia Management, ed. Frey, Elvsevier Munich