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Protocol - Oral Mechanism/Cranial Nerve Examination for Young Children

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Description:

This is a thorough examination of a child’s oral structures and functions that are necessary for speech production. It is designed to be administered in conjunction with, or as follow-up to, speech sound testing. Atypical observations may be used to identify the cause of speech disorders. For instance, deficits in neuromuscular functions during this protocol could confirm dysarthria, and deficits in motor planning could confirm apraxia of speech. The orofacial measures include observations of the structures and functionality of the facial muscles, lips, tongue, and jaw. Some speech productions are also assessed, but note that this protocol does not evaluate speech sound production systematically. Instead, other protocols such as the Goldman-Fristoe Test of Articulation 3 are designed to assess speech sound production. If abnormal structure or function is observed, closer examination by a clinician or specialist is required. The evaluator should familiarize herself or himself with the protocol prior to administering the tasks. Interpreting the results requires clinical training.

Specific Instructions:

This protocol is based on the following publication: Robbins, J., & Klee, T. (1987). Clinical assessment of oropharyngeal motor development in young children. Journal of Speech and Hearing Disorders, 52, 271–277. Administering it and interpreting the results may require training in the area of speech-language pathology or similar.

The protocol consists of three parts: Structures, Functions, and Rate and duration. The structures are scored as 1 (normal) or 0 (abnormal). The functions are scored as 2 (adult-like function), 1 (emerging skill but not with adult-like precision), or 0 (absent function). The rates of the child’s syllable repetitions and the duration of the vowel prolongation are compared to norms that are provided by the authors.

For the structural exam, the scores are based on visual inspections of the structures. Tongue carriage refers to the position of the tongue at rest; watch for things like tongue position that is too far forward. Fasciculations refer to muscle twitches in the tongue. Furrowing refers to abnormal grooves in the tongue. Atrophy and hypertrophy refer to tongue sizes that are too small or too large, respectively.

For the functional tasks, try to elicit the function with verbal instructions (e.g., “Stick your tongue out” (Item 34); “Lift your tongue tip up behind your teeth” (Item 35); “Move your tongue back and forth across the roof of your mouth” (Item 36), and “Stick your tongue between your upper and lower teeth.” Here are some suggestions for eliciting items 3 through 10:

3. Make your lips go round. 4. Push your lips out, like a pucker. 5. Give me a big smile. 6. Now go back and forth between a pucker and smile, as fast as you can. 7. Bite your lower lip. 8. Pinch your lips together. 9. Puff up your cheeks. 9. Open and close your lip, like a fish. Note that items 11–16 require exactly the same oral movement but are now overlaid with phonation to make speech sounds. The sounds to be produced are written in International Phonetic Alphabet, not English orthography, where /o/ corresponds to the vowel in “go,” /u/ is the vowel in “shoe,” and /i/ is the vowel in “see.” If you notice poorer performance during the alternating vowels /u/ and /i/ (Item 14) compared to just the alternating of the pucker and smile (Item 6), this is a red flag for apraxia of speech.

For Item 50, ask the child to open their mouth and say “ha, ha, ha.” You should see the soft palate moving up and down. If you do not see this movement, this may explain any hypernasal resonance in the child’s speech.

For the functional assessment, if the child is unable to follow the instructions, provide a model. After three unsuccessful trials, move on to the next item.

The syllable repetitions (Items 56– 60) measure how rapidly the child can produce strings of syllables. You can say, “We are going to say some sounds that are not real words. I’ll show you how to do it first, then we’ll do it together, and then you’ll do it on your own. The goal is to say these sounds as fast and accurately as possible. Watch this: papapapapa….” Count how many syllables the child produces in a 3-second interval and compare that number to the norms provided in the protocol. If you notice that the child’s productions of the multisyllabic trials (pataka, pattycake) are much slower than the monosyllabic trials, this is a red flag for apraxia of speech. If you notice slow productions in all types of syllable stimuli, this could indicate a neuromuscular deficit, for instance dysarthria.

Prolonging the vowel /a/ (as in “car”) requires adequate breath support and vocal fold functions. If you notice shorter durations than expected for age, this would warrant further evaluation in these areas.

