Discussion board questions

Question 1

Purpose of Oro Motor assessment

Answer 1

Determine the structure and functional adequacy of the oral mechanisms for speech
routine check of every speech evaluation to assist diagnosis and direction for treatment

Question 2

Why is assessment important? (4)

Answer 2

1.Determine if communication or swallowing behaviours are disordered (Does the person really have a problem?)
2.Determine the nature and extent of the problem including a description of:describe the individual’s capabilities
consistency
severity of involvement
stimulability
patterns
3.Search for causal factors and correlates of the disordered behaviour :
utilise all relevant information to develop a set of recommendations for effective and efficient management
structural
psychological
environmental
neurological
4.Determine the prognosis:
with intervention
without intervention

Question 3

List the 5 nerves used for the oro-motor assessment, and also what you check for with each nerve.

Answer 3

V (trigeminal): check masseter and temporalis, check jaw movements, sesnsation testing
VII (Facial) observe facial symmetry, smile, pucker lips, puff cheeks, alternate
IX&X (Glosopharyngela&Vagus): gag reflex, say ah, listen to vocal quality, couh, listen for strenght/effectiveness, voluntary swallow of saliva, take not of spontaenous swallows.
XII (Hypoglossal): tongue at rest, protude tounge, move to each side, likc lips, push agianst resitance

Question 4

Why is assessment important? (3)

Answer 4

1. Determine if communication or swallowing functions are disordered
2. Impairment of muscles often indicates underlying neurological dysfunction
3. This forms the basis for any further assessment and intervention

Question 5

Which steps are involved in the OMA?

Answer 5

1. check oral cavity for dentition, state of muscoa, saliva, other abnormalities (tonsils, palate)
   V
   -jaw at rest, jaw open, open against resistance.
   -clench teeth, clench teeth against resistance
   -check masseter and temporalis for bulk
   -open and close mouth rapidly
   -sensation testing (touch)
   VII
   -facial symmetry at rest
   -smile, pucker lips, alternate
   -puff cheeks- press on cheeks ask to keep air in.
   IX&X
   -gag reflex
   -open mouth wide and say ‘ah’. check elevation of soft palate. listen to vocal quality
   -ask person to cough - listen to abnormality
   -ask to do voluntary swallow- make note of spontaneous swallow
   XII
   -observe tongue at rest- protrude tongue-move to each side rapidly-lick lips-use tongue depressor and ask to push tongue against resistance

Question 6

What types of assessment are there?

Answer 6

Client interview
Case history taking
OMA
Speech and language sampling
Formal assessment tools (eg CELF)

Question 7

By asking your client to “puff out” their cheeks you are assessing function of which cranial nerve?

Answer 7

CN VII Facial Nerve

Question 8

By conducting a facial sensation test, you are assessing function of which cranial nerve?

Answer 8

CN V Trigeminal Nerve

Question 9

Practice writing SMART goals for one way to modify the environment for BJ.
“B.J. a four year old client who attends my clinic…has moderate to severe developmental dyspraxia and is 80% unintelligible to me. At kindergarten she faces severe disability because of her impairment…hitherto I have seen BJ in six weekly modules, within the clinic, with her mother. The targets have been speech sounds to try to “fix” her disability. Her mother is highly anxious about BJ’s readiness for school (next year). Am I using scarce clinical time wisely? What else should I be doing at a community level, instead of or as well as this therapy, to minimse the impact of the impairment?”

Answer 9

How did you go? Try some of the other case studies too.