The YTM® Tool Method for infants

The YTM® Tool Method for infants is a prescribed protocol of exercises designed to support oral and orofacial function. It considers the relationship between the mouth, facial structures, fascia, soft tissues and the wider body, recognising that feeding involves coordinated movement and function rather than the tongue acting in isolation.

The infant protocol uses the principles of release, lengthening and restoration. Its prescribed exercises are intended to address identified functional needs, which may include fascial tension and mobility, tissue length and movement, muscle tone, strength and coordination, sensory input, lymphatic flow and drainage, and oral and facial function (D-Restricted Ltd, 2026).

The YTM® Tool is a specialised intraoral instrument developed by Yulli Tamayo-Myerson, founder of Myofunctional Therapy UK, and is used for some exercises within the infant protocol. The method encompasses the prescribed programme as a whole, rather than simply the use of the physical tool (Myofunctional Therapy UK, 2025).

The YTM® Infant and SEN Protocol is one of the distinct protocols within the wider YTM® system. It is specifically adapted to infant anatomy, development and care and should not be confused with protocols intended for older children or adults (TBIOM®, n.d.).

What is the YTM® Tool Method for infants?

The YTM® Tool Method is a structured programme delivered following individual assessment. It combines prescribed exercises with professional guidance, caregiver participation and ongoing monitoring of progress.

The method considers how oral and facial function may be influenced by soft-tissue mobility, fascial tension, movement patterns, muscle function and sensory input. Rather than concentrating solely on one structure, the infant protocol considers these factors within the context of the infant's wider body and functional needs.

The principles of release, lengthening and restoration inform the approach. The exercises prescribed depend on the findings of the assessment and the goals established for the individual infant. The programme is suitable for infants up to two years of age, including infants with special educational needs (SEN), where the approach is appropriate to their presentation and clinical needs.

TBIOM® (The British Institute of Orofacial Myology) offers professional training in the YTM® Method, including a dedicated Infant and SEN Protocol. Its Level 3 Certificate in the Professional YTM® Method for Infants focuses on techniques adapted to infant anatomy, development and care (TBIOM®, n.d.).

Assessment, goal setting and monitoring

Assessment is central to the YTM® Tool Method. Before exercises are prescribed, the practitioner considers the infant's overall presentation, feeding function and relevant developmental and neurological factors. This helps establish which areas may benefit from support and provides a basis for setting meaningful goals.

Depending on the infant's presentation, assessment includes the following interconnected areas.

Full-body assessment

A full-body assessment considers movement, posture, soft-tissue mobility and areas of tension throughout the infant's body. This wider assessment reflects the relationship between the oral structures and the surrounding musculoskeletal and fascial systems.

Fascia is connective tissue that surrounds and connects structures throughout the body. Its mobility is relevant to how tissues move in relation to one another. The method incorporates techniques intended to address fascial tension and mobility where these are relevant to the infant's identified functional needs.

A full-body perspective does not mean assuming that every feeding difficulty originates outside the mouth, or that a particular area of tension necessarily causes an oral or feeding problem. It provides a broader context in which to consider the infant's presentation and the relationships between bodily functions.

Feeding assessment

Feeding assessment considers how the infant functions during feeding, rather than relying solely on oral anatomy or the appearance of the tongue. Depending on whether the infant is breastfed, bottle-fed, combination-fed or receiving expressed milk, relevant observations may include positioning, attachment where applicable, sucking patterns, oral seal, coordination, swallowing, feeding efficiency, fatigue and the experience of the feeding dyad.

The assessment also considers the caregiver's concerns, what is working well, the support already received and the outcomes that matter most to the family.

Where a feeding difficulty may have several contributing factors, these need to be considered rather than attributing the problem automatically to tongue-tie, fascial tension or muscle tone.

Neurological assessment

Neurological assessment considers relevant aspects of the infant's neurological presentation and function. Depending on the clinical context, this may include movement, muscle tone, reflex responses, sensory responses and coordination.

These observations help inform the practitioner's understanding of the infant's presentation and whether further assessment or referral is needed. They also help ensure that prescribed exercises are appropriate to the infant's developmental and clinical needs.

The findings from these assessments inform the goals agreed for the programme. Progress is monitored throughout the six sessions, with reassessment at the final evaluation session to establish what has changed and whether the original goals have been achieved.

Goal setting is therefore not simply an initial discussion. It provides a reference point for reviewing the infant's progress and deciding whether further support, maintenance or referral is appropriate.

What do the prescribed exercises address?

The infant YTM® Tool Method incorporates exercises intended to support several related aspects of orofacial function.

Fascial tension and mobility: Techniques are intended to support soft-tissue mobility and address areas of fascial tension identified during assessment.

Tissue length and movement: Prescribed exercises may support tissue mobility and movement patterns relevant to oral and facial function.

Muscle tone, strength and coordination: Exercises are selected to support the functional use and coordination of the oral and facial musculature where these are identified as areas requiring attention.

Sensory input and neuromuscular re-education: The protocol incorporates specific sensory and movement-based input intended to support functional movement patterns and the coordination of oral structures.

Lymphatic flow and drainage: The method includes techniques intended to support lymphatic flow where relevant to the assessment findings.

Oral and facial function: The exercises are selected according to the areas of function identified as requiring support, including those relevant to feeding.

Fascia connects structures throughout the body, so the relationships between different areas of function need to be considered as part of the overall assessment. An infant's presentation should not be understood by looking at individual structures in isolation. The prescribed protocol reflects the individual assessment and goals, rather than assuming that every infant presents with the same pattern of needs (D-Restricted Ltd, 2026).

