Two families ask a version of this question most often.
One has been told their child needs "oral motor work" and found a myofunctional therapist instead. The other has been doing straw hierarchies and horn blowing for a year and wants to know whether myofunctional therapy is the same thing under a newer name.
It is a fair question, because both approaches work on the same anatomy and both get described as "exercises for the mouth." What separates them is not the muscles. It is what they are trying to change.
The Short Answer
Oral motor therapy targets a movement. Can the jaw stay stable while the tongue moves independently? Can the lips round and retract on demand? Can the tongue tip elevate? The work is usually hands-on or tool-assisted, and the goal is a motor skill the person does not yet have.
Orofacial myofunctional therapy targets a resting pattern and an automatic function. ASHA's practice portal on orofacial myofunctional disorders defines them as "movement patterns that involve oral and orofacial musculature, which result in incorrect positioning of the tongue at rest and during swallowing, breathing, and speech production." The goal, per ASHA, is "to create an oral environment in which typical processes of orofacial and dental growth and development can take place and be maintained."
So: one is teaching the mouth to do something. The other is changing what the mouth does by default, when nobody is watching and nobody is cueing.
That difference drives everything else below — who is a candidate, how long it takes, and what the research supports.
What "Oral Motor Therapy" Actually Refers To
The term is loose, which is part of why this question keeps coming up. In practice it covers at least three different things that get filed under one label.
Hands-on oral motor intervention. Protocols like the Beckman Oral Motor Protocol work through assisted movement and deep tissue techniques. Beckman's own framing is a "focus on non-cognitive muscle responses" — meaning it does not require the client to understand or cooperate with the task. That is precisely why it is used with infants, with children who have significant motor involvement, and with clients who cannot follow a direction.
Oral placement therapy. Approaches such as Talk Tools Oral Placement Therapy use specific tools — bite blocks, straws, horns, chewy tubes — to train jaw, lip, and tongue placement and dissociation, often as a bridge toward speech or feeding targets.
Non-speech oral motor exercises (NSOMEs). This is the category that generates the arguments: blowing, licking, puffing cheeks, tongue push-ups, and similar drills performed in the hope they will transfer to clearer speech. It is also the category with the weakest evidence, and it is worth separating from the two above.
What Myofunctional Therapy Actually Treats
Myofunctional therapy is not aimed at speech sounds, and that surprises people. Its targets are four functions that run constantly in the background:
- Resting tongue posture — where the tongue sits when the mouth is idle
- Nasal breathing and lip seal — whether the mouth is closed by default
- The swallow — whether the tongue pushes forward against the teeth or elevates to the palate
- Oral habits — thumb sucking, nail biting, prolonged pacifier use
ASHA's guidance describes exercises used "to promote a closed-mouth resting posture and nasal breathing" — the emphasis is on posture, not on strength. A person with a tongue thrust swallow is not weak. They swallow roughly 500 to 1,000 times a day with a pattern that happens to be wrong, and the job is to replace it with one that runs just as automatically.
Speech does show up at the edges. ASHA lists the sound errors that commonly travel with orofacial myofunctional disorders: "distorted productions of /s, z/, often with an interdental lisp, or abnormal lingual dental articulatory placement for /t, d, l, n, ʧ, ʤ, ʃ, ʓ/." That is a short, specific list — not speech sounds in general. We cover the fuller picture in myofunctional therapy vs. speech therapy.
The Four Differences That Matter Clinically
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Skill vs. habit. Oral motor therapy adds a movement a person cannot make. Myofunctional therapy replaces a movement they make correctly on request and incorrectly by default. If your child can do the movement when you ask, the problem is not motor capacity.
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Cooperation required, or not. Beckman-style work runs on non-cognitive muscle responses and can proceed without the client's participation. Myofunctional therapy cannot. ASHA notes that awareness exercises "require self-monitoring skills that younger children may not possess," which is why most children are ready for a full program around age 7 — a point we go into on myofunctional therapy for kids.
