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,

Observe at least 10 typical people’s mouths

Listen to their voices Let’s practice

Universal precautions Protect others Protect yourself Tools?

Rubber gloves Pen flashlight Tongue depressor Stopwatch Facial tissue Dental mirror (?) Disinfectant

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 !!!

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

Mouth Lip closure Cleft? Smile symmetry

Eyes Eyebrows? Shape and ‘alertness’ of the eyes

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)

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)

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

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

Timed for 20 pahs, then tahs, then kahs Then asked to say pahtahkah 10 times

(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

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