The Oral-Motor Debate
I must admit, I love a good controversy every once in awhile! Recently I have been both fascinated and flabbergasted by some of the comments posted on the blog related to oral-motor therapy and its effectiveness. I myself am a huge supporter of oral-motor therapy and use it almost everyday with the majority of the children I treat in EI. I was shocked to read some of the recent comments announcing that oral-motor therapy is not supported by ASHA, there is no research to substantiate its validity, and that it may not really be a worthwhile practice especially when related to speech stimulation.
When I read these accounts, I had two immediate thoughts. The first was that I strongly disagree with many of these claims based upon my own success with oral-motor treatment and my second thought was to do some research of my own!!
So, I immediately went to ASHA's website and found the following information listed under "
Professional Roles and Activities":
"Speech-language pathologists address typical and atypical communication and swallowing in the following areas:
- speech sound production: articulation, apraxia of speech, dysarthria, ataxia, dyskinesia
- feeding and swallowing: oral, pharyngeal, laryngeal, esophageal; orofacial myology (including tongue thrust); oral-motor functions"
In addition, ASHA states that "oral anomalies" are within our scope of practice and potential etiologies of communication and swallowing disorders include examples such as: "cleft lip/palate, dental malocclusion, macroglossia, oral-motor dysfunction".
So, my next thought is, if ASHA recognizes that "oral anomalies" are within our scope of practice, why wouldn't we use oral motor therapy techniques to treat them when appropriate?? In addition, I was taught that oral-motor therapy is one of the best and most effective ways to treat apraxia, which is also listed above as within our scope of practice.
Back in April, 2009 I wrote a post entitled: What's In Your Oral-Motor Toolkit?, which included a complete list of the various tools and methods I use everyday to treat children with a variety of delays/disorders that require oral-motor support. The majority of what I do each day focuses on the mouth, whether it's related to speaking or feeding. To ignore a child's ability to recognize their mouth and the movements it makes doesn't make sense to me. I have found that the better a child can motor plan oral and verbal movements, as well as increase the overall awareness of their mouth, the more success I see with their speech.
One reader recently commented that she has "found [oral-motor therapy] very helpful for children with low muscle tone and tongue protrusion (Down Syndrome, certain neuromuscular disorders). I have noted increased intelligibility, by reducing tongue protrusion, strengthening jaw, (and) improving ability to make dissociated movements of tongue lips and jaw. Also helpful with numerous cases where child displays oral posture: retracted lips and a fixed jaw position."
Amen! I could not agree more! I know I do not have solid numbers and a published research study to support my belief or claims; however I see the benefits come to life everyday in many of the homes in which I work.
My final thought for today's post: If there is no current research to support oral-motor therapy as a valid method to treat speech production, maybe we, as a professionals, need to conduct research studies and begin documenting our successes so that we have numbers to back up our hard work!! Just because the research isn't there, doesn't mean the techniques do not work.
PLEASE write in and share your thoughts!!