Protocol:

Test of Oral and Speech Motor Control

Lips (CN VII)

 

Structure at rest:

structure*

function**

 

 

1

Symmetry

0   1

 

 

 

2

Relationship (open vs. closed)

0   1

 

 

Oral function:

 

 

 

 

3

Rounding

 

0   1   2

 

 

4

Protrusion

 

0   1   2

 

 

5

Retraction

 

0   1   2

 

 

6

Alternate pucker & smile

 

0   1   2

 

 

7

Bite lower lip

 

0   1   2

 

 

8

Lip Seal

 

0   1   2

 

 

9

Puff Cheeks

 

0   1   2

 

 

10

Open & close lips

 

0   1   2

 

Speech function:

 

 

 

 

11

Rounding /o:/

 

0   1   2

 

 

12

Protrusion /u:/

 

0   1   2

 

 

13

Retraction /i:/

 

0   1   2

 

 

14

Alternate /u i/

 

0   1   2

 

 

15

Bite lower lip /f/

 

0   1   2

 

 

16

Open & close lips /ma/

 

0   1   2

Mandible (CN V)

 

Structure at rest:

structure*

function**

 

 

17

Symmetry

0   1

 

 

 

18

Occlusion

0   1

 

 

 

19

Size (re: facial features)

0   1

 

 

Oral function:

 

 

 

 

20

Excursion (click teeth 5x)

 

0   1   2

Maxilla

 

Structure at rest:

structure*

function**

 

 

21

Symmetry

0   1

 

 

 

22

Size

0   1

 

Teeth

 

Structure at rest:

structure*

function**

 

 

23

Decay

0   1

 

 

 

24

Alignment

0   1

 

 

 

25

Gaps

0   1

 

 

 

26

Missing

0   1

 

 

 

27

Occlusion (re: maxillary teeth)

0   1

 

Tongue (CN XII)

 

Structure at rest:

structure*

function**

 

 

28

Symmetry

0   1

 

 

 

29

Carriage

0   1

 

 

 

30

Fasciculations

0   1

 

 

 

31

Furrowing

0   1

 

 

 

32

Atrophy

0   1

 

 

 

33

Hypertrophy

0   1

 

 

Oral function:

 

 

 

 

34

Protrusion

 

0   1   2

 

 

35

colspan="12"idge

 

0   1   2

 

 

36

Anterior-posterior sweep

 

0   1   2

 

 

37

Interdental

 

0   1   2

 

Speech function:

 

 

 

 

38

Elevation to alveolar ridge /n/, /t/, or /l/

 

0   1   2

 

 

39

Touch lateral edges of tongue to teeth /s/ or /?/

 

0   1   2

 

 

40

Interdental /θ/

 

0   1   2

 

 

41

Posterior tongue to palate /k/ or /g/

 

0   1   2

Velopharynx (CN X)

 

Structure at rest:

structure*

function**

 

 

42

Symmetry

0   1

 

 

 

43

Uvula

0   1

 

 

 

44

Tonsils

0   1

 

 

 

45

Vault height

0   1

 

 

 

46

Palatal juncture (palpate)

0   1

 

 

Oral function:

 

 

 

 

47

Blow on cold mirror

 

0   1   2

 

 

48

Suck through straw

 

0   1   2

 

Speech function:

 

 

 

 

49

/a:/

 

0   1   2

 

 

50

/ha.ha.ha/

 

0   1   2

Larynx-Respiration (CN X)

 

Structure at rest:

structure*

function**

 

 

51

Posture during quiet breathing

0   1

 

 

Oral function:

 

 

 

 

52

Cough, laugh, or cry

 

0   1   2

 

Speech function:

 

 

 

 

53

Pitch variation

 

0   1   2

 

 

54

Loudness variation

 

0   1   2

 

 

55

/ha.ha.ha/

 

0   1   2

Coordinated Speech Movements - Articulatory Accuracy

 

 

56

/pa/ repetitions

 

0   1   2

 

 

57

/ta/ repetitions

 

0   1   2

 

 

58

/ka/ repetitions

 

0   1   2

 

 

59

/pataka/ repetitions

 

0   1   2

 

 

60

"pattycake" repetitions

 

0   1   2

 

 

61

"you"

 

0   1   2

 

 

62

"top"

 

0   1   2

 

 

63

"beef"

 

0   1   2

 

 

64

"fume"

 

0   1   2

 

 

65

"cowboy"

 

0   1   2

 

 

66

"band-aid"

 

0   1   2

 

 

67

"half time"

 

0   1   2

 

 

68

"banana"

 

0   1   2

 

 

69

"kitty cat"

 

0   1   2

 

 

70

"puppy dog"

 

0   1   2

 

 

71

"communicate"

 

0   1   2

 

 

72

"1950"

 

0   1   2

 

 

73

"potato head"

 

0   1   2

 

 

74

"Winnie the Pooh"

 

0   1   2

Speech Sample

 

Prosody:

structure*

function**

 

 

75

Rate

 

0   1   2

 

 

76

Intonation

 

0   1   2

 

Voice:

 

 

 

 

77

Pitch

 

0   1   2

 

 

78

Loudness

 

0   1   2

 

 

79

Quality

 

0   1   2

 

 

80

Nasal resonance

 

0   1   2

* 1=normal, 0=abnormal

**2=adult-like function, 1=emerging skill but not with adult-like precision, 0=absent function

 

