This text-based course is a written transcript of recorded course, “Updating Evidence Against NSOME for Speech Sound Production”, presented by Gregory Lof.
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>> Amy Hansen: Our presenter this afternoon is Dr. Gregory Lof. We're very pleased to have him join us today. Dr. Lof is a Professor and the Chair of the Department of Communication Sciences and Disorders at the MGH Institute of Health Professions, a Graduate School founded by the Massachusetts General Hospital in Boston. His research teaching and clinical interests primarily are with children who have speech sound disorders. Dr. Lof has served on many ASHA convention program committees, and has been an editorial consultant for all of the ASHA journals. He was a member on ASHA's Center for Evidence-based Practice and Communication Disorders, on the Communication’s Committee of the Council on Academic Programs and Communication Sciences and Disorders, and he was recently elected to a three-year term to be the Massachusetts Representative on the ASHA Speech-language Pathology Advisory Board. In addition, Dr. Lof has published numerous articles, primarily on childhood speech sound disorders. He has presented over 40 peer-reviewed and 40 invited presentations and workshops at ASHA's conventions, universities, School Districts and State and International Association conventions. He was the Keynote Speaker at the Speech-Language Pathology Convention in Melbourne, Australia last May, 2010. Welcome, Dr. Lof. Thank you so much for joining us today.
>> Dr. Lof: Thank you, Amy. Good afternoon, everyone. It is an honor to be here today. It’s a little bit strange sitting in my office all alone and staring at a computer screen and not staring at real people, but I'll do my best at providing you with the information that we want to talk about today and that information today is on “Updating Evidence Against Nonspeech Oral Motor Exercises (NSOME) for Speech Sound Productions”. As we get started, I want to make sure that I thank Maggie Watson who is at the University of Wisconsin-Stevens Point, who has been a colleague of mine for many years.
As you can see in this picture she's outstanding in her field - just a little joke there. My talk today is - why not Nonspeech Oral Motor Exercises (NSOME) to change speech sound productions? I’ve got some practical questions that I think we need to ask before we move on to this. One of the questions is: Do speech pathologists routinely just use oral motor exercises? If so, why do they use them? If so, what exercises do they use? And finally, what proof do speech pathologists have that they are effective in bringing about changes in speech sound productions? When we talk about proof, of course, we need to talk about evidence-based practice.
What I'm going to talk about today – and you can follow along in your handouts – I'm going to talk about practice trends. I'm going to talk about logical reasons not to use oral motor exercises, and then I'm going to move on to theoretical reasons not to use Nonspeech Oral Motor Exercises. I'll present the evidence that we have that shows that Nonspeech Oral Motor Exercises don't work. So let's move onto the first thing and that is what am I talking about?
Nonspeech Oral Motor Exercises
What are some definitions of Nonspeech Oral Motor Exercises? A good definition could be: Any technique that does not require the child to produce a speech sound but is used to influence the development of speaking abilities. Another definition could be: A collection of nonspeech methods and procedures that are purported to influence tongue, lip, and jaw resting postures, increase strength, improve muscle tone, facilitate range of motion, and develop muscle control. That was by Dennis Ruscello. Then a longer definition is: Oral-motor exercises (OMEs) are nonspeech activities that involve sensory stimulation to or actions of the lips, jaw, tongue, soft palate, larynx, and respiratory muscles which are intended to influence the physiological underpinnings of the oropharyngeal mechanism and thus improve its functions. They include active muscle exercise, muscle stretching, passive exercise and sensory stimulation. I think you can understand what we're talking about is, doing tasks that are not speaking in the hopes that they will lead to improving speech.
Note that I'm going to talk about procedures and techniques that don't use speech. That is why the term is NSOME. I'm not going to be talking about feeding, I'm not going to be talking about swallowing, and I'm not going to be talking about drooling. I'm going to be talking about speech, so we are clear on what today's topic is about.
Do speech pathologists use nonspeech oral motor exercises? We did a nationwide survey published in 2008 that showed that 85% of speech pathologists are using some form of nonspeech oral motor exercises to change speech sound productions. Interestingly enough, a friend of mine up in Canada, Megan Hodge and her colleagues, were also conducting a survey at the same time and asking about the same questions. I didn't know that she was doing this, and she found in Canada that 85% of speech pathologists in Canada are using nonspeech oral motor exercises – the same exact number. These data are a little bit older, not too old, but we have some more recent data. For example at an ASHA convention in 2009, approximately 79% of Kentucky speech-language pathologists were using nonspeech oral motor exercises, and a presentation at ASHA last year showed that 81% of speech pathologists in South Carolina believe that nonspeech oral motor exercises are effective in bringing about speech sound improvements. So the numbers are staying about the same it appears.
How did these speech pathologists learn to use nonspeech oral motor exercises? Well, a study we conducted showed that about 87% of the people who use them found out about the information from continuing education events, workshops, and in-services. We found that about 25% of university professors who teach about speech sound disorders teach the use of nonspeech oral motor exercises, but the news is also that 75% of the university professors do not teach it.