Q: In your class on apraxia, I listened while you described the difference between an “oral-motor technique” (OMT) and a “non-speech oral-motor exercise” (NS-OME). I understood what you were saying at the time, but when I got home and looked at my notes, I found that I didn’t quite get it. Can you give an example to explain this to me?

The OMT and the NS-OME are two completely different concepts.  The difference between them has to do with the purpose of the method being used, and the goal one has in mind. Let’s use a very simple activity to illustrate -–

Example

Suppose you had a client who could not produce L because he was unable to lift the tongue-tip to the alveolar ridge.  Let’s also suppose that the therapist was able to teach the client to lift and lower his tongue-tip to his alveolar ridge by having him watch in a mirror.  Now let’s suppose that the client is assigned an exercise as homework for the week.  He is to lift and lower the tongue-tip to the alveolar ridge ten times in a row, three times every night.  This gives him a total of 210 lifts between therapy sessions.  [10 x 3 x 7 = 210]

Non-Speech Oral-Motor Exercise:  A therapist who was using this activity as a “non-speech oral-motor exercise” would greet the client the following week, and would check to see how well the client was producing L.  If he still were not producing L with appropriate lingua-alveolar contact, she would assume that the oral-motor activity did not work.

Oral-Motor Technique:  A therapist who was using this activity as an “oral motor technique” would greet the client the following week, and would check to see how well he was lifting the tongue-tip to the alveolar ridge.  If the client was lifting better, she would assume that the method worked, and then she would teach him how to use that movement to produce an L.

Differences

The first therapist’s goal was to use the oral-motor exercise to fix L. She used the phoneme to judge the effectiveness of the oral-motor exercise.  Since the phoneme was not improved, she assumed that the technique did not work.

The second therapist’s goal was to use the oral-motor exercise to facilitate consistent tongue-tip elevation.  She used the movement (not the phoneme) to judge the effectiveness of the oral-motor exercise.  Since the movement was improved, she made an assessment that the technique did work, and she went on to the next step, which was to teach the client how to use the new movement in L.

Implications

The upshot of all this is that an oral-motor technique is employed to improve oral movement, not phoneme production.   As such–

Therapists should not be using oral-motor activities to improve phonemes.  They should be using oral-motor activities to improve oral movement.  Then those improved oral movements can be used to teach improved phoneme productions.

Likewise, researchers should not be using phonemes to judge the effectiveness of oral-motor techniques.  They should be using the oral movements themselves to judge the effectiveness of the oral motor activities.