Orofacial Myofunctional Disorders (OMD) make it challenging for some children to breath, nurse, eat or speak. Orofacial Myofunctional Therapy (OMT) consists of exercises to assist the normalizing of craniofacial structure and function. While the pediatrician will most likely be the first professional you turn to for advice, they certainly aren’t your only stop. A speech language pathologist (SLP) has extensive expertise in communication and feeding problems — which may result from OMD. If your child is experiencing difficulty eating or has difficulty producing speech sounds for her age, learning about OMD is a step in the right direction. Before assuming anything, start by learning the OMD basics.
Muscle Coordination
Swallowing may seem simple. But in reality it requires a complex exchange between the facial muscles, nerves, throat, tongue and cheeks. In order to correctly swallow, you need to press the tip of your tongue against the roof of your mouth.
Chances are that you don’t even notice that this is happening. Even though the tongue press moves your mouth into the correct swallowing position, the muscle movements that get you to that point happen seamlessly. With OMD the coordination between the muscles and other parts of the mouth doesn’t happen fully or in the correct way. This can result in an improper tongue placement, where the tongue extends too far forward in the mouth (aka tongue thrust). A tongue thrust issue can affect the mouth at rest or as the child talks, chews and swallows.
Signs of OMD
A protruding tongue at rest is a red flag that the child has an OMD issue. An open bite and "tongue tie" are also commonly related to OMDs. While a tongue thrust swallowing movement is often normal for babies, it isn’t something that should stay into the toddler years or beyond.
Children with OMD often have difficulty with the oral preparation phase of swallowing and may have a noticeably different oral resting posture. Weakened lips, which are often a result of OMD, can take the form of a partially parted mouth when the child is at rest.
Along with visual tongue thrust issues, other symptoms may include a frontal lisp or dental malformations.
Condition Causes
What causes OMD? There isn’t just one culprit behind these muscle-related disorders. Children who chronically suck their thumbs, excessively use pacifiers or use the bottle for a prolonger time are at risk for developing OMD. This doesn’t mean that every child who sucks her thumb into the toddler years or who refuses to give up his paci will develop a disorder. But these oral behaviors may force the tongue into an unnatural position.
Other issues that can result in OMD include allergies, "tongue tie" (lingual frenulum restriction), enlarged tonsils, adenoids or tori. These conditions make breathing and/or chewing difficult for the child and affect the habitual resting posture of the tongue and lips. This position can cause the lip muscles to decrease in strength and the tongue to stay near the bottom of the mouth.
Speech Effects
Improper habitual resting position, reduced range of motion and structural abnormalities can all cause speech difficulties. While OMD doesn’t affect every sound, the "s, z, l, r, sh, ch, j” sounds are sometimes effected.
While speech symptoms are possible with these disorders, some children are able to speak clearly. In some cases, incorrect pronunciation or mixing up sounds is attributable to other speech and language issues that have nothing to do with OMD.
Swallowing and Eating
A protruding tongue can make eating a challenge for the child. Instead of pressing against the roof of the mouth, children with OMD may push the food out of the mouth. This can interfere with safe eating, cause the child to feel a sense of frustration at meal times or even force the child into food avoidance.
Treatment
OMD doesn’t have to persist or cause chronic problems for your child. Therapists and doctors can work in partnership with one another other to help your child reach his goals. Professionals that frequently work together to help children overcome OMD include otolaryngologists, dentists, speech-language pathologists, doctors, occupational therapists, lactation consultants and nutritionists. The SLP can create a treatment plan to help your child to overcome her speech and feeding challenges related of OMD.
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