The OMPAR Epidemic

March is Disability Awareness Month and I am here to talk to you about an issue that is commonly overlooked. It is a hidden epidemic that society has accepted as ‘normal’ but is silently harming our children. I am talking about Open Posture at Rest (OMPAR). OMPAR is a frequent sight, one that most of us ignore every day. We don’t bat an eyelash because it has become so common that it’s rarely talked about. But just because something is common doesn’t mean it’s normal.

What is OMPAR?

OMPAR is when a person’s lips remain apart and the jaw drops open when a person is not actively talking or chewing. Both children and adults can demonstrate OMPAR. If a child regularly rests with their mouth open, it may appear harmless or simply like it’s just a habit. However, chronic open mouth posture is often a sign that something deeper may be going on.

Open mouth resting posture may be due to:

  • Small airway
  • Enlarged tonsils and/or adenoids
  • Low oral tone
  • Orofacial myofunctional disorders
  • Sensory regulation differences
 

More importantly, chronic open mouth posture is not just a sign of an underlying issue. It can influence several aspects of a child’s development, from speech and feeding to dental growth, sleep quality, and overall health.

OMPAR is commonly overlooked, even among SLPs. I had a client who was receiving speech therapy for years before I started seeing him. He had trouble with different sounds so we were working on his overall articulation. His speech was unclear and he was difficult to understand in connected speech. During our first session, before we even started formal tasks, I noticed something important: His mouth was open at rest. Consistently. His lips were apart, his tongue was low and forward, and he was breathing through his mouth. When I asked him to close his lips, he could, but only briefly before returning to that open posture.

Instead of jumping straight into sound drills, I paused and looked at the bigger picture. I referred him to an otolaryngologist (ENT) to address any underlying airway issues. We discovered he had enlarged adenoids contributing to airway obstruction. He also showed reduced lip strength and poor oral awareness.

Once we addressed the airway concerns and incorporated oral motor awareness work, nasal breathing practice, and lip closure exercises, something shifted. His speech clarity improved. His stamina improved. Even his attention during sessions improved.

The articulation therapy became more effective because the foundation was stronger. This is the missing piece is a lot of articulation  therapy cases. OMPAR is something most pediatricians ignore, leading most families to believe it is not impacting their children. 

Not only can speech be impacted but, like I mentioned earlier in the post, so can feeding, dental growth, sleep quality, and overall health. An open mouth posture at rest can impact feeding by reducing lip closure and oral stability, which may affect chewing efficiency and safe swallowing. 

Over time, this posture can also influence dental growth by altering jaw development, tooth alignment, and the shape of the palate. Chronic mouth breathing is often associated with disrupted sleep, as it can contribute to airway concerns and decreased oxygen quality during the night. Poor sleep quality can, in turn, affect overall health, including attention, behavior, immune function, and daily energy levels.

When lips are closed at rest: The tongue rests on the palate, which supports proper development and contributes to facial symmetry.  Nasal breathing is promoted, which is important for filtering air. Speech production has a stable foundation. 

Some signs parents could look for include:

  • Chronic mouth breathings
  • Snoring or restless sleep
  • Frequent congestion
  • Drooling beyond developmental norms
  • Tongue resting low or forward
  • Open lips at rest most of the day

If you notice any of these signs  a collaborative approach can be powerful, involving your pediatrician, ENT, dentist/orthodontist, and SLP.

This month, Disability Awareness month includes awareness about subtle patterns that impact development.

As pediatric clinicians, we have the opportunity to:

  • Observe closely
  • Ask deeper questions
  • Support the whole child
  • Collaborate across disciplines

OMPAR might look small. But small foundational patterns shape big developmental outcomes. This March, let’s continue building awareness, not just of diagnoses, but of the underlying systems that support every child’s growth. Because when we strengthen the foundation, everything built on top becomes stronger.

Written by: Christina Vitale, Speech Language Pathologist

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