September 2, 2025 • 17 mins
Have you ever wondered why some children struggle with persistent speech sound errors despite trying every traditional approach? The missing piece might be right under their tongue.
After 30+ years as a pediatric speech-language pathologist, I discovered a game-changing approach that transformed how I treat articulation disorders. Oral facial myofunctional therapy addresses the underlying muscle patterns, breathing habits, and oral resting postures that create the foundation for clear speech. This isn't just another technique—it's a fundamental shift in understanding how our oral structures develop and function.
When the tongue maintains its correct resting position against the hard palate, it creates what experts call "the central operating zone" for speech sounds. Think about efficiency: if your tongue already rests in an elevated position, it's perfectly positioned to produce most consonant sounds automatically. Yet many children with speech disorders habitually rest their tongues in a low position, forcing them to consciously remember to elevate it for proper articulation—making speech laborious rather than automatic.
The results can be remarkable. One preteen client with persistent R errors made breakthrough progress after addressing a posterior tongue tie and implementing myofunctional exercises—without using a single traditional placement technique. These moments made me realize how this approach removes barriers to success rather than repeatedly drilling sounds without addressing underlying issues.
If you're an SLP feeling stuck with challenging articulation cases or simply wanting to work smarter rather than harder, explore the fascinating world of myofunctional therapy. Check out the resources mentioned in this episode, including books by Dr. Shereen Lim and Joy Moeller, and consider how this knowledge might transform your practice. As I've discovered, "When you master nasal breathing and tongue resting posture, complex articulation targets take care of themselves."
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 2 (00:06):
Welcome to the Speech Umbrella, the show that
explores simple but powerfultherapy techniques for optimal
outcomes.
I'm Denise Stratton, apediatric speech-language
pathologist of 30-plus years.
I'm closer to the end of mycareer than the beginning and
along the way, I've worked longand hard to become a better
therapist.
Join me as we explore the manytopics that fall under our
umbrellas as SLPs.
I want to make your journeysmoother.
I've worked long and hard tobecome a better therapist.
(00:26):
Join me as we explore the manytopics that fall under our
umbrellas as SLPs.
I want to make your journeysmoother.
I found the best therapy comesfrom employing simple techniques
with a generous helping ofmindfulness.
Welcome to the Speech UmbrellaPodcast.
I haven't published a podcast ina long time.
If you're a returning listener,thank you for tuning in again,
and if you're a new listener, Iwant you to know I have a whole
(00:48):
library of podcasts for yourpediatric speech therapy needs.
I didn't intend to go so longbetween podcasts, but life
happens.
One of the things that happenedis I became a myofunctional
therapist, which was quite ajourney.
It was a big time commitment,but I would do it again in a
heartbeat because I have learnedso much.
This is episode 104 and it'sall about oral facial
(01:09):
myofunctional therapy.
Oral facial myofunctionaltherapy is the precise term, but
it's such a mouthful peopletend to just call it
myofunctional therapy or evenjust myo for short.
I'll be referring to it asmyofunctional therapy in this
podcast, as myofunctionaltherapy in this podcast.
I became interested inmyofunctional therapy when I
interviewed a dentist, shireenLim, about her book Breathe,
sleep Thrive for this podcast.
(01:30):
You'll find that interview inepisode 92.
Her book was a real eye-openerfor me and she is the one who
got me interested in becoming amyofunctional therapist.
Her book is full of fascinatinginformation, but what really
stood out to me was the factthat some persistent and
long-standing speech disordersare being corrected through
myofunctional therapy and notnecessarily therapy done by a
(01:52):
speech therapist.
Since correcting speechdisorders is part of our job
description, I figured I betterfigure out what it was all about
.
I also recognize that much ofthe information in Dr Lim's book
is similar to Char Bouchard'swork.
Char is an SLP who has devotedher career to helping SLPs
understand the oral motoraspects of speech.
(02:13):
Many people can becomemyofunctional therapists.
In my cohort we had PTs, ots,dentists and dental hygienists
in addition to SLPs.
That is how we get people otherthan SLPs correcting speech
sound disorders, not becausethey are working on speech
directly, but because they areworking on improving the
function of oral muscles andspeech improves as a byproduct.
Another way to put it ismyofunctional therapy removes
(02:34):
barriers to developing precisearticulation, and I am all about
removing barriers for ourclients and ourselves.