Mean (M) and Standard Deviation (SD) of Rate and Duration Measures
for Each Age Group and for the Entire Sample

 

/pa/

/ta/

/ka/

/pǝrǝkǝk/

patticake

Max phon time

Age group

M

SD

M

SD

M

SD

M

SD

M

SD

M

SD

2:6–2:11

3.70

0.86

3.70

0.76

3.65

0.49

1.00

0.27

1.26

0.11

5.55

1.87

3:0–3:5

4.66

0.80

4.56

1.02

3.82

1.45

1.06

0.29

1.36

0.32

5.51

1.49

3:6–3:11

4.81

1.20

4.78

1.13

4.83

0.57

1.76

0.90

1.75

0.83

7.79

2.37

4:0–4:5

4.89

1.12

4.77

1.05

4.58

1.08

1.37

0.28

1.56

0.25

8.01

2.11

4:6–4:11

4.64

0.82

4.46

0.62

4.29

0.57

1.34

0.27

1.33

0.10

9.22

2.19

5:0–5:5

4.76

0.84

4.82

0.85

4.56

0.94

1.40

0.43

1.58

0.28

8.06

1.97

5:6–5:11

5.09

0.44

5.22

0.45

4.91

0.25

1.58

0.19

1.65

0.21

9.42

1.65

6:0–6:5

5.36

0.64

5.32

0.48

4.94

0.28

1.45

0.25

1.61

0.23

10.99

3.06

6:6–6:11

5.51

0.43

5.37

0.72

4.85

0.71

1.72

0.19

1.64

0.26

11.47

3.02

Total Sample

4.85

0.92

4.80

0.91

4.51

0.88

1.43

0.44

1.54

0.38

8.51

2.91

 

Structure and Function

structure

function

RAW SCORE

 

 

 

Z SCORE

 

 

 

 

Structure

 

Function

Age group

n

M

SD

SE

Min-Max scores

Range

 

n

M

SD

SE

Min-Max scores

Range

2:6–2:11

10

22.5

0.8

0.3

22–24

2

 

8

97.0

9.2

3.3

78–106

28

3:0–3:5

10

23.5

0.8

0.3

22–24

2

 

10

99.3

8.5

2.7

86–109

23

3:6–3:11

10

23.0

1.2

0.4

20–24

4

 

8

107.1

3.8

1.3

99–111

12

4:0–4:5

10

23.4

0.8

0.3

22–24

2

 

9

108.1

2.1

0.7

104–111

7

4:6–4:11

10

22.4

1.7

0.5

20–24

4

 

9

109.3

2.1

0.7

106–112

6

5:0–5:5

10

23.3

0.7

0.2

22–24

2

 

8

109.8

2.6

0.9

106–112

6

5:6–5:11

10

23.0

1.2

0.4

21–24

3

 

10

109.8

2.6

0.8

103–112

9

6:0–6:5

10

22.0

2.0

0.6

18–24

6

 

9

110.6

1.3

0.4

108–112

4

6:6–6:11

10

22.4

1.1

0.3

20–24

4

 

10

111.1

1.2

0.4

108–112

4

Total sample

90

22.8

1.3

0.1

18–24

6

 

81

107.0

6.5

0.7

78–112

34

 

Protocol Name from Source:

Robbins & Klee Test of Oral and Speech Motor Control

Availability:

Publicly available

Personnel and Training Required

A clinician or specialist is required to assess abnormal orofacial

structures or functions. Interpreting the results to rule in or rule out a motor disease such as apraxia of speech or dysarthria requires training in speech-language pathology or related field

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training Yes
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual Yes
Mode of Administration

Clinical Examination

Life Stage:

Child

Participants:

Ages 2 years, 6 months, to 6 years, 11 months

Selection Rationale

This protocol is widely used clinically and in research, and it is one of the only protocols that provides norms for structural and functional scores. It is freely available.

Language

English

Standards
StandardNameIDSource
Common Data Elements (CDE) Speech Oral Mechanism/Cranial Nerve Examination for Young Children Assessment Score Ê 6773747 CDE Browser
Derived Variables

None

Process and Review

The Expert Review Panel #7 (ERP 7) reviewed the measures in the Speech and Hearing domain.

Guidance from ERP 7 includes the following:

  • Added a new measure
  • New Data Dictionary

Source

Robbins, J., & Klee, T. (1987). Clinical assessment or oropharyngeal motor development in young children. Journal of Speech and Hearing Disorders, 52, 271–277.

Posted with permission from the American Speech-Language-Hearing Association (ASHA).

General References

Lewis, B., Freebairn, L., Hansen, A., Stein, C., Shriberg, L., Iyengar, S., & Taylor, H. G. (2006). Dimensions of early speech sound disorders: A factor analytic study. Journal of Communication Disorders, 39, 139–157.

