The hidden impact of mouth breathing and open mouth posture on speech and feeding

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When most people think about speech or feeding difficulties, they picture the tongue, lips, or chewing skills, but how a child breathes at rest plays a surprisingly big role too.

Mouth breathing and open mouth resting posture can quietly influence everything from how a child’s face grows to how clearly they speak, to how confidently they chew and swallow. It’s something many parents never think about, until they start noticing the subtle signs.

Let’s explore why this happens, what to look for, and how to gently support better breathing and oral posture.

Recent research supports this link between mouth breathing and speech difficulties. For example, a 2022 study by Alhazmi et al., published in the Journal of Pharmacy and Bioallied Sciences, found that 81.7% of children aged 9–17 who breathed primarily through their mouths presented with speech sound disorders. The study highlights how mouth breathing can significantly influence orofacial development and articulation patterns.

💨 Why we’re designed to breathe through our nose

Our bodies are made for nasal breathing. When we breathe through the nose, the air is filtered, warmed, and humidified before reaching the lungs. The tongue naturally rests against the roof of the mouth, the lips close gently, and the jaw stays relaxed, all of which encourage healthy oral development.

In contrast, mouth breathing often means the tongue rests low in the mouth and the lips stay apart. Over time, this posture can subtly reshape how the muscles and bones of the face grow.

Children who breathe through their mouths most of the time may develop:

  • A longer face and narrower palate
  • Forward head posture
  • Slightly open lips and low tongue position at rest
  • A tendency toward drooling or noisy breathing
  • A dry mouth and consequently bad breath
  • At times the tongue pushes constantly against the front teeth causing them to grow forward (buck teeth)

These changes are not anyone’s fault, as they often start because of blocked noses, allergies, enlarged adenoids, low facial muscle tone or habits formed when a child was younger. But understanding the pattern helps us know how to support change.

🗣 How mouth breathing affects speech

Speech depends on precise coordination between the lips, tongue, and jaw. The resting position of these structures affects how ready they are to move.

  1. Reduced tongue strength and placement, i.e. the tongue rests low in the mouth (as it does in mouth breathing), it’s harder for children to lift it efficiently for sounds like /T/, /D/, /N/, /L/, and /S/. This can lead to speech that sounds slightly slushy or unclear, or a frontal lisp.
  2. Open mouth posture and resonance: An open mouth at rest may affect how air vibrates in the oral and nasal cavities. Children might have speech that sounds a bit ‘muffled’ or lacks crispness because the lips and jaw aren’t fully supporting articulation.
  3. Fatigue and breath control: Mouth breathing can lead to drier mouths and less efficient breath support. That can make longer sentences or conversations feel tiring, especially in noisy environments.

🥄 How mouth breathing affects feeding and chewing

Feeding involves the same structures that control speech, so posture and breathing patterns matter here, too.

  1. Chewing efficiency: Children who habitually keep their mouths open often have low tongue tone and reduced jaw stability. They may prefer softer foods, chew slowly, or struggle with mixed textures.
  2. Swallowing pattern: A tongue that rests low may push forward when swallowing. This ‘tongue-thrust swallow’ can interfere with efficient chewing and even affect dental alignment over time.
  3. Breathing while eating: Since it’s hard to chew, swallow, and breathe through the mouth simultaneously, children who can’t comfortably nasal breathe may rush bites or pause to catch their breath. This can contribute to coughing, choking, or food refusal.

Common signs to watch for

Parents often notice subtle clues before realising mouth breathing is a pattern. Some red flags include:

  • Lips habitually open at rest
  • Drooling after the toddler years
  • Snoring or noisy breathing during sleep
  • Preference for soft foods or grazing eating habits
  • Dark circles under the eyes due to allergies
  • Frequent colds, congestion, or mouth odour
  • Speech that sounds slushy or unclear despite good effort

If several of these sound familiar, it’s worth mentioning them to your child’s GP, dentist, or speech and language therapist.