It makes our job so much easier.
This is my promise to you abouttoday's podcast.
If you're not already in themyofunctional world, you're
going to have a new worldview ofspeech therapy.
Once you see it, you can'tunsee it.
I mean that, literally Once youstart observing people's faces,
(02:57):
their jawline, their teeth, youcan almost diagnose a
myofunctional disorder byappearance alone.
Have I sold you onmyofunctional therapy yet?
Okay, time to cut to the chase.
Here's what we're going tocover today.
We're going to talk about whatoral facial myofunctional
disorders and oral facialmyofunctional therapy is.
We're going to talk about whatare the goals of myofunctional
(03:19):
therapy.
What is the relation betweensoft tissue and hard tissue and
skeletal development?
What are some commonmyofunctional disorders?
How is this related to speechdisorders?
We're going to take a bird'seye view of what myofunctional
therapy could look like for anSLP things to consider and what
you can do as an SLP if you'reinterested in learning more.
(03:40):
What is an oral facialmyofunctional disorder, or OMD
for short?
This definition comes from theAcademy of Oral Facial
Myofunctional Therapy and it's along one, so buckle in.
Omds are disorders of themuscles and functions of the
face and mouth.
Omds may affect, directly andor indirectly, breastfeeding,
facial skeletal growth anddevelopment, chewing, swallowing
(04:02):
, speech occlusion, tmj movement, oral hygiene, stability of
orthodontic treatment, facialaesthetics and more.
Most OMDs originate withinsufficient habitual nasal
breathing or with oral breathing.
The subsequent adaptation ofthe muscles and the oral facial
functions to a disorderedbreathing pattern creates many
OMDs.
(04:23):
Oral facial myofunctionaldisorders may impact treatment
by orthodontists, dentists,dental hygienists,
speech-language pathologists andother professionals working in
the oral facial area.
Okay, thanks for hanging inthere.
That's a really long definition, but we will get more into it
as we go through this podcast.
What all of this means?
Okay, let's talk about what themyofunctional therapy is.
(04:45):
Oral facial myofunctionaltherapy is neurological
re-education of the oral facialmuscles.
It is a rehabilitation therapyprogram designed to re-pattern
stomatic nathic functions,that's, teeth, jaw and soft
tissue such as chewing,swallowing and breathing.
This is accomplished throughthe use of therapeutic
techniques and positivebehavioral modification.
(05:06):
This definition is taken fromJoy Moller's book called Is your
Tongue Killing you?
Let's talk about what the goalsare for myofunctional therapy.
We want to establish nasalbreathing.
We want to strengthen and tonethe muscles of the tongue, lips
and face.
We want to promote the idealoral resting posture and that's
where the tongue rests in themouth and establish optimal
(05:26):
chewing, swallowing and bodyposture.
Now the relation between softtissue and hard tissue and
skeletal development is reallykey to understanding the whole
myofunctional world.
Soft tissue can affect how hardtissue, such as bone, develops.
The tongue is soft tissue andthe hard palate is bone, so it's
hard tissue.
When the tongue is in a correctresting posture against the
(05:49):
hard palate as a child grows itacts as a natural expander for
optimal palate growth.
When the palate is wide enough,there is enough space for adult
teeth.
Also, when the palate is wideand broad, it easily
accommodates the tongue restingup against it.
Some common oral facialmyofunctional disorders are low
tongue resting posture, mouthbreathing, lingual freedom
(06:11):
restrictions, what we commonlycall tongue ties, crowded and
misaligned teeth and high narrowpalates.
Many OMDs co-occur, such as ifyou're a mouth breather, then
your tongue is low.
Those two things happentogether.
That's just a sample of someOMDs.
You might notice I didn'tmention speech disorders.
They can indeed be an OMD, buthow common they are is a
(06:33):
question worth discussing.
So let's discuss how is thiswhole medical discipline of
myofunctional disorders relatedto speech disorders?
That's what you're all here for, right?
Perhaps the number one takeawayfrom this podcast is the
relationship between speech andtongue resting postures.
A correct oral resting postureplaces the tongue in the ideal
(06:53):
position for correct speech.
The correct oral restingposture is with the tongue
resting up against the hardpalate.
How many of you have emphasizedrepeatedly to a child working
on R that the sides of theirtongue need to make contact with
the back molars?
If our client's tongues wereautomatically in the correct
resting posture, we wouldn'tneed to be saying this over and
over again.
