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Allee Reid

RC 2001

Professor Rowe

15 April, 2019

Nonverbal Oral Motor Therapy

Today, Speech and Language therapy is a universal therapy method used to treat and

diagnose speech and language disorders with clients who are verbal and nonverbal. Therapies

such as these can be held in a school, hospital, or nursing home setting. In extreme cases

however, some can be held in a private practice that only specializes in speech and language

therapy. Shocking to some, SLPs or Speech and Language Pathologists also treat and diagnose

swallowing disorders. With consideration of this highly used therapy nationwide, debates have

emerged in to what is considered productive and effective, and what is ineffective in terms of

progress for the client. One of many apparent debates is nonverbal oral motor speech therapy, for

who would be considered as verbal individuals. This specific type of therapy uses certain and

narrow activities to stimulate certain muscles in the mouth to prepare the individual for therapy.

By activating theses muscles, the individual can then be prepared for their speech therapy. The

debate falls under the overall benefit of the individual and the effectiveness for him/her. Oral

motor speech therapy displays more negative results, that numerously outway the positive results

in benefiting from this type of therapy.

During this debate, many questions have came to the surface in regards to the topic

speech therapy, and what the overall purpose for this therapy is. People outside of the field will
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often ask what nonspeech oral motor therapy is, and the end goal of the overall therapy (Lof &

Watson, 2008). Activities such as chewing gum, or sucking on a popsicle could be considered a

form or nonverbal speech therapy. The overall goal of this therapy is “to influence tongue, lip,

and jaw resting postures, increase strength, improve muscle tone, facilitate range of motion, and

develop muscle control” (Ruscello, 2008). With an understanding of what nonverbal speech

therapy is, one can now determine whether it is considered efficient in terms of helping a client

with his/her speech journey. Nonverbal speech therapy can bring both a positive and negative

impact in the speech and language pathology field. What seems to bring up the debate whether

this type of therapy should be used in the speech and language pathology field, is due to

nonverbal therapy is exactly what it sounds like; nonverbal. When working with children or

adults who are indeed verbal, a speech pathologist’s goal is to progress forward within the

child’s or clients speech, instead of backtracking. It has been said that nonverbal therapy does

help activate the muscles to warm the correct muscles used within verbal communication;

however, the time spent on non verbal therapy can be used in verbal exercises that can provide

the client with tools to excel within their speech. Speech pathologists across the globe are torn

between whether therapy time/ each session with their client should be spent practicing exercises

that may or may not benefit their speech in the long run.

Oral motor therapy and the all treatment outcomes that follow, are different for each

individual who receives the therapy. In order to determine the correct treatment and course of

action, an EBP or Evidence Based Practice is applied. EBP is used in clinical medicine to make a

professional, unbiased report on the treatment plan that best fits the individuals needs. This

report is “the conscientious, explicit, and judicious use of current best evidence in making

decisions about the care of individual patients…[by] integrating individual clinical expertise with
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the best available external clinical evidence from systematic research” (Sackett 71). ASHA, who

is the national association of speech-language pathologists, has an execute board that meets to

discuss the appropriate and professional ways of writing and documenting an EBP. By using the

correct terminology, as well as the format, an SLP can form an overall synopsis of the best

course of action for the client. An EBP is developed through a series of tests that an SLP or

audiologist will run on the potential client. These test consists of detecting prolongations within

speech, and swallowing disorders, as well as hearing loss. Once all the evidence needed is

completed and collected, an SLP will form an EBP and present it to the client and their families.

Depending on the age of the client and the complexity of the communication disorder, will

determine where one might come in contact with an SLP. Hospitals, nursing homes, school

systems, and private practices are just a handful of the places where SLPs possibly work. Over a

course of studies conducted by speech-language pathologists, the studies have shown more

negative results towards nonverbal oral motor therapy, than successful result rates from therapy.

Despite the use of nonverbal oral motor therapy in past and recent years, SLPs have

simply came to the conclusion that NSOMTs are not productive and show far to none within

progression of speech within the client or child. “Limited evidence exists for the use of NSOMTs

to facilitate nonspeech activities. Therefore, the available evidence does not support the

continued use of NSOMTs as a standard treatment and they should be excluded from use as a

mainstream treatment until there are further data. SLPs should consider the principles of EBP in

making decisions about NSOMTs” (Lass, 2008). With the data collected by SLPs, nonverbal

speech therapy does not show any significance or a positive outcomes that weigh towards this

type of therapy. It has been noted that NSOMTs do activate certain muscles used for oral

communication; however, just because the muscles are warmed up for therapy does not weigh on
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the outcome for a increase in communication via speech. “NSOMTs continue to be used as a

treatment by many SLPs. However, based on a lack of high-level evidence, NSOMTs should be

excluded from use as a mainstream treatment until there are further data supporting their use”

(Lass, 2008). Furthermore, it is recommended that SLP should properly write an EBP to

determine whether or not NSOMTs should be practiced or used with their therapy outline. SLPs

can work in a school setting or nursing homes, and can be working with variety of clients of all

ages at a time if they choose to do so.

