Orofacial myofunctional disorders (OMDs) are patterns involving oral and orofacial musculature that interfere with normal growth, development, or function of orofacial structures, or call attention to themselves (Mason, n.d.A). OMDs can be found in children, adolescents, and adults. OMDs can co-occur with a variety of speech and swallowing disorders. OMD may reflect the interplay of learned behaviors, physical/structural variables, genetic and environmental factors (Maspero, Prevedello, Giannini, Galbiati, & Farronato, 2014).
Did you know that…
The incidence of orofacial myofunctional disorders (OMD) refers to the number of new cases identified in a specified time period. The prevalence of OMD refers to the number of individuals who exhibit OMD at any given time.
Tongue thrusting (protrusion of the tongue between the teeth) during swallowing is estimated to range between 33% and 50.5% of the general population of school-aged children (Fletcher, Casteel, & Bradley, 1961; Gross et al., 1990; Hale, Kellum, Nason, & Johnson, 1988; Hanson & Cohen, 1973; Wadsworth, Maul, & Stevens, 1998).
The presence of tongue thrusting (the protrusion of the tongue between the teeth) during swallowing is significantly related to age. Prevalence estimates are highest in preschool- and young school-aged children and lowest in adolescents (Fletcher, et al., 1961; Wadsworth, et al., 1998).
Children with articulation disorders are more likely to exhibit a tongue thrust swallow (55.3%; Wadsworth, et al., 1998).
Approximately 31% of children diagnosed with chronic mouth breathing (a common symptom of OMD) exhibit an articulation disorder (Hitos, Arakaki, Sole, & Weckx, 2013).
Higher estimates are reported for individuals receiving orthodontic treatment (62% to 73.3%) or with dental malocclusions (Hale, Kellum, & Bishop, 1988; Stahl, Grabowski, Gaebel, & Kundt, 2007).
In individuals with a temporomandibular disorder (TMD), the percentage of those with orofacial myofunctional variables is estimated to be 97.92% (Ferreira, Da Silva, & de Felicio, 2009).
Taken from ASHA website
Risk Factors
Airway incompetency due to
Obstructed nasal passages –
Enlarged tonsils,
Enlarged adenoids,
Hypertrophied turbinates
Deviated septum
Allergies (Bueno, Grechi, Trawitzki, Anselmo-Lima, Felicio & Valera, 2015).
· An obstruction of the nasal passages can lead to mouth breathing, which can, in turn, lead to lower facial tone, increased incidence of colds/infections, as well as difficulties with swallowing and chewing.
Chronic nonnutritive sucking & chewing habits past the age of 3 years of age (Sousa, et al., 2014; Poyak, 2006; Zardetto, et al., 2002)
Orofacial muscular/structural differences that encourage tongue fronting could include
Delayed neuromotor development
Premature exfoliation of maxillary incisors that encourage fronting of the tongue
Orofacial anomalies.
Ankyloglossia – also knows as tongue tie.
Many speech sound disorders are secondary to myofunctional disorders, such as poor tonus, poor mobility of the tongue, poor range of motion and muscle tone or the orofacial structures (I.e. cheeks, facial muscles, etc).
Orofacial myofunctional therapy aims to correct the muscular imbalances, as well as disrupted breathing patterns, as well as oral habits (I.e. thumb sucking, using dummy) that might be affecting the speech and chewing/swallowing.
Some goals of Orofacial myofunctional therapy include
- Establishing Patent Nasal Airway
- Improving Speech Sound Articulatory Placement
- Eliminating Nonnutritive Sucking (dummy, thumb and object sucking, such as pencil, pen, etc).
- Modifying Handling and Swallowing of Saliva, Liquids, and Solids
- Re-establishing appropriate Oral Rest Posture
- Developing Labial-Lingual-Pharyngeal Muscles’ competence via resistance exercises
Myofunctional therapy is especially helpful for children/adults with persistent speech disorders that have not resolved despite multiple interventions.
At JDS, our clients are privileged to have myofunctional therapy delivered by qualified Speech and Language therapists. This means the delivery of the service can be an articulation of myofunctional therapy and speech and language therapy, and targets in both areas can be addressed simultaneously.