Orofacial Myofunctional Disorders

Orofacial Myofunctional Disorders (OMD)

With OMD, the tongue moves forward in an exaggerated way during speech and/or swallowing. The tongue may lie too far forward during rest or may protrude between the upper and lower teeth during speech and swallowing, and at rest.

What are some signs or symptoms of OMD?

Although a “tongue thrust” swallow is normal in infancy, it usually decreases and disappears as a child grows. If the tongue thrust continues, a child may look, speak, and swallow differently than other children of the same age. Older children may become self-conscious about their appearance.

What effect does OMD have on speech?

Some children produce sounds incorrectly as a result of OMD. OMD most often causes sounds like /s/,/z/, “sh”, “zh”, “ch” and “j” to sound differently. For example, the child may say “thumb” instead of “some” if they produce an /s/ like a “th”. Also, the sounds /t/, /d/, /n/, and /l/ may be produced incorrectly because of weak tongue tip muscles. Sometimes speech may not be affected at all.

How is OMD diagnosed?

OMD is often diagnosed by a team of professionals. In addition to the child and his or her family or caregivers, the team may include:

  • a dentist
  • an orthodontist
  • a physician
  • a speech-language pathologist (SLP)

Both dentists and orthodontists may be involved when constant, continued tongue pressure against the teeth interferes with normal tooth eruption and alignment of the teeth and jaws. Physicians rule out the presence of a blocked airway (e.g., from enlarged tonsils or adenoids or from allergies) that may cause forward tongue posture. SLPs assess and treat the effects of OMD on speech, rest postures, and swallowing.

What treatment is available for individuals with OMD?

A speech-language pathologist (SLP) with experience and training in the treatment of OMD will evaluate and treat the following:

  • open-mouth posture
  • speech sound errors
  • swallowing disorders

SLPs develop a treatment plan to help a child change his or her oral posture and articulation, when indicated. If tongue movement during swallowing is a problem, the SLP will address this as well.

Treatment techniques to help both speech and swallowing problems caused by OMD may include the following:

  • increasing awareness of mouth and facial muscles
  • increasing awareness of mouth and tongue postures
  • improving muscle strength and coordination
  • improving speech sound productions
  • improving swallowing patterns

If airways are blocked due to enlarged tonsils and adenoids or allergies, speech treatment may be postponed until medical treatment for these conditions is completed. If a child has unwanted oral habits (e.g., thumb/finger sucking, lip biting), speech treatment may first focus on eliminating these behaviors.

What causes OMD?

The Following may cause OMD:

  • allergies
  • enlarged tonsils and adenoids
  • excessive thumb or finger sucking, lip and fingernail biting, lip picking, and teeth clenching and grinding
  • family heredity


This information was found at this website: http://www.asha.org/public/speech/disorders/OMD/ and was Posted by Emily K. Hulse

If you have any questions or concerns, please contact Speech Language Pathologist Christine Wilson.

Language-Based Reading Disorders Resources

Language-Based Reading Disorders: Resources for Parents

Created by JRReed & Posted by Emily K. Hulse

Games to play with your child:
  • Boggle and Boggle Jr.
  • Scattergories, Jr.
  • Scrabble Jr.
  • Sea of Vowels
  • Go Fish For Letters
  • Monster Consonants
  • Dino Vowel Jamboree
  • Beach Party Blends
  • Goofy Galaxy Word Endings
  • Ice Cream Party, Beginning Consonants
  • Do Bones, Long Vowel Rhyming Words
  • Cosmic Critters, Consonant Blends
  • Ladybug, Ladybug, Short Vowel Rhyming Words
  • Python Path, Phonics Word-ending Game
Computer Programs for Your Child:
  • Earobics, Cognitive Concepts
  • Reader Rabbit Series
  • Jumpstart (all grade levels)
  • Thinking Things
Websites to Check out:


Questions or concerns? Contact Speech Language Pathologist Christine Wilson

Christmas Themed Game to Practice Articulation!


What’s in the Stocking?

