Orofacial myofunctional therapy (OMT) is the therapy that delves into the intricacies of the facial, head, and neck muscles, always with a focus on functionality. It comes into play when addressing challenges related to feeding, swallowing, and oral habits.
Feeding and Fussy Eating
Fussy eaters are often referred to Occupational Therapists, who assess sensory preferences, assuming these preferences are the root cause of feeding issues. While sensory-based interventions can indeed be helpful for some children, at Spot Therapy Hub, we firmly believe that such therapies should never be prescribed without first conducting a comprehensive structural and oral motor assessment.
For instance, a child may resist eating popcorn or whole strawberries. A detailed assessment might reveal an exceptionally high, vaulted palate and a severely restricted tongue that lacks the necessary range of motion to reach the top of the palate. In such a case, when popcorn becomes trapped in a corner of their mouth, the child is unable to dislodge it with their tongue. They also struggle to prevent large chunks of strawberries from entering the pharyngeal space at the back of their throat. The child’s inability to move the food bolus around for proper chewing leads to larger food pieces. What might seem like fussiness is, in reality, the child’s instinct to keep themselves safe.
Moreover, the child may experience low muscle tone, reduced sensory awareness, or an obstructed nasal airway, forcing them to pause chewing every few seconds to breathe. In these scenarios, orofacial myofunctional therapy becomes a crucial tool to help the child use their lips and tongue effectively for functional feeding. Although sensory-based approaches may become necessary at some point, a thorough functional and structural assessment is imperative at the beginning of therapy to address all the contributing factors associated with fussy eating.
Swallowing
Swallowing is a fundamental aspect that extends beyond eating and drinking. We swallow our own saliva up to 2000 times a day, underscoring the significance of addressing dysfunctional swallowing patterns.
One indicator of the need for OMT to treat swallowing issues is a tongue thrust swallow. This can manifest as tongue thrust swallows while an individual swallows their own saliva at rest. Characteristic signs include tightened and flexed lips, with chin dimpling, often resulting from a restricted tongue tugging at the mentalis (chin) muscle.
In the act of drinking from a cup, one might observe the tongue making contact with the cup, followed by gulping the liquid, and a final tongue thrust as the cup is lowered. At times, individuals may hold water in their cheeks momentarily after lowering the cup, then initiate their swallow or tilt and jerk their head. This requires substantial effort, with all the muscles around the lips engaging to counteract the force exerted by the tongue.
In a typical swallow, the orbicularis oris muscle (lip muscles) should remain relaxed. The tongue tip moves up to the specialised spot behind the front teeth, initiating a backward, wave-like tongue movement to propel food or drink backward. This process is relaxed and natural. OMT focuses on coordinating the tongue and lips to ensure they perform their roles correctly in the right sequence and at the right location, thus facilitating safe and efficient swallowing.
Oral Habits
Oral habits encompass activities like thumb sucking, nail biting, finger sucking, tongue sucking, or placing objects in the mouth for chewing or sucking, which are no longer developmentally appropriate. At Spot Therapy Hub, we perceive these habits as symptoms of Orofacial Myofunctional Disorder. At the roof of our mouth, a cranial nerve should be stimulated by the tongue at rest. When the tongue doesn’t perform this function due to reasons such as tethered oral tissue or nasal congestion, it seeks the stimulation elsewhere.
Supporting our clients in eliminating these habits involves addressing underlying health issues and enabling them to succeed through positive functional retraining, rather than just implementing behavioral programs that leave children at high risk of developing substitute habits.
Many children with oral habits also contend with inflammatory conditions like eczema, asthma, and food allergies, factors that require consideration when planning to cease these habits. Emotional trauma should also be taken into account, making timing a crucial factor in therapy. Therapy should guide families in making informed choices, ensuring that the initial effort to eliminate oral habits is successful to avoid the disappointment and frustration of relapse.
To explore this further, reach out to us at spottherapyhub@gmail.com or contact us at 9326 6000. Don’t forget to tune in to our enlightening Spot Therapy Hub Podcast, available on Apple Podcast and Spotify.
