Understanding Oral Placement Therapy (OPT): Evidence-Based Speech & Feeding Intervention
A comprehensive guide to improving speech clarity, feeding skills, and oral motor function through targeted tactile-proprioceptive techniques.
What is Oral Placement Therapy?
Oral Placement Therapy (OPT) is a specialized approach that combines auditory, visual, and tactile stimulation to improve speech clarity. It’s commonly used as an addition to traditional speech treatment for clients with placement and movement deficits.
OPT focuses on improving articulator awareness, placement (including grading and direction of movement), stability, and muscle memory. Dissociation (independent control of jaw, lips, and tongue) is monitored and supported throughout the hierarchy as skills become more refined and functional.
OPT adds a tactile component to what clients already hear and see during therapy.
OPT follows a systematic hierarchy that builds skills from foundation to function. Each level supports the next.
Jaw Stability & Grading
Establish controlled jaw movement and appropriate jaw opening for different sounds and food textures. Jaw stability is the foundation that supports precise tongue and lip movements.
Lip Rounding & Closure
Develop strength and coordination for lip movements needed for labial sounds (like /p/, /b/, /m/, /w/) and functional feeding skills (lip seal, controlled airflow).
Tongue Lateralization
Teach side-to-side tongue movement to support chewing, moving food across the molars, and building coordinated oral control for speech and feeding.
Tongue Elevation
Build the ability to lift the tongue tip/blade toward the alveolar ridge—important for sounds like /t/, /d/, /n/, /l/, and /s/ and for more precise articulation.
Tongue Retraction
Improve back-of-tongue control for velar sounds (/k/, /g/, /ng/) and for more efficient swallowing patterns.
Dissociation of Movement
Coordinate independent movements of jaw, lips, and tongue—supporting clear speech, efficient feeding, and smoother transitions between sounds. Dissociation is assessed and shaped at every level as motor control develops.
Below are common OPT-style targets and activities that support the hierarchy (selected based on individual assessment).
1) Jaw Grading Bites
Use graduated bite blocks to teach controlled jaw opening/closure and improve stability. A stable jaw creates a reliable base for tongue and lip placement.
2) Horn Hierarchy
A progressive series that increases the demand on lip rounding and endurance. Supports vowel shaping and labial sound production.
3) Straw Drinking Hierarchy
Progress from easier to more challenging straw drinking tasks to develop suction control, lip seal, and cheek retraction.
4) Bubble Hierarchy
Bubble blowing tasks can support sustained lip closure, controlled airflow, and steady jaw positioning as a foundation for clearer speech.
5) Tongue Lateralization Tools
Tactile cues guide the tongue laterally across the teeth to support chewing and managing food in the mouth.
6) Tongue Elevation Techniques
Use tactile prompts to help the client learn tongue tip elevation toward the alveolar ridge, supporting accuracy for alveolar sounds.
OPT may be considered when clients struggle to produce or imitate targets using auditory/visual input alone, and when assessment shows placement/movement needs.
- ✓Childhood Apraxia of Speech (CAS): tactile cues can support awareness of placement and movement sequences.
- ✓Dysarthria & motor speech disorders: improve strength, stability, and coordinated movement.
- ✓Down syndrome: address low tone and oral motor coordination challenges impacting speech/feeding.
- ✓Persistent articulation difficulties: support placement and movement for specific sound targets.
- ✓Feeding difficulties: build the oral motor foundations for chewing and bolus management.
- ✓Cerebral palsy: support motor control strategies for speech and feeding tasks.
If several of these sound familiar, a comprehensive oral motor assessment may help identify the best next step.
- ✓Builds oral motor skills from foundation to function through a structured hierarchy
- ✓Adds tactile feedback to support accurate placement when hearing/seeing isn’t enough
- ✓Supports jaw, lip, tongue, and cheek strength for speech clarity and feeding safety
- ✓Improves coordination and dissociation of oral structures for more precise articulation
- ✓Targets underlying motor needs rather than only focusing on sound errors
- ✓Encourages better oral function through practice and consistent home carryover
- ✓Engages children using playful, motivating activities and tools
- ✓Complements traditional therapy as part of a comprehensive program
- ✓Step 1: Comprehensive assessment of jaw, lips, tongue, and cheeks during speech + feeding tasks.
- ✓Step 2: Individualized plan selecting targets based on the hierarchy and the client’s needs.
- ✓Step 3: Systematic progression measuring progress at each level before moving forward.
- ✓Step 4: Home program typically brief daily practice (often 5–10 minutes) to build consistency.
- ✓Step 5: Transition to speech integrating the oral motor foundation into functional sound production.
Ready to Support Clearer Speech & Safer Feeding?
Connect with a certified Oral Placement Therapy professional to learn which OPT targets are appropriate for your child or client.
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