Oral Motor Speech Therapy

 

This is a controversial topic among speech therapists but not among speech researchers! Oral motor speech therapy is divided into speech oral motor therapy, researched backed, and non-speech oral motor therapy- pure non-sense. Let’s start with the term oral motor, which is an ambiguous term to begin with. Speech sound disorders (articulation and phonological disorders) is the up-to-date nomenclature. Speech therapists, who incorporate non-speech oral motor techniques, learn about them at professional trainings, post graduation, when trends are prioritized over science. The content of these professional trainings are not endorsed by ASHA: American Speech Hearing Association. The majority (85% according to Dr. Gregg Lof’s research) of speech therapists use ineffective protocols when diagnosing and/or treating “oral motor” speech problems: pretty scary! Unfortunetly, there is a lack of quality post graduate support in our field.

I have seen so many children misdiagnosed and, as a result, receive ineffective speech treatment. In essence, when working on speech sounds (speech oral-motor), effective therapy always includes the production or shaping of a sound, e.g. close your lips and say “mmm” to teach /m/ or if the child is omitting a final “p” in words, the clinician helps the child say final “p” in short words, e.g. “hop”, “top”, “mop”, etc. Working on sounds, during speech therapy, is natural and a no brainer because it includes facilitating motor planning (agility), mouth strength, and linguistics: all of these underlying neurological processes need to be activated at once- that’s how we speak!

Se supone que los ejercicios motores orales que no son del habla fortalecen los m?sculos y / o mejoran el tono muscular, como sonar silbatos, chupar pajitas y masticar tubos masticables. No implica trabajar en sonidos reales. Puede mejorar el tono / m?sculo oral general de la boca, pero NO hay evidencia cient?fica de que realmente mejore el habla. S?, ninguno! Nuestras bocas se utilizan para una variedad de funciones, por ejemplo, respirar, beber, masticar, tragar, etc. Cuanto m?s sepa sobre la ciencia de la terapia del habla, m?s sentido tiene.

Speech is special! We actually use minimal muscle strength to talk. Tone is important when the speech muscles are at rest. Strength is important for chewing, not talking. Speech learning is primarily based on agility (motor planning, think of a ventriloquist) and cognition and linguistic- all brain based! Other animals vocalize but can’t talk; the differences reside in our brains, not our mouths! That’s the beauty of evolution.

An analogy, for example, would be to perform finger strength exercises to become a better piano player. Strong fingers and lack of actual piano practice is the equivalent of non-speech oral motor therapy. Would you hire a piano teacher to work only on strengthening your child’s finger muscles Non-speech oral motor techniques have nothing to do with speaking, e.g. chewing on chewy tubes, moving your articulators in ways in which we don’t speak, drinking from special straws, etc. Speech scientists strongly advise that speech therapists focus on techniques that facilitate shaping and/or producing sounds for a given language.

Para citar un extracto de una Carta al Editor, del NY Times (24/01/12), lo siguiente resume lo que sucede en el mundo de la terapia, sin importar qu? profesi?n:

“We frequently receive manuscripts in which people promote ideas and theories without adequate data, usually in pursuit of personal fame or monetary gain. Although the peer-reviewed medical literature is not without flaws, there is no better way than peer review to vet information before it is used in the diagnosis and treatment of disease. At least in medicine, we should think carefully before we decide that more, unfiltered information is better information.”
-Jeffrey M. Drazen, MD

El escritor es editor en jefe, The New England Journal of Medicine.