The next time you answer a phone call or greet your neighbor, stop to consider just how many muscles you use to utter each word. Your mouth, lips, jaw, tongue, throat, voice box, and lungs must all work together to coordinate the “h” in “hello” or the “g” in “good morning.” For people with brain injuries, the muscles that control speech are often paralyzed or weakened. Without this coordination, it may be difficult to speak clearly or loudly enough to be heard, or to talk at all. But there are therapies that can help give brain injury survivors a voice. One type, oral-motor exercises, may help restore strength and function to muscles that produce speech. Evaluating Speech Problems If a person’s speech is impaired after a brain injury, a speech-language pathologist (SLP) will perform an oral-motor evaluation. This helps assess the accuracy, strength, and coordination of the muscles used for speech. The SLP will also test for any language and cognitive (thinking and learning) problems that may affect communication. The SLP, in partnership with the person’s health care team, will then design a treatment plan. If weak or uncoordinated muscles are contributing to speech problems, oral-motor exercises may be part of the plan. Oral-Motor Exercises, Defined These exercises don’t involve speaking. Instead, they use other movements and techniques to strengthen and synchronize speech muscles. In general, they fall into three categories: active exercise, passive exercise, and sensory stimulation. Active exercise requires the person to make movements that strengthen or stretch the lips, jaw, tongue, soft palate, throat, and breathing muscles. Examples include blowing through different types of whistles, drinking from straws, yawning, or making popping motions with the lips. Passive exercise involves moving or stretching the muscles with assistance from the SLP or from a mechanical device. These motions are designed to increase flexibility, improve blood flow, and increase communication between the brain and the muscles. Sensory stimulation helps spark muscle function and increase responsiveness to touch and pressure. Therapists might use massage, vibration, hot or cold temperatures, or electrical stimulation. Part of a Complete Treatment Plan Experts say more research is needed to prove the benefits of these types of exercises for all patients, including people with brain injuries. However, they are widely used along with other treatment to improve communication, and many SLPs say they see functional recovery when using these techniques. If your loved one has a brain injury, the SLP and the rest of the health care team should have an open, honest discussion with you and with the patient about the treatment plan and techniques involved. Don’t be afraid to ask questions. Working together, you can help brain injury survivors learn to communicate better and improve their ability to function in daily life.