(07:14):
I referred to Char Boshartearlier, who has written books
and done multiple podcasts onthis very subject, and you can
find my interview with her inepisode 79.
In that episode she quoted oneof her professors, dr Fletcher
Tarr.
He said the correct oralresting posture is the central
operating zone for your speechsounds.
A correct resting posturefacilitates rapid, automatic,
(07:36):
precise articulation becauseit's so efficient.
Char has an analogy I reallylike If you were going to run
some errands in your car, you donot drive your car back to your
garage between every stop.
That would be very inefficientand it would slow you down.
If your ton is not naturallyresting against your hard palate
, then it is resting low.
If it's resting low, then youhave to remember to elevate it
(07:57):
in order to produce most speechsounds correctly.
Does everyone with a low toneresting posture have a speech
disorder?
The answer is no.
There are many people with lowresting tones who have good
awareness of how they sound.
They figure out the correctmovements for good articulation
and they are able to accommodateeven if their speech is less
efficient.
But for our clients with speechsound disorders, some of them
(08:19):
have a double whammy because inaddition to their myofunctional
issues, they also havephonological awareness issues,
which is all the more reason toremove barriers for them.
Myofunctional therapy is such ahelp in speech therapy.
It is fast and efficient,provided your clients are old
enough to participate in thetherapy.
By now you may be wonderingwhat myofunctional therapy looks
(08:40):
like.
Here's a bird's eye view of howit works in my clinic.
I start with an evaluation.
A good oral facialmyofunctional program will teach
you how to do a thoroughevaluation.
Then you will know if they areready to start myofunctional
therapy and if they will be agood fit.
I learned so much about reallyassessing oral structures in my
course when I learned how to doa thorough evaluation.
(09:01):
This is stuff I did not get ingraduate school.
So say your client is a goodcandidate.
What's next?
I have weekly appointments.
At the beginning I put anyother kind of speech or language
therapy on hold during thistime and the whole focus is on
teaching them exercises theywill do at home.
Each week they get a new set ofexercises and generally after
(09:22):
two to three months they will beready to move to exercises that
help them generalize andhabituate their new habits of
breathing, swallowing andmaintaining a correct oral
resting posture.
As they move into thegeneralization and habituation
exercises, they get newexercises every other week and
then every three weeks.
If they have other speech orlanguage goals, I start working
on these goals during the weeksthey don't get new exercises.
(09:44):
It has often been my experiencethat once a client who only has
speech goals has completedmyofunctional therapy, they are
ready to graduate.
It's altogether an easier wayto accomplish speech goals and
I'm all for working smarter andnot harder.
The entire process usuallytakes from six months to a year.
One of my first myofunctionalclients was a preteen working on
(10:07):
R and S.
Some of you may know Ispecialize in R and I've even
created an entire course aroundhow to teach R.
This particular client couldnot reliably produce an R, no
matter what I did.
Thanks to what I learned in mymyofunctional course, I was able
to identify a posterior tundiwhich he got released and that,
(10:27):
along with myofunctionalexercises, caused his R sound to
emerge without me doing asingle placement or elicitation
method.
That made me a believer.
Did I still use the techniquesI developed for my course?
I did, as you needed somerefining and generalization.
The methods I teach in mycourse and possible are made
possible are still valuable, butthe whole process is much
(10:50):
easier for my RNS clientsparticularly.
I've been doing myofunctionaltherapy for a year and a half
and here are some things I'velearned and put into practice.
It's a rigorous process forthese kiddos doing these
exercises two to three times aday, especially in the first two
to three months.
I help parents understand thisand choose a time to begin that
will work best for them.
(11:10):
For example, you might want towait until summer vacation to
begin or not start just beforeChristmas break or not before
you're going to take a two tothree week vacation because
you're not going to do thoseexercises on vacation.
Parents need to understand thatthey will be helping their
child to complete theseexercises correctly and
consistently.
Perhaps if you have a verymotivated older teen, parents
(11:31):
don't need to be as involved,but that's the exception rather
than the rule.
The parents and the child needto work as a team.
In the training you take tobecome a myofunctional therapist
, you'll learn when to involveother professionals such as ENTs
and dentists.
You don't want to starttreatment if nasal breathing is
obstructed, for instance.
You will want to know if a tontie is restricting movement so
(11:52):
you can work around that.
