Speech / Articulation

What are speech skills?

Articulation skills are most commonly referred to as speech skills. Articulation refers to the process of two areas of the body touching to form speech sounds. When we speak, a set of very complex and coordinated movements allow us to form sounds which are understood by others. More than one hundred muscles have to contract and relax to begin and end each syllable. Consult our age checklists to learn more about age-appropriate skills for children.

Why do some people have trouble saying speech sounds clearly?

Individuals may mishear sounds due to permanent or fluctuating hearing loss. Frequent ear infections may cause inconsistent sound perception. Other individuals may be tongue-tied, have dental or jaw problems, structural problems, cleft palate, motor speech disorders, apraxia, or neurological injury or diseases. Sometimes the origin of speech difficulties is unknown.

What are some types of speech errors?

Speech or articulation errors occur when sounds are omitted, distorted, or substituted. When an individual omits, distorts, or substitutes sounds, their speech may sound garbled or slurred. Children who misarticulate sounds may develop spelling and reading issues as they struggle to match the printed letter with their mispronounced speech sound. Individuals and adults at school, work, and in social situations may converse less with a person who is difficult to understand.

Phonological errors occur when the rules for groups or sound classes are in error. An individual may produce frontal tongue tip sounds such as “t” and “d” for all their back tongue sounds “g” and “k” (det for get, tate for take). They may produce all their blowing sounds “sh,” “ch,” “s,” “z,” as if they were stopping sounds “t”, “d” (ton for sun, doe for so). When individuals produce entire classes of sounds in error, their speech is often extremely difficult to understand, and both the speaker and listener may become very frustrated.

What can you do to improve your speech?

It’s never too late to change the way you speak. For adults, maturity and motivation often counteract long established speech muscle patterns. Speech sounds and accents may be transformed through individualized, confidential sessions at Granite Bay Speech.

Children usually develop sounds in a normal progression. For information on normal progression, please consult our age checklists to learn more about age-appropriate skills. If you feel your child has not reached the appropriate speech and language milestones for their age, we would love to consult with you. We can provide a personalized program for your family.

Tongue Thrust Therapy

Tongue thrust is the most common Orofacial Myofunctional Disorder (OMD). Orofacial Myofunctional Disorders are anatomical and physiological differences of oral and facial structures (lips, teeth, tongue, jaw, cheeks, and palate) that are noticeably different; interfere with normal dentofacial, speech, physical or psychosocial development; or that are of cosmetic concern. These include lip and tongue rest, swallow, and speech posture differences. (Hale, Kellum, & Gross 1991) Research has found an 81% prevalence of OMD disorders in children exhibiting speech problems (Maul, et. Al, 1999) compared to a prevalence of 38% in the general population (Kellum, 1992).

Should I Be Concerned About Tongue Thrusting?

Orofacial myofunctional disorders (OMD) may have a negative effect on the development of the dentition and speech. The pattern of when teeth erupt and/or the alignment of the teeth and jaw may be negatively affected. The function of the temporomandibular joint (TMJ) may be negatively influenced. For patients in orthodontic treatment, OMD therapy can help stabilize the orthodontic result and help in the retention of the treatment. Speech disorders often co-exist with OMD. Some children develop sound errors as a result of OMD. OMD most often causes sounds like “s,” “z,” “sh,” “zh,” “ch,” and “j” to sound different than they usually do. For example, the word “sink” may sound like “think.” Because of ineffective tongue tip muscles, sounds may be misarticulated. Not all children with an OMD such as tongue thrust have an associated speech disorder. If tongue thrusting and sound errors exist, remediation of the tongue thrusting pattern is essential to correcting the speech.

Some people who have a tongue thrusting pattern have difficulty maintaining a closed mouth while chewing and swallowing, and lose control of the food in their mouth. An open chewing pattern may be caused by inefficient oral motor control. An open chewing pattern during meals may be visually offensive to others and may contribute to reduced social interactions.

What is the treatment for OMD?

The success of a therapy program is dependent on several factors, and a team effort is essential. A licensed speech-language pathologist can evaluate and treat open-mouth posture, swallowing disorders, and speech misarticulations that result from OMD. Speech-language pathologists specialize in evaluating lip, palate, tongue, and facial muscles, both at rest and during the complex movements needed to produce clear speech and adequate swallowing. Other team members may include parents, the pediatrician, ENT doctor, dentist and/or orthodontist.

Not all treatment plans are created equal. With varying degrees of severity among individuals, it’s important to match the treatment to the patient. Here at GraniteBaySpeech we tailor our tongue thrust programs to fit your individual needs.

How Do I know if I Need Tongue Thrust Therapy?

You may need tongue thrust therapy, also called myofunctional therapy, if you answer yes to any of the following questions:

  • Has your dentist or orthodontist diagnosed you with tongue thrust?
  • Are your teeth or your bite out of alignment?
  • Is your dentist concerned that tongue thrust will affect your child’s eruption of teeth and the alignment of their teeth and bite?
  • Are there concerns about the effectiveness of braces or the retention of your straight teeth after orthodontic treatment?
  • Are you experiencing slow or ineffective therapy for a lisping pattern?
  • Does your child suck their thumb, bite their nails, or other objects?
  • Does tongue thrusting draw negative attention to your speech and interfere with your social or professional life?

What Causes Tongue Thrusting and Orofacial Myofunctional Disorders (OMD)?

  • Oral habits such as excessive thumb- or finger-sucking, lip/cheek and fingernail biting, lip licking, and teeth clenching and grinding.
  • Family heredity can be involved in determining such factors as the size of the child’s mouth, the arrangement and number of teeth, and the effectiveness of lip, tongue, mouth, and facial muscles.
  • A restricted nasal airway due to enlarged tonsils and adenoids may create an open-mouth breathing pattern. Environmental factors that contribute to airway difficulties include allergies.
  • Neurological or developmental abnormalities.
  • Abnormally large tongue, short lingual frenulum (tongue-tie), or other structural or physiological abnormalities.

Is there scientific evidence that OMD therapy is effective?

Recent scientific studies have shown that treatment for OMD may be 80-90% effective in correcting swallowing and rest posture function. These corrections are retained years after completing therapy (Hahn & Hahn, 1992). Some insurance companies cover OMD therapy as a necessary medical intervention.

How do I find out more about Tongue Thrust Therapy and OMD treatment?

Granite Bay Speech provides a free phone consultation to answer your questions about tongue thrust. A tongue thrust disorder is not considered educationally relevant, and therefore a child will not be eligible for public school speech therapy service for tongue thrusting.

My son has been receiving speech in the school system for 2 years with little to no progress. They were ready to graduate him and stop speech services because they didn't understand the problem. We have been seeing Nancy for the last 9 months and I am happy to say that she figured out what the true underlying issue is, and has been making great progress. He will officially graduate in a few months, thanks to her! She is a job to work with and always has new and exciting exercises for my son. The office staff is easy and wonderful as well. We couldn't be happier!

- Jordan C.

Nancy is a great speech pathologist and even a greater person she will spend the time she needs in order to help you out she has a lot of experience and will help you with techniques in order to improve your speech. Anyone looking to get help, Nancy is the person you are looking for whether you are a child or an adult she has the tools to better your speech and get over your fear and have you talking like you have always wished for. Highly recommend you won't regret it.

Jesus R.