normal range of structure and function of the speech mechanism is very broad and varied structural...
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Normal range of structure and function of the speech mechanism is very broad and varied
Structural deviations do not necessarily equal speech production difficulties
Looking for RED FLAGS during the oral exam Tremors, voice quality, nasal sounds,
breath support, structures,
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Observe at least 10 typical people’s mouths
Listen to their voices Let’s practice
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Universal precautions Protect others Protect yourself Tools?
Rubber gloves Pen flashlight Tongue depressor Stopwatch Facial tissue Dental mirror (?) Disinfectant
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Broad to specific assessment Symmetry of the face Client’s breathing
Open mouth posture Adequate breath support
Voice quality Connected speech (control of saliva) Some of your most valuable dx info can
be from functional situations !!!
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Facial structure – first sign of a syndrome
Symmetry Muscle control
Presence of tremors, spasms, or tics Abnormal tension or lax in the face at rest
Breathing Mouth or nasal breathing
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Mouth Lip closure Cleft? Smile symmetry
Eyes Eyebrows? Shape and ‘alertness’ of the eyes
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Sensations of upper and lower lip, cheeks by closing eyes (soft vs hard touch)
Hot/cold senses Respiration
In through nose, out through mouth Air flow during speech Abdominal breathing/shallow breathing Stridor or hoarseness in voice Straw for kids, hold their nose, blow bubbles
as long as they can (5 seconds – okay)
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Nose Look up in the nose for possible obstruction
Lips Important articulator and anatomical structure Eating, drinking, facial expression, speech Natural smile, Fill cheeks with air and hold for 10 seconds Retract, protrude, /pa/ /ba/ (lip/jaw movement) Pucker/smile (for adults) ‘baby’ or ‘mama’ (for
kids) O-e (over and over)
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Open mouth ( for kids = ‘let’s see what you had for lunch
Color of oral cavity Hard/soft palate
Normal arch to hard palate Healthy color – no growths Fistula Uvula Tonsils ‘ahhh’ soft palate elevation quick ‘ahhs’ Gag reflex
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Dentition Tongue (feeding and speaking)
Size, color, symmetry Tongue at rest (color), atrophy Tongue mobility (lollipop for kids) Stability of head and jaw during tongue
movmnts
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Timed for 20 pahs, then tahs, then kahs Then asked to say pahtahkah 10 times
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(more specialized area) Observe eating 2 or 3 textures Drinking liquids by cup and straw Food introduced by spoon and hand History is important here
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Why do an oral mech exam? Why is it important to look at the
function as well as the structure when assessing?
What are some factors influencing speech intelligibility besides structure and function?
What are some important precautions to take before you perform an exam