The term “oral motor skills” refers to the function and use of the lips, tongue, cheeks, jaw, and hard and soft palates in swallowing and in speaking. Oral motor development actually begins in utero and continues for the first several years of a child’s life. Sometimes, children show weaknesses in oral motor skills which can impact their speech, swallowing, or both. Speech-language pathologists (SLPs) are able to help children in these areas by targeting specific muscles or patterns of movement as part of treatment.
How are oral motor skills important in the swallowing process?
Eating is a multi-sensory and multi-step experience and oral motor skills impact a child’s ability to safely eat and drink. Before a child takes a bite, he touches and picks up a food on his plate and then brings it to his mouth. The mouth must open wide enough for the food or utensil to pass through the lips and then the jaw and lips must close to keep the food inside. The tongue must be able to hold the food together in a cohesive bolus (a bolus is what we call the food or liquid you take in while eating a bite or drinking a sip of liquid), and then the tongue must also move the food from the left side to the right side for chewing. The jaw muscles work to help the teeth to munch or grind up the food, and then the tongue moves the food back to the middle in preparation for swallowing (the cheeks can help with this step, too). The tongue will lift and push the food back into the pharynx (or the throat) and the food then moves into the esophagus and down to the stomach. A breakdown in the swallowing process within the mouth (such as if the tongue doesn’t move food from one side to the other or the food is not chewed up because the muscles are too weak) is characterized as oral dysphagia (oral for the mouth and dysphagia meaning swallowing disorder).
Red flags of possible oral motor dysfunction or weakness can include:
- Weak suck
- Sucking and swallowing incoordination
- Feeding periods longer than 30-40 minutes
- Unexplained food refusal and failure to thrive
- Frequently spitting out harder to chew/partially chewed foods
- Excessive drooling
- Spillage or loss of fluid when drinking from a cup or bottle
- Coughing/gagging
SLPs receive extensive training in normal swallowing processes and are also trained to treat swallowing disorders. Some SLPs pursue additional training in oral motor treatment strategies in order to strengthen muscles for a safer and more efficient swallowing pattern.
How are oral motor skills important in speech?
Speaking is another multi-step and complicated process. If a child has weakness in one of her articulators (e.g., the tongue), for example, her speech might sound somewhat slurred or unclear. In some cases, a child’s muscles might all have adequate strength and range of movement, but she might have difficulty in coordinating which sounds go first and last within a sound. Speaking requires that the lips, tongue, jaw, cheeks, and soft palate move rapidly in concert with one another. A breakdown in the process can be characterized as either a phonological disorder (difficulty in producing sounds appropriate for one’s age) or a motor speech disorder (apraxia or dysarthria).