The high position of the ball in this vestibular plate forces the previous-ascending movement of the tongue, which can be observed when pronouncing the gingival sounds sz, cz, ż, j and l, r. Effective complementation of speech therapy in children with mixed dentition. This special MUPPY is mostly used by children with Down syndrome and cerebral palsy so the muscleweak tongue can be guided to the palate by the pearl attached to the wire.