<p><strong>Background: </strong>Motor speech disorders in childhood may affect speech motor planning/programming, neuromuscular execution, phonation, articulation, prosody, intelligibility, and oral sensorimotor control. Childhood apraxia of speech (CAS) and dysarthria require different but sometimes overlapping treatment principles. Drooling may coexist when oral-motor control, posture, swallowing frequency, or salivary management is impaired.</p>

<p><strong>Objective:</strong> To examine whether speech-focused vocal/phonatory-articulatory coordination and oro-motor exercises (OME) have a defensible role in management of CAS, dysarthria, and associated drooling, with particular attention to textbook guidance and recent evidence.</p>

<p><strong>Methods.</strong> A narrative evidence review was developed using current professional guidance, systematic reviews, randomized or controlled treatment studies, and standard textbooks. Priority was given to sources addressing motor-speech treatment, CAS, dysarthria, pediatric oral-motor intervention, phonatory/respiratory management, and pediatric sialorrhea. Sources were cross-checked through September 2026, including the 2026 fifth edition of Duffy&rsquo;s Motor Speech Disorders and two 2026 pediatric drooling evidence syntheses.</p>

<p><strong>Results:</strong> The literature supports task-specific, speech-based motor treatment for CAS, including approaches such as Dynamic Temporal and Tactile Cueing (DTTC) and Rapid Syllable Transition Treatment (ReST). Studies indicate gains in treated speech targets and, in some trials, generalization or maintenance. For dysarthria, treatment may target the impaired speech subsystems&mdash;respiration, phonation, resonance, articulation, and prosody&mdash;rather than using a uniform exercise package. Systematic evidence for respiratory/phonatory management supports continued investigation of behavioural treatments, although much of the higher-level evidence is drawn from neurodegenerative populations rather than children. In contrast, older systematic reviews found insufficient evidence that nonspeech oral-motor exercises alone improve speech. More recent pediatric drooling reviews indicate that behavioral/rehabilitative interventions, including oral-motor approaches, can improve drooling and oral-motor outcomes in some children, but effects vary substantially and are not consistently durable or generalizable.</p>

<p><strong>Conclusion:</strong> Oro-motor activities may have a management role when they directly address an identified oral sensorimotor or swallowing-related impairment, particularly in drooling or feeding contexts. For speech sound improvement in CAS and dysarthria, however, exercises should be linked to functional speech tasks and motor-learning principles. The strongest evidence supports repeated, individualized, task-specific practice; oral-motor exercises should not replace speech practice when the treatment goal is speech intelligibility.</p>