Persistent Speech Disorders
Have you or your child received Speech Services but a Speech Problem still exists?
Sounds occur in a developmental sequence and improve with age. All should be mastered by age 8. They basically begin at the front of the mouth and end with more difficult, complex sounds. For example, the initial sounds heard are the vowels and ones made by the lips such as /p, b, m/ that simply require the lips to come together and then "explode" apart with exhaled air. Next, come sounds that are made with the tongue tip to behind the front teeth (n, d, t) then followed by /f/ with upper teeth on lower lip. Lastly, the sounds requiring very fine motor skills (s, r) develop as the child matures. See "Development of Sounds" tab.
When problems occur and Speech Therapy
Most children achieve most sounds without any problem. However, for all the sounds to eventually be mastered, a strong base or foundation of the muscle system is necessary. If a child does have difficulty reaching all the speech milestones, he/she may have speech therapy to remedy the misarticulations. This may begin very early if a problem is readily identified, but sometimes parents are told that the child will grow out of it and help is delayed. In the past, parents and even medical professionals assumed that the speech problem would be addressed by the school. Schools traditionally offered services for preschool ages and older. If there is no significant structural or muscular problem in the oral speech mechanism or related systems such as breath support and hearing, a "regular" speech therapy approach usually can teach the child how to make the sound(s) and then provide opportunities to drill and practice until the correct sound is habituated through to a conversational skill level. the child is then dismissed as a success.
Why do speech errors persist?
However, success may vary. If oral or facial muscle dysfunction is at the root of the problem, traditional speech therapy often does not address this first. Research indicates that about 81% of people with orofacial myofunctional disorders (OMD) have speech problems. A common OMD is , in layman's terms, called "tongue thrust" where the tongue rests against or between front or side teeth when swallowing, or when the person is not talking or eating. This is often accompanied by an open lips rest posture. OMDs contribute to problems in speech as well as dental development. A different, specialized approach is necessary to accomplish correction. Orofacial Myofunctional Therapy is an individualized plan of exercises to tone and train the oral and facial muscles that will establish a sound foundation for speech. A primary focus is to correct tongue and lip resting postures along with correcting speech, chewing efficiency and swallow patterns. IF an adverse oral habit also exists such as thumb/finger/tongue sucking, fingernail/cheek/lip biting or other behaviors, it must also be addressed for success. This is NOT available in the schools and requires an Orofacial Myology Specialist.
Is cause important?
Trying to determine the cause is not always conclusive; however, if certain suspected issues still are present, they must be managed either first or along with Orofacial Myofunctional Therapy (OMT). These may include one or more of the following: detrimental oral habits; problems affecting achieving an adequate nasal airway e.g. unresolved enlarged tonsils/adenoids, allergies/asthma, narrow nostrils; physical problems e.g. short lingual frenulum ("tongue tie"); and neurological/developmental issues e.g. Down Syndrome, Cerebral Palsy or other diagnoses. They do not necessarily affect successful therapeutic outcome. A team approach is utilized to include appropriate specialists. This is handled on a case by case basis.
Is Orofacial Myofunctional Therapy Effective with Persistent Speech Disorders?
Yes. Once the underlying system is improved, associated issues are managed, and speech techniques are assigned and mastered, success is shown to be 80-90%. It has helped thousands people all over the world for more than 30 years. It is a team effort and depends on the patient's desire, cooperation and self discipline as well as support from others.
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