I have enjoyed reading, learning and sharing practical knowledge to use in speech therapy from Pam Marshalla’s book on Articulation Carryover and am ready to tackle her book on “Oral-Motor Techniques in Articulation and Phonological Therapy” to blog about what I am learning and trying out!
Pam Marshalla is an expert in both areas and I appreciate that she goes deep and is practical in both subjects.
According to Pam, oral-motor therapy is incorporated in 6 treatment areas today of which articulation and phonological therapy is the one emphasized in this book. Practically, that is where I am looking to learn too.The primary goal of OM therapy is to facilitate improved oral (jaw, lip tongue) movements. She makes the point clearly that oral-motor therapy is INCLUDED in a program of articulation and phonological therapy and doesn’t stand alone.
Techniques fall into 3 categories, according to the book–exercises, cues and stimulation techniques:
1. Exercises where a client practices movements that have been taught. I am working with a child who has a strong tongue thrust and trying to teach him the /s/. We have been “exercising” getting to the spot on the alveolar ridge by making a clicking sound and repeated /t/ sounds
- Repeating movements: Again he is asked to practice lifting his tongue to the alveolar ridge 10 times in a row
- Maintaining Postures: He is asked to hold his “spot” and count to 10. It has been rewarding to see progress as kids practice during the week, strengthening their tongue by doing this holding exercise
- Lifting weights: Add weight through resistance in an exercise. I am also working with a child on tongue elevation for /l/ an overall precision. I have used an upside down spoon to provide a bit of resistance to elevation.
- Stretching Muscles: We all stretch to warm up before an athletic endeavor so we need to stretch the oral motor mechanism. This was a good reminder for me to begin with this. I do use “gigglers” to “wake up” the face as I tell my little clients. They love them if they are not overly sensitive to stimulation. I have had kids grab he alligator or elephant and start to press it against other parts of their body. Do you think they crave sensory stimulation?? I have to laugh. I have the alligator and elephant but noticed that now they have basketball players and cheerleaders.
2. Cues are used to teach and remind students of oral-motor movements
- Hands-On OralCues: These are touch cues a therapist uses on the client’s face. I prefer PROMPT and highly recommend taking that course to learn physical prompts. I am continually amazed at how difficult cases come around when I start to use physical prompts.
- Modeled Oral Cues: We can emphasize the intended movement on our own face. The tricky thing here is that many kids I work with have trouble with eye contact (or should I say maintaining eye contact with my mouth). I have a little guy right now who is hyper active and I have to give verbal cues to get his attention but when I do, he is able to imitate my oral cues.
- Cues on the Rest of the Body: Pam suggests that at times cues on the rest of the body are helpful such as “tickle the arm to remind the client to produce prolonged stridency,” etc. It would be fun to share those cues that have been successful. Anyone want to share?
3. Stimulation Techniques are used to cause new movement to arise. They “utilize tactile and proprioception stimulation” to inhibit abnormal movements to facilitate more normal ones.
That’s it for today, I am going to add “stretching” to my OM routine with kids today. I will continue to review this helpful manual over the next few weeks.
What are your favorite go-to manuals for teaching oral-motor techniques?