Do Oral Motor Exercises Improve Speech in Dysarthria?

Mark A. Ittleman, M.S., CCC/SLP
Speech Language Pathologist 
Author:  Teaching of Talking

I've never placed much credence in oral motor exercises, esp. the non speech variety.  I used to watch patients who could hardly speak spend the majority of their therapy time on exercises that did not involve the process of speaking.  Patients would be blowing bubbles, licking peanut-butter off a spoon or licking it off the upper lips etc.  I always thought the exercises were questionable esp. when noting there was no simultaneous speaking being practiced.  There was always this little voice in my head that was going "Why aren't they practicing talking?; "Why are they blowing bubbles like children?"  "What's that got to do with speaking clarity?"

Then I realized that people with severe aphasia and dysarthria had some pretty complex speaking difficulties and non-speech oral-motor exercises could be easier.  I could NEVER believe that working on moving the oral structures without speaking, would be helpful unless the individual with the speaking difficulty had a profound apraxia of speech.  (more on that subject in the future.)

The clinical priority for me was to find a way to help others speak so that they could be UNDERSTOOD.  That was always the thought.  How could I stimulate speaking clarity that would involve the structures and the muscles of speech?  The thought was to attempt to aways address building muscular strength of the lips, teeth, and tongue while also teaching a person with speaking difficulty to speak so others would not have to continually ask them to repeat themselves.    The goal to consider is to practice speaking in a certain way to get clarity and THAT WOULD EXERCISE THE STRUCTURES AND THE MUSCLES OF SPEAKING.

In these days of dwindling therapy visits and caps on how long a person can receive therapy we must make each visit count.  Patients come in with one thought in mind; to talk better, to speak with more clarity, and to be understood.  That must be done in a very short period of time “before the insurance runs out,” for many.  That is why the truly elegant clinician should be addressing speaking immediately with ways to compensate for the motor difficulty and showing the person with the speaking difficulty a way of speaking that would be understood by friends and loved ones.  To me that should be the major focus of speech therapy for those with dysarthria and who have some intelligible speech.  Having people do gross imitation tasks in non-speech tasks may be required in speaking difficulties such as profound apraxia but not necessarily in dysarthria or severely slurred speech.  

The Teaching of Talking is an approach; a philosophy of providing speech therapy in such a way to exercise the muscles that have been affected by stroke, aphasia, motor dysfunction or traumatic head injury.  Actually the process of speaking can also simultaneously address motor and muscle weakness and actually improve and strengthen them.  Our number 1 priority as speech language pathologists should be to help the person who has a speaking difficulty speak with more clarity.  We all know how important it is to be understood.

The number 1 priority for  those with speaking difficulties and their caregivers should be to find a speech language pathologist who places priority on the ability to speak, converse, and to be understood.

Mark A. Ittleman, M.S., CCC/SLP is a speech language pathologist with over 40 years of direct patient care with both children and adults.  He is also the author of Teaching of Talking, a book written for caregivers, family members, loved ones, and speech language pathologists to help them develop simple and fun ways to stimulate speech and language without flash cards, workbooks and computer programs.  To find out more about the Teaching of Talking:  http://www.teachingoftalking.com. You can also contact me personally through our website or Facebook at http://www.facebook.com/teachingoftalking. 

You can learn how to really take your loved ones speech therapy to a new level. Ask your speech therapist about The Teaching of Talking Method, and that you are interested in learning it.  We will be available to come to your city, hospital, school, or college to share with you the fundamentals of this method.

Best.

Mark A. Ittleman, M.S., CCC/SLP
Speech Language Pathologist, Author: Teaching of Talking
Taking a Stand for Speaking Clarity Around the Globe.




In a paper delivered before the American Speech Language Hearing Association in 2010, Geofrey L. Lof, Phd. presented an update regarding the controversy of these exercises.  In this lengthy paper, with numerous scientific references it was concluded that these exercises are not recommended as techniques that can improve speech productions in the treatment of dysarthria.

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=6&ved=0CFMQFjAF&url=http%3A%2F%2Fwww.asha.org%2FEvents%2Fconvention%2Fhandouts%2F2009%2F1955_Lof_Gregory_L%2F&ei=attxU9K0CI3QsQSzpoGICQ&usg=AFQjCNG3gh-2-3RkqInXgxwI7x09_6Pjng&sig2=y-Qq_LYrcYKeKRJtLoH7xA