Orofacial Myofunctional Disorders
In early development or infancy, “tongue thrusts” that cause children to pronounce sounds incorrectly are fairly common. Think of a child who cannot yet pronounce the /s/ sound. That child may say ‘thumb’ instead of ‘some’ because his or her mouth muscles are still underdeveloped. When a child reaches an age where normal pronunciation should already be in place and still has difficulties with pronunciation, he or she may have an orofacial myofunctional disorder (OMD).
An orofacial myofunctional disorder (OMD) occurs when the tongue moves forward abnormally during speech, swallowing, and rest postures. Compared with other children, a child with OMD may look, speak, and swallow differently. They may also look different and this can cause older children with OMD to become self-conscious.
Several causes have been attrituted to orofacial myofunctional disorders. They include¹:
- enlarged tonsils and adenoids
- excessive thumb-sucking
- excessive lip and fingernail-biting
- teeth clenching and grinding
- family heredity
Symptoms of orafacial myofunctional disorder include²:
- speech distortion, particularly a frontal lisp
- chronic open mouth positioning
- dental abnormalities, such as overjet and open bite
- tongue thrust, or when tongue pushes against teeth during speech or swallowing
A speech-language pathologist can diagnose OMD when it occurs. The SLP will look at the way the lip, cheeks, teeth, jaws, and tongue move while also examining the mouth’s structure as a whole. The child may be asked to speak or swallow solid and liquid foods. A photo of the child’s dental structure may be taken for reference. For examinations that are more complex, the SLP will make recommendations to see other specialists. These healthcare professionals can be dentists, orthodontists, and physicians. Together with the SLP, these professionals often make the diagnosis as a team.
Because orofacial myofunctional disorders vary among children, treatments can range from a variety of exercises that focus on tongue and facial resting postures, swallowing, and speech articulation. For OMDs caused by enlarged tonsils and adenoids or allergies, medical treatment should implemented before speech treatment. For causes that are behavioral, such as nail-biting or thumb-sucking, treatment can focus first on eliminating those behaviors.