What is oromotor?

Answer 1

Difficulty in using the lips, tongue, and jaw indicate impaired oromotor function; this is a sign that may be present in up to 90% of preschool-aged children diagnosed with cerebral palsy. Signs of oromotor function impairment include, but are not limited to difficulty with:

• Speaking
• Swallowing
• Feeding/hewing
• Drooling

Speech requires proper intellectual and physical development. Cerebral palsy impairs the physical aspects of speaking by improperly controlling the muscles required to speak. Oromotor impairment can affect:

• Breathing - the lungs, and specifically the muscles controlling inhalation and exhalation necessary for proper speech patterns. The diaphragm and abdominal muscles are important for proper air flow and posture.
• Articulating - muscles controlling the face, throat, mouth, tongue, jaw, and palate all must work together to form the proper shape necessary for pronunciation of words and syllables.
• Voicing - vocal cords are controlled by muscles that essentially stretch the vocal folds between two regions of cartilage.

Apraxia, an inability of the brain to effectively transmit proper signals to the muscles used in speaking, is one type of speech impairment common to cerebral palsy. It is divided into two types:

• Verbal Apraxia - affects the articulation muscles, especially regarding the specific sequence of movements needed to carry out proper pronunciation. It is common in children with hypotonia.
• Oral Apraxia - affects the ability to make nonspeaking movements of the mouth, but is not related solely to speaking. Example of oral apraxia would be the inability to lick the lips, or inflate the cheeks.

Dysarthria is another speech impairment common to cerebral palsy. Like apraxia it is a neurological disorder, as opposed to a muscular condition. It is often found in disorders like cerebral palsy that result in hypertonia and hypotonia. Dysarthria is broken into the following subgroups:

• Ataxic Dysarthria - slow, erratic, inarticulate speech caused by poor breathing and muscular coordination
• Flaccid Dysarthria - nasal, whiny, breathy speech caused by the inability of the vocal chords to open and close properly. There may be difficulty with consonants.
• Spastic Dysarthria - slow, strenuous, monotone speech and difficulty with consonants
• Mixed Dysarthria - all three may be present.

Drooling is another sign of cerebral palsy that results from muscles in the face and mouth not being able to properly control coordination. Some specific factors which can contribute to drooling are impairments in:

• swallowing
• closing the mouth
• positioning the teeth
• inability to move saliva to back of mouth
• tongue thrusting

Feeding difficulties can be present with cerebral palsy. They typically manifest as decreased ability to chew and swallow, and may also involve choking, coughing, gagging, and vomiting.