Myofunctional Therapy to address Articulation and Feeding Concerns

January 2023 | Lauren Pesta, SLP-CCC

What is Myofunctional Therapy and does my child need it?

This blog will focus on:

• What are Orofacial Myofunctional Disorders and Myofunctional Therapy?

• Why is Myofunctional Therapy useful?

• Who can provide Myofunctional Therapy?

• Helpful resources for parents

Throughout my career, I have always been stumped with how to make the connection between children who are having difficulty with feeding, and children who are having difficulty with speech sounds. These children have come with some ‘funky’ articulation errors, for lack of a better word, and difficulty with eating a wide variety of foods. These children have always seemed to have similar difficulties within the oral cavity, but given they came to the practice with were two separate complaints, most of the time they were addressed as two separate treatments. 

When you take a step back from looking at the specific treatment of articulation disorders or feeding and swallowing difficulties, what you see with both is a difficulty with moving the oral articulators and musculature in the appropriate way. This may be in difficulty to move the tongue correctly to make the /r/ or /s/ sound or learning to appropriately chew to eat a wide variety of foods, for example. In both of these scenarios, the main difficulty is with moving the muscles of the mouth, but for two very different reasons.  

This is where I was introduced to Orofacial Myofunctional Disorders, which is treated with Myofunctional Therapy. According to the Academy of Orofacial Myofunctional Therapy, “Orofacial Myofunctional Disorders (OMDs) are disorders of the muscles and functions of the face and mouth. OMDs may affect, directly and/or indirectly, breastfeeding, facial skeletal growth and development, chewing, swallowing, speech, occlusion, temporomandibular joint movement, oral hygiene, stability of orthodontic treatment, facial esthetics and more.” This type of therapy addresses the root of the problem, the movement, strength, and function of the muscles of the mouth that aid in the ability for accurate articulation and appropriate chewing patterns.  

Why Myofunctional Therapy:

Myofunctional Therapy is a relatively new name for a type of therapy that has been around within the Speech Therapy community for a long time. Historically, oral motor exercises have been utilized to address feeding therapy within the pediatric and adult populations. These oral motor exercises addressed the skills needed by the lips, jaw, and tongue to accurately accept food from a utensil, chew and manipulate it within the oral cavity, and move it towards the pharynx, or the throat.  Previously, these exercises were not recommended to address articulation given the thought that in order to address articulation, you need to address making the sounds and not the oral musculature.  

But what happens when a child is having difficulty with articulation and feeding skills due to difficulty with the oral musculature? That is where clinicians have leaned in on addressing these difficulties, articulation, and feeding, through addressing the root of the problem, the oral musculature. This type of therapy takes a step back from addressing a specific sound or toleration of a certain type of food and instead addresses how the muscles of the mouth and oral cavity work to obtain the complex set of movements needed to achieve accurate articulation and chewing.  

According to The American Speech-Language-Hearing Association per Hanson and Mason, 2003 “The primary purpose of orofacial myofunctional therapy is to create an oral environment in which normal processes of orofacial and dental growth and development can take place, and be maintained” (Hanson & Mason, 2003). What that means is that through myofunctional therapy, the goal is to address the function and, if indicated, the anatomy of the oral musculature to allow for adequate breathing, feeding, and articulation skills. The musculature needs to be addressed first, and the function (feeding and articulation) can be addressed subsequently.  

When to utilize a Myofunctional Therapy approach: 

While the myofunctional therapy approach is great to address both feeding and speech, it is not indicated for all children with concerns in these areas. Therefore, as adapted from the Signs and Symptoms of Orofacial Myofunctional Disorder by the American Speech-Language-Hearing Association, 2022, here are some signs and symptoms of an OMD and how it may look in your child: 

My child may have an Orofacial Myofunctional Disorder, now what??

If you recognize that you child is having any difficulties listed above, finding a Myofunctional Therapist in your area is the first place to start! Myofunctional Therapists can Speech Therapists, Dental Hygienist, Dentists, Orthodontist, or Osteopaths with specialty training in Myofunctional Therapy. Orofacial Myofunctional Disorders are best addressed through a multi-disciplinary approach, therefore, depending upon the concern your child is presenting with, there may be a group of professionals your child will be recommended to work with. If you have found Buttonloop Children’s Therapies and are starting to work with a Speech Therapist trained in myofunctional therapy, that is a great place to start! Clinicians trained in myofunctional therapy will utilize strategies and exercises to address the oral musculature with the intention to address the underlying cause of feeding and speech difficulties and, once addressed, children will make progress towards their goals with ease! 

For further information, check out the following websites: 

https://www.asha.org/practice-portal/clinical-topics/orofacial-myofunctional-disorders/#collapse_6. 

https://aomtinfo.org/myofunctional-therapy/ 

References: 

American Speech-Language-Hearing Association. 2022. Orofacial Myofunctional Disorders.  https://www.asha.org/practice-portal/clinical-topics/orofacial-myofunctional-disorders/#collapse_6.  

Hanson, M. L., & Cohen, M. S. (1973). Effects of form and function on swallowing and the developing dentition. American Journal of Orthodontics, 64(1), 63-82. 

Academy of Orofacial Myofunctional Therapy. 2022. What is Myofunctional Therapy? https://aomtinfo.org/myofunctional-therapy/