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Image Credit: The Doris Duan-Young Autism Center

Every child is different and so are their developmental trajectory. Some children have difficulty in their growth which can lead to delayed development of certain milestones. For example, a child may have a speech delay, which might make it difficult for them to talk and communicate with others. This speech delay may affect their overall development. One of the major deficits in Autism Spectrum Disorder (ASD) is social communication. Due to this major deficit seen, many children on the spectrum are either non-verbal or require a lot of prompts to speak. However, other children on the spectrum are verbal and develop words by the age of 3. Regardless of the child, many parents decide to start early intervention in order to work on the deficits in social communication.

With this being said, some of the children who were fortunate enough to start early intervention still do not see verbal speech develop in their child. Early intervention using traditional models of targeting articulation and speech sometimes doesn’t work. What do you do when “look, listen and say” is not successful? What are we missing? Data suggests that infants who are later diagnosed with Autism and fail to acquire spoken language show very significant delays in developing oral motor skills during the first year of life (Gernsbacher et al., 2008). To address this “missing link”, seasoned Speech Language Pathologists (SLP) like Sara Rosenfield-Johnson and Pam Marshalla, advocated on Oral Placement or Oro-motor therapy.

Oral Placement Therapy (OPT) is a tactile approach to targeting the development of oral motor skills needed for speech. It uses a combination of visual stimulation, auditory stimulation and tactile stimulation to help improve speech clarity. It can be used to improve and develop articulator awareness and stability, muscle memory and placement. It is a kind of oral sensory-motor treatments that can be used for those individuals who do not respond to look at me and say what I say, or the more traditional approach to treating articulation and speech.

At The Doris Duan-Young Autism Center (DDY), OPT is an integral part of the therapy plan for children who are not responding to the traditional speech and articulation therapy and also for the reason that it is an accepted approach and considered as an evidence-based practice by the American Speech-Language- Hearing Association (ASHA). The concept of OPT is to facilitate movement of the articulators with the assistance of a therapy tool such as:

• Horn

• Bite blocks

• Tactile-kinaesthetic (awareness of position and movement)

• Facilitation technique using prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT) facial cue As the child progresses verbally and sounds being made, the program is changed to allow for more verbal work to be done.

Some clients in DDY are non-verbal and have a habitually open mouth position and sometimes presents excessive drooling. Traditional models for articulation didn’t work in those cases. If the jaw is weak, the lips and the tongue cannot fully function as there is no speech to work with yet. Therefore, working on sensory-motor input, using the OPT tools, and facial cueing to facilitate neuromuscular habilitation to support oral placements for speech is our sequence of therapy. This OPT activities are part of the intervention plan but not a stand-alone program. It works in conjunction with other speech-language programs giving opportunities for communication, such as Makaton signs and use of PROMPT to help facilitate language and verbal approximation.

DDY has seen many success stories of children who benefited on these programs that started from being non-verbal to saying “I want cookie”. In addition to that, several children in DDY were able to develop a closed-posture mouth position and now had enough control of their drooling.

If you are a parent to a child who is in the same situation, you are more than welcome to inquire and visit in DDY to seek top-notch therapy assistance that your child needs.