Myofunctional Therapy

Myofunctional Therapy is specialized to evaluate and treat Orofacial Myofunctional Disorders (OMDs). “Orofacial myofunctional disorder includes dysfunction of the lips, jaw, tongue, and/or oropharynx that interferes with normal growth, development, or function of other oral structures, the consequence of a sequence of events or lack of intervention at critical periods, which result in malocclusion and suboptimal facial development” (D’Onofrio, 2019).

OMD is characterized by one or more of the following: 

  • abnormal labial (lip) and lingual (tongue) rest posture 
  • tethered oral tissue (TOT) 
  • atypical swallowing patterns (tongue thrust- tongue exits mouth during swallow)
  • dental malocclusions 
  • blocked nasal airways
  • atypical oral placement for speech

OMD can co-occur with speech misarticulations and is therefore not considered a developmental disorder. They result from poor oral placement and inappropriate oral muscle development” (Billings et al., 2018). 

The following should be noted for individuals with tethered oral tissue (TOTS). 

ORAL CAVITY: Poor oral and dental health has been attributed to TOTS (Fernando, 1998, Hazelbaker 2010) due to the inability of the tongue to elevate, retract, protrude, circulate and lateralize to clear food from the oral cavity. Poor control of saliva is another aspect of these children and adults. Orthodontic differences have also been observed in children with tethered Oral tissue.  

FEEDING: When the tongue has full ROM (range of motion), chewing, bolus formation, and swallowing are patterned correctly. When an individual is diagnosed with TOTS, abnormal patterns emerge, resulting in problems with gas, bloating, reflux, residue post-swallow, and constipation. Often individuals will be observed with open mouth chewing and reduced lingual retraction, lateralization, and elevation for correct and safe bolus collection and transport.

SPEECH: Due to reduced lingual function, individuals are often observed with reduced intelligibility as they struggle with precise articulatory contact.

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Below please find a list of articles either cited or found to be useful.

Billings, Mary and Davidson, Dianah: orofacial Myology: Make the Connection 2017 Coursework Manual. DeThorne, L.S., Johnson, C.J., Walder, L. Mahurin-Smith, J (2009). 

Defabianis, P. (2000). Ankyloglossia and its influence on maxillary and mandibular development. The Functional Orthodontist, 17, 25-33.

Morris, Suzanne Evans, and Marsha Dunn. Klein. Pre-Feeding skills: A comprehensive Resource for Feeding development. Tucson, AZ: Therapy Skill Builders, 1987. Print. 

Conti, Patricia Blau Margosian, Eulalia Sakano, Maria Angela Goncalves De Oliveira Riberio, Camila Isabel Santos Schivinsji, and Jose Dirceu Ribeiro. “Assessment of Body Posture of Mouth Breathing Children and Adolescents.” (2011) 357-63. Wed.

Anatomy and Development of the Mouth and Teeth. (n.d.). Retrieved from 

Academy of Oral Facial Myofunctional Therapy. (n.d.). What is myofunctional therapy? Retrieved November 17, 2019, from  

Arvedson, J. C. (2008). Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches. Developmental Disabilities Research Reviews, 14, 118-127. 

ASHA (2019) Speech Sound Disorder. Retrieved from 

Bahr, D. (n.d.) Treatment of Feeding, Speech, and Mouth Function in Pediatrics. Retrieved from webinar presentation completed on 

Bahr, D. (2011). Nobody Ever Told Me (or my Mother) That!: Everything from Bottles and Breathing to Healthy Speech Development. Cork:BookBaby. 

Bilings M. et. al. (n.d.). Oral Myofunctional Disorder Overview. Retrieved from: 

D’Onofrio L. (2019). Orofacial Myofunctional Disorder Oral dysfunction as a cause of malocclusion. Orthodontic and Craniofacial Research. 2019; 22 (Suppl. 1):43-48. 

Edwards, D., Gould, C., Mayfield, E., Simon, M. (n.d.). Pediatric jaw function: information you can chew on [PowerPoint slides]. Retrieved from URL  

Marshalla, Pam (2007) Marshalla Oral Sensorimotor Test. Super Duper Publications. Greenville, SC.

Merkel-Piccini, Robyn (2002). The Similarities and Differences of Oral-Motor Therapy and PROMPT  TalkTools®.  Tucson: Innovative Therapists International

Merkel-Piccini, R. and Rosenfeld-Johnson,S. (2003) Connections Between Tongue Placement and Dental Alignment Published in ADVANCE for Speech-Language Pathologists & Audiologists September 8, 2003 • Vol. 13 • Issue 36 • Page 9 

Mill, N. et al. (2019). What Is a Tongue Tie? Defining the Anatomy of the In-Situ Lingual Frenulum. Published online 19 February 2019 in Wiley Online Library ( DOI: 10.1002/ca.23343 

Rosenfield-Johnson, S. (2003). Oral placement therapy for speech clarity and feeding.    

Charleston: TalkTools®

Rosenfield-Johnson, S. (2005) Assessment and treatment of the jaw. Charleston: TalkTools®

Roy-Hill, Renee (n.d.). OPT (Oral Placement Therapy): Assessment and Program Plan Development Packet 1 of 2. [PowerPoint slides]. TalkTools® / Innovative Therapists International. Tucson, AZ.  

Seikel, Drumright and King. (2015) Anatomy and Physiology of the speech language hearing mechanism 5th edition.  Boston: Cengage publishing Inc