Unlocking the Power of Oral-Motor Therapy
Oral-Motor Therapy
Oral-Motor Therapy is a specialized branch of speech therapy focused on the muscle and motor movements needed for talking and eating. It allows the child to practice repeated motor patterns involving the jaw, cheeks, tongue, lips, and palate that’s needed for speech and feeding.
Who Can Benefit from Oral-Motor Therapy?
Oral-Motor Therapy is often beneficial for children who have difficulty with specific aspects of speech and feeding development including:
Challenges with Speech Clarity: When a child has difficulty with their overall speech clarity (rather than one or two specific speech sounds), they typically need support with their oral-motor development. By focusing on oral-motor patterns, young children can practice then apply the exact movements that’s needed to produce clear speech.
Excessive Drooling: If a toddler or young child is drooling excessively and is not teething, they may need support with saliva management. This involves targeting the strength and coordination of their muscles including the lips, tongue, cheeks, and jaw to manage their saliva.
Open Mouth Resting Posture: When babies, toddlers, and young children are developing, it is important that they have a closed mouth posture while at rest. The child’s mouth should be closed with the tongue up and sealed to the roof of the mouth. This seal and pressure from the tongue against the hard palate is needed to form a nice wide hard palate shape. However, when a baby, toddler, or young child is consistently mouth breathing at rest, their mouth is open with the tongue down. This can cause a host of issues including problems with palate formation, oral hygiene, and speech clarity. Speech is fast and when a child’s mouth is consistently open and tongue is down, it can affect their ability to produce clear, intelligible speech sounds. When the child’s mouth is open and they are are mouth breathing, the tongue is further away from their hard palate. Many speech sounds are made by the tongue making quick contact with the hard palate or the roof of the mouth. With the tongue further away from the hard palate, it makes it more challenging for the child to quickly make contact with the hard palate and produce the quick, precise movements that needed for clear, accurate speech. Oral-motor therapy can address open mouth posture at rest by providing strategies and techniques to practice and encourage closed mouth, nose breathing at rest.
Tongue Thrust: Tongue thrust refers to a motor pattern where the tongue protrudes too far forward and may be momentarily visible, between the teeth while the child talking or swallowing. Most sounds in English (with the exception of TH sounds) require us to pull our tongue back, behind our teeth to produce the accurate speech sound. Children with tongue thrust, however, have developed a pattern where the tongue is thrusting forward rather than pulling back, causing challenges with producing speech sounds during conversation. The tongue thrust pattern may also be present during swallowing of solids and liquids. Oral-motor therapy directly address the tongue thrust pattern by allowing the child to practice pulling or retracting their tongue during speaking and swallowing.
Challenges with Movement and Coordination Needed for Speech: Speech in conversation happens quickly and instantaneously. If a child has not developed the accurate motor movements that’s needed for speech, it can be difficult to quickly make the fast, precise speech movement that’s needed for conversation. For example, elevating the tongue, making fine jaw movements, pulling the tongue back are all required simultaneously for many speech sounds. Oral-motor therapy can assist in building these skills then translating them to conversation.
Feeding Difficulties: Children who struggle with feeding may benefit from oral-motor therapy. Children may need this therapy if they have difficulty with open cup drinking, straw drinking, or difficulty managing different textures while chewing. Oral-motor therapy builds up the necessary muscles and motor patterns for chewing, drinking, and swallowing.
How Oral-Motor Therapy is Different
When toddlers or young children demonstrate difficulties in the areas outlined above, mainstream speech therapy may not be enough to address their specific challenges.
Traditional or mainstream speech therapy focuses on individual speech sounds. It typically does not address the underlying motor patterns or oral-motor weakness that may be causing the child’s difficulties.
Oral-motor therapy, on the other hand, directly addresses the motor patterns, strength, and coordination that is needed to coordinate muscles for speech and feeding.
Evaluation: The first step to begin Oral-Motor Therapy is a thorough evaluation by a licensed Speech-Language Pathologist. This assessment will identify any areas where they child needs support including specific oral motor weakness or challenging motor patterns or movements.
Customized Therapy Plan: Based on the evaluation, an individualized therapy plan will be developed with specific goals for the child. The therapy plan typically includes exercises, activities, and techniques designed to target muscle weaknesses and motor patterns.
Therapeutic Techniques: Specific therapeutic techniques are then implemented. For example, as mentioned, many speech sounds require us to pull our tongue back then elevate our tongue tip, making contact with the roof of our mouth or hard palate (for the T, D, CH, J, and L sounds). Therefore, therapeutic exercises may include motor exercises requiring the child to practice pulling the tongue back, then eventually lifting the tongue tip to the roof of the mouth or the hard palate, over and over again. Eventually, this movement will be translated to speech sounds. These exercises are serious work but are presented in a fun, playful way, designed to keep the child motivated and engaged.
Home Practice: It's important for parents to participate in the therapy process. You will be given guidance on how to implement the oral-motor exercises at home, ensuring that progress continues between speech therapy sessions. Typically, a small amount of consistent practice every day is needed to support the child’s oral-motor system.
Progress Monitoring: Throughout the therapy process, your child’s progress will be closely monitored. As the child progresses, exercises will be adjusted to meet the child where they are.
Addressing underlying oral-motor skills and strength can significantly impact a child’s speech and feeding development. If you suspect that your child may benefit from oral motor therapy, consult with a qualified Speech-Language Pathologist who specializes in oral-motor development who can assess your child's needs and provide guidance on the best approach to improving their oral motor skills.
Laura is a licensed Speech-Language Pathologist with a private practice in Manhattan and Brooklyn in New York City.