In my program we do someexercises before a Tuntai
release to help prepare them andsome specific exercises after
the release for the best outcome.
If a child is sucking theirthumb or fingers, that habit
needs to be eliminated beforeyou even think about doing
myofunctional therapy and in thecourse that you take there
usually is a habit eliminationprogram included.
(12:15):
Age is a big, big considerationand this is from my own
experience, I've started withsome really young kids and had
them drop out of my functionaltherapy.
I've had one child who was fiveyears old complete the program
successfully, but it was hardgoing.
She was six by the time shecompleted it.
The family had an ABA therapistwho helped her with her
exercises, which I think reallyhelped the family be consistent.
(12:38):
I have another five-year-oldjust about to complete the
program, but I had to pause theprogram, do some preparation
work with her and then restartit.
Based on my experiences so farnow, I think a child who is six
or seven is generally matureenough to succeed with parent
support.
If you're considering a childyounger than that, you'll want
to think through that decisioncarefully.
(12:58):
If a child is not old enough todo myofunctional therapy, I
will use Prompt, which worksreally, really well to improve
their speech and sets them up tobe successful with
myofunctional therapy in thefuture.
Along with my evaluation, Ischedule an online meeting with
parents to explain my findingsand the ins and outs of
myofunctional therapy.
I do this even if we aren'tgoing to do it right away, and
(13:20):
this helps me educate them onthe value of it and the value of
seeking out a dentist who haseducated myofunctional issues.
It just opens up the parents'eyes to the whole concept of the
ton.
Resting up against the palateis ideal for their palate
development and it's ideal fortheir speech development.
It helps them connect those twoideas if you can have this
online meeting with them.
(13:40):
I've learned to be flexible withmy scheduling, since I have
clients who are tapering offtheir visits to every other week
or every third week.
I try to schedule thosebi-monthly visits or monthly
visits on a specific day of theweek, which helps my schedule
stay full.
It's important when introducingparents to myofunctional.
In other words, they came toyou for help with one thing
(14:03):
which is speech or language, andnow you're telling them they
need something else.
That can give parents the wrongimpression that you're trying
to sell them something extra.
And this is one reason I do anonline meeting with parents, so
I can explain the relationshipbetween oral structure and
function and speech very clearly.
I explain to them that I havetaken a motor approach to speech
disorders for many years withconsiderable success, and that I
(14:25):
have always done motor approachto speech disorders for many
years with considerable success,and that I have always done
exercises to promote correctspeech.
Myofunctional therapy issimilar to what I've done before
, but it's accelerated.
It's more thorough.
Because the parent and child doso much work at home, progress
is accelerated.
I always offer them the choiceto do myofunctional therapy or
not, and we talk freely aboutwhether the child is ready for
it.
(14:50):
What can you do as an SLP if youwant to learn more about
myofunctional therapy?
I have a couple of podcaststhat I mentioned the one with
Shereen Lim, that's episode 92,and the one with Char Boshar,
that's episode 79.
There's another podcast calledAirway Answers with Nicole
Goldfarb, and she's one of manypodcasts about myofunctional
therapy, but it's one I'velistened to and I enjoy it.
There's some books you couldread.
There's Dr Lim's book Breathe,sleep Thrive.
There's Is your Tongue Killingyou by Joy Moeller.
(15:13):
Joy is an instructor for theAOMT, who I took my
myofunctional course through.
There's Breath by James Nestor,and that's a very popular book
for a general audience thatintroduces people to the
importance of nasal breathing,among other things, and the
other two books that I mentionedare more scientific in nature.
There's Academy of Oral FacialMyofunctional Therapy AOMT for
short.
They have their FrequentlyAsked Questions page, which is
(15:35):
really informative, and I'llprovide links to all of these
resources in the show notes, ofcourse, and you can always send
me an email if you havequestions and I'd be happy to
talk to you about myofunctionaltherapy and all things speech
therapy for that matter.
Now that I'm a myofunctionaltherapist, I find I cannot
separate what I've learned in mytraining from speech therapy.
Rather than being a helpfuladjunct to our profession, like
(15:57):
another tool in my therapytoolbox, this material is
foundational to ourunderstanding of speech
development.
Now that I know what I know,I'm flummoxed that it's not
required coursework for SLPs.
This understanding about howour palates develop and where
our tongue should be resting forcorrect speech is super, super
important.
