Oral Motor Exercises for Down’s Syndrome

This blog is on Oral Motor Exercises for Down’s Syndrome.  Today we are going to talk about these adorable and loving children who are a little special to us because of the extra chromosome in them- know to us as Children with Down Syndrome. Hence, we will try to cover the oro-motor concerns in children with Down syndrome.  Further, it is of particular interest to us since it involves muscles that are involved in eating and talking. Additionally, before going ahead let’s try to understand what causes these oral-motor issues in this group of children. Therefore, we will talk about Oral Motor Exercises for Down’s Syndrome.

“We can complain because rose bushes have thorns, or rejoice because throw bushes have roses”- Abraham Lincoln

Down Syndrome: Myths and Facts

Down Syndrome is a rare genetic disorder.

Fact: Down Syndrome is a common disorder. It is due to the presence of an extra band of chromosome 21. In other words, it is very common and occurs in 1 in every 830 births in India.

Down Syndrome is heredity.

Fact: Down Syndrome is caused randomly in most cases. Therefore, less than 1% of all Down Syndrome cases have a heredity link.

Persons with Down Syndrome have severe delays in their development.

Fact: Each Person with Down Syndrome is unique in their way. Hence, not all children born with Down Syndrome show severe delays. Similarly, cognitive, motor, and speech milestone delays range from mild to severe. Appropriate early intervention and therapies can speed up their growth.

All Persons with Down Syndrome are dependent on their caregivers.

Fact: Persons with Down Syndrome can be empowered to be independent, educated, and make a living of their own. In conclusion, there are several Persons with Down Syndrome who grow up to be valuable contributors to society.

All Persons with Down Syndrome have a low Intelligence Quotient.

Fact: Persons with Down Syndrome may have a lower IQ compared to their peers. However, every individual irrespective of their IQ can possess unique talents and skills like no other. They can also grow up to have a typical family and career, just like us all!

Children with Down Syndrome go to Special Schools.

Fact: Every child irrespective of their abilities should be given an opportunity to go to an inclusive school. Similarly, not all children with Down Syndrome go to a special school. In addition, caregivers must evaluate the child’s abilities and skills before making this decision. Many children score good grades and earn graduate degrees and go on to build a successful careers.

Persons with Down Syndrome do not communicate or interact.

Fact: Early and regular Speech-Language Therapy intervention is the foundation of communication development. Children and adults with Down Syndrome learn to interact, communicate and form social relationships.

Persons with Down Syndrome have multiple medical issues.

Fact: Multiple medical issues ranging from cardiac defects, anatomical anomalies, poor swallowing function, and hearing issues can be present. Regular and constant medical check-ups will ensure the overall well-being of the individual. Regular hearing testing by an Audiologist is also mandatory.

Down Syndrome lowers the life expectancy of the person.

Fact: The life expectancy of every individual depends on several factors. In other words, regular medical check-ups and appropriate intervention will facilitate the normal life expectancy of the person with Down Syndrome.

Adults and Children with Down Syndrome are alike.

Fact: Adults with Down Syndrome are typical adults and need to be treated that way. They are not childlike and hence, have to be treated with dignity and respect.

Understanding Down Syndrome

As known by many, children with Down syndrome have lower muscle tone- hypotonia. Hence, as a result of this, the muscle strength is less leading to reduced movements, speed is affected and movements are un-coordinated. Thus, this is evident in the muscles of the tongue, jaw, lips, cheeks, and palate. Furthermore, as a result of this children show difficulty in learning feeding skills like sucking, chewing, and swallowing. Moreover, children with Down syndrome have issues in learning speech and language. Additionally, language development is usually slow as compared to their peers. Besides, they also have speech sound errors/ misarticulations, voice is different, intonation is affected, etc.

Further, apart from the hypotonia, sometimes co-morbid conditions which are present in this group of children also affect the development of feeding and speech and language skills. Therefore strengthening the muscles, to overcome the lower tone becomes very important and is an integral part of the therapy regime. Thus, before we go into the details of what to do, it becomes very important to know how to go ahead with the oro-motor exercises. Hence, key points to remember are:

1. Do the exercises at regular interval

2. Follow the step by step procedure when you are doing the exercise

3. Do it in a playful manner

4. Start from simple and go to complex exercises

   
   

Oral Motor Exercises of the lips

Therefore, the following exercises are designed in such a way that they help to increased the strength of the lip muscles, increases the range of motion of lips, and helps to ease the movement. Similarly, repetition of the exercises in steps helps to meet the target goal easily.

1. Lip Retraction:

Smile. Ask the child to imitate a smile and hold for 5 seconds.

Relax and repeat 5 times.

2. Lip Protrusion:

Ask the child to pucker the lips as if you were going to kiss someone. Hold for 5 seconds, relax and repeat 5 times.

3. Lip Retraction and Protrusion:

Repeat the exercises given in numbers 1 and 2 with exaggerated movements. Repeat 5 times.

4. Lip Press:

Ask the child to press the lips tightly together for 5 seconds. You can do it and ask the child to imitate it. Relax and repeat 5 times.

5. Lip Press on Tongue Depressor:

Ask the child to tightly press lips around the tongue depressor, while you try to remove it. Additionally, instruct them to perform for 3 to 5 seconds, relax and repeat 5 times.

