When a child has a craniofacial defect, oral motor skills can create problems in speech and speech therapy efforts. When someone says “oral motor skills”, and you don’t have difficulties in that area, it can be very difficult to understand the concept. Oral motor skills are simply having the ability to move your tongue and lips quickly and easily to form words and sounds properly.
The easiest way to determine whether or not your child has oral motor skill weaknesses is to listen carefully to your child. We hear our children not forming their words correctly, but we must truly listen carefully as they speak to isolate the problem. I have heard parents and therapists describe oral motor issues with words like “lazy tongue” or “mushy mouth”. These phrases are pretty clear. Please be careful to not use phrases like these in harsh or negative ways to your child. A lazy tongue is not caused by the laziness of the child. There are physical reasons for a child to have oral motor difficulties. Thankfully, so many parts of the mouth are mostly muscle, and those muscles can be developed through oral motor exercises to improve speech and understandability.
It is a simple matter to help your child develop better motor skills. You can count on your speech therapist, if you have one, to work with your child in this area. However, by working with your child on a regular basis at home, you can really see much faster improvement in oral motor skills. Working with your children on speech therapy in your home demonstrates to your child that this is important, and worth the time commitment.
Many oral motor skill exercises are similar to exercises you might do for tongue manipulation in speech therapy. In a past article, I explained several of the exercises we have successfully used to improve tongue control for speech. In addition to those, for specifically oral motor skills, there are several resistance exercises you can help your child to do.
1. Tongue resistance exercises. The first, and very simple, thing you can do is to encourage your child to press their tongue against the roof of their mouth or the back of their top teeth, with as much force as they can. While they are pushing against the roof of their mouth, count. The idea is to increase the numbers each week until you begin to see your child holding his/her tongue in that same position without struggling. Simply having the strength in their tongue to consistently hold that position will help speech therapy.
2. Another form of tongue resistance exercise. You can also use tongue depressors, lolly pops, or whatever will work with your child to get them to work on their oral motor skills by pressing their tongue in a particular direction.
3. Stretching their cheeks. Ok, I tried and tried to think of a better way to explain this oral motor skills exercise. But, let’s face it, you are stretching cheeks. You don’t literally stretch their cheeks, you encourage them to do it by demonstration. By this, I literally mean that you will want to over-emphasize the movement you make when you make the “ck” sound. If your child has unclear “ck” sounds, or substitutes a “T” sound, you have to try to make yourself clear any way you can. Oral motor skill exercises are designed to make that mouth move. You can achieve great results by over-emphasizing the movement. (This exercise is most successful when done in front of a mirror).
4. Use peanut butter or chocolate frosting to improve tongue movement. Children will work much harder to move their tongue up or down if they are trying to reach chocolate frosting smeared on their upper lip! For a time, I needed my child to move his tongue to the position just behind his top front teeth. In desperation, I stuck gum up there. He loved the taste, and would get his tongue under control just to taste the gum and feel the texture of the gum stuck to his teeth. Which leads to my next suggestion….
5. Tooth brushing. Brushes of different textures and sizes are available for this purpose. The idea is to use the brush as a tactile stimulant in the mouth to try to get your child to be more aware of their tongue location in their mouth. You will also want to simply brush teeth right after speech therapy if you are working with gum, frosting, and peanut butter!
6. Pinch that nose. Air escaping through the nose is a huge problem for many kiddos with cranio facial issues. Sometimes the only way to help the child hear how the word should sound without the escaping air is to cut off the escaping air. This also allows your child to feel the way the air should be moving, and then to use their oral motor skills to try to push the air in the proper direction. If this sounds difficult, that is because it is. It is also a process your child is certain to find irritating. This is not something you would do daily, it is only for the purpose of helping your child to understand the concept of the nasal sound and air escaping. Please note, I am including this exercise only because I have had two speech therapists tell me that this exercise can be successful. For us, it was not. When it came to escaping air and nasal sounds, we only had success with a surgical option. I include it here in a sincere hope that this exercise might help another family avoid having to use a surgical option.
5. Use exercises that you also use for tongue manipulation and control. Some include blowing bubbles, blowing whistles, using short puffs of air to move streamer pieces across a table, and trying to drink a shake through a straw.
The beginning of working with your child on their oral motor skill exercises can be tiring and intimidating. As adults, if we have never struggled with speech issues, simply trying to understand the process behind the formation of language can be challenging. Breaking down motions you have made for years without thought into small workable pieces is difficult. Take your time, stay calm with yourself and especially with your child, don’t be afraid to ask for help, and most of all, be consistent. Speech therapy is only successful if it is consistent. I hope these ideas are a blessing to you.