Before Your Kids Start Speech Therapy

Communication is an essential part of healthy relationships. A child who struggles to express themselves with clear speech or words might feel significant anxiety or frustration when interacting with important people in their lives. Younger children might express these feelings as aggressive or challenging behaviour. A Speech-Language Pathologist can help pinpoint how and why communication is difficult, and develop targeted therapy sessions to address these challenges. However, if clear speech and articulation are the primary concern, it’s important to address this critical health piece first:

Breathing. How does your child breathe? If your child is a chronic mouth breather, then their tongue isn’t in the ideal place to produce clear speech. To engage fully with Speech Therapy, your child needs to breathe easily through their nose.

Is your child a chronic mouth breather?

“The nose is for breathing, the mouth is for eating.” This quote is commonly attributed to the late yoga guru Iyengar and made all-the-more popular in the bestselling book “Breath” by James Nestor.

Mouth breathing is one of a handful of Breathing Pattern Disorders. In adults, this disorder is correlated to everything from anxiety to chronic pain, sleep apnea, and reduced cognitive function. (Please start with this article for more information about Breathing Pattern Disorders in adults.) For kids, chronic mouth breathing has serious implications beyond speech that include dental health, sleep quality, and ADHD symptoms.

Watch your child during the day: Does their mouth stay open a little bit during play or when entertained on a screen? At night, do they snore, drool, or complain of dry mouth or lips? If your child is a chronic mouth breather, they might be prone to bad breath, tooth decay or plaque build-up, or experience headaches in the morning. Older children might have a more forward head posture and higher, narrower, palate (roof of the mouth).

How to become a nose breather:  

One of the most common reasons for mouth breathing in kids is blocked nasal passages. These passages are commonly blocked by full sinuses or farther back in the throat by chronically swollen tonsils and adenoids. In many cases we can completely resolve these blockages without drugs or surgery with the following two-pronged approach.

Underlying causes of mouth breathing:

A holistic or integrative health approach usually involves exploring why our body creates a particular symptom. For example, we know that our sinuses and nasal passages help protect us from infection. Our tonsils and adenoids are lymphatic tissue that house our immune system. If these areas are compromised or chronically inflamed, something is triggering this response, and it reflects impaired immune function. Our first goal is to identify and remove this trigger to help restore optimal health.

The most common triggers for blocked nasal passages include lingering respiratory infection and/or allergies. A thorough exploration of environmental allergies like dust, mould, and pet hair, or food allergies and intolerances such as dairy, leads to full resolution of mouth breathing in some children.

Our second goal is to get the immune system back on track. An optimal immune system does not over-react to allergens or under-respond to respiratory infection. This part of our work often includes ensuring optimal digestive function since this is where most of our immune system is located. It could include testing for nutrient deficiencies and diet or lifestyle changes that address microbiome balance and sleep efficiency. Ultimately, we want to offer the body support where it’s struggling most, so that the body can do its own healing.

Finally, it’s important to mention that sometimes mouth breathing has more to do with mechanics, structure, or habit, than with a struggling immune system. This could include obstacles like a tongue tie, jaw misalignment, or even subtle changes in face structure following injury or birth trauma. In these cases, our Speech-Language Pathologist can help guide you to the right practitioner for additional support.

Next Steps For A Child Who Is A Mouth Breather:

If you’ve added a Speech-Language Pathologist to your healthcare team for your child, make use of your other healthcare providers to make the experience as successful and enjoyable as possible:

1. If your child has chronic nasal congestion and is a frequent mouth breather, speak to your MD or Naturopathic Doctor (ND) about allergy testing or about using nasal saline rinses, steam inhalation, or other hydrotherapy interventions to directly target nasal congestion.
2. Work with an ND or Holistic Nutritionist (RHN) to identify food triggers that impact mouth breathing, inflammation, and even speech or language development. Sugar restriction and adequate hydration often yield quick and effective results. Recent research also highlights gluten as a contributing factor to some speech disorders.
3. Address the health of other household members who are frequently sick so that you’re not unnecessarily passing along viral infection.
4. Consider working with an experienced Osteopathic Manual Practitioner (DOMP) to address jaw alignment, sinus structure, and digestion.

References & Resources:

Children’s Hospital & Research Center at Oakland. (2009, July 15). Scientists Characterizes New Syndrome Of Allergy, Apraxia, Malabsorption. ScienceDaily. Retrieved December 11, 2023 from www.sciencedaily.com/releases/2009/07/090714104002.htm

Fitzpatrick MF, McLean H, Urton AM, et al. Effect of nasal or oral breathing route on upper airway resistance during sleep. European Respiratory Journal. 2003;22: 827-832. doi: 10.1183/09031936.03.00047903.

Iliodromiti Z, Triantafyllou AR, Tsaousi M, et al. Gut Microbiome and Neurodevelopmental Disorders: A Link Yet to Be Disclosed. Microorganisms. 2023 Feb 15;11(2):487. doi: 10.3390/microorganisms11020487.

Jiménez EL, Barrios R, Calvo JC, et al. Association of oral breathing with dental malocclusions and general health in children. Minerva Pediatr. 2017;69(3):188-193. doi:10.23736/S0026-4946.16.04288-2.

Jung JY and CK Yang. Investigation on the Effect of Oral Breathing on Cognitive Activity Using Functional Brain Imaging. Healthcare (Basel, Switzerland). 2021;9(6): 645. doi: 10.3390/healthcare9060645.

Nestor, James. Breath. Penguin Life, 2020.

Neveen HN, Iman E, Hala MZ, et al. Childhood Apraxia of Speech: Exploring Gluten Sensitivity and Changes in Glutamate and GABA Plasma Levels. Pediatric Neurology. Dec 2023. https://doi.org/10.1016/j.pediatrneurol.2023.11.012.

Pacheco MC, Casagrande CF, Teixeira LP, et al. Guidelines proposal for clinical recognition of mouth breathing children. Dental Press J Orthod. 2015;20(4):39-44. doi: 10.1590/2176-9451.20.4.039-044.oar.