Palatal Training Appliances in Children with Mild to Moderate Oral Dysfunctions

Objective: The objective of the study was to evaluate the efficacy of palatal training appliances on speech articulation and orofacial functions in children undergoing speech therapy. Study design: The material consisted of 134 boys and 34 girls who were referred by speech and language therapists to the Public Dental Health Service in Vantaa due to mild to moderate problems with speech articulation or in oral motor skills. The mean age of the children at the start of the palatal plate therapy was 6.4 years (SD 1.9). The articulation assessment was performed by five speech and language therapist while the palatal plate therapy was carried out by an experienced dentist. The mean treatment time with the oral plates was 4.4 months (SD 2.3). Results: An improvement in speech articulation was observed by the speech and language therapists in 51% of the children. Tongue movements improved in 47%, and lip closure in 38% of the participants. Drooling decreased in 54% of the cases. A multiple logistic regression model revealed that with respect to speech articulation the best improvement was found in children with /r/-disorder, and in those with a crossbite. Conclusions: Palatal training appliances during speech therapy seemed to be an efficient way to improve speech articulation and tongue movements in children with mild to moderate problems in orofacial functions.

misarticulation, orofacial function, palatal training appliance

1. Rauhala R. Lasten erityishuolto ja -opetus Suomessa. Lastensuojelun Keskusliitto, Helsinki; 87, 1991.

2. Sonninen  A,  Sonninen  E.  Logopedic-phoniatric  observations  on  8-year-old schoolchildren in the town of Jyväskylä. Nord Tidskr Logop Foniat, 1: 74–8, 1976.

3. Qvarnström M, Laine MT, Jaroma M. Place of articulation in articula-tory speech disorders of different sounds in a group of Finnish first-graders. Folia Phoniatr Logoped, 43: 161–70, 1991.

4. Luotonen M. Early speech development, articulation and reading abil-ity up to the age of nine. Folia Phoniatr Logop, 47: 310–7, 1995.

5. Glatz-Noll E, Berg R. Oral dysfunction in children with Down´s Syn-drome: an evaluation of treatment effects by means of video registra-tion. Eur J Orthod, 13: 446–51, 1991.

6. Carlstedt  K,  Henningsson  G,  McAllister  A,  Dahllöf  G.  Long-term effect of palatal plate therapy and oral motor function in children with Down syndrome evaluated by video registration. Acta Odontol Scand, 59: 63–8, 2001.

7. Scholz F, Chapman E, Chapman JA. Die Frühbehandlung der Zungen-und  Lippendysfunction  beim  Morbus  Down  mit  Stimulationsplatten. Fortshr Kieferorthop, 44: 54–6, 1983.

8. Korbmacher HM, Limbrock JG, Kahl-Nieke B. Long term evaluation of orofacial function in children with Down syndrome after treatment with  stimulating  plate  according  to  Castillo  Morales.  J  Clin  Pediatr Dent, 30: 325–8, 2006.

9. Haberfellner H, Rossiwall B. Appliances for treatment of oral sensori-motor disorders. Am J Phys Med, 56: 241–48, 1977.

10.  Fischer-Brandies H, Avalle C, Limbrock GJ. Therapy of orofacial dys-functions in cerebral palsy according to Castillo-Morales: first results of a new treatment concept. Eur J Orthod, 9: 139–43, 1987.

11.  Limbrock GJ, Hoyer H, Scheying H. Drooling, chewing and swallow-ing dysfunctions in children with cerebral palsy: treatment according to Castillo-Morales. J Dent Children, 57: 445–51, 1990.

12.  Haapanen  M-L.  Suunsisäisen  irtokojeen  käytön  aiheet  ja  hoitovaste puhehäiriöissä. Suomen Lääkärilehti, 39: 3877–81, 2003.

13.  Castillo-Morales  R.  Die  Orofaziale  Regulationstherapie.  München: Pflaum Verlag; 1991.

14.  Turunen P. Production of word structure. A constraint-based study of 2–6  year  old  Finnish  children  at-risk  of  dyslexia  and  their  controls. Thesis. Jyväskylä studies in languages 52. Jyväskylä, 2003.

15.  Sarmavuori K. Lasten kielen oppiminen. Helsinki:Gaudeamus; 1982.

16.  Kunnari S, Savinainen-Makkonen T. (eds) Mistä on pienten sanat tehty. Lasten äänteellinen kehitys. WSOY; 2003.

17.  Sillanpää M. (edit.) Practices in orofacial therapy. Finnish association for orofacial therapy. Turku. Painosalama Oy; 2001.

18.  Laitinen J, Ranta R, Pulkkinen J, Haapanen M-L. Associations between dental occlusion and misarticulations of Finnish dental consonants in cleft lip/palate children. Eur J Oral Sci, 107: 109–13, 1999.

19.  Qvarnström  M,  Jaroma  M,  Laine  T. Accuracy  of  articulatory  move-ments  of  speech  in  a  group  of  first-graders.  Folia  Phoniatr,  45: 214–222, 1993.

20.  Kenney  KW,  Prather  EM,  Mooney  MA,  Jeruzal  NC.  Comparison among three articulation sampling procedures with preschool children. J Speech Hear Res, 27: 226–231, 1984.

21.  Beitchman JH, Nair R, Clegg M, Patel PG. Prevalence of speech and language disorders in 5-year-old kindergarten children in the Ottawa-Carleton region. J Speech Hear Disord, 51: 98–110, 1986.

22.  Zarb GA, Mohl ND, MacKay HF. Deglutition, respiration, and speech. In: A textbook of occlusion. Mohl ND, Zarb GA, Carlsson GE, Rugh JD, editors. Chicago: Quintessence Publishing Co. Inc., 1988. 

23.  Van  Dyke  DC,  Yeacer  D,  McInerney  JF,  Schellinger  D,  Fox  AA. Speech  and  language  disorders  in  children.  Am  Family  Phys,  29: 257–268, 1984.

24.  Fairhurst CBR, Cockerill H. Management of drooling in children. Arch Dis Child Educ Pract Ed, 96: 25–30, 2011.

25.  Van de Heyning PH, Marquet JF, Creten WL. Drooling in children with cerebral palsy. Acta Otorhinolaryngol Belg, 34: 691–705, 1980.

26.  Blasco PA. Management of drooling: 10 years after the Consortium on Drooling. Dev Med Child Neurol, 44: 778–781, 2002.

27.  Erasmus  CE,  Van  Hulst  K,  Rotteveel  LJ  et  al.  Drooling  in  celebral palsy: hypersalivation or dysfunctional oral motor control? Dev Med Child Neurol, 51: 454–459, 2009.

28.  Pani SC, Hedge AM. Functional appliance therapy to control drooling: a  case  of  a  child  with  mental  retardation.  J  Clin  Pediatr  Dent,  31: 284–6, 2007.