Thank You, Sonali!

The Use of Oral-Motor Techniques to Improve Speech Production

Using oral-motor techniques to work on articulation continues to be controversial in the field of speech-language pathology. Recent research appears to indicate that use of oral motor techniques do not in fact demonstrate better outcomes in terms of speech production. However, when reviewing any research it is important to understand that the study was carried out on a small group of participants. As parents and professionals we know that no two children are alike in terms of their deficits or their strengths. Techniques and treatment methods that work for one child may prove to be ineffective for another and vice versa. It is therefore my opinion that each child must be evaluated as an individual with unique needs and abilities. Techniques that work on building lip strength in a child with poor lip seal resulting in drooling and errors in production of bilabial sounds “p,” “b,” “w,” and “m” may in fact be effective.

I believe a detailed evaluation that includes an assessment of a child’s jaw, tongue and lips: their strength, coordination and dissociation (i.e. the ability to move independently of the other) is key to determining their effect on speech production. However, I cannot emphasize how important it is to always use oral motor techniques in conjunction with direct speech production therapy. It may not result in the desired articulation changes if used in isolation.

Cycles Approach

Cycles Approach to treating multiple articulation errors in children with poor speech intelligibility

Children often demonstrate errors in the production of sounds like /s/, /r/ and /l/. When a child presents with a few specific sound errors, a traditional articulation treatment is warranted. However, for some children the sound error includes a wide range of sounds and severely impacts their speech intelligibility. Their errors often follow patterns such as omission of final sounds in words (e.g. saying “ca” for “cat.”). Hodson and Paden (1991) proposed the “Cycles Approach” in which these patters are targeted in a specific sequence. The treatment includes specific treatment strategies used in each session such as auditory bombardment, a communication activity, drills and a generalization activity. Evidence suggests that treatment approaches that target patterns of sounds rather than each specific misarticulated sound for children with multiple errors are more efficient thereby reducing the overall treatment time. The more dramatic impact of using an approach such as the Cycles Approach is a significant impact in the child’s speech intelligibility. This video (Thank You, Sonali!) is a “Before and After Cycles Program” of a child (age 3 years). The little girl demonstrated multiple sound errors using essentially vowels to communicate. Following several months of intervention, she could produce complete sentences that are intelligible even to unfamiliar persons. The remarkable difference in her speech is impressive evidence of the overall effectiveness of the program.