Here’s something I’ve noticed recently- parents aren’t quite sure what kind of “mouth treatment” their child needs. The term PROMPT has been thrown around as an approach utilizing touch cues for the face and mouth to help with speech. Orofacial myology also requires work on the mouth including touch, exercises, etc. If a child isn’t talking or has difficulty with the movements for speech, which modality does the child need?
PROMPT is most known for being a tactile-kinesthetic (touch and feel) approach to speech therapy. A trained and/or certified PROMPT speech-language pathologist places his/her hands on the client’s face, targeting specific muscles, to guide his/her jaw, lips, and tongue to move sequentially to form words.
Simply put, PROMPT is beneficial when there is a breakdown in speech production. Assessment is utilized to determine where the motor speech breakdown occurs. There are three domains considered within the PROMPT conceptual framework.
Social-Emotional domain is comprised of skills related to interacting with and learning from others in the environment. Addressing this domain builds the client’s ability to participate in useful and functional communication with others.
-The PROMPT Institute
Cognitive-Linguistic domain is comprised of skills related to understanding and using language. Within this domain PROMPT aims to strengthen the client’s knowledge and accurate use of communication.
-The PROMPT Institute
Physical-Sensory domain is comprised of skeletal structure, muscular tone and motor skills. Treatment within this domain focuses on improving the client’s ability to be understood by others by refining how the client uses their jaw, lips, and tongue to produce sounds, words, and phrases.
– The PROMPT Institute
For example, if a client with cerebral palsy has difficulty keeping a closed mouth due to muscle weakness, targets may include plosives (or sounds where the lips need to meet) such as words with /m, p, b/) e.g., bye, me, top, etc. If a client with apraxia of speech (ability to program and plan speech movements), has difficulty with a high, back vowel /i/ (as in bee), targets will include sounds to facilitate this placement such as “need, key, he,” etc.
I was lucky enough to be able to attend a four-day course in August 2021 through the International Association of Orofacial Myology. I have only the highest praise for my instructors, both SLPs and COM® (certified orofacial myologists), Kristie Gatto MA, CCC-SLP, COM® of The Speech and Language Connection in Houston, TX and Amanda Chastain MA, CCC-SLP, COM® of The Speech Network in Lexington, KY. I’ve linked their clinics, as I found them both a wealth of knowledge, eager to teach, and super engaging. These instructors kept me glued to my chair all four days. A course over Zoom that keeps you that enthralled should be recognized!
Kristie Gatto is quoted below for her fantastic summary of OMT.
“Orofacial myology encompasses the oropharyngeal muscular complex during rest, breathing, mastication, bolus formation and transit, and co-articulation of those muscle movements for swallowing and in speaking.”
Kristie K. Gatto, M.A., CCC-SLP, COM®
While OMT can absolutely be useful in the infant and toddler ages, it would be more so teaching strategies to parents in regards to how to treat and/or prevent further issues from occurring e.g., breastfeeding strategies, cup/bottle choices, feeding skills, pacifier use, digit sucking, etc. OMT can be a direct treatment once a child is four-years-old, as they now have the cognitive awareness to actively participate in exercises.
OMT can be essential to the following health concerns:
-swallowing
-speech
-drooling
-lip competence
-open, oral posture (mouth breathing)
-appearance or symmetry of the face
-impaired posture
-ankyloglossia ( tongue tie) or structural changes impacting function
-buccal and/or labial ties
-pre- and post-frenectomy care
-picky eating habits
-orthodontic care planning
-extended pacifier use/digit sucking
-Ongoing, unsuccessful speech therapy
The symptoms and signs of an orofacial myofunctional disorder (OMD) can be easily dismissed. Let’s say an adult reaches the point where they find their sleep apnea, snoring, frequent headaches, tension/tightness in jaw/shoulders/neck, and poor posture have caught up with them. Guess what? ALL signs of an untreated tongue tie resulting in overcompensation of other muscles and structures.
Overall, PROMPT is beneficial for breakdowns of motor speech movements. OMT is beneficial for the deficits in mouth and facial musculature, resulting in function and structural incompetencies.
The good news? YSP offers BOTH treatment modalities and protocols. I am the proud owner and primary speech-language pathologist, Erin Gaul MS, CCC-SLP, currently working as a candidate on the COM® track through the IAOM. I am actively treating child and adult patients. Inquire today!
PLEASE NOTE: You find many trainings offering SLPs particular credentials for going through one myofunctional course. Please know the Gold Standard is the COM® through the IAOM. IAOM has a superior standard for their candidates including case studies, sit down test, and to be observed in active treatment to earn those initials after their name.