(16:17):
This podcast is my effort toscatter these seeds of knowledge
far and wide into the SLP world.
If enough of us start demandingchange, I believe we can change
our profession for the better.
To sum up everything I'vetalked about today, when you
master nasal breathing and tonresting posture, complex
articulation targets take careof themselves.
Thanks for listening.
Speaker 1 (16:40):
Thanks for listening to the Speech Umbrella.
We invite you to sign up forthe free resource library at the
speech umbrellacom.
You'll get access to some ofdenise's best tracking tools,
mindfulness activities and othergreat resources to take your
therapy to the next level.
All this is for free at thespeech umbrellacom.
If you've enjoyed this podcast,subscribe and please leave us a
(17:03):
review on apple podcasts andother podcast directories.
Thank you.
Welcome to the Speech Umbrella, the show that
explores simple but powerfultherapy techniques for optimal
outcomes.
I'm Denise Stratton, apediatric speech-language
pathologist of 30-plus years.
I'm closer to the end of mycareer than the beginning and
along the way, I've worked longand hard to become a better
therapist.
Join me as we explore the manytopics that fall under our
umbrellas as SLPs.
I want to make your journeysmoother.
I've worked long and hard tobecome a better therapist.
(00:26):
Join me as we explore the manytopics that fall under our
umbrellas as SLPs.
I want to make your journeysmoother.
I found the best therapy comesfrom employing simple techniques
with a generous helping ofmindfulness.
Welcome to the Speech UmbrellaPodcast.
I haven't published a podcast ina long time.
If you're a returning listener,thank you for tuning in again,
and if you're a new listener, Iwant you to know I have a whole
(00:48):
library of podcasts for yourpediatric speech therapy needs.
I didn't intend to go so longbetween podcasts, but life
happens.
One of the things that happenedis I became a myofunctional
therapist, which was quite ajourney.
It was a big time commitment,but I would do it again in a
heartbeat because I have learnedso much.
This is episode 104 and it'sall about oral facial
(01:09):
myofunctional therapy.
Oral facial myofunctionaltherapy is the precise term, but
it's such a mouthful peopletend to just call it
myofunctional therapy or evenjust myo for short.
I'll be referring to it asmyofunctional therapy in this
podcast, as myofunctionaltherapy in this podcast.
I became interested inmyofunctional therapy when I
interviewed a dentist, shireenLim, about her book Breathe,
sleep Thrive for this podcast.
(01:30):
You'll find that interview inepisode 92.
Her book was a real eye-openerfor me and she is the one who
got me interested in becoming amyofunctional therapist.
Her book is full of fascinatinginformation, but what really
stood out to me was the factthat some persistent and
long-standing speech disordersare being corrected through
myofunctional therapy and notnecessarily therapy done by a
(01:52):
speech therapist.
Since correcting speechdisorders is part of our job
description, I figured I betterfigure out what it was all about
.
I also recognize that much ofthe information in Dr Lim's book
is similar to Char Bouchard'swork.
Char is an SLP who has devotedher career to helping SLPs
understand the oral motoraspects of speech.
(02:13):
Many people can becomemyofunctional therapists.
In my cohort we had PTs, ots,dentists and dental hygienists
in addition to SLPs.
That is how we get people otherthan SLPs correcting speech
sound disorders, not becausethey are working on speech
directly, but because they areworking on improving the
function of oral muscles andspeech improves as a byproduct.
Another way to put it ismyofunctional therapy removes
(02:34):
barriers to developing precisearticulation, and I am all about
removing barriers for ourclients and ourselves.
It makes our job so much easier.
This is my promise to you abouttoday's podcast.
If you're not already in themyofunctional world, you're
going to have a new worldview ofspeech therapy.
Once you see it, you can'tunsee it.
I mean that, literally Once youstart observing people's faces,
(02:57):
their jawline, their teeth, youcan almost diagnose a
myofunctional disorder byappearance alone.
Have I sold you onmyofunctional therapy yet?
Okay, time to cut to the chase.
Here's what we're going tocover today.
We're going to talk about whatoral facial myofunctional
disorders and oral facialmyofunctional therapy is.
We're going to talk about whatare the goals of myofunctional
(03:19):
therapy.
What is the relation betweensoft tissue and hard tissue and
skeletal development?
What are some commonmyofunctional disorders?
How is this related to speechdisorders?