Written by Emily K. Hulse

Speech-Language Pathologist, Christine Wilson, has a variety of FUN games and activities at her clinic. One of our favorite games is called Ned’s head. What’s in Ned’s Head? Who knows? A rat? An eyeball? Reach in and find out! This icky game of funny feeling fun will have children giggling with delight as they race to pull an object out of Ned’s head and match their game card! It is perfect for children who need help describing (What does it feel like?), storytelling (How did this get in Ned’s head?), and matching. You can play your own customized games. For example, fill Ned’s head with articulation cards and turn him into a silly articulation game.

If you are in the Christmas spirit, try playing What’s in the Stocking? Pick a stocking and fill the stocking with objects of your choice. Try to pick objects with sounds that your child is currently working on in Speech Therapy. For an example, if you child is working on “r”, put objects containing the letter “r” in the christmas stocking (red crayon, red fire truck, train, etc.). Play this game as you would Ned’s Head. Make articulation cards that match the objects in the stocking. This game is a fun way to practice articulation skills with your child at home!

If you have any questions or concerns, contact Speech-Language Pathologist Christine Wilson. Merry Christmas!

Normal Development of Language Skills

Are My Child’s Language Skills Developing Normally?
by Becky L. Spivey, M.Ed.
A very complicated and amazing foundation of language skills begins developing at birth. Children develop certain skills at different times as they move through the early stages of learning language. On the average, children learn to read by age seven, but learning to read is dependent upon their acquisition of a good foundation of skills.
The following list of milestones is the result of current research in the field where studies continue to analyze how and when children learn and begin to present certain language skills. As you look over this list, keep in mind that children vary greatly in how and when they develop and learn these skills. These skills do not follow a concrete order.
From birth to age 3, most babies and toddlers become able to:
  • Make cooing, babbling sounds in the crib which gives way to enjoying rhyming and nonsense word games
  • Play along in games such as “peek-a-boo” and “pat-a-cake.”
  • Respond to gestures and facial expressions.
  • Associate words they hear frequently with what the words mean.
  • Imitate the tones, rhythms, and sounds that adults use when talking.
  • Handle objects such as board books and alphabet blocks in their play.
  • Recognize certain books by their covers.
  • Pretend to read books.
  • Understand how to handle a book.
  • Share books with an adult as a routine part of life.
  • Name some objects in a book.
  • Talk about characters in books.
  • Look at pictures in books and realize they are symbols of real things.
  • Listen attentively to stories.
  • Begin paying attention to specific print such as the first letters of their names.
  • Scribble with a purpose as if writing or drawing something.
  • Produce letter-like forms and scribbles that resemble writing.
  • Ask or demand that adults or others read or write with them.
From ages 3-4, most preschoolers become able to:
  • Enjoy listening to and talking about storybooks.
  • Understand that print carries a message.
  • Make attempts to read and write.
  • Identify familiar signs and labels.
  • Participate in rhyming games.
  • Identify some letters and make some letter-sound matches.
  • Attempt writing letters to represent meaningful words like their name or phrases such as “I love you.”
At age 5, most kindergartners become able to:
  • Sound as if they are reading when they pretend to read.
  • Enjoy someone reading to them.
  • Retell simple stories.
  • Use descriptive language to explain or to ask questions.
  • Recognize letters and make letter-sound matches.
  • Show familiarity with rhyming and beginning sounds.
  • Understand that reading print goes left-to-right and top-to-bottom.
  • Match spoken words with written ones.
  • Write letters of the alphabet and some words they use and hear often.
  • Write stories with some readable parts.
At age 6, most first-graders can:
  • Read and retell familiar stories.
  • Use a variety of ways to help themselves read and comprehend a story (rereading, predicting, asking questions, or using visual cues or pictures).
  • Decide on their own to use reading and writing for different purposes.
  • Read some things aloud with ease.
  • Identify new words by using letter-sound matches, parts of words, and their understanding of the rest of a story or printed item.
  • Identify an increasing number of words by sight.
  • Sound out and represent major sounds in a word when trying to spell.
  • Write about topics that mean a lot to them.
  • Use some punctuation marks and capitalization.
If you have questions or concerns about your child’s progress, talk with your child’s doctor, teacher, or a speech-language pathologist. For children with any kind of disability or learning problem, the sooner they can get the special help they need, the easier it will be for them to learn.
Contact Speech-Language Pathologist Christine Wilson to schedule an appointment today!

