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What is Orofacial Myofunctional Therapy?

(IAOM webpage, 2019). Orofacial Myofunctional Disorders are atypical, adaptive patterns that emerge in the absence of normalized patterns within the orofacial complex. The regular presence of these adaptive movements can often result in a variety of disturbances.

Examples of Orofacial Myofunctional Disorders include one or a combination of the following:
  • Thumb and finger sucking habits
  • A routine habit of resting with the lips apart
  • A forward resting posture of the tongue between or against the teeth
  • Tongue Thrust
  • Other harmful oral habits

Orofacial Myofunctional Disorders are often related to, or can contribute to a variety of medical and dental disorders. These disorders can include:

  • Malocclusion (improper alignment of the teeth)
  • Periodontal disorders
  • Orthodontic relapse
  • Changes associated with abnormal jaw growth and position
According to ASHA, oral motor therapy can be effective in the treatment of OMDs, including:
  • Therapeutic intervention can involve the selection of appropriate oral tools such as straws, lip or bite blocks, appropriate food items, etc. for jaw-lip-tongue dissociation needed for eating and drinking.
  • Techniques for handling and swallowing of saliva, liquids and solids
  • Oral resting posture activities
  • Labial-lingual-pharyngeal muscle resistance exercises
  • Exercises to improve lip closure may include holding a tongue depressor between the lips (Ray, 2003), use of a lip gauge (Paskay, 2006), smiling widely and then rounding lips alternately (Meyer, 2000), and lip resistance activities (Satomi, 2001).
  • Exercises to improve tongue, lip, and jaw differentiation include oral tactile stimulation and tongue movements without assistance from the jaw, such as tongue tip to alveolar ridge or tongue clicks against the palate (Meyer, 2000). Isotonic and isometric exercises target the lips and tongue, in order to teach closed mouth resting posture and nasal breathing


TalkTools Certified Orofacial Myologists (COMs®)

Orofacial Myofunctional Disorders

Combining Muscle and Motor Based Approaches to Facilitate Speech in Individuals with Orofacial Myofunctional Disorders 

IAOM Poster Session 2019, New Orleans, LA.

Robyn Merkel-Walsh, MA, CCC-SLP/COM®

Renee Roy-Hill, MS, CCC-SLP/COM®


ASHA (2019). Speech sound disorders-articulation and phonology practice portal. Retrieved from: https://www.asha.org/Practice-Portal/Clinical-Topics/Articulation-and-Phonology/
ASHA (2018) Orofacial myofunctional disorders practice portal. Retrieved from: https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589943975&section=Assessment
Bahr, D. & Rosenfeld-Johnson, S. (2010). Treatment of children with speech oral placement disorders (OPDs): a paradigm emerges. Communication Disorders Quarterly, 31(3), 131-138.  
Billings, M. & Davidson, D. (2018) Make the connection. Live presentation, New York, NY. 
Boshart, C. (2017). Swalloworks- 4th edition. Elijay, GA: Speech Dynamics.
Broad, F.E. (1972). The effects of infant feeding on speech quality. N Z Med J, 76, 28-31.
Green, J.R., Moore, C.A., & Reilly, K.J. (2002). The sequential development of jaw and lip control speech. JSLHR, 45(1), 66-79.
Hiiemae, K.M., & Palmer, J.B. (2003). Tongue movements in feeding and speech. Crit Rev Oral Biol Med, 14(6), 413-429.
Kent, R.D., (2015). Nonspeech oral movements and oral motor disorders: A narrative review. AJSLP, 24, 763-789.
Lof, G.L. (2007). Reasons why non-speech oral motor exercises should not be used for speech sound disorders. Presentation at the ASHA Annual Convention, Boston, MA.   
Marshalla, P. (2007). Oral Motor Techniques Are Not New.     Oral Motor Institute, 1(1). Available from: www.oralmotorinstitute.org
Merkel-Walsh, R. (2018). How do I correct that pesky lisp. Webinar presentation. Charleston, SC: TalkTools. 
Merkel-Walsh, R. (2016). A modern look at Van Riper’s phonetic placement approach. Poster presentation at the ASHA Connect Convention, Minneapolis, MN. 
Merkel-Walsh, R. (2011). Systematic intervention for lingual elevation-2nd edition (SMILE). Charleston, SC: TalkTools. 
Moore, C.A., & Ruark, J L. (1996). Does speech emerge from earlier appearing oral motor behaviors? JSLHR, 39(5), 1034-1047.
Pierce, R. (2002). Swallow right. Austin, TX:Pro ed.
Ray, J. (2003). Effects of orofacial myofunctional therapy on speech intelligibility in individuals with persistent articulatory impairments. , IJOM, 29, 5-14.
Shotts, L.L., McDaniel, D.M., & Neeley, R A. (2008). The impact of prolonged pacifier use on speech articulation: A preliminary investigation. Contemp Issues Commun Sci Disord, 35, 72-75.