Oral motor, feeding and speech-language disorders occur in more than 75% of individuals diagnosed with Smith-Magenis Syndrome (SMS). Although there is variation amongst these difficulties, SMS children do share similar traits in the swallowing and communication functional arena.

The oral motor and swallowing/feeding difficulties typically begin within the first year of life and improve throughout childhood with therapeutic interventions. Frequently, sucking abilities are poor and transitioning to specific food textures are often challenging for parents. Although infrequent, it is not uncommon for children to develop failure to thrive if feeding issues are severe. These may require alternate feeding sources or feeding supplements to assist with growth and development. Services to enhance children with these difficulties can be obtained with specialists such as gastroenterologists, nutritionists, speech-language pathologists and other professionals within early intervention programs. Chewing and mastication are often delayed and food refusals and transitions can be difficult. Often delays in oral motor movements contribute to these problems. Speech Pathology therapeutic interventions can assist with these and can help with oral motor skill development necessary for these functional skills.

In addition to the oral motor and swallowing/feeding delays, communication skills are frequently delayed in SMS children. These skills are important for expressing needs and wants, interacting with family members, fostering education/social development and transferring into work environments. Expressive speech skills are often delayed and frequently verbal speech is unintelligible. It is not uncommon that verbal speech is absent until early school age years. Don’t be discouraged if your child is not talking. While progress may be slow, most persons with SMS are able to eventually speak using a variety of interventions to enhance communication.

When a child is not talking, an assessment with speech-language pathology is imperative to determine the nature of the problem and to implement strategies to foster and bridge communication development. If a child is not talking at all, alternative forms of communication may be considered to bridge development. Even though an alternate system of communication (sign language, gestures, or a picture system) may be used initially, speech and language skills typically develop. With implementation of an additional system, communication will improve thereby reducing communicative frustrations and allowing opportunities for interaction and continued education. Alternate methods of communication in conjunction with verbal speech should be regarded as a vehicle in which children can communicate. Speech language pathologists are the professionals who can assist most in this area. They are involved typically in early intervention programs schools, hospitals and private practices.

During early childhood years, speech/language pathology services should concurrently focus on the speech/language communication aspects in addition to optimizing oral motor, swallowing and feeding issues. Therapeutic goals of increasing sensory input, fostering movement of the articulators, increasing oral motor endurance and decreasing hypersensitivity to touch in and around the oral cavity are needed to develop skills related to swallowing and speech production.

Expressive language should be expanded to phrases and sentences with additional emphasis on auditory comprehension. Home practice programs with exercises and strategies for fostering oral motor, speech and language skills should be included in all therapeutic programs. Goals to enhance overall intelligibility are suggested once a strong language foundation is in place and spontaneously being used by the child.

To obtain more information about speech language pathology services in your state,
visit the web site of the American Speech-Language-Hearing Association.

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