Speech and Language

Nonspeech Oral Motor Treatments

by Elizabeth Christopher

One of our purposes in blogging is to assist practicing clinicians in Pennsylvania schools in finding research and professional articles that address common questions. In a study performed by Muttiah, Georges, and Brackenbury (2011), it is noted that “50% of practicing clinicians who participated stated that the professional time is a barrier to utilizing EBP”.

The intent of our posts are to limit the time needed in looking for specific studies or systematic reviews that may relate to your specific needs. The purpose is not to provide a directive or opinion but rather a resource for SLPs to reflect on their current practice and assist in evidence based decisions.

Speech Intervention With Nonspeech Oral Motor Treatment

One controversial topic in the field of speech language pathology is the use of nonspeech oral motor treatments for intervention in speech production (NSOMT). There are many commercially available products that target skills like blowing, smiling, puffing cheeks and other oral motor movements. This type of exercise differs from oral motor placement intervention as oral motor placement instructs the child the place, manner and type of articulation required when a sound produced (i.e., place teeth on your bottom lip to make the /f/ sound. Keep your voice off). Oral motor placement includes sound production during the activity. NSOMT involves manipulation of the structures involved in speech in isolation without co-articulation or speech production. Some therapists target isolated oral motor movements without sound production as a precursor to improved articulation of specific sounds. This intervention strategy is used for various other motor disorders including swallowing however, is there research to show that this technique works for speech impairments?

This month’s recommended reading includes a systemic review article on the evidence for both sides of the argument.

Research Review:

McCauley, R. J., Strand, E., Lof, G. L., Schooling, T., & Frymark, T. (2009). Evidence-based systematic review: Effects of nonspeech oral motor exercises on speech. American Journal of Speech Language Pathology, 18(4), 343-360.

Synopsis: This highly cited article discusses and reviews literature from 1960-2007 for validity of nonoral speech exercises for improvement of speech physiology and improve functional articulation production. The study concludes that there is limited evidence to support use of nonspeech oral motor exercises for sound production intervention however; there is little evidence to against use as well.

Lass, N. J. & Pannbacker, M. (2008). The application of evidence-based practice to nonspeech oral motor treatments. Language, Speech, and Hearing Services in Schools, 39, 408-421.

Synopsis: The purpose of this article is to provide SLPs in the schools with information regarding the use of nonspeech oral motor exercises and efficacy studies in order for therapists to make informed EBP decisions about their use for students on their caseloads. The article looks at 45 articles/reports were published between 1981 and 2006 in peer-reviewed and non-peer-reviewed journals. The authors conclude that 25 of the 45 sources were based on weak anecdotal evidence. The article discusses both the ethical and fiscal issues related to EBP and nonspeech oral motor exercises and clinical implications.

Additional Reading on the Topic:

Ruscello, D. M. (2008). Nonspeech oral motor treatment issues related to children with developmental speech sound disorders. Language, Speech, and Hearing Services in Schools. 39 380–391

Synopsis: Detailed look at the background, theories, types of treatments that are considered NSOMT and discussion of the ethics and concerns with NSOMT.

Powell, T. W. (2008). Epilogue: An integrated evaluation of nonspeech oral motor treatments. Language, Speech, and Hearing Services in Schools. 39 422–427
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Synopsis: While not an research article, this epilogue to the journal dedicated to NSOMT in 2008 sums up the articles presented in the forum.

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