We're going to take a bird'seye view of what myofunctional
therapy could look like for anSLP things to consider and what
you can do as an SLP if you'reinterested in learning more.
(03:40):
What is an oral facialmyofunctional disorder, or OMD
for short?
This definition comes from theAcademy of Oral Facial
Myofunctional Therapy and it's along one, so buckle in.
Omds are disorders of themuscles and functions of the
face and mouth.
Omds may affect, directly andor indirectly, breastfeeding,
facial skeletal growth anddevelopment, chewing, swallowing
(04:02):
, speech occlusion, tmj movement, oral hygiene, stability of
orthodontic treatment, facialaesthetics and more.
Most OMDs originate withinsufficient habitual nasal
breathing or with oral breathing.
The subsequent adaptation ofthe muscles and the oral facial
functions to a disorderedbreathing pattern creates many
OMDs.
(04:23):
Oral facial myofunctionaldisorders may impact treatment
by orthodontists, dentists,dental hygienists,
speech-language pathologists andother professionals working in
the oral facial area.
Okay, thanks for hanging inthere.
That's a really long definition, but we will get more into it
as we go through this podcast.
What all of this means?
Okay, let's talk about what themyofunctional therapy is.
(04:45):
Oral facial myofunctionaltherapy is neurological
re-education of the oral facialmuscles.
It is a rehabilitation therapyprogram designed to re-pattern
stomatic nathic functions,that's, teeth, jaw and soft
tissue such as chewing,swallowing and breathing.
This is accomplished throughthe use of therapeutic
techniques and positivebehavioral modification.
(05:06):
This definition is taken fromJoy Moller's book called Is your
Tongue Killing you?
Let's talk about what the goalsare for myofunctional therapy.
We want to establish nasalbreathing.
We want to strengthen and tonethe muscles of the tongue, lips
and face.
We want to promote the idealoral resting posture and that's
where the tongue rests in themouth and establish optimal
(05:26):
chewing, swallowing and bodyposture.
Now the relation between softtissue and hard tissue and
skeletal development is reallykey to understanding the whole
myofunctional world.
Soft tissue can affect how hardtissue, such as bone, develops.
The tongue is soft tissue andthe hard palate is bone, so it's
hard tissue.
When the tongue is in a correctresting posture against the
(05:49):
hard palate as a child grows itacts as a natural expander for
optimal palate growth.
When the palate is wide enough,there is enough space for adult
teeth.
Also, when the palate is wideand broad, it easily
accommodates the tongue restingup against it.
Some common oral facialmyofunctional disorders are low
tongue resting posture, mouthbreathing, lingual freedom
(06:11):
restrictions, what we commonlycall tongue ties, crowded and
misaligned teeth and high narrowpalates.
Many OMDs co-occur, such as ifyou're a mouth breather, then
your tongue is low.
Those two things happentogether.
That's just a sample of someOMDs.
You might notice I didn'tmention speech disorders.
They can indeed be an OMD, buthow common they are is a
(06:33):
question worth discussing.
So let's discuss how is thiswhole medical discipline of
myofunctional disorders relatedto speech disorders?
That's what you're all here for, right?
Perhaps the number one takeawayfrom this podcast is the
relationship between speech andtongue resting postures.
A correct oral resting postureplaces the tongue in the ideal
(06:53):
position for correct speech.
The correct oral restingposture is with the tongue
resting up against the hardpalate.
How many of you have emphasizedrepeatedly to a child working
on R that the sides of theirtongue need to make contact with
the back molars?
If our client's tongues wereautomatically in the correct
resting posture, we wouldn'tneed to be saying this over and
over again.
(07:14):
I referred to Char Boshartearlier, who has written books
and done multiple podcasts onthis very subject, and you can
find my interview with her inepisode 79.
In that episode she quoted oneof her professors, dr Fletcher
Tarr.
He said the correct oralresting posture is the central
operating zone for your speechsounds.
A correct resting posturefacilitates rapid, automatic,
(07:36):
precise articulation becauseit's so efficient.
Char has an analogy I reallylike If you were going to run
some errands in your car, you donot drive your car back to your
garage between every stop.
That would be very inefficientand it would slow you down.
If your ton is not naturallyresting against your hard palate
, then it is resting low.
If it's resting low, then youhave to remember to elevate it
(07:57):
in order to produce most speechsounds correctly.