👩‍⚕️ What can help

  1. Address the underlying cause: If nasal blockage, allergies, or enlarged adenoids are making nasal breathing difficult, a medical assessment is the first step. ENT specialists can rule out or treat physical causes.
  2. Encourage closed mouth rest: Gentle reminders like ‘Lips together, tongue up, breathe through your nose’ can help older children become aware of their resting posture. For younger ones, visual cues (stickers or mirrors) can make it a game.
  3. Build oral-motor strength and awareness: Speech therapists can design activities to strengthen the tongue and lips, improve jaw stability, and encourage balanced breathing. This might include blowing games, tongue-tip lifts, use of dental-palatal devices or oral-motor exercises disguised as play.
  4. Support good posture: Sometimes mouth breathing goes hand-in-hand with forward-head posture. Encouraging upright sitting during meals and screen time helps keep the airway open and supports better breathing habits.
  5. Make nasal breathing part of daily routines: Gentle nose-breathing practice during calm times (reading, bedtime, car rides) helps normalise it. Avoid making it a battle: calm, consistent reminders work best.

🌱 A gentle note on change

Patterns of mouth breathing develop over time, and change doesn’t happen overnight. It’s important to approach this with curiosity, not criticism. The aim isn’t ‘perfect breathing,’ but to give your child the tools and awareness to breathe comfortably and efficiently.

Small improvements in nasal breathing and resting posture can lead to big gains in speech clarity, eating confidence, and even sleep quality.

💡 The takeaway

Breathing seems automatic, and it is! but how we breathe matters. Mouth breathing and open-mouth posture can quietly shape how a child speaks, eats, and grows.

By noticing early signs, addressing underlying causes, and building supportive habits, you can help your child move toward stronger, clearer speech and more comfortable mealtimes.

Just like every area of development, progress starts with connection, patience, and gentle consistency, one calm breath at a time.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

References

Alhazmi, A., Alshamrani, A., Alhussain, A., et al. (2022). Mouth Breathing and Speech Disorders: A Multidisciplinary Study. Journal of Pharmacy and Bioallied Sciences 14(5):911. https://www.researchgate.net/publication/361978128_Mouth_breathing_and_speech_disorders_A_multidisciplinary_evaluation_based_on_the_etiology


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

2

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    Yes. Absolutely.

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    Nothing is missed. It’s just sequenced in a way that supports success.

    A different way of thinking about progress

    One of the biggest mindset shifts with the Cycles Approach is this:

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    • Speech becomes clearer over time, not overnight

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    Starting with syllables might seem unexpected but it’s one of the most powerful foundations we can give a child whose speech is hard to understand.

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    Sonja McGeachie

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    Health Professions Council registered
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    Member of ASLTIP

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

    Parent FAQ section

    Why is my child practising words like ‘banana’ instead of sounds like /K/ or /S/?

    Because your child first needs to be able to hold and produce the full shape of a word. If they’re dropping syllables (e.g. ‘banana’ → ‘nana’), working on individual sounds won’t carry over into real speech. We build the structure first, then refine the sounds.

    What if my child can already say some long words?

    That’s great. But we’re looking for consistency and clarity across many words, not just a few familiar ones. This stage helps stabilise that skill so it becomes reliable in everyday talking.

    How long will we stay on syllables?

    Usually, this is a short but important phase within each cycle. We revisit it regularly, but we also move on to other patterns (like specific sounds or sound processes) within the same therapy block.

    Will this delay my child learning their sounds?

    No. In fact, it often speeds things up overall. Once the syllable structure is in place, children are much more able to use correct sounds in longer words and sentences.

    What can I do at home?

    Keep it simple and playful:

    • Clap out words together (e.g. ‘el-e-phant’)
    • Emphasise full words naturally in conversation
    • Repeat back what your child says with the full structure (without pressure)

    Consistency and exposure matter more than correction.

    My child gets frustrated. Will this help?

    Yes. Many children become frustrated when they’re not understood. Improving syllable structure often leads to quick wins in clarity, which can boost confidence and reduce that frustration.

    Building clearer speech: Why we practise syllables first

    What are syllables?

    Syllables are the ‘beats’ in words.

    • ‘Table’ = 2 beats (ta-ble)
    • ‘Banana’ = 3 beats (ba-na-na)

    Why is my child working on this?

    If your child:

    • Drops parts of words (‘banana’ → ‘nana’)
    • Mumbles longer words
    • Is hard to understand

    …then we need to build the structure of words first.

    This helps your child:

    ✔ Say longer words clearly

    ✔ Be easier to understand

    ✔ Feel more confident speaking

    What does this look like in therapy?

    We practise:

    • Clapping or tapping out beats 👏
    • Saying full words with rhythm
    • Repeating target words through play
    • Using visuals or actions to support learning

    How you can help at home

    Keep it light and playful, little and often!