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Where the airway sits in the plan. Myofunctional therapy is airway-first by doctrine. ASHA is explicit that "closed-mouth posture cannot be consistently established until any airway interferences have been successfully resolved," which means allergies, enlarged tonsils and adenoids, and nasal obstruction get addressed by an ENT or allergist before lip-seal work starts. Oral motor therapy has no equivalent gate, because it is not trying to establish nasal breathing.
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Timeline and endpoint. An oral motor goal is met when the movement is reliable. A myofunctional goal is met when the new pattern holds without cueing, which takes months of short daily practice and a habituation phase most people underestimate.
What the Research Actually Supports
This is where the comparison gets genuinely useful, because the evidence is not uniformly good or bad for either approach. It depends entirely on what you are treating.
For speech sounds: the evidence does not support non-speech exercises
The most rigorous look at this is a Cochrane review by Lee and Gibbon (2015). After screening the literature, the reviewers found only three eligible studies covering a combined total of 22 children, and concluded there is "currently insufficient evidence supporting or refuting NSOMT for children with SSD. Additional high-quality research is needed."
An earlier systematic review published in ASHA's own American Journal of Speech-Language Pathology — McCauley, Strand, Lof, Schooling, and Frymark (2009) — reviewed 15 peer-reviewed studies spanning 1960 to 2007 and reached a similar place: the state of evidence is "equivocal due to the lack of well-designed, experimentally controlled studies with adequate statistical power and well-described participants." Their guidance to clinicians is worth reading literally: "the use of [nonspeech oral motor exercises] must be considered exploratory, and clients should be informed of this prior to initiating their use in treatment."
It is worth knowing how common these exercises nevertheless are. A nationwide survey of U.S. speech-language pathologists by Lof and Watson (2008), with 537 respondents, found that 85% reported using non-speech oral motor exercises to treat speech sound disorders. Widespread use is not the same thing as evidence, and parents who have spent a year on horns and straws without clearer speech are not imagining the gap.
What does work for a speech sound error is speech practice: motor-based articulation therapy, or for motor planning disorders, an approach like PROMPT or DTTC, which cue real speech movements rather than non-speech ones. Our guide to phonological disorder vs. articulation disorder covers how the target is chosen.
For feeding and swallowing: better evidence, narrower claims
Oral motor intervention holds up considerably better here. An ASHA-published systematic review by Arvedson, Clark, Lazarus, Schooling, and Frymark (2010) examined 12 studies of oral motor interventions in preterm infants. Non-nutritive sucking, alone and combined with oral and perioral stimulation, produced "strong positive findings" for improvement in some feeding and swallowing physiology measures and for reducing the transition time to oral feeding. The honest caveats are in the same paper: pre-feeding stimulation alone gave equivocal results, none of the interventions consistently improved weight gain or growth, and the authors flag methodological limitations that "warrant careful consideration of their clinical use."
That is a real but bounded result, and it maps onto how oral motor work is used in feeding therapy — jaw stability, chewing, bolus management, and the mechanics of a safe, efficient swallow.
For the airway: myofunctional therapy as an adjunct
On the myofunctional side, a systematic review and meta-analysis in Sleep (Camacho et al., 2015) found that myofunctional therapy "decreases apnea-hypopnea index by approximately 50% in adults and 62% in children," and framed it as something that "could serve as an adjunct to other obstructive sleep apnea treatments." Adjunct is the honest word. ASHA adds that more study is needed on compliance and long-term outcomes. That is the basis for how we approach sleep apnea and airway health — alongside a physician, never instead of one.
Where the Two Are Used Together
They are not rivals, and plenty of children get both — in sequence rather than simultaneously.
A common pattern: a child with low jaw stability and poor tongue-jaw dissociation does oral motor and placement work first, because a tongue that cannot move independently of the jaw has no chance at a palatal resting posture. Once the movement exists, the myofunctional phase can start, because now there is something to habituate.
The reverse sequence also happens. A child with a significant tongue restriction may need tongue-tie assessment and release before either approach gets traction, since neither exercises nor habituation can extend a frenulum.
What should not happen is a year of non-speech mouth drills assigned in the hope they produce clearer speech. That is the specific pattern the Cochrane and ASHA reviews above speak to.
