You may have heard that not all speech sound disorders are treated the same and not all speech pathologists have the same training. In order to receive certification as a Certified Cranial Oral Facial Myologist, from the International Association of Orofacial Myology, a speech pathologist must go through rigorous training and gain experience in order to practice under their strict standards. 

This certification in cranial oral facial myology provides extra depth of knowledge in the face, lips, tongue, jaw, swallow, and other speech and swallowing patterns in these areas.  The purpose of involving a Cranial Oral Facial Myologist into your child’s speech therapy is important because, as it is outlined in the literature on oral facial myology therapy “…creates an oral environment in which normal processes of orofacial and dental growth and development can take place, and be maintained (Hanson & Mason, 2003)”. 

A Cranial Oral Facial Myologist helps with your child’s speech impairment by, most generally, bringing awareness to the muscles and structures that help you speak! Many speech impairments are based on the placement of the tongue, mouth, teeth, palate and other structures in our mouths. One small incorrect placement can occur and a different sound could be produced (i.e articulation disorder). This is not something that is necessarily easy to assess or treat. An Oral Facial Myologist finds and discovers the underlying causes and creates individualized speech pathology treatment plans. There is usually homework involved with exercises to practice daily.

In most cases the speech impairment is coupled or could be caused by an orofacial myofunctional disorder. Some of the more common disorders include tongue thrusting, articulation disorders, thumb suckingm chronic mouth breating, but it also included orthodontic and dental treatment and temporomandibular disorder (TMJ/D). 

Like mentioned before the causes of an Orofacial Myofunctional Disorder could contribute to a speech impairment, so let’s look at some of the symptoms that are outlined by the American Speech-Language-Hearing Association (ASHA). 

• Open mouth, habitual lips-apart resting posture (in children, adolescents, and adults)
• Structural abnormalities such as: 
  • Restricted lingual frenulum (tongue tie)
  • Dental abnormalities (underbite, overbite etc) 
• Abnormal tongue rest posture, either forward, interdental, or lateral posterior (unilateral or bilateral), which does not allow for normal resting relationship between tongue, teeth, and jaws, otherwise known as the interocclusal space at rest, or the freeway space (Mason, 2011)
• Distorted productions of /s, z/ (articulation disorder). 
• Abnormal placement for /t, d, l, n, ʧ (ch), ʤ (as in job), ʃ (sh), ʓ (as in usual) / (articulation disorder)
• Drooling and poor oral control, specifically past the age of 2 years
• Nonnutritive sucking habits, including pacifier use after the age of 12 months and finger, thumb, or tongue sucking 
• Lack of a consistent seal between lips, tongue and palate  during liquid, solid, and saliva swallows.
• Tongue coming in contact with the teeth abnormally while swallowing.

The symptoms outlined above are treated by a Cranial Oral Facial Myologist (Certified Oralfacial Myologist, COM), to learn more about what would occur in therapy, read out next article on Treatment and What to Expect!

References: 

ASHA 

IAOM