There are precious few data available to support the notion that training non-speech oral movements facilitates the speech-sound production abilities of children with motor speech disorders. However, there are many advocates on both sides of this issue. Although there has been a proliferation of motor training programs for sale that are replete with specialized equipment and food textures, none provide treatment efficacy or outcome data that show improvement in the speech production abilities of speech disordered children.
Emerging data from various research groups across the country suggest that the physiological mechanisms that control non-speech and speech movements are quite different. A number of researchers have argued that different motor tasks involve task-specific control strategies and that it is inappropriate to use non-speech motor tasks as window into speech motor control processes. Nevertheless, many clinicians continue to employ non-speech oral movement tasks, to varying degrees, in their intervention programs for young children with motor speech disorders.
Does training non-speech oral movements improve speech-sound production? The fact is we just do not know at the present time. Controlled clinical studies are desperately needed to determine the efficacy of these procedures for children with different speech disorders and severity levels. The results of these investigations will more than likely vary depending on the type of speech disorder (e.g., apraxia, dysarthria) and the behavior that one is attempting to change or increase (e.g., coordination, precision, endurance, strength, awareness, or range).
Until these important clinical studies are completed, speech-language pathologists should employ a hefty dose of common sense when incorporating nonspeech motor training into their treatment programs for children with motor speech disorders. If the treatment objective is to improve speech-sound production, then speech tasks should be used whenever possible. For young children with severe speech motor deficits and limited speech-sound inventories, you must start somewhere. For these children, imitation of non-speech movements may be all they can achieve initially and could serve as a foundation for future speech-sound production. It makes the most conceptual sense to choose non-speech tasks that are components of speech gestures and directly linked in time and space to a speech-sound production. These non-speech tasks should be faded or eliminated as soon as the child is able to produce the speech sound of interest. In addition, some focus on non-speech oral movements at the start of a therapy session (2-3 minutes) may serve to increase awareness of the speech system and establish a starting point or anchor for a group of related speech sounds. However, extended use of nonspeech tasks that are not clearly connected to the speech production goal makes little sense if the objective is to improve the child’s speech-sound production abilities.
(Dr. Campbell, a member of the Childhood Apraxia of Speech Association Professional Advisory Board, is Assistant Professor of Communication Sciences and Disorders and Neurology at the University of Pittsburgh. He is also director of the Department of Audiology and Communication Disorders at Children’s Hospital of Pittsburgh and the Center for Acquired Communication Disorders. Dr. Campbell was honored by his profession in 1998, being named a Fellow of the American Speech, Language and Hearing Association. Currently, Dr. Campbell is conducting research in the areas of molecular genetics of childhood apraxia of speech; acquired speech motor disorders in children; and developmental phonological disorders.)