July 25, 2025

Updating Children's Speech (2nd edition) - Effectiveness of orofacial myofunctional therapy for speech sound disorders in children: A systematic review

I was interested to read this paper as it informs what we write in the intervention chapters of the second edition of our Children's Speech book (McLeod & Baker)

Merkel-Walsh, R., Carey, D., Burnside, A., Grime, D., Turkich, D., Tseng, R. J., & Smart, S. (2025). Effectiveness of orofacial myofunctional therapy for speech sound disorders in children: A systematic review. International Journal of Orofacial Myology and Myofunctional Therapy, 51(1), 4. https://www.mdpi.com/2694-2526/51/1/4 

Here is the key takeaway "Findings from high quality studies showed no improvement to speech that could be directly attributed to OMT, and lower quality studies yielded mixed results. This review found no conclusive evidence supporting the use of OMT as a standalone treatment for the effective remediation of SSDs."

Here is the full abstract

Orofacial myofunctional therapy (OMT) is an intervention approach used to remediate orofacial myofunctional disorders (OMDs). OMDs are abnormal patterns involving the oral and orofacial musculature that can subsequently interfere with the normal growth, development, or function of orofacial structures, including speech production. Historically, articulation therapy is used to remediate speech sound disorders (SSDs). Currently, there is a dearth of literature on the use of OMT to treat non-developmental (organic) SSDs in children. The aim of this systematic review is to examine the effectiveness of OMT in treating organic SSDs in children and adolescents between 4 and 18 years of age. A search of five electronic databases (ProQuest, Scopus, Ovid, CINAHL, and Embase) was conducted, including backward (identifying and reviewing references from earlier studies from sources) and forward searching (reviewing newer studies that have cited a source). Only primary research including OMT with post-treatment outcome measures for speech production were included. Thirteen studies were reviewed, including a total of 397 participants between 4 and 17 years of age. A range of study designs, diagnoses, and intervention approaches were discussed. Studies yielded mixed results on the effectiveness of OMT to treat organic SSDs. OMT alone, and in combination with articulation therapy, was not found to be more effective than articulation therapy alone. The methodological quality of the studies ranged from limited to strong. Findings from high quality studies showed no improvement to speech that could be directly attributed to OMT, and lower quality studies yielded mixed results. This review found no conclusive evidence supporting the use of OMT as a standalone treatment for the effective remediation of SSDs. This is attributed to significant variability in speech outcomes, small sample sizes, limited comparison groups, diverse participant diagnoses, and inconsistent methodologies and treatment protocols, yielding mixed results. In addition, while the term OMT was used in the papers to designate treatment methodology, an analysis of the exercise descriptions revealed that some reported OMT exercises were non-speech oral motor exercises (NSOMEs) and oral motor therapies. Overall, many of the techniques utilized across studies did not provide speech-like movements in their therapeutic interventions based on their description. Finally, traditional articulation therapy, including speech drills to work on articulation disorders, was not included in many of the included studies. SLPs using OMT as a modality would typically combine this with articulation practice to treat the SSD. This study highlights the need for robust future studies including prospective cohort studies to compare OMT, combined OMT and articulation therapy, and articulation therapy alone to provide clearer guidance for future clinical practice.