Structural Anomalies that Contribute to Speech Problems
Speech irregularities can be caused by structural anomalies in the mouth and teeth. When we evaluate children for speech sound delays or disorders, we assess their mouths and teeth for any observed deviations in structure or form, as these can directly impact the sounds they are able to make. The structural anomalies below are the most common ones that affect speech production and sounds.
- Tongue Thrust:
Tongue thrusting is the habit of pushing the tongue against or between the front teeth when speaking or swallowing. This can have an impact on normal swallow pattern, speech, and dentition (the development of the teeth and their arrangement in the mouth). Most children outgrow a tongue thrust. If they do not, a trained speech language pathologist (SLP) can help re-train the muscles to a normal speech and swallowing pattern.
- Open Bite/Malocclusions:
Open bite/malocclusion is an anomaly in the alignment of the teeth. This can be caused by prolonged pacifier usage and thumb sucking, which can alter dentition as teeth grow in and cause speech problems. The structural part of the problem can be solved by an orthodontist and the functional problems that coincide with this can be addressed by a speech therapist.
- Cleft Lip/Palate:
A cleft lip/palate occurs when the roof of the mouth has an opening into the nose. This can cause feeding problems, speech problems, and other health related issues. Repairing a cleft lip/palate requires a surgical team. Often, after surgery, the child is referred to speech therapy. In the case of a sub mucous cleft (which is less common and sometimes goes undetected until a child presents with speech, feeding, or other problems at a later time), a referral to a physician would also be warranted for this type of anomaly to determine if repair would be needed .
- Tongue Tie (aka Ankyloglossia):
A tongue tie is when a short, tight band of tissue tethers, or “ties”, the tongue’s tip to the floor of the mouth. It can affect how a child eats and speaks. Depending on how severe the problem is, this can require surgical intervention and speech therapy following it. Some cases can simply require speech therapy.
- Open Mouth Resting Posture:
This posture is exactly what it sounds like: when the mouth rests in an open position. This can interfere with speech over time as the tongue typically “falls” out of the open mouth, pushing against the teeth and causing secondary changes as well. If your child has an open mouth posture and perfect speech, it’s still a good idea to see a physician because this mouth posture can cause other problems with facial and mouth growth later on. In terms of speech impact, a closed mouth resting posture with the tongue in the mouth is important for developing normal speech and reducing drooling.
- Changes to the Palate:
Any changes to the palate (roof of the mouth) can impact speech, so we evaluate the palate and any related changes continuously.
- Enlarged Tonsils, Mouth Breathing, Congestion, Allergies:
All of these can impact speech and we may make a referral to an E.N.T. (ear, nose, and throat doctor), too. Some of these issues can cause secondary changes in the development of your child’s teeth and mouth, which can lead to speech problems later on. For example, a child with consistent congestion caused by allergies will often have to mouth-breathe because of a stuffy nose, which results in an open mouth posture and a possible tongue “falling” or pushing against the teeth. As discussed earlier, this can impact dentition, etc. When a child is consistently congested, it can also impact their perception of the sounds they are producing or those being modeled by an adult, consequently impacting accurate learning of these sounds.
It Takes a Village!
It takes a village to raise a child and, sometimes, it takes a village to help with a child’s speech. Regardless of what your child’s mouth anomalies are, it’s important to have the right team on your side. Not every issue can be solved by a speech therapist alone, but if we can’t fix the issue on our own, we will be sure to refer you to the appropriate professionals who can also work with him or her. Speech therapy cannot change abnormal structure if it is detected and if it impacts speech; that’s a dentist’s, orthodontist’s, or surgeon’s job. The purpose of speech therapy is to change abnormal function, such as speech errors. Having a correct bite, dentition, or oral structure will have a positive impact upon a child’s ability to produce correct speech. Speech therapy can help teach your child how to produce developmental sounds and correct speech errors, or retrain your child’s oral structures given whatever anomaly they may be presenting with!
https://www.asha.org › Events › convention › handouts › 1371-Kummer-Ann
Classic 5-Part Problem (anterior open bite, high arch palate, reverse swallow pattern, frontal lisp, an oral habit like sucking)
DISCLAIMER: Information published about one particular disorder does not necessarily apply to every individual who has the disorder discussed in this article. Treatments and therapies are highly individual and must be customized to the needs of each person to be effective. Do not make changes to your/your child’s treatment plan as a result of what you read in this article (or any content published by AASL) without consulting your/your child’s physicians and therapists. This content does not necessarily reflect the opinions of All About Speech and Language or its therapists. To understand the opinions and recommendations of your/your child’s AASL therapist, schedule an appointment with your therapist to discuss your concerns.