Can Anyone Become a Myofunctional Therapist?

In a word, no; but the important operative word is, however, “become.”  It’s all about qualifications and training:  formal training (conventions, seminars, and courses that lead to certification) and informal training (on-the-job training, reading and studying).  It’s a learning process that takes place over-time; a matter of years.  Our clients deserve quality services.  By way of explanation regarding quality control, here’s a bit of history.

In the 1950’s and ‘60’s, anyone and everyone hung out their shingle and became a “tongue thrust” therapist.  Information about the discipline was new and implemented indiscriminately.  There were no regulations.  I can only surmise that treatment was arbitrary and substandard and treatment worked for some and didn’t work for others.  As the saying goes, “reputation is everything.”  At that time, tongue thrust’s reputation and reviews were mixed by those in the dental field as well as in speech pathology.

We, as professionals, know more today.  We know more about muscles, bone, neuro, teeth, movement, the oral mechanism, the respiratory system, what constitutes an unharmful swallow, what constitutes a harmful swallow, how the act of swallowing relates to speaking, and how oral resting postures, chewing, and harmful oral habits fit into the mix.  We know therapy methods:  How to motivate young children and teens, how to alter methods to fit the needs of individual cases, how not to just teach swallowing technique but how to establish the oral movement pattern long-term.  We know how soft tissue can profoundly impact hard tissue through repetitive pressure during primary cranio-facial growth years.  A well-educated, well-informed Orofacial Myologist is ready to deal with any-and-all combination of characteristics.

As a speech-language pathologist (SLP) I’m tempted to say that SLPs are best equipped to be the prime discipline to do the bulk of swallowing-type therapy, but I won’t. Speech-language pathologists focus on communication; the mouth being the nucleus.  SLPs remediate the “other” function (speech sounds), and we work with infants and their feeding, as well.  SLPs know how to parse instruction and present and shape it appropriately for children and adults.  They know about motivation and how to present and sequence instruction.

However, to be forthright, few university speech pathology programs offer comprehensive training about cranio-facial and oral hard tissue, oral soft tissue, and respiration that is needed to do competent, effective therapy with complex myofunctional cases.  Within an individual case there may be concurrent factors that need to be recognized and dealt with (thumb sucking, tongue sucking, large tonsils, obstructed airway, narrow dental arch, etc., etc.).  Sadly, few speech pathology programs in the United States, and text books used in the university programs today even discuss the mouth. 

Within the past several decades, individuals within oral-facial associated fields, mostly from the dental field, some within the occupational therapy field, have joined, trained, met the qualifications, and became a certified Orofacial Myologist.  It’s great that we can all share and learn from one another.

There are those that would say that doing myofunctional therapy is straightforward and routine.  If all our clients were the same, it would be.  But obviously, each client brings their own unique characteristics and challenges, and, ethically, one must be capable of successfully meeting each client’s unique needs.  A depth and breadth of oral-facial-respiratory knowledge is required.

It makes sense that people from several disciplines view myofunctional therapy as being in their bailiwick.  Why? Because the mouth, unlike other body-parts, is a crossroads that involves several disciplines:  speech-language pathology, feeding therapy, those in the dental field especially orthodontists, pediatric dentists and dental hygienists, maxillofacial surgery, pediatrics, general medicine, specialists such as Ear, Nose and Throat specialists (ENTs), physiology, developmental psychology, occupational therapy, even respiratory therapy.  I’m sure there are others but you get the idea. 

I understand that many disciplines are intrigued with the orofacial myology area, but I cannot justify opening the doors to all disciplines.  To do so would be setting the field back several decades, and unfair, and un-responsible to our future clients.

Several training programs and associations have developed over the years.  Only one, however, offers such extensive training as to be able to provide certification, i.e., regulations, consistency of knowledge and breadth of topics, and in effect, a label of assurance of competence.  The International Association of Orofacial Myology (IAOM; www.iaom.com) is the original certifying body.  The IAOM has entry standards, offers training seminars and conventions, and are managed by a professional blend of speech-language pathologists and dental professionals.

Welcome to an exciting field!

Char Boshart, M.A., CCC-SLP

2017,  Copyright, Speech Dynamics, Inc.

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Speech Dynamics, Inc.

90 Davis Lane

Ellijay, GA 30540

951-315-2145

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