Oral Motor Exam Elise Peltier MS CCC SLP Jeanine Geisler MS CCC SLP What is an Oral Motor Exam Determine the structural and functional adequacy of the oral mechanisms A variety of medical professionals may complete dentists doctors and speech language pathologists ID: 772698
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Oral Motor Exam Elise Peltier MS CCC SLP Jeanine Geisler MS CCC SLP
What is an Oral Motor Exam Determine the structural and functional adequacy of the oral mechanisms A variety of medical professionals may complete dentists, doctors and speech language pathologists.
Alternative terminology Oral Motor Exam Oral Peripheral E xam Oral Mechanism Exam (Oral Mech ) Speech Mechanism
Why do an Oral Motor Exam ? Stroke ( CVA) Feeding and Swallowing Aritculation Disorder Motor Speech Disorder Dysarthria Apraxia
Tools Gloves Tongue Depressor Pen Light Small hand held mirror Watch ( stop watch) Other helpful tools : sucker, cotton guaze
What structures do we look at ? Face Lips Teeth Tongue Jaw ( mandible) Hard/Soft Palate Cheeks
How do we illicit desired results Adult clients Give direct verbal instructions Model
Target: Facial Symmetry Have subject look straight at you Are facial features symmetrical?
Target: Tongue Elicitation Stick straight out, left then right, left right quickly, elevation, retraction, protrusion and lateral movement against resistance ( cheek or tongue blade) Observations Look for symmetry and range of motion, size and evidence of fasiculations . https:// www.youtube.com/watch?v=xuwdvBXcr30 Assess ability to exert force against resistance Assess coordination of fast m ovements
Target: Lips Elicitation Smile Pucker Open Close Tight Puff up cheeks, hold against resistance Observations- Look for symmetrical movements, extent of movements, ability to close completely and hold against resistance
Target: Oral Cavity and Velum Elicitation Open Wide Say “ah” or “E-E-E-” Observation Look at conditions of teeth, any dentures or partials? Watch for extent and symmetry of velar elevation and pharyngeal constriction
Target: Voice/Airway Protection Elicitation Maximum phonation duration S:Z ratio, pitch glides Volitional cough and Throat clearing Observations Listen for intensity, pitch and quality Listen for breathy, horas/harsh, strained, wet/ gurgly Listen for hyper or hyponasality
Special considerations for adults Hearing loss or auditory comprehension - check for hearing aids, write instructions, model Adults with Apraxia Blow a kiss, smile Give a spoon or straw
How can we describe/ measure We can describe muscle and function and movement using STARRS MUSCLE S TRENGTH MUSCLE T ONE A CCURACY OF MOVEMENT R ANGE OF MOVEMENT S PEED OF MOVEMENT S TEADINESS OF MOVEMENT
Get your ped to participate! Ped friendly language Glove considerations Extra-Oral -> Intra- Oral Use of lollipop or pudding Flavored tongue depressors Flashlight with lights off Take turns looking into each others mouth “Simon Says” game Assess during meal or “snack”
Anatomy Age 5 is when anatomy + physiology (for feeding/swallowing) is like that of an adult Structures and their relationship are previously designed to provide stability, control, and airway protection
Structural Considerations Cleft palate or lip
Tongue tie (ankyloglossia ) or Lip tie Structural Considerations cont.
Hypotonic Facial Characteristics
Drooling Assess why - Postural Control - Oral sensory responses - Oral-motor skills - Swallowing ability - Cognitive level - Structural Problems - Dental/Occlusion problems - Medications - Diet
Teeth Normal Occlusion Class II Malocclusion (Overbite) Class III Malocclusion ( Underbite )
Teeth cont. Cross Bite Open Bite Tooth Decay
Assessing for Apraxia of Speech Diadochokinetic Rate - Repeat “ papapapa ” - Repeat “ tatatata ” - Repeat “ kakaka ” Alternate Motion Rate - Repeat “ pataka ” Nonspeech tasks (assess for oral apraxia)