Does everyone with a low toneresting posture have a speech
disorder?
The answer is no.
There are many people with lowresting tones who have good
awareness of how they sound.
They figure out the correctmovements for good articulation
and they are able to accommodateeven if their speech is less
efficient.
But for our clients with speechsound disorders, some of them
(08:19):
have a double whammy because inaddition to their myofunctional
issues, they also havephonological awareness issues,
which is all the more reason toremove barriers for them.
Myofunctional therapy is such ahelp in speech therapy.
It is fast and efficient,provided your clients are old
enough to participate in thetherapy.
By now you may be wonderingwhat myofunctional therapy looks
(08:40):
like.
Here's a bird's eye view of howit works in my clinic.
I start with an evaluation.
A good oral facialmyofunctional program will teach
you how to do a thoroughevaluation.
Then you will know if they areready to start myofunctional
therapy and if they will be agood fit.
I learned so much about reallyassessing oral structures in my
course when I learned how to doa thorough evaluation.
(09:01):
This is stuff I did not get ingraduate school.
So say your client is a goodcandidate.
What's next?
I have weekly appointments.
At the beginning I put anyother kind of speech or language
therapy on hold during thistime and the whole focus is on
teaching them exercises theywill do at home.
Each week they get a new set ofexercises and generally after
(09:22):
two to three months they will beready to move to exercises that
help them generalize andhabituate their new habits of
breathing, swallowing andmaintaining a correct oral
resting posture.
As they move into thegeneralization and habituation
exercises, they get newexercises every other week and
then every three weeks.
If they have other speech orlanguage goals, I start working
on these goals during the weeksthey don't get new exercises.
(09:44):
It has often been my experiencethat once a client who only has
speech goals has completedmyofunctional therapy, they are
ready to graduate.
It's altogether an easier wayto accomplish speech goals and
I'm all for working smarter andnot harder.
The entire process usuallytakes from six months to a year.
One of my first myofunctionalclients was a preteen working on
(10:07):
R and S.
Some of you may know Ispecialize in R and I've even
created an entire course aroundhow to teach R.
This particular client couldnot reliably produce an R, no
matter what I did.
Thanks to what I learned in mymyofunctional course, I was able
to identify a posterior tundiwhich he got released and that,
(10:27):
along with myofunctionalexercises, caused his R sound to
emerge without me doing asingle placement or elicitation
method.
That made me a believer.
Did I still use the techniquesI developed for my course?
I did, as you needed somerefining and generalization.
The methods I teach in mycourse and possible are made
possible are still valuable, butthe whole process is much
(10:50):
easier for my RNS clientsparticularly.
I've been doing myofunctionaltherapy for a year and a half
and here are some things I'velearned and put into practice.
It's a rigorous process forthese kiddos doing these
exercises two to three times aday, especially in the first two
to three months.
I help parents understand thisand choose a time to begin that
will work best for them.
(11:10):
For example, you might want towait until summer vacation to
begin or not start just beforeChristmas break or not before
you're going to take a two tothree week vacation because
you're not going to do thoseexercises on vacation.
Parents need to understand thatthey will be helping their
child to complete theseexercises correctly and
consistently.
Perhaps if you have a verymotivated older teen, parents
(11:31):
don't need to be as involved,but that's the exception rather
than the rule.
The parents and the child needto work as a team.
In the training you take tobecome a myofunctional therapist
, you'll learn when to involveother professionals such as ENTs
and dentists.
You don't want to starttreatment if nasal breathing is
obstructed, for instance.
You will want to know if a tontie is restricting movement so
(11:52):
you can work around that.
In my program we do someexercises before a Tuntai
release to help prepare them andsome specific exercises after
the release for the best outcome.
If a child is sucking theirthumb or fingers, that habit
needs to be eliminated beforeyou even think about doing
myofunctional therapy and in thecourse that you take there
usually is a habit eliminationprogram included.
(12:15):
Age is a big, big considerationand this is from my own
experience, I've started withsome really young kids and had
them drop out of my functionaltherapy.
I've had one child who was fiveyears old complete the program
successfully, but it was hardgoing.
She was six by the time shecompleted it.
The family had an ABA therapistwho helped her with her
exercises, which I think reallyhelped the family be consistent.
(12:38):
I have another five-year-oldjust about to complete the
program, but I had to pause theprogram, do some preparation
work with her and then restartit.
