A couple of my kids have a lisp as well as difficulty with the R sound. What tools would be the most efficient to strengthen oral function to help their speech progress?
First and foremost, it is important to understand that we do not need “strength” to produce articulate speech however some of our patients present with hypotonia, motor execution, motor, Praxis issues and / or structural deficits. Strength and resistance training is reserved for those with dysarthria or a muscle imbalanced caused from an Orofacial myofunctional disorder.
The way in which we determine the tools we use for therapy comes from a detailed, oral placement and orofacial myofunctional assessment. Determining the why of the articulation problem is imperative because for example – could the tongue have limited range of motion from a tongue tie? Could the patient be lacking motor execution where the motor planning system is intact, but the muscles are not receiving the message correctly? Is the patient’s oral resting posture with the tongue up into the palate and the tip to the alveolar ridge with nasal breathing!
According to the ASHA portal in the clinical topic of OMDs, if there is poor oral rest posture, it will be very difficult even with speech therapy to remediate the sound. The sounds will be much quicker to remediate when the oral resting posture is corrected . Articulation can also be impacted by noxious, oral habits, such as thumb sucking or using a sippy cup. All of these issues need proper assessment.
Now, with that being said in general tools which can achieve these goals are our original horn hierarchy, our original straw hierarchy, the tongue tip elevation tool, and exercises found in OPT for speech clarity and feeding, or the new MYOSolutions program. Hope this helps! –Robyn Merkel-Walsh, MA, CCC-SLP, COM®️