From infancy to adulthood: Speech therapy for SMA at every age

Last updated Oct. 27, 2025, by Susie Strachan
Fact-checked by Patrícia Silva, PhD

Speech therapy for children and adults with spinal muscular atrophy (SMA) focuses on strengthening the muscles involved in speech, improving breath support, and safely managing swallowing difficulties.

Speech-language pathologists, known as SLPs, can adapt speech therapy to different SMA life stages, starting with early feeding support in infancy and continuing with helping to maintain clear communication in adulthood.

Speech therapy for infants and toddlers

Pediatric speech therapy focuses on helping children with SMA develop feeding skills and early communication, even before words begin.

Their SLP can use exercises to encourage safe swallowing and strengthen oral muscles. These exercises may involve:

gentle mouth and tongue movements, such as blowing through straws or bubbles, to develop breath control
chewing soft but slightly resistant foods to build jaw strength
engaging in simple vocal play or gentle lip exercises to promote muscle coordination

As a caregiver, you can give your child time to respond, encourage eye contact and vocal sounds, and engage them in simple back-and-forth games, such as making animal sounds or smiling together.

Some babies with severe SMA may require tracheostomy and ventilator support early in life. Early speech therapy includes adapting communication and swallowing approaches around this type of treatment.

Speech therapy for school-age children

When your child reaches school age, speech therapy can support clearer speech, literacy, and participation with friends and teachers.

SLPs can work with you and educators to provide communication support in SMA that fits in the classroom, playground, and at home. This may include:

teaching educators how to use communication devices such as speech-generating apps or picture boards so your child can participate in lessons and discussions
teaching your child alternative ways to express thoughts, such as gestures or writing, to support communication when speaking is tiring
suggesting simple group activities and communication cards or signals to include your child in games and play
helping peers and staff understand how to support your child’s involvement during social times
guiding you to practice speech and language skills with fun games, storytelling, or daily routines at home
suggesting apps, visual schedules, or communication books that match your child’s interests, and everyday activities to help make communication easier and more enjoyable

Speech therapy for teens

As a teenager with SMA, the focus of therapy is helping you communicate confidently with friends, teachers, and your healthcare team. As a parent of a teen with SMA, the focus is on support and practicing communication strategies.

Speech therapy exercises for teens with SMA differ from those for younger children, reflecting progression in muscle weakness affecting oral, facial, and respiratory muscles.

Some areas of focus are:

preserving the strength and coordination of the jaw, tongue, and lips to maintain clear speech as long as possible
managing muscle fatigue using pacing, breath support, and voice conservation techniques
enhancing swallowing safety and lowering aspiration risk through targeted exercises
using augmentative communication SMA tools, such as speech-generating devices, to supplement speech when needed.

Finally, some teens may depend on ventilators or have tracheostomies, requiring specialized speech therapy that focuses on the use of speaking valves and managing swallowing.

Speech therapy for adults

As an adult with SMA, your speech therapy goals may include staying as independent as possible at work, in relationships, and in daily life.

Through targeted exercises, adult speech therapy focuses on swallowing safety and maintaining vocal strength and clarity. These exercises might include:

breath control techniques, such as sustained vowel sounds or paced breathing, to improve vocal support and reduce fatigue
oral exercises to maintain the strength and flexibility of the tongue, lips, and jaw
speech pacing and clarity drills to improve understanding by slowing speech or emphasizing sounds
swallowing exercises, such as effortful swallows and chin tuck maneuvers, to improve coordination and safety
voice projection and resonance exercises to maximize sound output despite reduced muscle strength

In addition to physical exercises, SLPs can help you select and maximize the benefits of augmentative and alternative communication (AAC) devices that fit your evolving needs.

An SLP may also provide strategies for using these tools effectively at work, in social situations, or during medical appointments, helping you maintain meaningful communication.

As with children and teens, adults with SMA may use ventilators or have tracheostomy tubes. Speech therapy continues to address communication options, swallowing safety, and device management.

Speech therapy for older adults

Aging with SMA can bring new challenges to your health and communication.

Therapy for older adults focuses on preserving your ability to speak clearly and swallow safely while managing other health concerns, such as scoliosis and breathing difficulties.

Because you may experience age-related health problems earlier than most people, your care needs might become more complex and require ongoing attention.

For example, you might find it harder to control the muscles in your mouth and face, which can affect your speech clarity and make swallowing less safe.

Speech therapy can also:

help prevent lung infections through swallowing evaluations and teaching safer eating and drinking techniques
include gentle exercises to keep the mouth and facial muscles working without causing fatigue
shift more focus toward using communication aids, like speech devices, to stay connected
provide ongoing training and adjustment of AAC devices
involve an SLP working with your caregivers and family to support your communication and ability to eat safely

Tips for making the most of speech therapy at any age

An SLP can provide practical strategies across ages and stages of SMA to help you communicate and stay connected as your needs change.

There are some things you can keep in mind that may help you or your child maintain speaking and swallowing skills:

Consistency matters. Whether you’re a parent or an adult with SMA, regular practice and good communication with an SLP can help you build steady progress.
Don’t hesitate to ask for more personal approaches. Every person with SMA is different, and therapy should be geared to you or your child.
It helps to track changes over time. Know that you can raise concerns or ask for a technology upgrade if your old tools are no longer working for you.
Support is important. Connecting with other families and people living with SMA, either in person or online, can also provide practical advice and encouragement.

Keeping up with speech therapy might take some time and effort, but following the right approaches by age can make a difference in communicating while living with SMA.

SMA News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.