American Speech-Language-Hearing Association
Certified Member

Audiology Hearing Aids Speech Pathology

Additional Office Services:
Correction of Myofunctional Disorder (OMD)
(Tongue Thrust Swallowing Disorder)

Tongue thrust exam by Michele Wilson, Ph.D.

Relevant DX codes
American Speech and Hearing Association (ASHA )
787.2 dysphagia) 
524.5 dentofacial functional abnormality 
784.5 speech disorder
Summary: Deviant swallow and/or orofacial hypotonicity (facial droop) can adversely affect jaw structures and positioning of teeth with a negative effect on ability to properly masticate (chew), swallow and produce speech sounds.

Definition: The tongue moves forward in an exaggerated way during speech, chewing and swallowing. The tongue may also lie too far forward at-rest. The tongue may push against the teeth or protrude through the teeth. This pressure interferes with normal tooth eruption and alignment of the teeth and jaws. Continuous forward tongue posture causes a child to look, speak and swallow differently.

Causes: The most frequent cause of OMD is a blocked airway from enlarged tonsils, adenoids or from allergies. An open-mouth breathing pattern can become habituated and continue even after successful medical treatment of the airway blockage. Secondary causes include deviant dental alignment, excessive thumb sucking, lip licking, teeth clenching and grinding.

Remediation for OMD

  • Medical management for nasal airway blockage.
  • Dental/orthodontic intervention for alignment of teeth and jaws
  • Speech treatment by speech pathologist to help both speech and swallowing problems. Typically this follows medical treatment and may precede, continue in conjunction with orthodontic treatment or follow completion.

The remedial program I use includes:

  1. Initial evaluation of lip, palate, tongue and facial muscles both at rest and during complex movements needed for both clear speech and adequate swallowing.
  2. Monthly therapy sessions to demonstrate and teach at-home exercises to:
  • Increase awareness of oral, lingual and facial muscles and postures.
  • Improve oral and facial muscle strength and coordination.
  • Establish normal speech articulation and swallowing patterns

    For children and adolescents a parent attends the therapy sessions to learn the exercises and then assists in the daily exercises at home. Typically the process is completed in 6 months with consistent at-home practice.

   3.   Follow-up evaluation six months post completion of the training to
         ensure that the normal speech and swallowing patterns have continued.

For further information, contact Michele Wilson, Ph.D.

Hear-More home page.

Back to Ear Plugs main page.

Audiology Hearing Aids Speech Pathology
Certified Member of American-Speech-Hearing Association
Fellow of the American Academy of Audiology

4010 Barranca, Suite 220 (at Culver), Irvine, California 92604
Phone: (949) 857-6051 Fax: (949) 857-0941