Getting the oral motors running in therapy

Oral-motor therapy is possibly one of the oldest therapeutic perspectives in our field (Marshalla, 2008), but has recently raised some controversy. The controversy may stem from a lack of clear definition of oral-motor therapy (Bahr, 2008).  So, what is the definition of oral-motor therapy?  Pam Marshalla has a definition of oral-motor therapy on her website:  “the process of facilitating improved jaw, lip, and tongue movement for speech” (Marshalla, 2008). Many SLPs consider oral-motor therapy as using specific motor speech techniques to accomplish this task. For example, backward or forward chaining and successive approximations such as those that Nancy Kaufman has produced. Controversy does not appear to stem from oral motor therapy from that perspective, but from the use of non-speech oral motor exercises (NSOMEs).

Many clinicians have become famous for their approaches to oral-motor therapy. Nancy Kaufman, Pam Marshalla, Debra Beckman and Sara Rosenfeld-Johnson have various oral-motor therapy suggestions and programs that many S-LPs use and love. Not all clinicians consider all aspects of their programs equal, however, as a result of perceived use of non-speech oral motor exercises (NSOMEs) as part of some programs. It should be noted that not all oral motor therapy programs incorporate NS-OMEs and that oral motor therapy in a speech context can be discreet from NS-OMEs. You can read about Pam Marshalla’s view on OMT and NS-OMEs here.  You can read about Sara Rosenfeld Johnson’s view on OMT and NS-OMEs here (PDF).

So, what are NSOMEs? Greg Lof defines it as: “any techniques that do not require the child to produce a speech sound but are used to influence the development of speaking abilities” (Lof, 2007 in interview).  In 2009, Lof and Watson reported that 85% of US SLPs are using NS-OMEs in the attempt to change speech sounds. Dr. Hodge and colleagues (2009) independently found out that 85% of Canadian SLPs were doing likewise.

During the #slpchat on March 13th, 2011 at 2 pm EST, we will be discussing oral motor therapy. We will discuss: how and when you decide to use oral-motor techniques and therapy vs. typical articulation or phonological approaches; approaches and techniques that you like or dislike and why; and we will touch on the use of non-speech oral motor exercises: the controversy and evidence that surrounds it.

For more information on oral motor therapy please see (list not exhaustive):

Mass, E., Robin, D., Austermann-Hula, S., Freedman, S., Wulf, G., Ballard, K., & Schmidt, R. (2008). Principles of motor learning in treatment of motor speech disorders. American Journal of Speech-Language Pathology. Vol. 17,  277–298.

What is oral-motor therapy? By Pam Marshalla:

What does oral motor therapy have to do with speech? By Pam Marshalla:

For more information on NS-OMEs please see (list not exhaustive):

Ruscello, D. (2008). Nonspeech oral motor treatment issues related to children with developmental speech sound disorders. Language, Speech and Hearing Services in Schools, 39, 380-391. Retrieved from

An interview with Greg Lof about NS-OMEs:

Oral Motor Treatment and NS-OME by Pam Marrshalla:

Caroline Bowen and NS-OMT:


Bahr, D. (2008). The oral motor debate: where do we go from here?. Proceedings of the 2008 ASHA convention (pp. 1-23). Chicago: Poster session 2054.

Hodge, M. (2009). What can we learn about clinical practice from SLPs’ experiences using nonspeech oral motor exercises in children’s speech therapy? In C. Bowen,Children’s speech sound disorders. Oxford: Wiley-Blackwell.

Lof, G. L., & Watson, M. 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(3), 392-407.

Marshalla, P. (2008, April 9). Oral motor treatment vs. non-speech oral motor exercises. Oral Motor Institute Monograph2, Retrieved from

Marshalla, P. (2008, July 10). Oral motor treatment and ns-ome. Retrieved from


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2 responses to “Getting the oral motors running in therapy

  1. I’m sorry if this is a very naive question (I am just in pre-grad school leveling courses), but I was under the impression that NSOMEs are not supported by EBP and that therefore we should not use them. Am I misunderstanding something?

    • Hi Shannon,

      Nope, you’re not misunderstanding. NSOMEs are neither completely supported nor completely unsupported and many SLPs now consider this to be something we should not use for speech therapy (see Lof’s interview). However, NSOMEs and oral-motor therapy are not the same thing. Most of the chat will surround oral motor therapy (outside of NSOMEs). Also, the entire purpose of #slpchat is to have SLPs consider and discuss. Therefore, SLPChat does not provide answers, but poses questions to stimulate discussion.

      I’m fairly certain you’ll agree, however, that 99% of the references I cited in this blog post are against NSOMEs. We hope you’ll participate and share your views on the current research and trends 🙂

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