This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Oral Motor Goals in IEPs
By Pam Marshalla
Q: How should we write IEP goals for oral-motor?
The answer I always give is: DON’T. Our goals are not to improve jaw, lip or tongue function. Our goals are to improve speech. Write SPEECH goals. Oral-motor techniques are just that: TECHNIQUES. Oral-motor techniques are used to help us achieve the speech goals we have set.
For example, let’s say that we are working with a child who has no back sounds – no [k] or [g]. Our therapy techniques will be multisensory:
- Visual – e.g., use a mirror, draw a picture, use a puppet, use your hands
- Auditory – e.g., present a model, amplify it, prolong it, whisper it, make it salient
- Tactile – e.g., touch the part of the tongue that needs to move
- Proprioceptive – e.g., have the client press down the back of his tongue gently while he pushes it up
- Verbal – e.g, tell him what to do, use vocabulary at his language level
- Imaginative – e.g., “Make the crashing sound” or “Make the froggie sound”
- Repetitive – drill the appropriate responses to make the client more aware of and in more control of the sounds and movements; use drill to gain voluntary control
I like to call traditional articulation therapy “Show and Tell Therapy.” We show the client what to do and we tell him about it. If that is all he needs, then that is all we do. Oral-motor techniques are the tactile and proprioceptive techniques that may be necessary to achieve the oral positions we desire. The oral movements and positions are not our end products: the speech sounds are.
This is nuts. Most therapists dont do the oral motor component so adding it as an IEP goal can actually be helpful. Many kids with artic probs need to exercise their tongues and move their mouths in different ways beyond just the artic drills
I don’t think we need to call any therapist’s opinion “nuts.” Not very professional. As Van Riper said, we all do this our own way.
The reason I recommend NOT writing IEP goals for oral-motor is because of what happened in the 1990s. Once oral-motor techniques became widespread, there began to be many reports from parents nation-wide that some therapists were doing oral-motor activities INSTEAD of doing articulation therapy. These therapists thought that doing jaw, lip, and tongue “exercises” would help develop speech. Having taught hundreds of OM classes throughout the 1980s and 1990s, I felt partially responsible for this lack of understanding. Thus I began to teach firmly that OM is NOT the goal: Better speech is the goal. The OM methods are your means of moving toward the speech goal.
For example, one should not, I believe, set a goal to have the child wiggle his tongue left and right. HOWEVER, one might use this method to unlock the undifferentiated and primitive tongue-jaw movement pattern that is preventing certain speech movement patterns to emerge. Waggling the tongue is a METHOD not a GOAL.
I agree Samantha. Of course, in the role of being a professional 24/7, let’s just call it psychotic! LOL
What about in cases where the tongue is compromised such as in someone presenting with ankyloglossia? Would it be appropriate to include an oral motor goal then?
I would say no because you will be working on speech or feeding goals/objectives. I suggest writing goals/objectives that address the targeted speech sound/s and/or feeding skills you are are targeting and how you get there may be with oral-motor or oral placement techniques, but you are actually measuring progress with improved speech sounds and feeding–not how many times they can lift their tongue tip to their alveolar ridge or how many times they can lateralize their tongue.
I am a grad student and I would like to learn more about how to implement oral motor techniques as a method in therapy. I am interning with students with apraxia and other students who have oral motor goals (children who drool, or overall low tone). any suggestions would be great.
I disagree. I believe oral motor goals should be written in conjunction with articulation and feeding goals. My fear is that universities are not educating SLPs as they should. We have had many new SLPs begin working with us and it’s like they have had no training at all.
The problem is(coming from a graduate clinician) that these universities are show loooooots of data and research articles that show these exercises don’t improve speech. The danger has been with therapists who (apparently) focus on just tongue, lip, or face strengthening excersises. It is movements that are functional and within the actual production of the specific sounds in error that help improve speech, and just working on one movement over and over improves that specific movement. If you put it all together and just use the time to work on the functional movement to produce the sound, it is helpful. For example, blowing through a straw over and over teaches the client how to blow through a straw. Not that helpful, but using the straw to help the client keep their tongue behind their teeth while producing an /s/ sound, that is useful. Then you fade the use of the straw. Then it moves away from oral motor exercises for “strengthening” and moves towards shaping the speech sounds. It is functional and evidence-based. Just make sure to put those techniques within the context of functionality, and it is good to go!
I’m a pediatric feeding therapist as well as a school SLP. Oral motor exercises are warranted with students presenting with tongue weakness, poor oral control and limited range of motion. Typically these are students presenting with reduced feeding skills and ankyloglossia as they often present with tongue weakness. Students with apraxia may benefit as it can increase their ability to imitate motor movements, increase their awareness of their mouth (sensory) and increase oral control.
I think that in simplistic terms, oral motor exercises are the means, not the goal- whether it be for speech or feeding.
I began researching how to word what I plan to target because he had great difficulty imitating the movements on the OME and demonstrated low tone. Imitation is a must to be able to produce the sound correctly. I know that NSOME are not evidence based. This information was very helpful in helping me word what my thoughts are for a goal. A simple way to add this concept to a goal would be “In (timeframe), using multisensory techniques, student will produce target sound in (isolation, words, etc) with (data rate).
Thank you! This is exactly what I was looking for, I just couldn’t word it correctly.
I agree OM activites are strategies, not goals. How are you measuring lip. tongue, and jaw strength and what is the standard measure of strength? I would measure these by functional skills such as being able to produce plosive sounds or elevate tongue for /l/ or chew meats, etc.