Advantages of the lip exercises:

1. Helps with better lip closure

2. Aids in reducing drooling

3. Helps to produce bilabial sounds with better clarity

4. Is also helpful to have a better lip seal while the child is eating

Exercises for the cheeks

The following exercises are designed to improve the strength of the cheek muscles, increase the range of movements of cheek muscles and ease the movements.

1. Cheek Puff exercise

First, ask the child to take in a deep breath and puff your cheeks out. Next, hold the air in the cheeks by tightly closing the lips together. Additionally, instruct them to hold the air in the cheeks for 5 seconds.

2. Alternate Cheek Puff Exercise

Instruct the child to take in a deep breath and only hold air in the left cheek. Further, then switch and hold air only in your right cheek. Additionally, fill cheeks with air, move air from one cheek to the other 5 to 10 times. Further, tell the child that during this exercise no air should escape from around the lips or the nose. Similarly, you can give tactile feedback to the child if required by placing their finger under the nose. Finally, relax and repeat 5 times.

3. Making a fish face

Ask the child to pull their cheeks inside like that of a fish. Ask them to hold it for 5 seconds, relax and repeat 5 times.

Advantages of the cheek exercises

1. Help to increase the strength of facial muscles, which helps to improve blood circulation and tone.

2. It also firms and tightens the skin of the face.

   
   

Motor Exercises for the tongue

1. Tongue Extension exercise:

Ask the child to protrude tongue between lips. Instruct them to stick out the tongue as far as possible and hold the tongue steady and straight for 3 to 5 seconds. Relax and repeat 5 times. Once the child can do the above, repeat the same by applying resistance. Ask the child to stick out the tongue. Put something flat, such as the back of a spoon or a tongue blade against the tongue. Ask them to push against the tongue with the flat object. Hold it for 2-3 seconds, relax and repeat 5 times.

2. Tongue Retraction exercise

Firstly, ask the child to retract the tongue. Secondly, imitate touching the back of your tongue to the roof of your mouth (as if producing the /k/).  Thirdly, ask them to hold for 1 to 3 seconds, relax and repeat 5 times.

3. Tongue Extension and Retraction exercises

 Now, combine the exercises in numbers 1 and 2. Then, instruct the child to alternate between the exercises, as fast as possible. Finally, instruct the child to hold in each position for 1 to 3 seconds, relax and repeat 5 times.

4. Tongue Tip-Up exercise

  First, ask the child to place the tongue on the alveolar ridge, (the area behind the top teeth.)  Secondly, instruct the child to open mouth as wide as possible maintaining tongue contact. Finally, hold for 3 to 5 seconds, relax and repeat 5 times

5. Tongue Elevation along with the palate exercise

Ask the child to place the tongue tip on the alveolar ridge. Instruct them to move in anteriorly to posteriorly along the palate. Relax and repeat 5 times.

6. Tongue side to side exercise

Ask the child to put the tongue tip to the left side of the mouth and hold it for 3 to 5 seconds. Next, ask them to place the tongue tip to the right side of the mouth and hold for 3 to 5 seconds. Relax and repeat 5 to 10 times.

Once the child can do the above exercises, instruct them to extend the tongue as far as possible to the corners of the mouth, while you try to press it against a tongue depressor. Hold for 1 second and repeat 5 times.

7. Tongue Tip-Up – Jaw Down

Instruct the child to lower their jaw as far as possible while keeping their tongue tip up behind the top gums/teeth. Ask to hold for 1 to 3 seconds, relax and repeat 5 times.

Advantages of the tongue exercises

1. Helps with tongue strength and movements

2. Better productions of tongue tip sounds

3. Better swallowing abilities

1. Jaw Opening exercise

Instruct the child to open the jaw as wide as possible until you feel a stretching, but no pain. Ask them to hold this furthest open position for 5 seconds then relax and close your mouth. Repeat this open posture 5 times.

2. Side-to-Side Movement exercise

Ask the child to move the jaw to the right side as far as you can until it pulls but does not hurt. Instruct them to hold it there for 5 seconds then relax. Later, move the jaw to the left side as far as possible until they feel a stretch but it does not hurt.  Finally, hold it there for 5 seconds then relax. Also, alternate this right to left movement 5 times.

3. Increasing Circular Jaw Movement

Ask the child to move the jaw around in a circle making it move as far in each direction as possible until they feel a stretch but no pain.  Further, in this circular movement, the child will be increasing the range of motion in all directions.Moreover, repeat the circular movement 5 times.

Advantages of jaw exercises

1. Better strength and movement of jaw muscles

2. Helps in improving the clarity of speech

   
   

Fun with oro- motor exercises at home

1. Blowing Bubbles: It helps to strengthen muscles of the lips and improves breath control.

2. Licking peanut butter or marshmallow crème from the roof of the mouth or behind the top front teeth. It helps to improve tongue elevation/lifting.

3. Chewing gum improves jaw strength.

4. Making silly faces: It helps to improve strength, coordination and range of motion of the lips, jaw, and tongue.

Conclusion

Children and adults with Down Syndrome are capable, intelligent, and full of potential. By debunking myths, encouraging inclusion, and supporting them through evidence-based oral motor exercises, we can empower them to communicate confidently and live fulfilling lives. Down Syndrome is not a limitation it’s a different way of learning, growing, and expressing. With love, patience, and consistent therapy, every individual with Down Syndrome can shine bright. Remember, progress takes time, but every small step counts toward a bigger milestone.