EFFECTS OF ORAL MOTOR THERAPY IN CHILDREN WITH CEREBRAL PALSY: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Cerebral palsy is a neurological disorder that causes ongoing difficulties with posture and movement, ultimately hindering daily tasks. The diagnosis of cerebral palsy may be made as early as 16 weeks after birth and is attributed to several anomalies that develop beyond the first 28 days of a baby's presence. Speech-language pathologists (SLPs) collaborate with occupational therapists (OTs) and physical therapists (PTs) to address speech disorders, feeding difficulties, and gastrointestinal problems in infants and young children. Verbal motor movements usually referred to as "mouth exercises," "non-speech oral motor training," and "oral motor therapy," are specifically designed to achieve this objective.

Objective: The objective of this study was to assess the effects of oral motor therapy in children with cerebral palsy who have feeding and swallowing difficulties.

Methods: This randomized controlled trial was conducted at Riphah International University, Lahore Campus, with data collection from Mobility Quest. The study lasted six months after synopsis approval. Participants included children aged 4 to 13 years diagnosed with CP and feeding and swallowing disorders. Exclusion criteria were uncontrolled epilepsy and dependence on nasogastric or feeding tubes. A total of 12 patients were recruited, assuming a 10% attrition rate, resulting in a final sample size of 10. The children were assigned at random to either the training group, which received both conventional speech treatment and oral motor therapy, or the control group, which only received traditional speech therapy. One group got both forms of therapy. Oral motor therapy sessions were conducted for a duration of sixteen weeks, with a frequency of three sessions per week, each lasting thirty minutes. In addition to the assessments, the Feeding Oral Motor Scale and the Drooling Severity and Frequency Scale (DSFS) were used. The data was analysed with SPSS version 25, employing a significance level of p<0.05.

Results: In the training group, mandible mobility (lateral) improved significantly, with 40% achieving regular mobility post-intervention (p = 0.038). Tongue retraction activity showed 100% improvement in the training group compared to 20% in the control group (p = 0.010). Lip protrusion improved to 20% optimal in the training group, while the control group showed 60% improvement (p = 0.026). Drooling frequency decreased significantly in the training group, with 20% showing occasional drooling post-intervention compared to 80% in the control group (p = 0.038).

Conclusion: Oral motor therapy significantly improves feeding and swallowing functions in children with cerebral palsy. SLPs should incorporate oral motor therapy into their treatment protocols to enhance the quality of life and overall health outcomes for these children.