speech oral motor assessment checklist

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What Do I Look for in an Oral Motor / Feeding Assessment?

Posted by Debra C. Lowsky, MS, CCC-SLP on 15th Jun 2018

What do I look for when I’m doing an oral motor / feeding assessment?   It's never a cookie-cutter check list.  It always depends on the individual and their skills and goals and where the evaluation, medical history, family history, etc. lead me.  But, there are some general skills that I look for and “tests" that I do:

Is there  tongue lateralization ? Is the tongue moving from side to side, or is it just pumping up and down?

Is there tongue elevation ( tongue tip , mid-blade, and  back of tongue )?

Is there  lip closure ?

How is the individual manipulating food?  Is there  rotary chewing ?  The tongue should be moving food from side to side before forming it into a bolus (ball of food).  The bolus should then be positioned between the palate and the middle of the tongue, and then passed to the back of the tongue, triggering an automatic swallow?

How many times does the individual chew a bite of food?   This will vary a lot depending on the kind of food.  For example, a banana slice will be a lot easier to chew and will require fewer chews than a piece of carrot.  I’ll try the food myself to see how many it should take - that’s really key.  Personally, I sometimes have to chew things up to 20-30 times, which takes strength and endurance.  

When the individual is chewing, I’ll feel the masseter bulge and the temporalis to see if they’re working.

Is there oral tone?   Drooping,  drooling , the  tongue positioned low and forward , open mouth posture, flaccid not toned cheeks, food loss, etc. may be signs of low oral tone.

Is the individual swallowing everything?  After the individual swallows, I’ll ask him/her to open the mouth so I can see if there are food particles left on the tongue and/or scattered throughout the oral cavity.  Can the individual do a lingual sweep to collect any leftover food particles? Is there awareness of food left on the lip, tongue, cheek, palate, or gum area?  Does he/she swallow on their own, or do they need to be cued/prompted to swallow? 

How is the oral resting posture?   The tongue should be not be making contact with either the bottom or top teeth, but retracted inside the oral cavity with the tongue tip resting on the alveolar ridge.   The jaw should be maintained in a high but not completely closed (upper and lower teeth almost touching each other, but not touching).

I’ll watch the individual drink from a straw, looking for lip closure, lip tension, cheek tension, tongue retraction, spillage, etc.  I’ll also check the length of the straw to make sure they’re not putting too much of the straw inside the mouth.   You can see how I do this at about 1:11 into the video below - As he takes a sip, I put my fingers where the straw meets the lips, then remove the straw to see how much of the straw he had in his mouth.  Using a  Lip Blok can help here.  Ideally I only want 1/4" of the straw inside the mouth ( click here to learn why ).

Is there a  tongue thrust ?  One thing I’ll have the individual take a small sip of water and hold it in his/her mouth.  Very lightly I’ll rest my hand under the chin, tell the individual to swallow, and “follow the swallow” with my hand.  If my hand moves forward during the swallow, this is one of several indications that there may be a tongue thrust.  The hand should not move.

As the individual drinks, I’ll also listen for gulping and gurgling sounds, which could mean there's too much air in the swallow, and/or that the swallow isn’t coordinated.

Check the food diary - I’ll have the parents keep a food diary to gather more information.  Everything the child eats for three days, including notes on how easy or hard it was for him/her to eat each food.

I’ll also check the individual’s medical history, especially GI - everything must be ruled out and/or addressed first - ENT, GI, esophagus, swallow study, MBSS, FEES, etc.

I’ll look at the parent’s history, too.  The parents might have a tongue thrust too for example.  Or the parents might dislike certain foods and may have passed those preferences on to their kids (my own kids won’t go near mushrooms because of me for example - I think they’re gross).  And so forth.

Are there any signs of  sensory issues / aversions ?  I’ll watch facial expressions and body language.  Grimacing, gagging, pulling away, turning the head - those are the easy/obvious ones.  I also look at facial expressions and read the eyes as well, looking for signs of dislike, fear, concern, like, delight, etc., especially if the individual is nonverbal.

This list is by no means all-inclusive, but I hope you find it helpful!

To any parents reading this - If you are at all concerned about your child's oral motor / feeding skills, please do consult with a feeding therapist so they can assess things in person, put together a personalized treatment plan if needed, and guide you through it.    

Debra C. Lowsky, MS, CCC-SLP

• #feeding-therapy
• #lip-closure
• #oral-motor
• #tongue-elevation
• #tongue-lateralization
• #tongue-retraction

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This advice-column-style blog for SLPs was authored by Pam  Marshalla  from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.

Standardized Oral Motor (OM) Tests

By Pam Marshalla

Q: I need information on evaluating oral-motor skills in school age articulation/phonological cases as well as appropriate oral-motor exercises/goals for educational IEP’s/settings.

The only test I know of that will give you a standard score for oral motor skills is my test called the MOST —  The Marshalla Oral-Sensorimotor Test . It is  available through SuperDuper Publications .

The MOST was normed on kids 4;0 – 7;11. It will give you individual scores for jaw, lips, tongue, velum, respiration, phonation, and oscillating oral movements.

All other tests that I am aware of are simple checklists.

