Can exercising or strengthening movements help my child’s speech?
You want a big bicep, so you go to the gym and lift heavy weights to make it stronger. You want to throw the perfect pitch in a baseball game, so you practice the movements until they are second nature and you are pitching no-hitters. Naturally, mouth muscles would be conditioned in a similar fashion, right? Unfortunately, your mouth muscles—including your tongue, lips and cheeks—do not work this way; greater strength does mean better speech.
Here is why:
- The use of oral motor exercises (non-speech movements of the mouth muscles) alone to improve speech is doubtful. We do not speak in isolated movements. Instead, speech is a series of fluid movements of the tongue, lips and jaw connecting from one sound to the next. Practicing an isolated movement is not directly applicable to how we produce speech, and therefore we cannot expect a great deal of benefit from it.
- Speech and nonspeech movements are controlled by different areas of the brain. The area of the brain that tells your tongue tip to lift a Cheerio is different from the area of the brain that tells your tongue tip to elevate to produce a “t.”
- Nonspeech oral motor exercises break apart the highly integrated task of speaking. All movements must be practiced in conjunction to help speech. Take shooting 3-pointers, for instance. Practicing only the jump will not improve your 3-point shot as all the movements are integrated and can’t be practiced in isolation.
But here is what can help:
- Speech therapy must be learned within the actual act of speaking. The context of learning is important. For an intervention to improve articulation, the activity must be done with behaviors related to their specific goal.
- It is important to consider how much strength is required for speech. It seems beneficial to work on strength; when our knee starts to hurt, we often have to strengthen the surrounding muscles. But again, our muscles for speech work differently. Research indicates we don’t need a great deal of strength to speak. Rather, agility—the ability to move your tongue quickly and easily from one sound to the next—is more important. However, agility cannot be addressed in these isolated, nonspeech movements.
So what does this mean for clinicians and parents trying to ensure their therapy is appropriate? If your child is blowing out of a straw in therapy, make sure to ask your therapist why. If it is only to develop oral musculature with the expectation of improving speech, research does not support this type of intervention.
In sum, oral motor exercises are not endorsed by research. Parents should always ask clinicians to explain their rationale if using oral motor exercises. And clinicians should always rely on evidence to first direct clinical practice. However, in light of limited research to provide direction, theoretical soundness should always be a guide.
- Clark, H. (2005). Clinical decision making and oral motor treatments. The ASHA Leader, pp. 8-9, 34-35.
- Lof, G.L., Watson, M.M. (2008). A nationwide survey of nonspeech oral motor exercise use: Implications for evidenced-based practice. Language, speech and hearing services in schools, 39.
- McCauley, R.J., Strand, E., Lof, G.L., Schooling, T., & Frymark, T. (2009). Evidence-based systematic review: Effects of nonspeech oral motor exercises on speech. American Journal of Speech Language Pathology, 18.