What is Myofunctional Therapy? A comprehensive guide for SLPs
Many speech-language pathologists complete grad school without being properly introduced or educated about myofunctional therapy.
This gap in education leaves many talented, successful SLPs asking: “What is myofunctional therapy? And why do I need to learn about it?”
This post will help you understand:
What myofunctional therapy is
The goal of myofunctional therapy
The ins and outs of OMDs (orofacial myofunctional disorders)
How myo is different from traditional articulation therapy
The importance of nasal breathing
Who benefits from myo therapy
Keep reading to learn everything you need to know about Myofunctional Therapy. And if you’re looking for more help, check out this free Guide to OMDs for SLPs.
What is myofunctional therapy?
Myofunctional therapy addresses orofacial myofunctional disorders (OMDs).
It offers specific interventions targeting:
Oral rest posture
Tongue positioning
Lip competence
Nasal breathing
Swallow patternsJaw stability
Myo treats dysfunction in the mouth.
If you break down the name — orofacial myofunctional— you can see what this type of therapy focuses on.
Oro → Mouth
Facial → Face
Myo → Muscle
Functional → How the muscles move and rest
Orofacial myology is basically understanding how the muscles of the face and mouth work the best.
We want the muscles of the face and the mouth to work really well and exactly as they should for optimal breathing, chewing, swallowing, and speaking.
But when there is dysfunction, when something has gone wrong, children and adults need myofunctional therapy to help them breathe and live better!
Myofunctional therapy is a neuromuscular re-education of the mouth, tongue, jaw, and face.
What are the goals of myofunctional therapy?
The purpose of myofunctional therapy is to help clients enjoy unrestricted breathing during both day and night, with good airway development and proper function of the tongue and other throat muscles that form the upper airway.
We want to restore function without compensation while awake and sleeping.
This goal is achieved by targeting and achieving:
Optimal oral rest posture
Efficient swallow patterns
Functional breathing patterns
Harmonious orofacial muscle coordination
Myofunctional therapy helps clients in many different ways. It can be used to help children or adults improve their speech, achieve orthodontic stability, and breathe through the nose while awake and asleep.
In addition, children also rely on myofunctional therapy for proper feeding and craniofacial growth and development.
Myofunctional therapy is a holistic approach
In therapy, we focus on addressing the root causes of airway problems.
Many issues, like snoring, teeth grinding, ADHD, bedwetting, fatigue, trouble concentrating, and behavioral challenges are symptoms of airway or breathing disorders.
Instead of treating the symptoms, we get to the root cause of the symptom and create a treatment plan customized to the individual’s needs, development, and disorders.
Myofunctional therapy is not just about a series of exercises. It's really looking at a patient holistically from an integrative approach and working collaboratively with an aligned team of professionals to give patients the best results.
What is an orofacial myofunctional disorder (OMD)?
An OMD is any functional problem that has been diagnosed from the lips all the way to the larynx (voice box).
An impaired mouth comes with a narrow airway. If the jaws are narrow, then the airway is narrow, which leads to poor sleep and the issues that come with oxygen deficiency.
OMDs can involve abnormal:
Tongue posture
Lip seal
Muscle tone
Swallow patterns
Oral habits
Myofunctional therapy is a holistic approach to OMDs.
How do OMDs present in school-aged children?
Many SLPs work with the school population, so it’s important to understand symptoms and signs that indicate a need for myo therapy.
Each child presents with their own specific combination of issues, but SLPs in schools should look for clients who demonstrate:
Open mouth posture
Low tongue posture
Anterior tongue thrust
Interdental speech distortions
Persistent thumb sucking history
Chronic mouth breathing
Crowding or high palate
If you have a client who has been in language-based speech therapy without making progress with articulation and one or more of these symptoms is present, that’s a good sign the client would benefit from an official Myo evaluation.
We often see children for myo therapy who are sensitive to dairy and gluten, even if they don’t have a positive allergy test. Sometimes this sensitivity can cause chronic congestion, which leads to other related issues.
If you suspect a school-aged client has an OMD or would benefit from myo therapy, the next step is to have them properly evaluated by a myo specialist. Based on the evaluation, you may need to recommend outside professionals to assist with treating the root cause of the client’s issues.
Why should SLPs care about OMDs?
Untreated orofacial dysfunction can undermine speech therapy outcomes.
This means you could be stuck in unsuccessful therapy with a client who isn’t making progress if you don’t understand OMDs and the need for myo therapy.
Getting stuck in therapy is frustrating for SLPs, clients, and the client’s parents.
You may be focusing on treating articulation disorders, residual /r/ distortions, lisps, speech sound generalization issues, and feeding challenges with traditional language-based or play-based therapy.
But until you get to the root cause of these issues, those types of therapy won’t help your client improve.
As you learn more about the connection between OMDs and speech therapy outcomes, you may want to add these specific items to your evaluation:
Rest posture checks (tongue/lips)
Swallow observation (with water and food)
Lingual strength and tone observations
Breathing pattern review
Looking for issues in these specific areas can help you spot the underlying OMDs causing their speech issues.
