Orofacial myofunctional therapy (OMT) is a combination of pre-feeding therapy, feeding therapy, and Oral Placement Therapy (OPT) with the ultimate goals being the establishment of a correct oral rest posture and functional chewing/swallowing patterns. Please note that OPT is not the same as a Non-Speech Oral-Motor Exercise (NSOME).
The OMT program that I use involves 3 phases: (1) pre-treatment conditioning, (2) chewing and swallowing mechanics, and (3) habituation into lifestyle. Our individual exercises and therapies build upon one another, and we routinely complete progress checks to ensure that the basic goals of each phase have been successfully met before advancing in the program. Speech therapy, which falls under the scope of practice of a SLP, is not a part of my program.
The following comments are from SLPs that practice OMT, representing their thoughts on this matter…
“In my understanding, NSOMEs are things like blowing or sticking your tongue out, all in the name of trying to develop ‘speech,’ but with no purpose or function in mind. We have functional goals. When we see that a patient is unable to achieve lingual mandibular differentiation, we know that eating, speaking, and swallowing will be affected. We teach them movement for a purpose. Teaching someone to be aware of the lateral edges of their tongue and how to anchor their tongue and move their tongue tip is functional…”
“I’ve been thinking of it as setting the stage for success. It’s about the environment that we use for speech and swallowing. My analogy is Michael Jordan: he could be great playing basketball anytime but he would probably be better in sneakers than he is in flip-flops. He’d probably be better in a 70 degree gym than a 105 degree one. Similarly, we want to set the stage by providing a stabilized environment with a full range of motion without promising that these things alone will improve speech but that they will set the environment from which we will then target speech with improved chance of success and carryover.”
“The goal of myofunctional therapy is to establish a correct rest position, chewing process, and swallowing sequence. The exercises are hierarchical in nature, all with the intent of meeting those goals…In establishing what is necessary to meet those 3 functional goals [rest posture, chewing, and swallowing], there is a high likelihood that speech will be easier to address…”
“I think of it as having a really structured game plan to set the stage for articulation/speech, rather just doing a few oral motor exercises randomly and seeing what works.”
“I realized we treat the SYMPTOMS of a bigger problem and not the cause when we work on articulation. Since most articulation disorders don’t have a known cause (which usually surprises the RDHs), it is possible they stem from a myo problem… For some kids, we are able to help them and they COMPENSATE and adapt to new patterns to fix their speech; however, the ones that could not, looking back, had a lateral lisp with a cross bite, or couldn’t get r because they were [tongue] tied, so it all makes sense now…. The descriptions others have mentioned about building a foundation are correct. We need to remember that these [orofacial myofunctional therapy] exercises do NOT treat speech disorders. They are correcting improper movement and resting postures; however, since a lot of speech issues may come out of these improper movement and resting postures, it’s not surprising to see speech improve, but it is NOT the goal….”