    Try this:

    • Clap words together أثناء play (e.g. toys, food, animals)
    • Model full words naturally (‘Yes, ba-na-na!’)
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    Child: ‘nana’

    You: ‘Yes! Ba-na-na‘

    Important to know

    • This is a key first step in speech therapy
    • We will move on to sounds—but this helps them stick
    • Small changes here can make a big difference in clarity
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    • In other words, you will see that there suddenly is JOINT PLAY. Yes, granted it may not be according to your adult agenda, but there will be more togetherness than there was before. And this is the START of communication and social engagement.

    USE Core words and a coreboard — to help your child understand the power of words

    Core words are the building blocks of communication. Try using a coreboard like the one below, they are versatile and can be used in countless ways. By modelling these words naturally during play, you expose your child to their meaning and function in context. This approach is far more effective than isolated drill and practice, more powerful than flashcards!

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    Photo by lemonlenz

    Let’s say your child is playing with a pop-up toy like you see me do in the above photograph. Here, I followed my child’s lead by waiting to see what she wanted to do with the toy. You are now OWLING! (Observe Wait and Listen)

    Once I noticed that there was repetitive opening of the flaps going on I then pointed to OPEN and MORE on the board, as I said: ‘let’s OPEN this one’ / let’s see MORE animals’ / ‘MORE cow! it says moo!’ ‘OPEN another one’ and so on.

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    Naturally in time your child will look at the board and at your pointing and they will eventually want to copy you!

    By incorporating these strategies into your daily interactions, you can create a supportive environment that fosters language development and communication growth.  If you would like more guidance please get in touch and book in for a consultation, some individual therapy and/ or some parent coaching.

    I look forward to supporting you. Please contact me and let’s see how.

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    Submucous cleft palate: What is it and how does it impact on speech?

    What exactly is a submucous cleft palate?

    A submucous cleft palate (SMCP) is much less obvious than its counterparts, cleft of lip and/or palate, and can profoundly impact a child’s speech development. It leads to often extreme hyper nasal speech and difficulty with producing many sounds (/K/ /G/ /T/ /D/ /P/ /B/ /S/ /Z/ /F/ /V/).

    In short, the muscles and bone of the soft palate, and sometimes the hard palate, do not fuse completely during foetal development and the mucous membrane that lines the roof of the mouth remains intact, effectively camouflaging the underlying muscular and bony deficit.

    So, while the surface of the palate appears normal, the essential muscle and functions responsible for sealing off the nasal cavity from the oral cavity during speech are compromised. This cleft (or lack of muscle) can be seen as a bluish midline discoloration of the soft palate, often a bifid (split) uvula, and at times a notch in the posterior border of the hard palate can be felt upon palpation. However, these signs aren’t always present or easily discernible, contributing to the difficulty arriving at a diagnosis.

    Diagnosing a submucous cleft palate is often akin to searching for a needle in a haystack, especially for the untrained eye. Unlike overt clefts that are visually apparent at birth, an SMCP can go undiagnosed for years, sometimes well into childhood or even adolescence. Paediatricians and even ENT surgeons have been known to miss it during routine checks due to the intact mucosal lining. Parents might notice their child’s speech sounds ‘different’ or ‘nasal’ but struggle to pinpoint the cause. Children might undergo extensive speech therapy without a proper diagnosis, as the underlying structural issue continues to hinder progress.

    My experience as a speech therapist in private practice:

    Over my years of practice, I have encountered several children presenting with persistent hyper-nasal speech and significant difficulties producing plosive and fricative sounds.

    It has been incredibly rewarding, though at times challenging, to successfully diagnose SMCP in a number of these children. My approach often involves:

    • a meticulous oral motor examination,
    • careful listening for the specific qualities of hypernasality,
    • and a deep understanding of the physiological requirements for clear speech sound production.

    When I suspect an SMCP, I refer these children to Great Ormond Street Hospital where a fantastic multidisciplinary team, typically including ENT surgeons and a specialist speech-language therapist can conduct more definitive assessments. These assessments often involve instrumental analyses such as videofluoroscopy or nasoendoscopy, which provide objective measures of velopharyngeal function and visual confirmation of the anatomical deficit.

    The path to resolution: surgery, therapy, and successful outcomes

    Surgery

    The journey for these children, once diagnosed, often involves surgical intervention. It’s not uncommon for children with SMCP to undergo multiple operations to achieve optimal velopharyngeal closure. These procedures aim to reconstruct or augment the velopharyngeal mechanism, enabling it to effectively separate the oral and nasal cavities during speech. The specific surgical approach depends on the individual child’s anatomy and the severity of the velopharyngeal insufficiency. It’s a testament to the skill of these specialised surgeons that such intricate repairs can be performed with remarkable success.