How is myofunctional therapy different from traditional articulation therapy?
Articulation therapy targets phoneme production, while myofunctional therapy targets posture and biomechanics. Myofunctional therapy doesn’t target surface sound errors. It focuses on underlying structural patterns and development. You could cue /s/ as many times as possible, but if the client has low tongue rest posture, they are not capable of producing a stable sound.
How does oral rest posture impact speech?
Proper oral rest posture means the tongue is actively supporting oral, airway, and facial development, even at rest.
Check your clients’ oral rest posture. You want to see:
Lips that are gently closed and relaxed.
The tip of the tongue touching just behind the front teeth and the body of the tongue suctioned to the roof of the mouth.
A relaxed jaw with teeth slightly apart. (Ideally 2-3mm of freeway space)
Speech begins from rest. Which means if the tongue isn’t resting in the proper posture, speech will be affected.
Children with poor oral rest posture have to work harder or overcompensate to produce some sounds, which results in an inability to produce accurate speech sound or retain previous improvements.
There are some specific oral rest posture red flags SLPs should look for:
Interdental /s/ and /z/
Mouth breathing, open-lip posture
Tongue visible during swallow
Prolonged articulation errors despite consistent therapy
History of prolonged pacifier/thumb sucking
Malocclusions, specifically open bite and overjet
Orthodontic relapse
Treating oral rest posture can help many clients make rapid progress in articulation therapy.
What does myofunctional therapy target?
Myofunctional therapy is all about identifying and treating the root cause of the problem.
In myo, we typically target specific issues including:
Mouth breathing
Tongue thrust
Oral rest posture
Oral and tongue ties
These issues are often identified by first identifying symptoms like snoring, inability to focus, difficulty chewing or swallowing, sleep issues, and speech sound disorders.
Mouth breathing
Airway capacity is the most important hallmark of well-being.
Many people don’t even realize they are mouth breathing, because they assume mouth breathing means your mouth is wide open. But mouth breathing can happen through a very small opening. True nose breathing means the lips are sealed in a relaxed position without any muscle tension. Mouth breathing can be caused by a current issue or a past issue that created the habit. Both can be treated with myo therapy and sometimes require support from outside professionals as well.
Mouth breathing can be caused by:
Allergies
Enlarged adenoids and/or tonsils
Enlarged nasal turbinates
Deviated septum
Tongue tie
Many children do breathe through their mouths, but that doesn’t make this any less serious of an issue. Mouth breathing can cause all kinds of issues, from dry mouth and increased risk of tooth decay to crooked teeth, poor facial development, behavioral and/or learning problems, and speech issues.
Tongue thrust
A tongue thrust is a dysfunctional swallowing pattern that involves the tongue pushing against or between the teeth when swallowing.
If you’re an SLP trying to evaluate tongue thrust, you should try using cheek retractors to make it easier to see what’s happening. These inexpensive, useful tools also make it harder for the child to recruit their lips or cheeks to support their swallow.
Tongue thrust is a symptom, not the problem. The goal is to determine why your client has a tongue thrust so you can treat the root cause.
Oral rest posture
Proper oral rest posture means the tongue is actively supporting oral, airway, and facial development even at rest.
The tongue should never be floppy or collapsed. It’s slightly active, even at rest.
To understand your client’s oral rest posture, ask:
“Where is your tongue when you’re not using it to chew, sing, or talk?”
Proper oral rest posture means the lips are sealed and the tongue is resting against the roof of the mouth. Proper tongue posture guides the dental arches to develop wide and forward, creating more airway space for easier nasal breathing.
Low tongue rest can lead to issues with speech, breathing, and sleeping.
Key takeaways
Myofunctional therapy is a specialized treatment that addresses orofacial myofunctional disorders (OMDs) by improving oral rest posture, tongue positioning, nasal breathing, swallow patterns, and jaw stability.
Myofunctional therapy is a form of neuromuscular re-education, not traditional articulation or language therapy.
The primary goal of myofunctional therapy is to restore proper oral and airway function so individuals can breathe through their nose, maintain optimal tongue posture, and support healthy speech, orthodontic stability, sleep, and craniofacial development.
SLPs need to understand myofunctional therapy because untreated OMDs can undermine speech therapy outcomes, particularly in cases of persistent articulation errors, tongue thrust, mouth breathing, and orthodontic relapse.
Myofunctional therapy focuses on treating the root cause of dysfunction, rather than just surface speech errors.
Want to learn more about myofunctional therapy and improve your work as an SLP?
At Brooklyn Myo, we help SLPs better understand orofacial myofunctional disorders, airway health, and oral function.
There are a number of ways we can support your professional growth and development:
Free myo resources for SLPs
Our shop full of therapy tools and materials
Head to our website to learn more about how we can support you and your clients!
