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.
What is Oral Stability?
By Pam Marshalla
Q: You use the phrase “lack of stability” in relation to oral motor function. What do you mean by “stability”?
I will have a full chapter on oral stability in my next book to be called The Marshalla Guide to 21st Century Articulation Therapy. Until then, the following is something I wrote in an article for the Oral Motor Institute:
Stabilize Oral Movements
To stabilize is “to make or become stable” (Jewell & Abate, 2001, p. 1656) or “not likely to change” (p. 1656). Stability is a fundamental concept in motor therapy. “We must have a stable base from which to develop movement and functional skills. Without that stability, our function or mobility is less controlled [and may be] impossible” (Morris & Klein, 2000, p. 62). There is interplay of stability and mobility in all movement. Stability does not mean rigid or fixed, however. Stability is relative and dynamic: one part of the body holds relatively still so that another part can move with greater accurately. The body stabilizes proximally while moving distally. “Generally, the central or proximal parts of the body are the first to develop stability or become controlled. From a controlled, proximal base of stability, the infant can have the possibility of greater mobility and more refined distal control” (Morris & Klein, 2000, p. 62). “Postural control of a part of the body always precedes movement control of that part” (Mysak, 1980, p. 105).
Speech-language pathologists utilize techniques to stabilize the jaw for improved lip and tongue mobility. “The ability to stabilize the jaw creates the needed prerequisite for the development of skilled and refined tongue and lip movements” (Morris & Klein, 2000, p. 63). Techniques to stabilize the cheeks and face are used to improve lip mobility. Techniques to stabilize the back lateral margins of the tongue are used in order to facilitate improved mobility of other parts of the tongue. And techniques to stabilize the hip and should girdle, and the head and neck, also are incorporated in order to facilitate improved jaw mobility. “The emergence of stability and mobility functions is an essential part of speech skill development” (Fletcher, 1992, p. 13). Techniques to facilitate oral stability are found in a variety of speech texts. Examples:
- To stabilize the jaw for improved tongue mobility for production of lingua phonemes: “Using a bite block to stabilize the mandible and reduce mandibular support during speech may help to increase independent lingual movement and result in improved oral articulation for speech … [The] bite block is placed between the first molars on one or both sides … With the block in place and following a period in which the child adjusts to the presence of the block, a series of speech sounds and sound sequences are presented for imitation by the child” (Crary, 1993, p. 224).
- To stabilize the lips and facial muscles with low muscle tone: “Play patty-cake, peek-a-boo, and other children’s games that incorporate patting, tapping, stroking, and other types of tactile and proprioceptive stimulation of the cheeks and lips. Tapping can be done directly around the temporomandibular joint to provide better jaw stability for lip and cheek mobility” (Morris & Klein, 2000, p. 445).
- To stabilize the back of the tongue for eliminating a frontal lisp: “We can help our clients keep the tongue inside the mouth by developing [the tongue’s] back lateral stability” (Marshalla, 2007, p. 115). Techniques include: “draw a picture,” “stroke the zones,” “smile,” “bite gently on the zones,” “establish the butterfly position,” “hold the butterfly position,” and “spread the back of the tongue” (p. 115-116).
References
- Crary, M. A. (1993) Developmental Motor Speech Disorders
. San Diego: Singular.
- Fletcher, S. G. (1992) Articulation: A Physiological Approach
. San Diego: Singular.
- Jewell, E. J., & Abate, F. (2001). The New Oxford American Dictionary
. NY: Oxford University.
- Marshalla, P. (2007) Frontal Lisp, Lateral Lisp. Mill Creek: Marshalla Speech and Language.
- Morris, S. E., & Klein, M. D. (2000). Pre-feeding skills: A comprehensive resource for mealtime development
. Austin: Pro-Ed.
- Mysak, E. D. (1980). Neurospeech therapy for the cerebral palsied: A neuroevolutional approach
. NY: Teachers College Press.