Disorders that SLPs Often Use NSOME for
Childhood Apraxia of Speech (CAS)
Children with CAS have adequate oral structure movements for nonspeech activities but not for volitional speech (Caruso & Strand, 1999), so this would preclude the use of NSOME because non-speech is not the problem.
There is no muscle weakness for children with CAS, so there is no need to do strengthening exercises. If there is weakness, then the correct diagnosis is dysarthria, not apraxia.
“The focus of intervention for the child diagnosed with CAS is on improving the planning, sequencing, and coordination of muscle movements for speech. Isolated exercises designed to “strengthen” the oral muscles will not help. CAS is a disorder of speech coordination, not strength.” (ASHA Technical Report on Childhood Apraxia of Speech, 2007).
The VP mechanism can be strengthened through exercise (many studies have demonstrated this since the 1960s), but added strength will not improve speech productions.
“Blowing exercises, sucking, swallowing, gagging, and cheek puffing have been suggested as useful in improving or strengthening velopharyngeal closure and speech. However, multiview videofluoroscopy has shown that velopharyngeal movements of these nonspeech functions differ from velopharyngeal movements for speech in the same speaker. Improving velopharyngeal motion for these tasks do not result in improved resonance or speech. These procedures simply do not work and the premises and rationales behind them are scientifically unsound. (Goldening-Kushner, 2001).
Ruscello (2008) evaluates the use of NSOME and craniofacial anomalies in his article.
NSOME for Non-Motor Speech Disorders
Some may believe that motor exercises can help children with motor production speech problems, such as functional misarticulators (phonetic/ articulatory problems) or children with structural problems; however the evidence does not support this.
It makes no sense that motor exercises could help improve the speech of children who have non-motor problems such as language/ phonemic/phonological problems like children in Early Intervention diagnosed as late talkers.
It is puzzling why clinicians would use a motor approach for non-motor speech disorders; therapy must target the system that is impacting the speech problem.
NSOME for Children with Dysarthria
NSOME are frequently used for acquired dysarthria, but their use is influenced by ¡§folklore¡¨ and not by evidence of effectiveness (Mckenzie, Muir, & Allen, 2010).
Following guidance from adults with acquired dysarthria, “strengthening exercises are probably only appropriate for a small number of patients” (Duffy; 2005).
“weakness is not directly related to intelligibility…” for patients with ALS (Duffy; 2005).
Based on the adult acquired dysarthria literature, it appears that NSOME are not recommended as a technique that can improve speech productions.