Oral Motor Examination
Sample Protocol to Get You Started
 
 
Target
Elicitation
Observations
Facial Symmetry Have subject look straight at you Are all facial features symmetrical?
Lips Smile 
Pucker 
Open 
Close tight 
Puff up cheeks, hold against resistance
Look for symmetrical movements, extent of movements, ability to close lips completely, and hold against resistance
Tongue Stick straight out 
Left 
Right 
Left and Right quickly 
Elevation 
Retraction 
Protrusion & lateral movement against resistance (with tongue blade)
Look for symmetry and range of motion. Look at size of tongue and for evidence of fasiculations. Assess ability to exert force against resistance. Assess coordination of fast movements
Oral Cavity Open wide Look at teeth, tongue, hard and soft palate. Look for evidence of lesions, atrophy, or missing structures. 

Also observe jaw excursion, listen for "clicks," watch for lateral shifts

Velum Say "ah" 

Elicit gag reflex by touching anterior faucial arches, posterior faucial arches, or base of tongue. Elicit gag on both sides

Watch for extent and symmetry of velar elevation and pharyngeal constriction.
Voice Maximum Phonation Time 
s:z ratio 
Pitch glides
Listen for vocal intensity, pitch, and quality. Note especially breathiness or gurgles