Orofacial Myofunctional Disorders

I left graduate school much less prepared for the real world than I initially thought. I am pretty sure this is mostly due to my own youthful arrogance and just the naturalness of forgetting things that you don’t immediately use. I don’t blame my university at all. I am telling you this story because I believe in transparency and continual learning. This story certainly does not make look like one of those all knowing SLPs that seem to flood our inboxes and instagram feeds.

Each new year, I better understand why I was told do something (Language Sample Analysis- I am looking at you). Or, I see a new disorder that I haven’t seen before. Or I come across a student with a disorder I have heard about, but honestly, I am not really sure how to treat it or evaluate it (ahem, Voice Disorders).

But recently, I came across a disorder I don’t remember learning about in graduate school. I am not quite sure if it is because I wasn’t paying attention, I forgot I learned about it, it was called something else, or because I really wasn’t taught it existed. *shrugs shoulders*

You want to know what it is, don’t you?

It’s called Orofacial Myofunctional Disorders or OMD. That’s a mouthful, I know. It is also commonly referred to as a tongue thrust.

So how did I find out about this? Well, I had a little boy come in for a standard, run of the mill, articulation evaluation. I tested him and holy moly, he had an interdental lisp on any and every sound that could be lisped! “Well, that was a nice easy evaluation”, I thought to myself. But something kept nagging at my mind. His mom kept mentioning how concerned she was that he drooled-A LOT.

So, on a whim, I got onto trusty old Google and decided to type in the symptoms “interdental lisp” and “drooling”. I am so glad I did.

The first thing that came up in my search was this ASHA page on Orofacial Myofunctional Disorders. I was not expecting an ASHA page to come up first, and since I had never heard of this disorder, I eagerly clicked the link. As I scanned the page, I realized my student had about 90% of the symptoms that are associated with this disorder.

Let’s look at some common symptoms, shall we?

  • “Distorted Productions of /s/, /z/ often produced with an interdental lisp” and “Abnormal lingual dental articulatory placement for /t, d, l, n, ʧ, ʤ, ʃ, ʓ/” -Check, my student did that.
  • Open mouth resting posture-Yep, he did that too.
  • Drooling beyond 2 years of age-Yes again.
  • Airway incompetence due to enlarged tonsils or adenoids- I wasn’t sure.
  • Restricted Lingual Frenulum- I needed to check that too.
  • Typical swallowing patterns- I had no idea.
  • Structural differences of the face- I didn’t think so, but maybe.

So, I went back and did a better Oral Mechanism Exam. I determined that he did have severely enlarged tonsils. He did have restricted tongue movement. He did have a funky swallow. It turns out he already had a relationship with and ENT and the ENT was already suggesting having his tonsils removed. It also turned out he had a dentist appointed scheduled the next day, so his mom ran everything past the dentist too. A care of plan was established and mom wanted to move forward with therapy after he had a tonsillectomy and the ENT gave us the green light to move forward.

Based on what I read from ASHA, I wrote goals for articulation, swallowing, and oral rest postures.


I needed to know more so I could confidently treat this little boy. So, I studied, and I researched, and I obsessed. I took the things I learned and I used them to make an Orofacial Myofunctional Disorders tool box. I wanted something that would help me through each step of the process- Evaluation, Education, Oral Rest, Swallowing, and Articulation. I needed it all right there, planned for me so I didn’t have to think about it any more.

It’s beautiful, isn’t it?

Here is the thing. This disorder is actually pretty common. According to my research, about 30% of the general population are tongue thrusters. In retrospect, I have treated several kids who probably had this, I just didn’t know it had a name. If I had known, I would have known that I needed to target skills like swallowing and oral rest posture too. If you have a student who is suffering with a significant lisp, maybe they have an OMD too.

If you are like me and you feel a little uncertain about treating this disorder or you suspect your student might have this disorder and you want to learn more about it, I have listed two versions of this toolbox for sale in my Teachers Pay Teachers Store. The first version is the complete toolbox, with hundreds of articulation cards to help you treat the speech component of this disorder.

Orofacial Myofunctional Disorders Activties
Click this image if you want to see the complete tool box!

The second version is the abbreviated version. It has all of the evaluation and teaching tools, but it DOES NOT include the articulation cards.

Tongue Thrust Activities
Click this image if you want to see the shorter, therapy guide that does not include the articulation cards or the organization tools to make the complete tool box.

So, if you feel like you have access to all the articulation cards you need, then go ahead and check out the second set. If you need some more flashcards or you just love all things color coordinated and organized, check out the complete toolbox!