I am starting a new private practice and I’m looking for a good oral mechanism exam checklist. Do you have one or know of a place that would have one?
Congratulations on starting up a practice. Being that I have focused on orofacial myology for so many years, my eval is complicated and requires too much explanation for someone to use without having attended my course. It also will depend upon what type of patient you are seeing. For example, if I were seeing a young child with a language disorder, I wouldn’t delve as deeply as I would for an artic case since I know that almost all artic cases have some structural connection. For an adult stutterer or voice case, I’d look at other things, etc. If you will be seeing mainly one type of patient/client, and if you’d like some guidance with it, I’ll try to give you some input. One thing for sure, I check everyone for tongue tie or even slightly restricted lingual frena. I can’t believe how many calls I get from those I’ve trained, telling me that they have found several on their caseloads who have restricted lingual frena; some had been in therapy elsewhere for years without progressing; yet their restricted frenum was overlooked.
Whether they nose breathe or mouth breathe is critical. If they mouth breathe, enlarged tonsils/adenoids, severe allergies, etc. must be ruled out prior to therapy.
You might also take a look at the labial frenum, under the upper lip since it sometimes is tight or short and doesn’t let the lips close easily enough to produce bilabials and certain vowels and diphthong sounds.
If they are 4 years or older, they should be able to separate the tongue and mandible and lips during movements such as: side to side with tongue, in and out with tongue, up to “spot” on alveolar ridge and down numerous times.
These are but a handful of the involved exam I give/teach, and hopefully they are some areas that might help you out since others sometimes miss these areas.
Let me know if you have more questions,
I’ve got her oral habits “fixed” for during the daytime. However, the nighttime is creating a pretty big problem and I’ve racked my brain…
Sometimes a frenum is not short but is still restrictive because of the attachment location on the tongue or onto the lower alveolar ridge.
He presents with decreased lingual movement but does not have an obvious anterior tongue tie. He is unable to stick out his tongue without it resting on his teeth and he cannot click his tongue without moving also moving his jaw. I am really at a loss for how to help him.
Would you use your digit sucking elimination program with a client to eliminate the noxious habit of lip licking?
He substitutes lingua alveolar sounds for these three (s/f, z/v, l/w). I worked with him for 45 minutes and during the entire session, he chronically licked his lips (predominantly his lower lip). His tongue was deeply scalloped when he was asked to protrude it and he had an abnormal rest posture (since all he was doing was licking his lips! ) He was not able to pucker/move the upper lip at all and the lower lip barely moved. He had a very long philtrum.
Do you really see the patient two times a week, does once a week work? Is half hour enough time?
Now that I am older I realize that a lot of my nieces and nephews and cousin are doing the same thing too
All of us have to evaluate from several perspectives
There is no easy help for an adult (or child) tongue sucker. That’s where psychology has to be incorporated. As with all noxious oral habits, you want to work first on Awareness…
I’ll be leaving these patients within 3-6 months. Do you think it’s fair to start?