Oral Motor Deficits

pediatric oral motor deficits

Children learn and master a wide range of developmental skills as they grow, including oral motor skills, which are not fully developed until around the age of six or seven. Oral motor skills are necessary for proper eating and overall functioning.

Oral motor delays or deficits affect the function of the mouth's movement. Lips, tongue, jaw, and palate must all work together synchronously from birth in order for a child to eat successfully. If your child has difficulty controlling her mouth muscles while talking and eating, and is unable to master chewing, blowing, or making specific sounds, they may have an oral motor deficit.

Although oral motor delays/deficits are a physical condition, there can sometimes  be an underlying neurological cause. Oral motor difficulties can impair your child's ability to manipulate food in their mouth, use straws when drinking, and may also impair the clarity and accuracy of their speech. A child may frequently gag or choke, drool, struggle to keep food down, make poor transitions between foods, have difficulty sucking, chewing, and swallowing, or have picky eating habits if they lack appropriate oral motor skills.

Children with oral motor difficulties may have muscle tone and motion difficulties, as well as poor postural control and balance. Sucking, swallowing and breathing can also be problematic. A child with oral motor deficits may also struggle with behavior, speech, and language development.

 

CAUSES OF ORAL MOTOR DYSFUNCTION

 

Although oral motor delays/deficits are a physical condition, there can sometimes  be an underlying neurological cause. Oral motor difficulties can impair your child's ability to manipulate food in their mouth, use straws when drinking, and may also impair the clarity and accuracy of their speech. A child may frequently gag or choke, drool, struggle to keep food down, make poor transitions between foods, have difficulty sucking, chewing, and swallowing, or have picky eating habits if they lack appropriate oral motor skills.

 

  • Sometimes associated with conditions that cause impaired muscle function, such as Down syndrome, mitochondrial disease or congenital hypotonia. The muscles don’t move responsively or move in the wrong way, making it difficult to manage food in the mouth and to produce intelligible speech. 

 

  • Low muscle tone of the lips, tongue, or jaw can be another cause. Children with low muscle tone in the jaw often have their mouth open. Children with weak lips have trouble puckering up to drink from a straw, and often lose control of liquids while trying to drink. A weak tongue makes it hard to push food around the mouth while eating. Drooling also can be a problem associated with low muscle tone.

 

  • If a neurological disorder affects a portion of the child's brain, they may have difficulty programming their motor movements for the mouth. Nerve problems cause both oral-motor and oral-sensory problems. Feeding difficulties in children can be caused by neurological conditions such as cerebral palsy or hydrocephalus.

 

  • The oral motor dysfunction may also occur in children who have structural abnormalities affecting their head or face, like Pierre Robin sequence or cleft palates.


 

Diagnosis and evaluation of oral-motor and oral-sensory problems

It's important to have a complete medical history: It's necessary for your child's medical team to know how feeding has gone since birth in order to pinpoint the source of the problem. The feeding specialists may want to know how long your child takes to eat and which foods he or she refuses.

Children with oral-motor or oral-sensory deficits may be evaluated for difficulty swallowing. Aspiration can be caused by poor oral control, so the speech pathologist will ensure that your child can swallow safely. A videofluoroscopic swallow study, also known as a modified barium swallow study, can reveal any swallowing problems.

TYPES OF ORAL MOTOR DISORDERS

Oral motor dysfunction is a broad term that encompasses a variety of oral motor disorders. Some of these disorders have an impact on speech, while others have an impact on eating. Eating is not only necessary for survival; it is also an important part of our social lives. A child who is unable or unwilling to eat can have a negative impact on the entire family's quality of life.

Prevalence oral motor deficits

Children's Wisconsin reports oral motor deficits in 5 to 10 percent of typically developing children have a serious feeding disorder at some point, and that could include oral-motor or oral-sensory problems. Up to 80 percent of children with developmental disabilities have some sort of feeding disorder.

 

SIGNS OF ORAL MOTOR DYSFUNCTION

Weak muscles may impair a child's gag reflex or cause choking, making eating uncomfortable and eventually leading to a feeding disorder. Oral motor dysfunction can manifest itself in a variety of ways, depending on the infant. Some or more of the following signs can be noticed by parents of affected children.

• Difficulty swallowing food or drinks, coughing, choking, or gagging during meals

• Drooling not associated with teething or excessive drooling when teething 

• Open mouth posture at rest

• Difficulty sucking from bottles or straws

 • Refusal to consume hard foods like fresh fruits, vegetables, or meats in favor of  soft, easily chewed foods

• Inability to gain weight 

• Excessive mouth movement during conversation 

• Unintelligible or  slurred speech

 

TREATMENT OF ORAL MOTOR DYSFUNCTION

Your feeding therapist may recommend exercises and activities that improve oral skills, strengthen weak muscles, and optimize oral movement patterns necessary for feeding and speech.