    Speech therapy

    Following surgery these children embark on the crucial phase of speech therapy. While surgery addresses the structural problem, speech therapy helps a child learn to utilise their newly improved anatomy. It involves intensive work on developing oral airflow, establishing correct articulatory placement, and reducing learned compensatory strategies that have developed due to the original structural deficit. It is immensely gratifying to witness the transformation. Children who once struggled to produce basic sounds, whose speech was difficult to understand, gradually develop clear speech.

    Next steps?

    If you’re a parent concerned about your child’s speech and feeding, you’re not alone. The journey can feel confusing, but professional guidance can make all the difference. Never hesitate to have a second opinion when you have that niggling feeling that there is something that has not yet been explored. At London Speech and Feeding I specialise in being thorough and thinking outside the box.

    I am here to provide the support you need. Reach out to schedule a consultation and take the first step towards helping your child communicate and thrive.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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  • · ·

    Explaining pronoun reversal: A window into gestalt language processing

    Explaining pronoun reversal: A window into gestalt language processing

    Have you noticed your child referring to themselves as ‘you’, or calling you ‘me’? This seemingly confusing mix-up of pronouns, known as pronoun reversal, often raises concerns for parents. Below I outline why your child does this and want to reassure you that it is to do with his or her unique language learning style.

    Gestalt language processing: Learning in chunks

    Many children, particularly those on the autism spectrum, use a gestalt language processing approach. Unlike analytic language processors who learn individual words and build sentences, gestalt language processors learn language in whole ‘chunks’ or ‘gestalts’. Think of these gestalts as pre-packaged scripts they pick up from their environment — phrases, sentences, even snippets of songs or movie lines.

    As Marge Blanc, author of Natural language acquisition on the autism spectrum, explains, ‘When a child picks up an entire gestalt (script), he’s got the pronoun of the original speaker. So ‘pronoun reversal’ is nothing more than that.’

    So your child is simply repeating what they’ve heard, without yet understanding the individual word meanings or grammatical functions.

    Imagine your child hearing ‘You want a rice cake?’ repeated frequently. They might then use this phrase to express their own desire for a rice cake, even though it doesn’t grammatically fit. So they are thinking and saying ‘You want a rice cake?’ and the meaning of this phrase is: ‘I want a rice cake’. This isn’t a sign of confusion, but a natural step in their language development. They’re working with the tools they have: the scripts they’ve acquired.

    How can we support their natural language journey

    Instead of trying to ‘correct’ pronoun usage, our role as caregivers and speech therapists is to support the child’s natural language progression. Here’s how we can do this:

    1. Learn about their gestalt stage and run with it: In the early stages (1–3) of gestalt language development, correcting pronouns can be counterproductive. These children are still processing language as whole units, not individual words. Direct corrections can lead to frustration and hinder their natural language exploration.
    2. Patience and trust: Gestalt language processing follows a predictable, albeit sometimes non-linear, path. By understanding their current stage, we can provide targeted support. Language sampling and scoring, guided by the Natural Language Acquisition framework, help us pinpoint their stage and tailor our approach.
    3. Model language strategically: In the early stages, avoid using pronouns like ‘you’ and ‘you’re’. Instead, model language from the child’s perspective or use joint perspectives. For example, instead of ‘Are you thirsty?’, try ‘I’m thirsty!’ or ‘Let’s get some water’,

    The big picture: Language unfolds naturally

    Pronoun reversal is a stepping stone, not a stumbling block. As gestalt language processors progress, they begin to break down these gestalts into smaller units and develop their own self-generated language. This is when their understanding and use of pronouns naturally emerge.

    By shifting our perspective from ‘error correction’ to ‘developmental support’, we create a nurturing environment for these children to thrive. We empower them to navigate their unique language journey, ultimately leading to more meaningful and independent communication.

    So, to summarise:

    • Pronoun reversal is a typical characteristic of early-stage gestalt language processing.
    • Focus on modelling language from the child’s perspective or a joint perspective.
    • Avoid correcting pronouns in the early stages.
    • Trust the process and support the child’s natural language development.

    Let’s celebrate the diverse ways our children learn to communicate and empower them to find their unique voice!

    If you have any questions or would like some help with understanding your little gestalt language learner, please get in touch with me via my contact form.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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