MYOFUNCTIONAL SYMPTOMS AGES 1-5+

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Let’s discuss the Myofunctional symptoms which can be observed in children aged roughly 1 to 5+. There are a variety of physical and social problems which can be caused by myofunctional issues.

Orofacial myofunctional disorders (OMDs) in early childhood can have far-reaching consequences for feeding, speech, breathing, facial development, and overall health. Children between the ages of 1 and 5+ are in a critical period of craniofacial growth and neuromuscular development, making early recognition and intervention essential.

If your child exhibits any of the symptoms or behaviors described below, they may benefit from Early Intervention Myofunctional Therapy.

One of the most common and easily observable signs of myofunctional dysfunction in toddlers and preschool-aged children is difficulty with feeding.

Parents often report:

• Extreme picky eating (“He only eats chicken nuggets!”)
   
• Limited acceptance of food textures or types (especially meats, vegetables, and fruits)
   
• Gagging or vomiting during meals
   
• Messy, inefficient eating
   
• Choking episodes due to difficulty managing solids
   

Underlying cause: Many of these issues result from inadequate tongue strength, coordination, and mobility. A child with poor tongue function may be unable to form a proper bolus (a cohesive ball of food) or move food efficiently to the center of the tongue to initiate a swallow. This difficulty often becomes more apparent after the first year of life, when the child transitions from purees to firmer solids.

Without intervention, these feeding challenges can persist and may contribute to nutritional deficiencies, oral aversions, and prolonged mealtime stress for both child and family.

Myofunctional issues can significantly impact speech development and clarity. Children may:

• Speak later than expected
   
• Produce speech that is difficult for unfamiliar listeners to understand
   
• Exhibit specific speech sound errors, particularly with alveolar sounds (/t/, /d/, /n/) and lingual elevation sounds (/l/, /r/)
   
• Show frustration when trying to communicate
   

A restricted lingual frenulum (tongue tie) is a common underlying factor. This structural limitation restricts tongue elevation and range of motion, impairing precise articulation. Some children demonstrate immediate speech improvement after a tongue tie release, while others require post-release myofunctional therapy to retrain muscle patterns for accurate sound production.

For detailed developmental expectations, visit www.speechlanguagespot.com for speech, language, and feeding milestones.

A healthy swallow pattern requires the tongue to elevate and press against the palate, creating the intraoral pressure necessary to move food and liquid safely and efficiently.

When lingual elevation is blocked—either by structural restriction (e.g., tongue tie) or maladaptive muscle patterns—the tongue often thrusts forward against or between the teeth during swallowing. This is called a tongue thrust or reverse swallow.

Potential consequences include:

• Dental malocclusions (e.g., anterior open bite)
   
• Speech distortions of /s/ and /z/ (lisp)
   
• Difficulty swallowing solids efficiently
   

Given that humans swallow 700–1,000 times per day, an incorrect swallow pattern can have profound effects on dentition, facial growth, and oral function.

Several early childhood habits can lead to, or reinforce, OMDs:

• Prolonged pacifier use
   
• Extended bottle feeding
   
• Reliance on sippy cups
   
• Thumb or finger sucking
   
• Sucking on clothing or blankets
   

These behaviors promote low resting tongue posture, disrupt proper swallowing mechanics, and alter facial growth by restricting optimal mandibular and maxillary development. They also create a cycle of oral sensory-seeking behaviors, as sucking stimulates endorphin release—something that should occur naturally with correct tongue posture and swallowing.

Without retraining oral muscles, these habits can be extremely difficult to break and can have permanent effects on the face and airway.

Myofunctional issues are closely linked to sleep-disordered breathing in young children. Impaired oral posture and nasal breathing can contribute to:

• Snoring
   
• Mouth breathing during sleep
   
• Night terrors
   
• Frequent nighttime waking
   
• Bedwetting after potty training
   
• Restless, “active” sleep
   

Why this matters: Poor sleep quality in early childhood affects more than energy levels. Oxygen desaturation, airway restriction, and fragmented sleep can lead to behavioral patterns that mimic ADD/ADHD, such as:

• Inattention
   
• Impulsivity
   
• Low frustration tolerance
   

These behaviors are often misinterpreted as personality or discipline issues rather than symptoms of disrupted sleep and poor oxygenation.

From ages 1–5+, the bones of the face and jaw undergo significant growth. The way a child uses their oral and facial muscles during feeding, swallowing, and breathing directly influences this development.

Breastfeeding supports optimal jaw and palate formation through correct lingual and mandibular positioning. Bottle feeding, prolonged pacifier use, or mouth breathing can lead to:

• Low resting tongue posture
   
• Narrow palates
   
• Retruded jaws
   
• Loss of airway space
   
• Swallowing dysfunction
   

Early identification and correction of these patterns can prevent malocclusion, reduce orthodontic needs, and support a healthier airway.

Incorrect swallowing mechanics can affect the Eustachian tubes, preventing proper ventilation and drainage of the middle ear. 

This increases the risk of:

• Recurrent ear infections
   
• Middle ear fluid buildup
   
• Need for pressure equalization (PE) tubes
   

Mouth breathing also promotes tonsillar and adenoidal hypertrophy, further narrowing the airway and perpetuating a cycle of obstruction and infection. In severe cases, enlarged tonsils can block nasal breathing entirely.

While tonsil and adenoid removal may temporarily improve symptoms, studies show a relapse rate exceeding 50%—often due to regrowth of lymphoid tissue when the underlying myofunctional dysfunction remains unaddressed. Myofunctional therapy can play a critical role in preventing recurrence by restoring correct oral posture, nasal breathing, and swallowing mechanics.

Early Intervention Myofunctional Therapy can significantly improve outcomes related to:

• Feeding and swallowing
   
• Speech development
   
• Sleep quality
   
• Craniofacial growth
   
• Airway health
   

Because young children’s bone structure is still highly adaptable, therapy started early is typically shorter in duration and produces more lasting results.

Successful treatment of OMDs in children requires collaboration among:

• Airway-focused pediatric dentists
   
• ENTs (airway focused only)

• Body Work (Chiropractor, CST etc) - This is a wonderful adjunct therapy but does NOT replace what needs to happen intra-orally
   
• Speech-language pathologists with advanced training in orofacial myofunctional therapy, feeding, infant feeding and lactation
   

As a specialist in this field, I maintain close working relationships with some of the most experienced airway-centric pediatric dentists and tongue tie release providers. If your child exhibits any of the symptoms above, I can provide referrals and a comprehensive care plan tailored to their needs.

Myofunctional disorders in early childhood are more than minor quirks—they can be early warning signs of significant feeding, speech, breathing, and developmental concerns. The earlier these patterns are addressed, the greater the potential to optimize health, function, and growth.

Dena Freedman-Muchnick, M.S., CCC-SLP, CLC

Speech Language Pathologist

Certified Lactation Consultant

Orofacial Myofunctional Therapist

www.lactationspot.com

www.myofunctionalspot.com

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