Speech-language-hearing interventions in orofacial functions in individuals with Down syndrome: a scoping review.

Only 10 studies met the criteria, spread over 2009 to 2024, and just three were published in the last five years, so this is a small and ageing evidence base. The review lists six of the studies as having no control group, so readers cannot tell how much of the improvement was the therapy and how much was growth, development or the extra attention the children received. Half of the studies judged their results without statistics, describing what they thought they saw rather than measuring it, which the authors of one included study also flagged. Most studies had between 1 and 20 participants, and one of the swallowing studies was a single child; only one study had 42 participants. One included study of seven children contained only two with Down syndrome, the rest having other diagnoses, so its results are only partly about this population. Assessment and intervention protocols were not standardised, session numbers ranged from seven to continuous treatment and duration from 1 to 12 weeks, so results cannot be compared between studies. Eleven eligible full texts could not be obtained and the paper reports that detail was missing from some intervention descriptions, which limited what could be extracted. The authors did not rate the quality of the included studies, so a reader cannot weigh the stronger trials against the case reports. Almost all participants were children and adolescents; only one study included adults, so this says nothing about older people with Down syndrome.

The work was funded by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), a Brazilian federal agency, under process number 88887.672324/2022-00. No other funding source or competing interest is stated in the supplied text.

Do not read this as proof that orofacial myofunctional therapy works in people with Down syndrome. Only three of the ten studies were randomised trials, six are listed as having no control group, half judged their results without statistics and most had between one and twenty participants, so the improvements described could reflect normal development, maturation or the extra attention children get in therapy. Also do not carry the marginal sleep apnoea result into practice as a treatment for apnoea.