Preparing to Serve Individuals With Orofacial Myofunctional Disorders
Orofacial Myofunctional Disorders Resources
It is important that speech-language pathologists (SLPs) have adequate training and experience when serving individuals with orofacial myofunctional disorders (OMD). This resource provides information on how to gain the appropriate knowledge. An interdisciplinary approach is essential for study, evaluation, and treatment of OMD. Effective communication among SLPs and dental and medical specialists helps ensure optimal client/patient care.
Elements in understanding dentofacial patterns and applied physiology pertinent to orofacial myology include recognition/knowledge of:
- normal and abnormal dental, skeletal, and soft tissue anatomy and physiology;
- developmental anatomy, physiology, and cognitive factors as they affect evaluation and strategies for treatment;
- etiology and treatment modalities for dental and skeletal malocclusions;
- orofacial muscle compensatory adaptations to dental or skeletal variations;
- dental development and terminology relevant to orofacial myology;
- the role of dental and medical specialties and procedures related to the interdisciplinary management of orofacial myofunctional disorders;
- skills in analyzing/interpreting patient/client data regarding orofacial myology.
Elements in understanding contributing causative factors related to OMD include recognition/knowledge of:
- the complexity and potential interactions of etiological factors related to OMD (e.g., airway interference, thumb sucking, anterior malocclusion);
- the signs and symptoms of OMD;
- the complexity and potential interactions of etiological factors related to OMD;
- the role of dental and medical specialties and procedures related to interdisciplinary management of OMD.
Elements in understanding basic orthodontic concepts include recognition/knowledge with respect to:
- communicating pertinent orofacial myofunctional clinical findings to colleagues from other disciplines,
- incorporating knowledge of present and future orthodontic treatment procedures for individual clients/patients into treatment planning decisions,
- orthodontic evaluation and treatment procedures and appliances,
- basic interactions with dental specialists to develop appropriate treatment plans and formulate realistic treatment expectations.
Elements in understanding interrelationships between speech and OMD include recognition/knowledge with respect to:
- relating interrelationships of speech and orofacial myofunctional disorders to medical and dental specialists;
- inappropriate lingua-dental contacts during speech and whether they result in acoustically typical or atypical speech;
- interrelationships among dental malocclusions, abnormal articulatory patterns, and nasal airway patency;
- identification of articulatory patterns related to OMD;
- orthodontic appliances and their potential impact on speech function.
Elements in demonstrating competence in comprehensive assessment procedures and in identifying factors affecting prognosis, include recognition/knowledge with respect to:
- evaluating tongue and lip resting postures and tongue, lip, and teeth movements in the handling and swallowing of saliva, liquids, and foods;
- determining the likelihood of spontaneous modification of inappropriate myofunctional patterns without intervention;
- identifying positive and negative factors associated with the prognosis for treatment;
- relating assessment results to the total medical or dental plan of treatment;
- the relationships among orofacial structures and functions as they influence OMD;
- the complexity of oronasal airflow patterns and the need for interdisciplinary management;
- the physical and behavioral factors affecting patient selection or treatment outcomes;
- eliminating associated parafunctional behaviors and habits (e.g., chewing, sucking) that affect oral structures and function;
- physical and behavorial factors affecting patient selection or treatment outcomes.
Elements in demonstrating competency in selecting an appropriate, individualized, criterion-based treatment plan include recognition/knowledge with respect to:
- coordinating the OMD treatment program with other medical and dental procedures;
- establishing a home-based program as an integral part of treatment, as appropriate;
- educating the patient/client and family about treatment goals and procedures;
- the impact of family educational, linguistic, and cultural/ethnic background on treatment planning;
- establishing dismissal criteria and follow-up care in the treatment process.
The SLP must be knowledgeable with respect to appropriate clinical environments for the provision of professional services, specifically including infection control procedures.
Elements in demonstrating appropriate documentation of all clinical services include recognition/knowledge with respect to:
- obtaining a case history on each client/patient;
- incorporating case history and clinical findings into a report, including factors affecting prognosis and recommendations;
- documenting client/patient progress for each treatment session;
- clinical data recording, organization, and reporting.
Elements in demonstrating professional conduct within the scope of practice for speech-language pathology include recognition/knowledge with respect to:
- adhering to the ASHA Code of Ethics;
- recognizing orofacial myofunctional conditions to include in an orofacial myofunctional practice, such as digit and oral habits, lingual and labial posturing variations, and swallowing variations that are non-organic;
- establishing as the most important goal of orofacial myofunctional intervention the creation, reestablishment, stabilization, and maintenance of an oral environment conducive to normal processes of orofacial growth and development;
- educating referral sources regarding the goals and nature of orofacial myofunctional treatment.
Knowledge is obtained through course work and training specific to the evaluation and treatment of orofacial myofunctional disorders prior to the provision of clinical services in this area. Unless an SLP holds credentials in appropriate medical/dental specialty areas, the practice of orofacial myology does not include
- treatment of parafunctional problems related to temporomandibular joint disorders and myofacial pain dysfunction,
- nutritional counseling or management,
- craniosacral manipulation or practices,
- practices related to the reduction of medical conditions, such as sleep apnea.