Why Oral Motor Exercises Do Not Improve Speech - What You Can Do Instead.

Happy New Year Parents!
In my first post this year, I want to address a question which parents often ask me: "do​ non-speech oral motor exercises improve speech?"

What are Non-Speech Oral Motor Exercises?
Non-speech oral motor exercises are widely used around the world when working with children who have speech difficulties. Non-speech oral motor exercises include:
- actions of the lips, jaw, tongue, soft palate, larynx and respiratory muscles (e.g. ‘blowing a horn’, ‘sucking on a straw’ and ‘blowing bubbles’), which aim to improve strength, range of movement or coordination.
- sensory stimulation (e.g. massaging the area around the child’s mouth)
(McCauley et al., 2009)

Do These Exercises Work? What Does The Research Say?
Even though these exercises are commonly used, there is no scientific evidence proving that non-speech oral motor exercises improve speech.

Wait! What? Why?
A practical way to understand why these exercises do not improve speech is:
Picture yourself training to run a marathon. You stretch your limbs daily and do muscle-strengthening exercises, however, you never actually practice the act of running. It would not be reasonable for you to expect that your daily stretching and strengthening exercises will improve your running, because you haven’t actually done any running. The same goes for children who are working on their speech. For a child’s speech to improve, the child needs to practice the act of speaking.

In terms of the research, some of the explanations about why non-speech oral motor exercises do not improve speech include:

- There are differences in the neural system’s organization for non-speech oral-motor tasks vs. speech (Moore & Ruark, 1994).
- Oral-motor exercises lack generalization to speech, because they focus only on a ‘fragment’ of the complex act of speaking (Lof, 2003).
- Oral-motor exercises focus on increasing oral-muscular strength, however, many children who have Apraxia of Speech or Cleft Palate exert the same amount of force when using their jaw and lips as children with typically developing speech (Forrest, 2002).

So Then, What Will Improve My Child’s Speech?
Below are five things that will improve your child’s speech:

1. Speech Practice - For a child’s speech production to be improved, the child needs to practice speaking.  This can be done during Speech Therapy or during practice at home. You can read more information about working on speech at home by clicking here.
2. Functional Practice - If your child is not talking yet, start by working on the most important words that they would need to be able to say at this stage. Functional words include (but are not limited to): ‘no’, ‘yes’, ‘go’, ‘eat’, ‘water’, ‘more’, ‘help’, ‘hurt’ and ‘more’. Functional words like these are likely to have the most impact on your child’s daily life, at this stage.
3. Short Practice - Recent evidence has shown that short bursts of practice are more effective in improving speech than practice for long periods where children are likely to become fatigued and bored.
4. High-intensity - Evidence shows that intensive practice which involves lots of repetition of the same words and phrases is likely to result in better speech outcomes.
5. Fun Practice – Speech practice can involve movement (e.g. treasure hunt to find target word cards), games (e.g. memory game with picture cards) and involve rewards (e.g. verbal praise / tangible rewards).

As a parent of a child with speech difficulties, you want the best available therapy for your child that has been scientifically proven to improve speech. You can always ask your child’s Speech Therapist about the scientific evidence behind the method used in your child’s speech sessions.
 
In the meantime, you can read about how to help your child with their speech at home on my website by clicking here. 

Speak soon,
The Expat Speechie, 

References:
                    Forrest, K. (2002). Are oral-motor exercises useful in the treatment of phonological/articulatory disorders? Seminars in Speech and Language, 23 (1), 15–25.
             Lof, G. L. (2003). Oral motor exercises and treatment outcomes. Perspectives on Language Learning and Education, 10 (1), 7–11.
                    McCauley, R., 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, 343-360.
                     Moore, C., & Ruark, J. (1996). Does speech emerge from earlier appearing oral motor behavior? Journal of Speech and Hearing Research, 39, 1034–1047