Orofacial Myofunctional Disorders (OMD) in Children

By: VocoVision

Orofacial myofunctional disorders can be frustrating for both children and parents. Understanding the symptoms of this condition is critical, and ensuring that children get the appropriate treatment early on can make a significant difference. Many children grow out of these symptoms, but other signs are important to pay attention to, and can impact the physical and behavioral development of children.

What are Orofacial Myofunctional Disorders?

An orofacial myofunctional disorder (OMD) occurs when the tongue moves forward abnormally during speech, swallowing, and rest postures. In early development or infancy, “tongue thrusts” that cause children to mispronounce sounds are relatively common. Think of a child who cannot yet pronounce the /s/ sound. That child may say ‘thumb’ instead of ‘some’ because their mouth muscles are still underdeveloped.  When a child reaches an age where standard pronunciation should already be in place and still has difficulties with articulation, they may have an orofacial myofunctional disorder.

OMD Disorder Symptoms & Signs

Children who have an orofacial myofunctional disorder may present a variety of symptoms and signs. Some people demonstrate some of these symptoms without having an OMD, so it is crucial that you confirm a diagnosis with a professional. When children have this disorder, they may have problems talking, eating, and swallowing. They may also struggle to breathe through their nose or need to strengthen the tongue. Some common symptoms and signs of orofacial myofunctional disorders include:

  • speech distortion, particularly a frontal lisp
  • chronic open mouth positioning
  • dental abnormalities, such as overjet and open bite
  • tongue thrust, or when the tongue pushes against teeth during speech or swallowing
  • difficulty with specific sounds, especially “s,” “sh,” and “j
  • drooling, especially in children older than two
  • struggling to close lips when swallowing

What Causes Orofacial Myofunctional Disorders?

There is no single known cause of orofacial myofunctional disorder. However, various root issues can lead to OMD.


When allergies cause nasal passages to inflame, it may lead to increased mouth breathing.

Enlarged tonsils and adenoids

Children with enlarged tonsils and adenoids can struggle with blocked nasal passages. This blockage can lead to OMD symptoms.

Excessive thumb-sucking

If children continue to suck their thumbs after two years of age, certain symptoms may develop.

Excessive lip and fingernail-biting

Similar to thumb-sucking, these habits can cement OMD symptoms in children.

Teeth clenching and grinding

Teeth clenching and grinding can lead to OMD symptoms, including how the facial and mouth muscles operate.

Family heredity

There is research that shows a link within families who have OMD disorders. Many children who display symptoms have parents or other relatives who also have the condition.

In some cases, orofacial myofunctional disorders may be preventable. Especially with causes such as thumb-sucking, fingernail-biting, and teeth clenching, children may prevent an OMD by avoiding these actions.

Seeking Help – When & Who?

If parents are concerned that their child may have OMD, there are several options available. Serious long-term effects can result if children are not diagnosed early, especially when they have open mouth resting posture.

An orofacial myofunctional disorder treatment is often more effective when started at a young age. 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. Specialists may take a photo of the child’s dental structure for reference, as well.

 For more complex examinations, 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.

Treatment: Orofacial Myology Speech Therapy

 Because orofacial myofunctional disorders vary among children, treatments can include various exercises that focus on tongue and facial resting postures, swallowing, and speech articulation. Medical treatment should be implemented for OMDs caused by enlarged tonsils and adenoids or allergies, before speech treatment. For behavioral causes, such as nail-biting or thumb-sucking, treatment can focus first on eliminating those behaviors.

Orofacial myofunctional speech therapy is a popular and effective solution for many children. By adhering to the proven principles of orofacial myology, specialists can improve the quality of life for children struggling with OMD. According to experts, kids should begin therapy between five and seven years old, and the total duration of treatment varies widely depending on the symptoms and severity of OMD. Rarely, individuals may continue therapy into adulthood. Speech language pathologist roles include helping children understand their tongue placement, alter how they chew and swallow, and saying sounds more clearly.

In today’s world, both online speech therapy and in-person sessions are possibilities, creating positive outcomes for children with orofacial myofunctional disorder.

More Resources