This is a controversial topic among speech therapists but not among speech researchers! Oral motor speech therapy is divided into speech oral motor therapy, which is researched-backed, and non-speech oral motor therapy—pure nonsense. 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 the American Speech Hearing Association (ASHA). The majority (85% according to Dr. Gregg Lof’s research) of speech therapists use ineffective protocols when diagnosing or treating “oral motor” speech problems—pretty scary! Unfortunately, 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 (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!
Non-speech oral motor exercises are purported to strengthen muscles and improve muscle tone, including blowing whistles, sucking straws, and chewing on chewy tubes. It does not involve working on actual sounds. It may improve general oral mouth muscle or tone, but there is NO scientific evidence that it actually improves speech. Yep, none! Our mouths are used for a variety of functions (breathing, drinking, chewing, swallowing, etc.), and the more you know about the science of speech therapy, the more this makes sense.
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), cognition, and linguistics—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.
- Does Oral-Motor Therapy Really Work by Isaa Marrs – (SpeechLanguageFeeding.com: The Resource for Parents and Professionals)
- Terapia motora oral por la Dra. Caroline Bowen
- Logic, Theory and Evidence Against the Use of Non-Speech Oral Motor Exercises to Change Speech Sound Production (An Interview with Gregory L. Lof, Ph.D., CCC SLP) – (The Childhood Apraxia of Speech Association of North America – CASANA)
- The Application of Evidence-Based Practice to Nonspeech Oral Motor Treatments – (American Speech-Language-Hearing Association)
- Pasos para identificar la debilidad muscular pedi?trica y los signos de enfermedad neuromuscular (ChildMuscleWeakness.org)
- El problema con los chupetes (The New York Times)
- Is Tongue Strength an Important Influence on Rate of Articulation in Diadochokinetic and Reading Tasks (Journal of Speech Language and Hearing Research)
- Una revisi?n de las pruebas estandarizadas del rendimiento no verbal del motor oral y del habla (HighBeam Research)
- A Meme’s View of Non-Speech Oral Motor Exercises
- Controversial Practices – Oral Motor Therapies – readings, abstracts, references
- Toma de decisiones cl?nicas y tratamientos motores orales
- Isolating muscle during speech therapy- it doesn’t really work.
- Diagn?stico diferencial del deterioro grave del habla en ni?os peque?os
- Apraxia Kids About Nonspeech Oral Motor
- The Use of Nonspeech Oral Motor Exercises in the Treatment of Children with Cleft Palate: A Re-Examination of Available Evidence
- Ankyloglossia Tongue Tie: To Clip or Not to Clip? That’s the Question.
(Find out more about Brooklyn Letters’ Speech Therapy and Pronunciation Enunciation Articulation Therapy!)