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Lip Exercises to Strengthen Weak Muscle Tone in Cheeks

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Lip Exercises to Strengthen Weak Muscle Tone in Cheeks

All material Copyright © May 2009 The Down Syndrome Centre
Reprinted with the express permission of the Down Syndrome Centre as originally published on their website.

By: Marinet vanVuren
Marinet vanVuren is a South African born Speech and Language Therapist. For the past seven years she has worked with a range of Irish disability organisations including Enable Ireland, St Michael’s House and the Children's Sunshine Home. She recently set up her own private speech and language therapy practice where she sees children of all disabilities with various speech, language and feeding difficulties.


Low muscle tone in the cheeks reduces the strength and skill with which the lips can move during eating, drinking and speech production. Low muscle tone in the cheeks may also cause children to pocket food in the cheek areas. Drooling or saliva loss is also a cause of low muscle tone in the musculature controlling the lips. Furthermore, the production of lip sounds (also known as bilabials e.g. /p,b,m,w/ are often weak and imprecise in children with low muscle tone in the cheek and lip musculature.

When targeting oral-motor skills, it is very important to remember the developmental hierarchy of oral motor tasks. By 18-24 months (in children with normal muscle tone) children should be able to copy the following oral motor tasks:

  1. Lip closure (children should be able to close their lips when requested to do so).
  2. Lip protrusion (children should be able to push their lips forward as in kissing).
  3. Lip retraction (children should be able to pull their lips back as in a smiling).



What activities can I do to develop lip and cheek strength and mobility?

These exercises are designed to increase strength of the lips. Use a mirror so your child can see what he/she is doing.
  • Make kissing faces with your lips, being sure to push the lips out as far as you can.
  • Make smiling faces, pulling the lips all the way back towards your ears.
  • Blow your cheeks up with air. Press down on your lips, making sure the air doesn’t escape.
  • Blowing kisses into the air.
  • Practising the ‘ooo’ sound in front of the mirror.
  • Practising the ‘eee’ sound in front of the mirror.
  • Practise changing from ‘ooo’ to ‘eee’ shape. Everyone pretends to talk like monkeys by alternately pulling the lips to a wide grin and then pushing them forward while saying /eee/ and /ooo/ respectively.
  • Paint lips with lip-stick and make round lip-stick prints on paper.
  • Place food tastes on bottom lip for removal with top lip.
  • Place food tastes on top lip for removal with bottom lip.
  • Use your lips to pick up Cheerios from the table or a plate.
  • Practise blowing out and saying the sound ‘p’ ‘p’ ‘p’.
  • Exploding lips – bits of paper are torn from a sheet of paper and individually placed on a child’s closed lips. While doing this, the child should tilt his head backwards. Then encourage the child to make a /p/ sound to blow away the pieces of paper.
  • Lip smacking.
  • Blow out candles with a big, voiceless /p/-sound.
  • Where have my lips gone? Put the bottom lip over the top lip to make it disappear, or the top lip over the bottom lip.
  • Two plates with plastic food (or different objects like pens, counters, bottle lids, cutlery, etc.) and two empty plates are prepared for this activity. Who can, using their LIPS, move all the objects onto the empty plate?
  • Elephants: Pretend to be elephants that have to carry logs (i.e. straws) from one place to another by picking up and holding the straw between their lips. The following exercises are aimed to assist in developing a child’s lip movement as well as breath control.
  • Blowing bubbles.
  • Blowing bubbles into water using a straw
  • Blowing bubbles into water without a straw
  • Blowing ping pong balls off a table (if this is too difficult try using cotton balls)
  • Blowing plastic windmills
  • Blowing out candles
Whistles are also a great way to develop lip strength and mobility. Look at the different mouth pieces of whistles. Some whistles have round mouth pieces, these are good to develop lip protrusion and lip rounding and will aid in the production in sounds like /oo/ and /w/. Other whistles have flat pieces that can aid in developing lip closure in children as well as sounds like /m, b, p/. Look for large flat whistles (like a harmonica), these whistles are also good to develop lip closure but is particularly useful in targeting lip retraction (for sounds like /ee/). Make sure your child is only using their lips when blowing the whistles and does not bite down on the whistles to stabilise the whistle! You can buy your own whistles from local toy shops but for a more structured whistle blowing programme (as recommended by TalkTools trained SLT) see www.thinkingtoys.iefor the whistles needed at each level.

Featured Organization: The Down Syndrome Centre

We thank the Down Syndrome Centre for allowing us to reprint their copyrighted article. For more information about this organization please visit The Down Syndrome Centre

Tags: January 2007 Newsletter Down Syndrome SLP Oral Motor Therapy Article