In any setting such as schools or nursing homes, SLPs are recieveing referrals from

potential clients of their own, as well as coming up with therapy plans for their current clients.

However, the therapy debate still rises as whether nonverbal speech therapy truly is efficient in

terms of increasing a client’s overall speech. “Perplexity about the relationships among tasks

classified as nonspeech, paraspeech or quasispeech, speechlike, and speech arises in part because

there is no explicit, universally accepted set of criteria for their distinction.” Ray D. Kent, author

of Nonspeech Oral Movements and Oral Motor Disorders: A Narrative Review continues,

“Definitional and methodological differences exist among studies that have compared motor

performance in tasks designated with these terms for the design of experiments, clinical

assessments, or clinical treatments” (Kent, 2015). With consideration for this upcoming debate,

one similar thought that has been brought of up by several SLPs is this, Why are we wasting time

on something that has not been documented to be beneficial for the overall speech development/

growth of our client?. “The proposed definition of nonspeech tasks leaves room for another

category of behaviors that are not necessarily regarded as speech” (Kent, 2015). This statement is

true in the sense of oral motor therapy is verbalizing sounds while also using muscles within

one’s mouth. Nonverbal oral motor therapy however, is only activating muscles within one’s
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mouth that are used for speech, but no sounds are voiced during the actual therapy session. If one

were to analyze this issue closely, nonverbal oral motor therapy seems to be “backtracking” the

progress in overall speech development. “Especially when speech production or functional

speech outcomes are the ultimate goals of intervention, treatments that directly work toward

those outcomes have been proposed and studied for a large number of populations”. (McCauley

355). If the overall goal is to increase fluency, and speech production within a client, then an

SLP should not “backtrack” in order to accomplish this goal. Many SLPs today are becoming

frustrated with this debate due to their own records of previous or current clients, do not show

any signs of improvement with the use or nonverbal oral motor speech therapy. Activities such

as chewing gum, which is one activity used in nonverbal therapy, can simply be performed

outside of the therapy session instead of being paid for. In a speech therapy setting, time is

limited and the clock is always ticking. An SLP might only see the client two days out of the

week, and due to this each therapy session has to be engaged and productive to reach

development within speech production. In a school system and nursing home, time is limited do

to other activities that the client has during the day. The child, as well as the older adult both

have other activities that they have to tend to. While an SLP has the client with him or her, they

must do their best at making every minute valuable to ensure that each goal that was set, is on the

correct track of being reached and accomplished.

Oral motor speech therapy displays more negative results, that numerously outway the

positive results in benefiting from this type of therapy. Nonverbal oral motor therapy is a debate

that has always been discussed, but recently just came to the surface. Speech and Language

Pathologists are becoming frustrated and are trying to be an advocate as well as put their client’s

best interest at heart. Research, along with experiments have been put to the test to see is
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nonverbal oral motor speech therapy truly benefits one’s overall speech production. Due to

several complaints, ASHA is now looking into this controversial issue within the speech and

language field, and plans to collect evidences that supports each claim that nonverbal oral motor

therapy does not establish a firm foundation for a client to productively developed speech

fluency or skills.

Works Cited

Kent, Ray D. “ Nonspeech Oral Movements and Oral Motor Disorders: A Narrative Review.”

American Journal of Speech-Language Pathology, American Speech-Language-Hearing

Association, Nov. 2015,

web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=8&sid=79667a2d-91ea-4185-ade5-

0caf6b19fba2%40sessionmgr4010.
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Lass , Norman J. “The Application of Evidence-Based Practice to Nonspeech Oral Motor

Treatments.” Language, Speech, and Hearing Services in Schools, ASHAwire , 1 July

2008, ajslp.pubs.asha.org/doi/full/10.1044/0161-1461%282008/038%29.

Lof, G., & Watson, M. (2008). A nationwide survey of non-speech oral motor exercise use:

Implications for evidence-based practice. Language, Speech and Hearing Services in Schools,

39, 392-407.

McCauley, Rebecca J., et al. “Evidence-Based Systematic Review: Effects of Nonspeech Oral

Motor Exercises on Speech.” American Journal of Speech-Language Pathology,

American Speech-Language-Hearing Association, Nov. 2009,

ajslp.pubs.asha.org/article.aspx?articleid=1757559.

Ruscello, Dennis M. “Nonspeech Oral Motor Treatment Issues Related to Children With

Developmental Speech Sound Disorders.” Language, Speech, and Hearing Services in

Schools, American Speech-Language-Hearing Association, July 2008,

lshss.pubs.asha.org/article.aspx?articleid=1778840.

Sackett, David L, et al. “Evidence Based Medicine: What It Is and What It Isn't.” The BMJ,
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British Medical Journal Publishing Group, 13 Jan. 1996,

www.bmj.com/content/312/7023/71?eaf%2523R5=&utm_source=trendmd&utm_mediu

m=cpc&utm_campaign=tbmj&utm_content=americas&utm_term=1-B.