Oral motor problems – what you may recommend your little patients

Main Article Content

Johannes Limbrock


Babies and infants getting osteophatic therapies may show oral functional disorders, such as insufficient sucking, problems with mashed, semisolid or solid food, up to choking (dysphagia); open mouth, tongue protrusion, drooling. This article highlights medical contexts (muscle hypotonia, hypertonia/spasticity) and explains indications to a more specific therapy: such as the Castillo Morales®- Conzept .

Keywords: Drinking and eating disorder, Feeding disorder, Choking/dysphagia, hypersalivation/sialorrhea, hypotonicity, cerebral palsy, Castillo-Morales®-Conzept, stimulating palatal plates

Article Details

How to Cite
LIMBROCK, Johannes. Oral motor problems – what you may recommend your little patients. Medical Research Archives, [S.l.], v. 9, n. 8, aug. 2021. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2465>. Date accessed: 23 may 2024. doi: https://doi.org/10.18103/mra.v9i8.2465.
Research Articles


1 Hadders-Algra Mijna. Early human development: From variation to the ability to vary and adapt.
Neurosci Biobehav Rev . 2018 Jul; 90:411-427

2 Gisel Erika. Interventions and outcomes for children with dysphagia. Dev Disabil Res Rev 2008; 14:165-173

3 Arvedson Joan C. Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches. Dev Disabil Res Rev 2008;14: 118-127

4 Fucile S., Gisel E. G., Lau C. Effect of an early stimulation program on sucking skill maturation of preterm infants. Dev Med Child Neurol 2005; 47: 158-162

5 Palmer, J. B., & Hiiemae, K. M. Eating and breathing: Interactions between respiration and feeding on solid food. Dysphagia, 2003; 18, 169-178

6 Teismann IK. Korikale Repräsentation des Schluckaktes – Neues zur Physiologie und Pathophysiologie des Schluckens. Klin Neurophysiol, 2009; 40: 183-193,

7 Wellhöner P, Fellermann K. Diagnostik und Therapie gastroenterologischer Ursachen von Dysphagie bei Säuglingen und Kleinkindern. Sprache-Stimme-Gehör, 24, 2010, S. 25-30

8 Blasco P. Management of drooling: 10 years after the Consortium on Drooling1990.
Dev Med Child Neurol 2003; 45:844-846

9 Enders A. Der hypotone Säugling. Monatsschrift Kinderheilkunde 2010; 158:889-990

10 Haris S. R. Congenital hypotonia: clinical and developmental assessment. Dev Med Child Neurol. 2008; 50:889-892

11 Schaller C, Eiffert H, Christen HJ. Wichtige Differenzialdiagnose beim Floppy-Infant-Syndrom. Pädiatr Hautnah 2009; 3:190–192. Google Scholar.

12 Schara U. Neuromuskuläre Erkrankungen im Kindes- und Jugendalter. Neuropadiatr Klin Prax 2006;1:6–30

13 Kahl-Nieke B: Einführung in die Kieferorthopädie. Urban + Fischer, 3. Auflage 2009

14 Michaelis R, Niemann G.Entwicklungsneurologie und Neuropaediatrie. Grundlagen und Diagnostische Strategien.4.Aufl. Stuttgart Thieme 2010

15 Bax M, Goldstein M, Rosenbaum P. et al. Executive Commission for the Definition of Cerebral Palsy. Dev Med Child Neurol. 2005; 47(8): 571-576

16 Greaves S, Guzzetta A, Hadders-Algra M. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr. 2017;171(9):897-907.

17 Schwartz S, Gisel EG, Clark D. Association of occlusion with eating efficiency in children with cerebral palsy and moderate eating impairment. J Dent Child 200;.70:33-39

18 Corrie EE, Van Hulst K et al. Drooling in cerebral palsy: hypersalivation or dysfunctional oral motor control?
Dev Med Child Neurol 2009; 51: 454–9.

19 Tahmassebi JF, Curzon MEJ. The cause of drooling in children with cerebral palsy-hypersalivation or swallowing defect? Intern .J. of Pediatric Dentistry 2003, 13:106-111

20 Senner JE, Logemann J, Zecker S. Drooling, saliva production, and swallowing in cerebral palsy. Dev Med Child Neurol 2004; 46: 801-806.

21 Ferluga ED et.al. Interventions for Feeding and Nutrition in Cerebral Palsy. Comparative Effectiveness Reviews, No. 94. AHRQ Publication March 2013

22 McAllister Byun, T. (2012). Positional velar fronting: an updated articulatory account.J. Child Lang.39, 1043–1076.
doi: 10.1017/S0305000911000468

23 McAllister Byun, T., and Tessier, A. (2016). Motor influences on grammar in an emergenist model of phonology. Lang. Linguist. Comp.10, 431–452. doi:10.1111/lnc3.12205

24 Arvedson Joan, Clark H, Lazarus C, Schooling T, Frymark T. The effects of oral-motor exercises on swallowing in children: an evidence- based systematic review. Dev Med Child Neurol 2010, 52: 1000-1013

25 Türk C, Söhlemann S, Rummel H. Das Castillo Morales-Konzept. Stuttgart: Thieme, 2020.

26 Takasaki K, Umeki H, Kumagami H, Takahashi H. Influence of head rotation on upper esophhageal sphincter pressure evaluated by high-resolution manometry system. Otolaryngology – Head and Neck Surgery, 142. 2010;11-02: 214-217

27 Bäckmann B, Grever-Sjölander A, Bengtsson K, PerssonJ, Johansson I. Children with Down syndrome: oral development and morphology after use of palatal plates between 6 and 48 months of age. Int J Paed Dent 2007; 17: 19–28

28 Hohoff A, Ehmer U. Short-term and long-term results after early treatment with the Castillo Morales stimulating plate – a longitudinal study. J Orofac Othop 1999; 60: 2–12

29 Schuster G, Giesel R. Retrospective Clinical Investigation of the Impact of Early Treatment of Children with Down's Syndrome According to Castillo-Morales. J Orofac Orthop. 2001 Jul;62(4):255-63

30. Korbmacher HM, Limbrock GJ, Kahl-Nieke B. Long-term evaluation of orofacial function in children with Down syndrome after treatment with a stimulating plate according to Castillo
Morales. J Paed Dent 2006; 30 (4): 325–328

31. Limbrock GJ, Korbmacher H, Bender MP. Mund- und Sprechentwicklung 12 Jahre nach
Castillo Morales Therapie. pädiatrie hautnah 2004; 4: 223–226

32. Gerek M, Çiyiltepe M (2005). Dysphagia management of pediatric patients with cerebral palsy. Brit. J. Dev. Dis. 51 (1/100): 57-72

33. McAllister A, Björnström M (1995). Treating children with persistent articulatory problems using palatal plates ad modum Castillo Morales. The 12th International Congress of
Phonetic Science, Proceedings 4, Stockholm, 602–605

34. Lundeborg I, McAllister A. Treatment with a combination of intra-oral sensory stimulation and electropalatography in a child with severe developmental dyspraxia. Logopedics Phoniatrics Vocology 2007; Vol.32:71-79

35. Pörnbacher T. Sprach-, Sprech-, Stimm- und
Schluckstörungen, Bd. 2: Therapie, 4. Aufl. München: Urban & Fischer in Elsevier, 2006

36. Pereira LM. Padovan method as early stimulation in neonatal intensive care unit. International Archives of Medicine 2015; 8. doi: 10.3823/1765

37. Nusser Müller-Busch R. Schluckstörungen auf der Intensivstation: Atmen und Schlucken – eine vitale Beziehung. DIVI 2013; 4: 7–14