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Non-speech oral motor treatment for children with developmental speech sound disorders

Word difficulties in developmental speech sound disorders, whether for structural, sensory or neurophysiological reasons (such as hearing impairment) or of idiopathic etiology, are sometimes addressed with non-speech oral motor treatment (NSOMT). These are activities like smiling, pursing, blowing into horns, blowing bubbles, or lip massage. A database review of their efficacy has been undertaken recently in the Department of Speech and Hearing Sciences at University College Cork, in Ireland (Lee AS, Gibbon FE. Non-speech oral motor treatment for children with developmental speech sound disorders. Cochrane Database Syst Rev. 2015 Mar 25;2015(3):CD009383. doi: 10.1002/14651858.CD009383.pub2).

Surveyed were randomized and quasi-randomised controlled trials that compared (1) NSOMT versus placebo or control, and (2) NSOMT as adjunctive treatment or speech intervention versus speech intervention alone, for children aged three to 16 years with developmental speech sound disorders, as diagnosed by a speech and language therapist. Individuals with an intellectual disability (e.g. Down syndrome) or a physical disability were not excluded.

Three studies (from four reports) emerged, involving a total of 22 children. One included four boys aged seven years one month to nine years six months, all with speech sound disorders, and two had additional conditions (one was diagnosed as "communication impaired" and the other as "multiply disabled"). Of the two quasi-randomised controlled trials, one included 10 children (six boys and four girls), aged five years eight months to six years nine months, with speech sound disorders as a result of tongue thrust, and the other study included eight children (four boys and four girls), aged three to six years, with moderate to severe articulation disorder only. Two studies did not find NSOMT as adjunctive treatment to be more effective than conventional speech intervention alone. One study reported a change in post-intervention articulation test results but used an inappropriate statistical test and did not report the results clearly. None of the included studies examined the effects of NSOMTs on any other primary outcomes, such as speech intelligibility, speech physiology and adverse effects, or on any of the secondary outcomes such as listener acceptability. The two quasi-randomised trials used randomisation but did not report the method for generating the random sequence. The three included studies were deemed to have high risk of performance bias as, given the nature of the intervention, blinding of participants was not possible. Only one study was blinded. One study showed high risk of other bias as the baseline characteristics of participants seemed to be unequal. The sample size of every study was very small. Moreover, they collectively covered only limited types of NSOMTs.

The authors conclude that no strong evidence yet suggests that NSOMTs are an effective treatment or an effective adjunctive treatment for children with developmental speech sound disorders. This has obvious implications for clinicians in decision-making. More, and better-designed, research is still needed.

MyoNews from BreatheWorksTM is a report on trends and developments in oromyofunctional disorder and therapy. These updates are not intended as diagnosis, treatment, cure or prevention of any disease or syndrome.

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