NSOMs are techniques or motor exercises that do not require the child to produce a speech sound. Examples of NSOMEs: blowing, tongue push ups, pucker-smile, big smile, check puffing, tongue wags.They involve sensory stimulation or actions of the articulators. Lof & Watson (2008) reported that 85% of SLPs use NSOME.
A Cochrane review in 2015 did not find evidence for NSOME and characterized the three studies conducted on NSOME as having serious methodological limitations. Other reviews by ASHA (McCauly et al., 2009) and Lee & Gibbon (2015) did not find evidence for this method.
Lof & Watson (2009) summarized the reasons why NSOMEs do not work as follows:
1- They assume that working on a discrete individual part of the speech gesture (e.g., lip strengthening), will transfer to a mastery of the whole gesture (i.e., production of the /b/ sound), which is not correct.
2- Another assumption behind NSOMEs is that strengthening speech muscles will improve speech, but this is not supported by evidence.
3- Organization of the brain has shown that the same structure (e.g., tongue) can be used for speech and non-speech tasks and they are mediated by different brain structures. Therefore, we do not expect working on nonspeech tasks will lead to improvement in speech tasks.
4- NSOMEs do not help with awareness of articulators as shown by research.
5- Systematic reviews did not find supporting evidence.
ASLL Position: We do not recommend using NSOME with children with speech sounds disorders or childhood apraxia of speech (CAS)>
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