According to Merkel-Walsh (2020), Orofacial Myofunctional Disorders (OMDs) sit at the intersection of structure and function, forming a complex relationship in which one continuously influences the other. Structural anomalies may lead to compensatory or dysfunctional oral habits, while maladaptive oral behaviors and muscle-based deficits can, over time, create or exacerbate undesirable structural changes. This course explores the ways in which structural variations and OMDs contribute to reduced speech intelligibility, altered resonance, and persistent articulatory errors.

Grounded in Robyn Merkel-Walsh’s clinical philosophy, the course emphasizes remediation through improved oral placement skills and addressing the underlying etiology rather than relying solely on compensatory strategies. While some clinicians argue that individuals can learn to “work around” structural differences, this course presents evidence supporting targeted intervention that restores appropriate orofacial function to support speech remediation whenever possible.

Participants will examine key structural anomalies including ankyloglossia, occluded nasal passages, dental malocclusions, and cleft palate which may influence speech clarity. In addition, additional adaptive functional skills such as thumb sucking and mouth breathing will be discussed in relation to speech clarity.

A comprehensive literature review will highlight what is currently understood in the evidence base, identify areas where research is still evolving, and situate clinical controversies within the broader scientific discussion. Compensation patterns commonly observed in clinical practice will be analyzed and compared with prevailing debates on treatment philosophy, scope of practice, and interdisciplinary collaboration.

Finally, participants will explore treatment considerations and referral pathways involving orthodontics, otolaryngology, oral surgery, and allied health therapies such as physical therapy, occupational therapy, and speech-language pathology. Emphasis will be placed on an interdisciplinary model that restores structural and functional stability while supporting optimal speech production.

1. Define and describe the bidirectional relationship between structural anomalies and functional OMD patterns.
2. Analyze the impact of specific structural anomalies on speech clarity and resonance.
3. List one current research study that positively correlated a structural anomaly to reduced speech clarity.

• Robyn Merkel-Walsh, MA, CCC-SLP, COM®️

Registration Fees

• $150  0.2 ASHA CEUs, digital workbook & certificate of completion.

Schedule

Timed Agenda

• 10 mins: Introduction
• 45 mins: Structural anomalies and their impact on speech: a literature review in progress
• 45 mins: Therapeutic considerations for speech sound disorders when a structural anomaly is present
• 10 mins: Conclusions and Future Research
• 10 mins: Q&A

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Content Disclosure: This presentation will focus on treatment methods related to the use of TalkTools® resources. Other similar treatment approaches will receive limited or no coverage during this lecture.

TalkTools®️ is an AOTA Approved Provider of professional development. PD activity approval ID# 8649. This Distance Learning-Interactive activity is offered at 0.2 CEUs Intermediate Level, OT Service Delivery and Foundational Knowledge. AOTA does not endorse specific course content, products, or clinical procedures.

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