Articulation in Oro-Motor Exercises

Nayi Disha organized a speech therapy workshop with speech and language pathologist, Ms.Chitra Thadathil. The workshop conducted discussions on various topics such as Hearing, language and speech concerns in children with Down syndrome, Sensory issues in children with Down syndrome and the importance of ORO-MOTOR exercises. Articulation is step 4 in the Oro-motor exercise. The above video talks about and explains articulation in oro-motor exercises. You can check the other videos here.

What is articulation?

Articulation in oro-motor exercises refers to the movements of the lips, tongue, jaw, and palate – referred to as articulators- used for speech. Proper articulation can be obtained through the synchronous movement of the articulators.

Key aspects of articulation

• Grading: refers to the gradual improvement of the ability to close the mouth effectively.
• Dissociation: Involves the functioning of the tongue independent of the jaw.
  • Many children have concerns about the tongue not functioning independent of the movement of the jaw.
  • Children with Down have been observed to have the tongue outwards and the tongue protrusion may result in speech sound differences
  • This may often result in hindrance of proper speech production

Concerns in the articulators

Jaw: Some commonly observed features in children with Down Syndrome are:

• Jaw weakness
• Asymmetrical weakness
• Jaw tongue dissociation

Exercises: The most important and effective way to improve jaw functioning is to strengthen the jaw muscles

• Massages: Includes massages to the neck muscles, cheek muscles, jaw muscles, :
• Jaw grading
• Chewy tubes: These are tubes that can be chewed onto. They come in different colours based on their strength. Chewy tubes help in improving chewing in children.
• It is important to remember that these exercises may vary for different children and should be done only with guidance from your therapist. It is also important to note that exercises should be done in moderation and not be overdone.

Lips: Slouched posture coupled with dissociation between the jaw, tongue and lips may often result in the lips not being sealed properly. This may result in drooling in children. It is therefore important to work on exercise that will help in sealing of the lips.

Exercises:

• Breadcrumbs: The child can be asked to dip their mouths into powdered breadcrumbs and then lick it. This helps in strengthening the lips.
• Cup drinking
• Kissing
• Humming
• Sucking: through different types of straws. Remind the child to suck through their lips and not through their teeth.

These activities can be demonstrated and asked to model as children learn best through modelling. It is however, important to remember to identify when the child is tired and can no longer proceed with them.

Exercises to work on lower lip retraction will also be helpful for the production of speech sounds of ‘p/,b/, and m/”

Tongue: It is important that the tongue functions without being associated with the jaw. The tongue should remain inside the mouth. Tongue outside the mouth may hamper speech as well as chewing and swallowing.

Exercises:

• Sucking
• Blowing
• Lateral chewing: helps the tongue remain inside and retract backwards. Some exercises to promote this are using chewy tubes or something (like a murukku) to bite and chew onto sideways. This helps in the tongue remaining inwards.
• Spoon feeding: An important thing to remember while spoon feeding is ‘placement’. It is crucial to keep the child at eye level and the neck is straight, without the child needing to lift or turn their neck. If the child finds it difficult, it indicates muscle weakness and is important to work on muscle strength as well. Use a spoon that is suitable for the size of the child’s mouth.

Follow the order of working on the jaws, the lips and then proceeding to the tongue. This will make it easier for the child, reducing any frustration due to the difficulty of the task.

Additionally, you may download this caregiver’s manual to understand the long-term care and health of individuals with Downs Syndrome. 

If you have questions about Autism, Down Syndrome, ADHD, or other intellectual disabilities, or have concerns about developmental delays in a child, the Nayi Disha team is here to help. For any questions or queries, please contact our FREE Helpline at 844-844-8996. You can call or what’s app us. Our counselors speak different languages including English, Hindi, Malayalam, Gujarati, Marathi, Telugu, and Bengali.

DISCLAIMER: Please note that this guide is for information purposes only. Please consult a qualified health practitioner for safe management.