Oral Motor Exercises: What They Are, What the Evidence Says and When They Help

01What

What are oral motor exercises?

• Blowing: bubbles, whistles, horns, cotton balls or straws.
• Tongue exercises: pushing against a spoon, moving side to side, lifting the tip.
• Lip exercises: pursing, smiling, holding a button between the lips.
• Jaw exercises: opening and closing, biting on chew tools.
• Cheek exercises: puffing out the cheeks.
• These are called “non-speech” oral motor exercises because they do not involve producing speech sounds.

02Evidence

What the evidence says for speech

An evidence-based systematic review published in the American Journal of Speech-Language Pathology examined studies of non-speech oral motor exercises and concluded that there was insufficient evidence to support or refute their use for improving speech. A Cochrane review of non-speech oral motor treatment for children with developmental speech sound disorders found only a small number of trials and no strong evidence that these exercises improved speech. ASHA’s guidance on speech sound disorders emphasises treatment approaches based on speech practice.

03Why

Why they do not work for speech

• Speech movements are fast, precise and coordinated, very different from blowing or pushing the tongue against resistance.
• Most children with speech sound disorders do not have weak muscles.
• Motor learning research shows that skills improve most when practised directly.
• Strength needed for speech is only a small fraction of maximum strength.
• Time spent on non-speech exercises may delay effective therapy.

04Better

What works better for speech sounds

• Articulation therapy: practising target sounds in syllables, words and sentences.
• Minimal pairs: contrasting words such as “key” and “tea” to show sounds change meaning.
• Phonological approaches such as the cycles approach.
• Motor-based speech therapy for childhood apraxia of speech, focusing on speech movements.
• Auditory discrimination and listening activities.
• Activities are in speech therapy exercises.

05When

When oral motor work may help

• Feeding difficulties in children, such as trouble chewing or moving food around the mouth.
• Drooling, as part of a programme including posture, awareness and swallowing.
• Swallowing problems (dysphagia) after stroke or in neurological conditions, using specific exercises chosen by a therapist.
• Oral sensory sensitivities affecting eating.
• Weakness after facial nerve problems, under medical guidance.
• In these cases, exercises are combined with functional practice such as eating and drinking.

06Apraxia

Oral motor exercises and childhood apraxia of speech

Childhood apraxia of speech is a motor speech disorder in which children have difficulty planning and coordinating speech movements. Although it is a “motor” problem, research supports treatment that practises speech movements directly, with many repetitions and feedback, rather than non-speech exercises. Children with apraxia often need frequent, intensive therapy.

07Adults

Adults with speech or swallowing difficulties

In adults, speech difficulties after stroke or with conditions such as Parkinson’s disease are often due to dysarthria, which affects the muscles used for speech. Treatment usually focuses on speech-based tasks, breathing support, loudness and clarity, rather than isolated strengthening. Swallowing therapy may include specific exercises chosen after an assessment. See dysarthria.

08Parents

Advice for parents

• Ask your speech-language pathologist how each activity links to your child’s speech goals.
• Focus home practice on sounds and words, not blowing or tongue exercises.
• Read, talk and play sound games with your child every day.
• Model clear speech without pressuring your child to repeat.
• Typical speech development is described in the speech sound development chart.

09Myths

Common myths

• Myth: blowing exercises strengthen speech. Fact: they do not improve speech sounds.
• Myth: children with lisps need tongue strengthening. Fact: speech-based practice is effective.
• Myth: chew toys fix speech. Fact: they may help sensory needs but not speech sounds.

10Cases

Three common situations

• Four-year-old with unclear speech given blowing exercises: ask for speech-based therapy instead.
• Toddler who struggles to chew and gags on lumpy food: feeding therapy, which may include oral motor work.
• Adult with swallowing difficulty after a stroke: a swallowing assessment and specific therapy.

11Questions

Questions to ask your therapist

• What is the goal of this exercise?
• How does it relate to my child’s speech or feeding?
• What evidence supports it?
• How will we measure progress?
• What should we practise at home?
• How long before we review whether it is working?

12Drooling

Managing drooling

Drooling is normal in babies and toddlers, especially when teething, and usually stops by around four years. Persistent drooling may occur in children with cerebral palsy or other neurological conditions. Management may include improving posture, awareness and swallowing frequency, oral motor and sensory activities, medicines, or, rarely, injections or surgery. A speech-language pathologist can help assess the causes and plan treatment.

13Summary

Key points to remember

• Non-speech oral motor exercises do not improve speech sounds.
• Speech-based therapy is the effective approach.
• Oral motor work may help some feeding, drooling and swallowing problems.
• Always link exercises to clear, functional goals.