The relationship between tongue-tie restriction and the YTM® Tool Method

Tongue-tie, or ankyloglossia, describes a lingual frenulum that restricts tongue movement and may contribute to functional difficulties. However, the presence or appearance of a frenulum alone does not establish whether an infant has a clinically significant restriction. Tongue movement and feeding function need to be considered alongside the infant's presentation and the caregiver's experience (Academy of Breastfeeding Medicine, 2021).

A restrictive lingual frenulum may be one factor affecting oral function. Restricted movement can influence how an infant uses the tongue during feeding, but feeding difficulties may also involve other oral, muscular, sensory, developmental or feeding-related factors.

The YTM® Tool Method is not designed solely for infants with tongue-tie. It provides a structured programme of prescribed exercises intended to support identified aspects of orofacial function. Where tongue-tie restriction is present, the method may complement tongue-tie division by supporting neuromuscular re-education of the muscles and oral structures following the procedure. Outcomes cannot be guaranteed, and the appropriateness of the programme depends on the infant's individual assessment and goals.

The method and surgical division have different purposes. Frenulotomy divides the restrictive lingual frenulum when a clinical assessment indicates that the procedure may be appropriate. The YTM® Tool Method is a prescribed exercise protocol intended to support orofacial function. It is not a substitute for tongue-tie division where the procedure is clinically indicated, and the presence of tongue-tie does not automatically mean that surgical division is necessary.

At D-Restricted Ltd®, two distinct programmes are available:

• Tension & Tone: a six-session programme using the YTM® Tool Method without surgical tongue-tie division.

• Tongue-tie, Tension & Tone: a six-session programme combining tongue-tie assessment and, where indicated and consented to, surgical division with the YTM® Tool Method.

The decision about whether to divide a tongue-tie is made through clinical assessment in session 1 and discussion of the potential benefits, risks and alternatives. The goals of the exercise programme remain individual to the infant, whether or not a procedure forms part of the care plan.

Where the infant's presentation indicates that further investigation or a different type of support is needed, referral to an appropriate specialist service may be recommended.

The role of the caregiver

Caregivers have an active role in the infant YTM® Tool Method. Following assessment and professional instruction, the caregiver completes the prescribed exercises with the infant three times per day throughout the programme.

The exercises are demonstrated and explained by the practitioner. The caregiver receives the relevant instructions and can refer to the exercise information within the infant's patient profile between appointments. The YTM® Tool is used for the exercises for which it is prescribed; other exercises within the protocol do not require the tool.

Regular participation allows the prescribed programme to continue between sessions. The caregiver should follow the instructions provided and contact the practitioner if clarification is needed or if concerns arise about the infant's response.

The caregiver's role is not limited to completing a set of exercises. The programme also creates opportunities for attentive, responsive interaction between caregiver and infant. Gentle, guided interaction can support positive connection and bonding, while allowing the caregiver to become more familiar with the infant's responses and cues. The exercises should remain appropriate to the infant's comfort and presentation, with the quality of the interaction taking precedence over simply completing a prescribed task.

The structure of the infant programme

At D-Restricted Ltd®, the infant programme consists of six sessions delivered over ten weeks, with approximately two weeks between sessions.

Individual goals are established at the outset, and targeted exercises are prescribed according to the assessment findings. The caregiver completes the exercises three times daily, and progress is reviewed throughout the programme.

At the final evaluation session, the practitioner reassesses the infant's current function and reviews progress against the original goals. This helps determine whether the goals have been achieved, whether further work is appropriate, or whether another form of support or referral should be considered.

Maintenance exercises may be discussed where appropriate. An optional review appointment is also available following completion of the programme.

What can families expect?

The YTM® Tool Method provides a structured approach to supporting identified aspects of infant orofacial function through assessment, goal setting, prescribed exercises and monitoring. The programme considers oral function in the context of the infant's wider body and feeding experience, with active caregiver participation between appointments.

The intended outcomes depend on the infant's individual presentation and the goals established at the beginning of the programme. Families should receive clear explanations of what the exercises are intended to address, how progress will be monitored and what the available evidence can and cannot establish.

The method is described as research-informed and draws on principles relating to movement, muscle function, sensory input and neuromuscular re-education. However, evidence supporting individual principles or related interventions should not automatically be interpreted as proof that the complete YTM® Infant and SEN Protocol has been shown to produce specific clinical outcomes.

Where feeding difficulties persist, further assessment or referral may be appropriate. The programme should remain responsive to the infant's needs, with goals and prescribed exercises reviewed in light of progress. No particular outcome can be guaranteed.

The central principle is that the infant YTM® Tool Method combines an individual assessment with a prescribed exercise protocol, regular caregiver participation and monitoring of functional goals. It considers the infant as a whole, while keeping the intervention focused on the specific areas identified during assessment.

References

Academy of Breastfeeding Medicine (2021) ‘Academy of Breastfeeding Medicine Position Statement on Ankyloglossia in Breastfeeding Dyads’, Breastfeeding Medicine, 16(4), pp. 278–281.

D-Restricted Ltd (2026) YTM® Tool Method. Available at: https://www.tongue-tie.info/ytm.

Myofunctional Therapy UK (2025) The YTM® Tool and Method. Available at: https://www.myofunctionaltherapy.co.uk/ytm-tool-method (consulted 14 October 2026).

TBIOM® (n.d.) Level 3 Certificate in the Professional YTM® Method for Infants. Available at: https://www.t-biom.com/accreditedytminfantmethodcertificate (consulted 14 October 2026).