1. Elise Peltier MS CCC SLP Jeanine Geisler MS CCC SLP
Oral Motor Exam
Elise Peltier MS CCC SLP
Jeanine Geisler MS CCC SLP

2. 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.

3. Alternative terminology
Oral Motor Exam
Oral Peripheral Exam
Oral Mechanism Exam (Oral Mech)
Speech Mechanism

4. Why do an Oral Motor Exam ?
Stroke ( CVA)
Feeding and Swallowing
Aritculation Disorder
Motor Speech Disorder
Dysarthria
Apraxia

5. Tools Gloves Tongue Depressor Pen Light Small hand held mirror
Watch ( stop watch)
Other helpful tools : sucker, cotton guaze

6. What structures do we look at ?
Face
Lips
Teeth
Tongue
Jaw ( mandible)
Hard/Soft Palate
Cheeks

7. How do we illicit desired results
Adult clients
Give direct verbal instructions
Model

8. Target: Facial Symmetry
Have subject look straight at you
Are facial features symmetrical?

9. Target: Tongue Elicitation Observations
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.
Assess ability to exert force against resistance
Assess coordination of fast movements

10. 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

11. 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

12. 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

13. 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

14. How can we describe/ measure
We can describe muscle and function and movement using STARRS
MUSCLE STRENGTH
MUSCLE TONE
ACCURACY OF MOVEMENT
RANGE OF MOVEMENT
SPEED OF MOVEMENT
STEADINESS OF MOVEMENT

15. 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”

16. 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

17. Structural Considerations
Cleft palate or lip

18. Structural Considerations cont.
Tongue tie (ankyloglossia) or Lip tie

19. Hypotonic Facial Characteristics

20. Drooling Assess why - Postural Control - Oral sensory responses
- Oral-motor skills
- Swallowing ability
- Cognitive level
- Structural Problems
- Dental/Occlusion problems
- Medications
- Diet

21. Teeth Normal Occlusion Class II Malocclusion (Overbite)
Class III Malocclusion (Underbite)

22. Teeth cont.
Cross Bite
Open Bite
Tooth Decay

23. Assessing for Apraxia of Speech
Diadochokinetic Rate
- Repeat “papapapa”
- Repeat “tatatata”
- Repeat “kakaka”
Alternate Motion Rate
- Repeat “pataka”
Nonspeech tasks (assess for oral apraxia)