Preverbal speech therapy focuses on the treatment of eating/drinking problems and/or swallowing disorders in young children. Even before birth, the mouth responds to tactile stimuli; around 7 weeks this process begins, and between 15 and 18 weeks, the fetus already has well-developed sucking-swallowing patterns. The mouth plays a crucial role in early development because the coordination between sucking, swallowing and breathing is a basic requirement for life.

The development of oral reflexes

When a baby is born, he has a number of innate oral reflexes. These reflexes give the baby information about the sequence and progression of movements, which later helps to perform these movements consciously. Sucking thus becomes a learned skill, where repetition is essential to ingrain the movements well enough that they can later be performed automatically. However, if these oral reflexes persist, they can interfere with the development of voluntary movements. The child must be able to make conscious movements with the lips, tongue, jaw and palate in order to chew, babble and eventually speak.

Problems with the development of chewing and swallowing

In sucking, swallowing, biting and chewing, the movements are relatively gross. When oral reflexes persist, a child may have difficulty adjusting the swallowing and chewing movements needed to process different types of food. These problems can lead to eating and drinking problems and thus delay speech development.

The relationship between speech and oral development

The same muscles used in eating and drinking are also needed for speech. The difference is that in speaking, the movements are much finer, more nuanced and varied to achieve good articulation. During eating development, a child learns to move his lips, tongue and jaws in an increasingly coordinated manner, which is essential for speaking. If there are abnormal mouth movements during eating and drinking, this can carry over to speech. An example is interdental speech (for example, with the tongue between the teeth). This pattern often occurs before the first year of life when eating and drinking and can lead to speech problems later on.

Early recognition of abnormal mouth movements

The earlier abnormal movements in the oral area are recognized, the more likely it is that ingrained problematic patterns can be avoided. As a result, normal functioning can be achieved more quickly. However, problems can also occur when oral reflexes are absent or too weak.

The importance of mouth development

When there are problems in the mouth area, you often see at an early age that children do not put objects in their mouths and exploration of the mouth is delayed. Lack of positive experiences in the mouth area can not only cause eating and drinking problems, but also delay speech and language development.

Consequences of poor oral development

If insufficient experience is gained in the oral area, the following problems may arise:

• The mouth lacks essential information needed to start the learning process.
• The sensitivity of the mouth remains too high, which can lead to further problems with eating and drinking and speech.

A child who does not gain sufficient experience in infancy will need to catch up. The mouth will continue to ask for stimulation until this need is met and insufficient experiences are stored.

Addressing speech and language problems through oral development

When a child experiences problems in speech and language development, or in oral development, it is essential to identify where the cause lies. It is then necessary to work on the basics to most effectively address the problem. Discovering gaps in sensory development and engaging the senses is indispensable here. Proper development of the mouth is crucial for optimal speech and language development. Treatment of eating and drinking takes place in the child’s own environment and thus largely following at home rather than in the practice.