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Heather Clark (The ASHA Leader, June 14, 2005) notes that oral motor (OM) treatment workshops and products are not supported by assessment and treatment data. That situation invites malpractice. Clark would base OM therapy on a philosophy. But speech-language pathology is based on evidence and science-not philosophy and hopefully not commercialism. Clark also says that clinicians may conduct research to contribute to the evidence base for OM treatments. That, of course, would require approval by a review committee, informed consent of the subjects, and expertise in the design and conduct of research. If improvement is observed, what other variables may account for it? What is the effect size?
Response acquisition and automatization in motor learning differ from strength, endurance, and range of motion exercises used in OM treatments. Development of skill is important to both lines of study. There is a broad literature concerning motor learning and therapeutic exercise. Are we building on it or ignoring it? Pertinent information is provided in Motor Learning as a Model for Articulation Instruction by Dennis M. Ruscello (Speech Disorders in Children, 1984 edited by Janis Costello, San Diego, College-Hill Press) and by Ann Bosma Smit (2004, Articulation and Phonology Resource Guide for School-Age Children and Adults, Clifton Park, New York. Thomson Delmar Learning). Smit's discussion of oral-motor exercises focuses on verbal dyspraxia.
Ralph Shelton
Arivaca, Arizona
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