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Oral Motor Exam Assessment Cards

When children are reluctant to engage in oral motor assessments, it can be hard to gather the information you need for a thorough assessment. These Oral Motor Exam Assessment Cards are designed to help you thoroughly assess the child’s oral motor functions, but in a fun child-friendly way. With engaging visuals and instructions that make sense to children, you will have the information you need in no time. Also included is a two-page assessment form to help you record your findings.

Description

Have you ever struggled to elicit a simple oral motor evaluation with your students? Do you find that children are reluctant to open their mouths, or are confused by some of the directions in typical oral-facial exams?

Download the Oral Motor Assessment Cards if you want:

➊ — child-friendly instructions and pictures that make sense to children ➋ — to try to increase participation during an oral-facial exam ❸ — a digital oral motor version for online/telehealth evaluations ❹ — an easy-to-follow, two-page assessment form to record your findings

These colorful and engaging cards contain relatable and funny actions such as ‘move your tongue like a puppy wagging its tail’, to increase participation (especially with your preschool-aged students) but MORE IMPORTANTLY , allow you to get the information that you need about a child’s oral motor functioning.

Don’t want to print? This file contains a separate PDF document so that you can upload the informal assessment to your tablet and use as a quick to access, on-the-go option. Just use your favorite way to transfer PDFs to your iPad (like dropbox) and save in a place such as iBooks (free app on the iPad) and it will always be stored there for easy access.

⭐ Read on the Blog my tips and tricks to getting an oral motor evaluation done. ⭐

The cards are may help as part of your everyday assessment , particularly for children with speech difficulties . Make it play-based and have toys, puppets, and pretend food so that you can elicit these cards easily as part of dynamic assessment. Please note that this is not an exhaustive list of oral motor movements, so I have listed below what the cards cover in terms of oral movements.

===================================== CONTENTS: The cards included for the oral movements: ✅ — Jaw – open, open-close ✅ — Lips – protrusion, retraction, lip seal, rapid protrusion-retraction ✅ — Tongue – appearance, protrusion, retraction, depression, elevation, lateralization, rapid lateralization ✅ — Oral exam card (to look in the child’s mouth) – dentition, palate, tonsils, and soft palate ✅ — DDK cards for /p/, /t/, /k/ and “pat-a-cake” ✅ — Two-page Oral Motor Screener form ✅ — For an idea on size – there are 4 cards to a page for the printed version, but one card to a page for the iPad document. If you are wanting to save the 21-page ‘tablet’ version to your iPad, I just save the PDF in my free iBooks app so that it is always there. =====================================

What SLP’s like you are saying:

❝ Great product for my little kiddos on caseload. It makes oral-mechs fun for everyone!❞ ❝ My kids love the visuals and are more willing to imitate OM movements with them!❞ ❝ LOVE IT! Such a fun and engaging way to do oral motor exams.❞ ❝ Fun and kids love it. They think they’re pulling silly faces at me.❞ ❝ Finally – a way to make oral motor assessments fun and engaging!❞

IMPORTANT INFORMATION: This is a digital file and is licensed for one person to use. Upon purchase, you will receive a link to download the product. Printing and assembly of the product may be required. For more information about single-person use, please refer to our Terms of Use.

Do you need FREE 100 Trials for Speech no-prep worksheets? Sign up for my newsletter to get access to my Freebie Library of goodies that are aimed at your speech sound caseload.

ABOUT THE AUTHOR: Rebecca Reinking is an SLP who works privately with children who have speech sound disorders. She has a particular interest in phonological interventions and strives to connect and collaborate with speech scientists to bridge the gap between research and clinical practice.

Follow  our 100,000-strong Instagram account: @adventuresinspeechpathology Learn  more about treating speech sound disorders and join our email list Contact  our support team: [email protected] Watch  short therapy-related clips on YouTube: youtube.com/c/AdventuresinSpeechPathology

6 reviews for Oral Motor Exam Assessment Cards

Jessica B. (verified owner) – June 21, 2024

I love using these visuals while I’m doing an oral mech exam! They’re playful and colorful and silly, but also informative and helpful for me. Highly recommend!

Madison F. (verified owner) – June 21, 2024

These are a great resource to complete an oral-mech without your student realizing they’re even doing one! I have a copy downloaded on my iPad and the students love the pictures. Great resource for evaluations and screenings.”

Stefanie H. (verified owner) – June 28, 2024

LOVE these pictures! It makes an oral motor examination more engaging and comprehensible to little ones. Thank you!

Rebecca S. (verified owner) – June 28, 2024

This was a great resource for preforming an Oral Motor Exam! My students were able to understand exactly what to do from the kid friendly pictures!

Abbey W. (verified owner) – September 1, 2024

Absolutely love everything and anything by AISP. The pictures help my students understand exactly what movements to do, and make the OMA really fun and engaging for them. The score form is so useful too. This resource is a MUST for all pead slps!!!

Kelsey S. (verified owner) – September 1, 2024

I love ALL things Adventures in Speech Pathology! If Rebecca makes it- I’m buying it! Lol This product is so cute and engaging when trying to motivate a student to participate in an oral motor exam. Thank you for this fun resource!

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Pediatric Oral-Motor & Feeding Evaluation Form

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Pediatric Oral-Motor & Feeding Evaluation Form

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Quick Pediatric Oral Motor Assessment

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Oral Motor Assessment Checklist

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This oral motor assessment screener can be used to guide informal, screening assessments of oral motor abilities needed for swallowing and speech. It is a quick and concise tool sectioned by cranial nerves.

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