What are orofacial myofunctional disorders (OMD)?

With OMD, the tongue moves forward in an exaggerated way during speech and/or swallowing. The tongue may lie too far forward during rest or may protrude between the upper and lower teeth during speech and swallowing, and at rest.

What are some signs or symptoms of OMD?

Although a “tongue thrust” swallow is normal in infancy, it usually decreases and disappears as a child grows. If the tongue thrust continues, a child may look, speak, and swallow differently than other children of the same age. Older children may become self-conscious about their appearance.

What effect does OMD have on speech?

Some children produce sounds incorrectly as a result of OMD. OMD most often causes sounds like /s/,/z/, “sh”, “zh”, “ch” and “j” to sound differently. For example, the child may say “thumb” instead of “some” if they produce an /s/ like a “th”. Also, the sounds /t/, /d/, /n/, and /l/ may be produced incorrectly because of weak tongue tip muscles. Sometimes speech may not be affected at all.

What treatment is available for individuals with OMD?

A speech-language pathologist (SLP) with experience and training in the treatment of OMD will evaluate and treat the following:

SLPs develop a treatment plan to help a child change his or her oral posture and articulation, when indicated. If tongue movement during swallowing is a problem, the SLP will address this as well.

Treatment techniques to help both speech and swallowing problems caused by OMD may include the following:

If airways are blocked due to enlarged tonsils and adenoids or allergies, speech treatment may be postponed until medical treatment for these conditions is completed. If a child has unwanted oral habits (e.g., thumb/finger sucking, lip biting), speech treatment may first focus on eliminating these behaviors.