Oral Motor and Its Affect on Feeding Disorders

What is an oral motor deficit?  An oral motor deficit affects the musculature of the mouth including the lips, tongue, and jaw.  The following are causes of oral motor disorders:

• Incorrect motor programming of the muscles of the mouth.  In other words, the brain sends a message to the muscles of the mouth, but the muscles don’t receive the message or it is misinterpreted.  This causes the muscles either to not move at all, or to move in an incorrect fashion that results in mismanagement of food in the mouth.

• Low muscle tone, meaning the muscles of the lip, tongue, or jaw are weak.  Many times children with low muscle tone in the jaw have an open mouth posture.  Difficulty with puckering, drinking from a straw, or frequent spilling of liquids when drinking is caused by weak lip strength.  Poor tongue strength can result in an inability to stick the tongue out, or move it from side to side.  Drooling can also be caused by weakness in the muscles of the mouth.  Strengthening these muscles can be very important in improving both feeding deficits and speech intelligibility.   

Weakness of the muscles of the lip, tongue, or jaw can have a great impact on the ability to manipulate food in the mouth, including chewing and swallowing.  The ability to remove food from silverware and keep food from falling out of the mouth are also difficulties resulting from weak musculature.  Having weak muscles can affect a child’s gag reflex, which makes feeding even more unpleasant.  Weak musculature can also result in episodes of choking that can affect a child’s willingness to eat altogether, creating a feeding disorder.  Muscles that are weak or receiving incorrect information from the brain can cause chewing, swallowing, and manipulating the food within the mouth to be hard work.  When children are faced with unsuccessful eating because they gag, choke, or spend long periods of time eating, it reduces the motivation to continue with this activity.  Strengthening the muscles and resetting the neural pathways is essential for improving feeding disorders.

So how do we improve oral motor deficits?

• Undertaking an oral motor program designed to strengthen the lips, jaw, and tongue.  The program should utilize a developmental approach that increases in difficulty as the muscles begin to strengthen.  Parents should be involved in the oral motor program, and should have an understanding of what the exercises entail.  Daily practice is essential in not only improving strength in the lips, tongue, and jaw but in strengthening the neural pathways and improving motor programming.

• Utilizing food as an effective tool in strengthening the muscles of the mouth.  Try blowing a marshmallow across the table to improve lip rounding.  Suckers can be used to strengthen lip and tongue muscles.  Have a seed spitting contest to improve tongue strength.   Strengthen jaw muscles by having the child try to make deep teeth impressions in a slow poke sucker or piece of taffy. 

While not all children with feeding disorders have difficulty with the muscles of the mouth, a certain percentage do.  Improving the oral motor deficits for these children is essential to the success of correcting feeding disorders.  If you recognize any of the symptoms listed above, you are encouraged to seek assistance from a speech/language pathologist or occupational therapist in your area.