Ask a Therapist: Physical Therapist Question on Oral Motor

Posted by Deborah Grauzam on



I am a physical therapist working in Early Intervention in NJ. I have a 12 month child that I suspect has an undiagnosed syndrome. She has very low muscle throughout. Her cognitive level is about 6 months. She cannot sit unsupported. She can imitate a play action. She is making very few sounds. Frequently sticks out her tongue, open mouth posture. She can only eat pureed foods. I called for a speech assessment and was told by the Speech Therapist that there is no evidence that Oral Motor Therapy can help her speech at this age. Is that true?

Thank you for your help!




Dear Tal, 

Thank you for your question.  My name is Monica Purdy and I am a speech and language pathologist that also specializes in oral placement therapy and feeding. There is a lot of research on oral motor and the effectiveness and evidenced based information. If you visit this page on the TalkTools website you will find articles that you can print off and give to the speech therapist. Many speech therapists assume when someone mentions "oral motor" that they are referring to exercises such as "tongue wagging" (moving the tongue from side to side outside of the mouth), puffing the cheeks, and/or elevating the tongue to the nose or chin (again outside of the mouth). These activities do not have any support and are not related to speech or feeding and should not be used. However as you know being a physical therapist you can address muscle function by working on stability, dissociation, grading, precision and endurance in order to help a client with feeding and speech intelligibility. At TalkTools we do this by using kinesthetic feedback or tactile cues to help a client achieve these skills. Many times we work on feeding because it is a precursor to speech and we can prevent speech sound distortions from occurring if we address the muscles in feeding.   

I hope this helps, if you have any further questions please do not hesitate to contact me. 

Monica Purdy, M.A., CCC-SLP

Early Intervention kinesthetic feedback low muscle tone low tone NSOME open mouth posture oral motor therapy Oral Placement Therapy physical therapist physical therapy tactile cueing tactile cues tongue protrusion tongue wagging

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  • Great reply Monica ! I’d like to add that here in NJ the EI model doesn’t include feeding. This child should be evaluated by an oral motor and feeding specialist because EI will not provide the services required even if diagnosed . It’s also important to differentiate oral motor for feeding and Oral Placement for speech. If this child has delays in feeding than a thorough assessment of pre-feeding skills is required . It is often true that when the muscles for speech are an issue that speech is also affected . This is why Sara developed the Three Part Treatment Approach . The Oral Motor Institute also had evidenced based practice support at

    Robyn Merkel Walsh on

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