Rebus Activities for Articulation


Rebus Activities for Articulation

by Julie A. Daymut, M.A., CCC-SLP
Rebus activities use pictures or symbols to represent words or phrases. By substituting images for text, children have a fun activity to practice skills such as articulation (speech sound production). This is also a great activity for nonreaders, as they can participate in storytelling by naming each image as the story is read aloud. The stories can vary in length and in the difficulty level of vocabulary. In addition, you can make your own rebus stories using cut-out or online/computer images and lots of creativity!
Rebus Activities at Home:
Use the following activities from “Say and Do”® Rebus for Articulation to help your children practice their speech sounds at home. Note: Be sure to check with their speech-language pathologist (SLP) before beginning any home speech practice.
  1. Read the story aloud, emphasizing the target words.
  2. Read the story and stop at the rebus words and let your child fill them in.
  3. If your child is a reader, let him/her read the story for you. Remember, only the target sound words should be monitored. There may be other story words that contain your child’s target sound but may not be the focus for that particular story.
  4. Go through the story and say just the rebus words.


How to Break Oral Habits


Oral Habits

The Pacifier

Pacifier use is the most common non-nutritive sucking habit. It usually begins when parents introduce it in order to calm their child. Over time, it becomes a form of amusement as well, and the child becomes attached to it. Depending on the intensity, frequency, and duration of the habit, pacifiers may affect dental occlusion. Improvement may occur once the habit is eliminated, depending on the child’s age and other factors.

Pacifiers are usually an easier habit to break because the parent can regulate when and for how long the child gets to use one. Many parents have had success with collecting all the pacifiers and “mailing them to the paci fairy.”

Thumb Sucking

When a thumb or finger is inside the mouth, it takes up the space where the lips, teeth, tongue and jaw are normally positioned. This prevents them from functioning in the correct way. Even when the thumb is removed, the structures often remain in the incorrect positions, leading to an open bite, mouth breathing, and an undesirable way of chewing, swallowing, and speaking.

Thumb habits can be more difficult to address, but some simple tricks include placing a band aid on the thumb to help remind your child not to suck it, or placing a sock or glove on the hand when the child goes to bed.

Nail Biting

Unsightly fingernails may cause problems beyond the social issues we are aware of. Fingernail biting can also damage the gums, make the fingertips red and sore, and cause the cuticles to bleed. It increases the risk of bacterial infection around the nail beds and the mouth, which in turn may affect overall health. Stress has been shown to increase the likelihood of nail-biting.

To break this habit try covering the nails, as this will provide a physical reminder. You could also try bad-tasting nail polish, which can act as a deterrent to nail-biting. False nails (not for children) and gloves are other barrier methods that help some people.

Some Additional Tips!

Although these oral habits are a physical act, there is also a strong psychological component to them.  Because many children use these habits for self soothing it may be difficult for them to initially give them up. Keeping this in mind, it is important to give your little one lots of encouragement and positive reinforcement as you begin to wean them from their habit.  Positive reinforcement has been show to be significantly more successful than negative reinforcement when trying to conquer oral habits. Having the child feel like they are on the same team as you and getting them to the place where they want to stop is the best approach.

When you begin the process of trying to break an oral habit a helpful method is to get a large calendar and place stickers on days where your child was able to go without their habit. Studies have shown that it takes at least 30 consecutive days of avoiding the habit to help prevent relapse. In addition to these simple at home tips, there are dental appliances that can be placed in the patient’s mouth to help them overcome these habits. These appliances work best when a child wants to stop but needs a constant reminder, as many of these habits occur without the patient consciously aware that they are doing it.


If you have any questions or concerns, contact Speech-Language Pathologist Christine Wilson.