Based on my experiences so farnow, I think a child who is six
or seven is generally matureenough to succeed with parent
support.
If you're considering a childyounger than that, you'll want
to think through that decisioncarefully.
(12:58):
If a child is not old enough todo myofunctional therapy, I
will use Prompt, which worksreally, really well to improve
their speech and sets them up tobe successful with
myofunctional therapy in thefuture.
Along with my evaluation, Ischedule an online meeting with
parents to explain my findingsand the ins and outs of
myofunctional therapy.
I do this even if we aren'tgoing to do it right away, and
(13:20):
this helps me educate them onthe value of it and the value of
seeking out a dentist who haseducated myofunctional issues.
It just opens up the parents'eyes to the whole concept of the
ton.
Resting up against the palateis ideal for their palate
development and it's ideal fortheir speech development.
It helps them connect those twoideas if you can have this
online meeting with them.
(13:40):
I've learned to be flexible withmy scheduling, since I have
clients who are tapering offtheir visits to every other week
or every third week.
I try to schedule thosebi-monthly visits or monthly
visits on a specific day of theweek, which helps my schedule
stay full.
It's important when introducingparents to myofunctional.
In other words, they came toyou for help with one thing
(14:03):
which is speech or language, andnow you're telling them they
need something else.
That can give parents the wrongimpression that you're trying
to sell them something extra.
And this is one reason I do anonline meeting with parents, so
I can explain the relationshipbetween oral structure and
function and speech very clearly.
I explain to them that I havetaken a motor approach to speech
disorders for many years withconsiderable success, and that I
(14:25):
have always done motor approachto speech disorders for many
years with considerable success,and that I have always done
exercises to promote correctspeech.
Myofunctional therapy issimilar to what I've done before
, but it's accelerated.
It's more thorough.
Because the parent and child doso much work at home, progress
is accelerated.
I always offer them the choiceto do myofunctional therapy or
not, and we talk freely aboutwhether the child is ready for
it.
(14:50):
What can you do as an SLP if youwant to learn more about
myofunctional therapy?
I have a couple of podcaststhat I mentioned the one with
Shereen Lim, that's episode 92,and the one with Char Boshar,
that's episode 79.
There's another podcast calledAirway Answers with Nicole
Goldfarb, and she's one of manypodcasts about myofunctional
therapy, but it's one I'velistened to and I enjoy it.
There's some books you couldread.
There's Dr Lim's book Breathe,sleep Thrive.
There's Is your Tongue Killingyou by Joy Moeller.
(15:13):
Joy is an instructor for theAOMT, who I took my
myofunctional course through.
There's Breath by James Nestor,and that's a very popular book
for a general audience thatintroduces people to the
importance of nasal breathing,among other things, and the
other two books that I mentionedare more scientific in nature.
There's Academy of Oral FacialMyofunctional Therapy AOMT for
short.
They have their FrequentlyAsked Questions page, which is
(15:35):
really informative, and I'llprovide links to all of these
resources in the show notes, ofcourse, and you can always send
me an email if you havequestions and I'd be happy to
talk to you about myofunctionaltherapy and all things speech
therapy for that matter.
Now that I'm a myofunctionaltherapist, I find I cannot
separate what I've learned in mytraining from speech therapy.
Rather than being a helpfuladjunct to our profession, like
(15:57):
another tool in my therapytoolbox, this material is
foundational to ourunderstanding of speech
development.
Now that I know what I know,I'm flummoxed that it's not
required coursework for SLPs.
This understanding about howour palates develop and where
our tongue should be resting forcorrect speech is super, super
important.
(16:17):
This podcast is my effort toscatter these seeds of knowledge
far and wide into the SLP world.
If enough of us start demandingchange, I believe we can change
our profession for the better.
To sum up everything I'vetalked about today, when you
master nasal breathing and tonresting posture, complex
articulation targets take careof themselves.
Thanks for listening.
Speaker 1 (16:40):
Thanks for listening to the Speech Umbrella.
We invite you to sign up forthe free resource library at the
speech umbrellacom.
You'll get access to some ofdenise's best tracking tools,
mindfulness activities and othergreat resources to take your
therapy to the next level.
All this is for free at thespeech umbrellacom.
If you've enjoyed this podcast,subscribe and please leave us a
(17:03):
review on apple podcasts andother podcast directories.
Thank you.
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