Goldenhar Syndrome and Reduced Tongue Movement

By Pam Marshalla

Q: Is oral-motor therapy beneficial in treating a child with Goldenhar syndrome with one-sided facial weakness?

If you are asking for “proof” of this, no. But your question reveals perhaps a limited understanding about what the term “oral-motor therapy” means. Let me explain…

Speech is movement, and whenever part of the speech movement mechanism is impaired, then therapy needs to address that movement impairment. The term “oral-motor techniques” simply refers to any of the myriad ways in which we facilitate improved movement for speech.

Considering your client… One-sided facial weakness means that the muscles are not firing swiftly enough, or with enough strength on that side, to move adequately to support the movement requirements for speech. The result is dysarthria.

The technique that one finds in the motor speech literature more than any other for the treatment of dysarthria, is exaggeration. Exaggeration of speech movements IS an oral-motor technique, meaning that it is a technique to improve oral movements for speech.

Most authors who have written about dysarthria claim exaggeration to be the key to success. Exaggeration can help improvement of speech movement in the type of one-sided weakness seen in Goldenhar syndrome.

We are not talking here about “non-speech oral-motor exercises” like wagging the tongue. We are talking about making speech movement more precise, more clean, more crisp, and more correct.

Working with dysarthria is a matter of teaching the client to become more intelligible given his speech movement disability: To speak up, speak out, over-articulation, pace himself, over-articulate syllables, over-articulate vowels, produce round and resonant vowels, produce both parts of diphthongs, produce crisp consonants, watch others to make sure he is being understood, deciding when and where he needs to do this (because it will be too exhausting to do all the time).

Textbooks with excellent chapters on dysarthria:

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