About Orofacial Myofunctional Disorders

Infants, children, teenagers and adults may suffer from orofacial myofunctional disorder (OMD). An orofacial myofunctional disorder may interfere with how the muscles of the face and mouth are placed during rest or while eating/drinking.

Individuals with an orofacial myofunctional disorder may have difficulty and present with open mouth breathing, forward or low tongue posture (sometimes referred to as ‘tongue thrust’), or decreased chewing/feeding skills.

Signs and Symptoms of Orofacial Myofunctional Disorders

Assessment by a clinician trained in orofacial myofunctional assessment and therapy. Note that playTOK provides orofacial myofunctional therapy to children aged 4+ only (e.g., children have to be able to follow instructions).

Some signs of an OMD may include the following (from American Speech and Hearing Association):

• Someone who always breathes through the mouth or has difficulty breathing through the nose.
• Limited tongue movement.
• Eating may be messy or difficult. Keep in mind that it is normal for babies to stick their tongue out and push food out of their mouth. Over time, they do this less.
• The tongue pushing past the teeth, even when a person is not talking or using the tongue.
• Drooling, especially beyond age 2.
• Difficulty closing the lips to swallow.
• Other difficulties listed on ASHA (e.g., individuals with OMDs may also present with speech errors)

Causes of Orofacial Myofunctional Disorders

There is not a known, single cause of orofacial myofunctional disorders. OMDs may be caused by several factors and proper assessment and referral is required to support optimal orofacial myofunctional development.

OMDs are increasingly more present in individuals who may have blocked nasal passages because of tonsil size or allergies, tongue misplacement as a result of various reasons resulting in chronic open mouth posture, sucking and chewing habits past the age of 3 years.

A speech-language pathologist will focus on the oral rest posture, tongue rest posture and proper feeding/chewing skills. Any concerns beyond this scope will be directed to other professionals (e.g., should there be breathing, dental, or other concerns, a discussion with patients will occur to seek proper evaluation by other professionals).

Seeing a Professional

Orofacial Myofunctional Disorder (OMD), Speech-Language Pathology & Other Professionals

SLPs can focus on how you/your child postures their lips/tongue, and how they eat or drink. SLPs do not focus on medical or dental concerns and referrals elsewhere will be discussed if concerns are noted.

In order to address concerns beyond SLP scope of practice, you may be recommended to discuss concerns with other professionals (e.g., doctor, dentist, orthodontist). It is important to have other professionals rule out or provide recommendations (e.g., if there are underlying health conditions affecting OMDs, they must be addressed elsewhere by a doctor, if there are structural dental concerns they must be addressed by a dentist or orthodontist).

SLPs trained in OMDs can help your child do the following:

• Pay closer attention to their mouth and facial movements at rest and during chewing.
• Know where their tongue and mouth muscles are when they speak, drink, and eat.
• Change how they chew and swallow.
• Practice proper oral rest posture

In addition to the above areas in OMD, your child may have concerns in a different area — speech production. SLPs at playTOK are able to provide support for:

• Apraxia and motor speech disorders
• Articulation and phonology disorders
• Voice and resonance disorders