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Oral Motor

The mouth is the most sensitive area of the body and is used at an early stage of development to increase knowledge of different textures. This exploratory stage is important for developing oral motor control. These skills include the ability to suck, blow, and chew. 

The tongue and lip movements used during feeding and speaking depend on adequate sensitivity in the oral area.

When a child presents with sensitivity to touch it is not uncommon for the area within and around the mouth to be most problematic. This can result in frustration for parents at meal times, dental hygiene activities etc.

Oral motor skills are developed in the following sequence:

  1. Suck

  2. Blow

  3. Biting

  4. Crunching

  5. Chewing

It is important that you consider this sequence when presenting activities to your

child. If your child has good sucking skills then activities can be centered on blowing. The activities within the program follow this sequence of development.

Occupational therapists and speech therapists often take a collaborative approach to help a child with oral motor and feeding. 

Occupational therapists often focus on sensory to decrease oral sensitivity and work on oral motor control. 

Oral Desensitization: This is the process of introducing a variety of inputs and textures for the mouth to decrease aversions. It is important to begin with input that the child can control such as vibrating toothbrushes, teethers, and playing with food textures. Then helping a child tolerate oral motor exercises such as check/lip stretches, z-vibe, cold textures and deep pressure to facilitate oral motor skills. Then finally moving into the child’s ability to try new food and textures. It is important to start with preferred food and allow creativity and some control as you move to non-preferred foods. 

Oral Motor Exercises: Oral motor exercises help to facilitate lip closure, moving a bonus in their mouth, tongue position, and rotary chew. These activities include chewy tubes, sucking exercises, blowing exercises, tongue movements and lip/check movements. 

Skill Development: 

Birth to 3 months - This is the time when a child begins to integrate the reflexes they were born with to volitional motor control. For example, when a baby is born they feed mostly through reflexes including rooting, gag reflex, suck/swallow/breath reflex and several others. 

3 to 7 months - During this stage of development a baby begins to gain head control and jaw motor movements. They begin to move into a munching jaw movement. 

7 to 9 months - During this stage of development a baby begins to have jaw stability, rotary chew and lip closure. 

When working on feeding with a baby it is important to look at skill level when introducing foods. A child that still has a strong gag reflex and poor head control should wait to start with food. This will cause increased adverse reactions to foods and cause fight or flight reactions with feeding. Developmental milestones are key to avoid long term feeding problems. 

Speech therapists often focus on tongue placement, tongue movements, oral motor exercises, and resting mouth posture as it relates to feeding, speech and breathing.   The focus of therapy can include but not be limited to exercises that help improve oral awareness and oral movements that can assist with speech production/ articulation and feeding.

Mouth positioning at rest is something that parents and clinicians can often overlook but can be a major indicator of oral motor dysfunction. At rest, your lips should be closed, your teeth approximated, and your tongue should be resting in an elevated position. There are numerous things that can be negatively impacted by an inappropriate resting mouth posture including structural development of the face and oral cavity as well as the functions of swallowing, breathing and speech.

Appropriate mouth and tongue positioning is crucial for appropriate facial development and palatal/ orthodontic development. Inappropriate tongue posture including a low lying tongue or anterior movements such as in a tongue thrust can impact dental development resulting in malocclusions or inappropriate bite patterns (i.e. crossbite). Appropriate tongue placement is also crucial for appropriate palatal expansion as the tongue should be elevated and assisting in spreading your palate. Appropriate tongue positioning when you swallow is also crucial to ensure you are getting an appropriate elevated and posterior movement. 

Mouth breathing can also be a sign that your child may have an oral motor dysfunction or an airway obstruction. Breathing through your nasal cavity is the healthiest and most efficient manner of breathing. Signs of mouth breathing can include snoring, dry mouth, bad breath, brain fog/ fatigue, dark under eyes, irritability/ behavioral problems. Often addressing issues related to mouth breathing/ open resting posture needs to be a collaborative approach from an airway focused team including a Speech Pathologist, dentist/ orthodontist and/ or an Ear Nose Throat specialist. Often a medical and therapeutic approach will be necessary in order to diagnose, treat and retrain your musculature. 


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