How to Tell Which One You Are Looking For
Ask yourself one question: can they do it when asked?
- No, the movement is not there. Tongue tip will not elevate, jaw slides, lips cannot round, chewing is disorganized, suck-swallow-breathe is uncoordinated. That is motor skill territory.
- Yes, but only when asked. Mouth falls open the moment attention moves, tongue rests low and forward, swallow pushes forward, thumb goes back in at bedtime. That is a resting-pattern problem, and exercises alone will not hold it. Our guide to myofunctional therapy exercises shows what that daily work looks like and, more importantly, what it cannot fix.
- Yes, and the issue is a specific sound. That is articulation or motor speech therapy, not either of the above.
Where We Come In
Laura Friedman is a Qualified Orofacial Myologist (QOM) and a certified speech-language pathologist (CCC-SLP) who is also Beckman Oral Motor trained and Talk Tools Oral Placement Therapy trained. Holding both sides of this is less interesting as a credential list than as a conflict of interest removed: there is no incentive to describe a resting-posture problem as a motor problem, or the reverse, because both are on the table.
What that looks like in practice is an evaluation that separates the two before anything is assigned — what the tongue does at rest, what it does on command, what the swallow looks like, whether the nasal airway is open, and whether a speech sound error is actually connected to any of it. Sometimes the answer is myofunctional therapy. Sometimes it is oral motor and feeding work. Sometimes it is articulation therapy with no mouth exercises at all, and sometimes it is a referral to an ENT or a dentist first.
If you have been doing mouth exercises without the result you expected, or you are trying to work out which of these two your child actually needs, schedule a free consultation — in person in Dallas or by telehealth nationwide.
Frequently Asked Questions
Is myofunctional therapy the same as oral motor therapy?
No. Oral motor therapy works on the movement itself — jaw, lip, and tongue movements for speech or feeding, usually hands-on or with tools. Myofunctional therapy works on what the mouth does when nobody is thinking about it: tongue resting posture, lip seal, nasal breathing, and the swallow. One builds a skill; the other replaces a habit with a new automatic one.
Does my child need oral motor therapy or myofunctional therapy?
It depends on what the problem is. If a child cannot make the movement at all, that is motor skill territory. If they can make it on request but revert to an open mouth and a forward swallow the moment attention moves, that is a resting-pattern problem and myofunctional therapy is the fit. An evaluation sorts this out.
Is there research supporting oral motor exercises for speech?
Not for non-speech oral motor exercises used to improve speech sounds. A 2015 Cochrane review found only three eligible studies covering 22 children and concluded the evidence is insufficient either way. A 2009 ASHA systematic review of 15 studies called the evidence equivocal and said these exercises "must be considered exploratory," with clients informed of that before treatment begins.
So is oral motor therapy useless?
No, but the evidence depends on what you are treating. For feeding and swallowing in preterm infants, an ASHA review of 12 studies found non-nutritive sucking produced strong positive findings for some physiology measures and for shortening the transition to oral feeding — though no intervention consistently improved weight gain. What the research does not support is non-speech mouth exercises as a route to clearer speech.
Can a child be too young for myofunctional therapy but ready for oral motor work?
Yes. Oral motor approaches like the Beckman protocol are built around non-cognitive muscle responses, so they can be used with infants and children who cannot follow directions. Myofunctional therapy asks the opposite — ASHA notes awareness exercises require self-monitoring younger children may not have. Most children are ready for a full myofunctional program around age 7.
Does Laura Friedman do both?
Yes. Laura is a Qualified Orofacial Myologist and is also Beckman Oral Motor trained and Talk Tools Oral Placement Therapy trained. The practical value is honest triage — the recommendation follows the evaluation findings, not whichever training is in the room.
Not Sure Which Kind of Mouth Work You Need?
If you have been handed a program of mouth exercises and are not sure what it is meant to accomplish, or you suspect the real issue is where the tongue sits rather than what it can do, schedule a free consultation with Laura Friedman, CCC-SLP and Qualified Orofacial Myologist. You will get a straight read on which of these two your child needs — including the answer that it is neither.