Murray, E., McCabe, P., Heard, R., & Ballard, K. (2015). Differential diagnosis of children with suspected childhood apraxia pf speech. Journal of Speech, Language, and Hearing Research, 58, 43–60.

Peter, B., Wijsman, E., Nato, A., University of Washington Centers for Mendelian Genomics, Matsushita, M., Chapman, K., Stanaway, I., Wolff, J., Oda, K. & Raskind, W. (2016). Genetic candidate variants in two multigenerational families with childhood apraxia of speech. PLoS ONE, 11(4), e0153864. doi:10.1371/journal.pone.0153864

Protocol ID:

201601

Variables:
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Banana
PX201601680000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "banana" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Bandaid
PX201601660000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "band-aid" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Beef
PX201601630000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "beef" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Communicate
PX201601710000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "communicate" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Cowboy
PX201601650000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "cowboy" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Fume
PX201601640000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "fume" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Half_Time
PX201601670000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "half time" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Kitty_Cat
PX201601690000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "kitty cat" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Potato_Head
PX201601730000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "potato head" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Puppy_Dog
PX201601700000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "puppy dog" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Repetitions_Ka
PX201601580000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: /ka/ repetitions show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Repetitions_Pa
PX201601560000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: /pa/ reptitions show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Repetitions_Pataka
PX201601590000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: /pataka/ repetitions show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Repetitions_Pattycake
PX201601600000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "pattycake" repetitions show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Repetitions_Ta
PX201601570000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: /ta/ repetitions show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Top
PX201601620000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "top" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Winnie_Pooh
PX201601740000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "Winnie the Pooh" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_Year
PX201601720000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "1950" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Coordinated_Speech_Articulatory_Accuracy_You
PX201601610000 Rate the coordinated speech movements more
(articulatory accuracy) based on saying the following: "you" show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Larynx_Respiration_Cough_Laugh_Cry
PX201601520000 Rate the oral function of the more
larynx-respiration based on: cough laugh or cry show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Lips_Alternate_Pucker_Smile
PX201601060000 Rate the oral function of the lips based on: more
alternate pucker & smile show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Lips_Bite_Lower
PX201601070000 Rate the oral function of the lips based on: more
bite lower lip show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Lips_Open_Close
PX201601100000 Rate the oral function of the lips based on: more
open & close lips show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Lips_Protrusion
PX201601040000 Rate the oral function of the lips based on: more
protrusion show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Lips_Puff_Cheeks
PX201601090000 Rate the oral function of the lips based on: more
puff cheeks show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Lips_Retraction
PX201601050000 Rate the oral function of the lips based on: more
retraction show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Lips_Rounding
PX201601030000 Rate the oral function of the lips based on: more
rounding show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Lips_Seal
PX201601080000 Rate the oral function of the lips based on: more
lip seal show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Mandible_Excursion
PX201601200000 Rate the oral function of the mandible based more
on: excursion (click teeth 5x) show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Tongue_Anterior_Posterior_Sweep
PX201601360000 Rate the oral function of the tongue based more
on: anterior-posterior sweep show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Tongue_Elevation_Alveolar_Ridge
PX201601350000 Rate the oral function of the tongue based more
on: elevation to alveolar ridge show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Tongue_Interdental
PX201601370000 Rate the oral function of the tongue based more
on: interdental show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Tongue_Protrusion
PX201601340000 Rate the oral function of the tongue based more
on: protrusion show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Velopharynx_Blow_Cold_Mirror
PX201601470000 Rate the oral function of the velopharynx more
based on: blow on cold mirror show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Oral_Function_Velopharynx_Suck_Straw
PX201601480000 Rate the oral function of the velopharynx more
based on: suck through straw show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Larynx_Respiration_Posture
PX201601510000 Rate the structure of the larynx-respiration more
at rest based on: posture during quiet breathing show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Lips_Relationship
PX201601020000 Rate the structure of the lips at rest based more
on: relationship (open vs. closed) show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Lips_Symmetry
PX201601010000 Rate the structure of the lips at rest based more
on: symmetry show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Mandible_Occlusion
PX201601180000 Rate the structure of the mandible at rest more
based on: occlusion show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Mandible_Size
PX201601190000 Rate the structure of the mandible at rest more
based on: size (re: facial features) show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Mandible_Symmetry
PX201601170000 Rate the structure of the mandible at rest more
based on: symmetry show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Maxilla_Size
PX201601220000 Rate the structure of the maxilla at rest more
based on: size show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Maxilla_Symmetry
PX201601210000 Rate the structure of the maxilla at rest more
based on: symmetry show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Teeth_Alignment
PX201601240000 Rate the structure of teeth based on: alignment N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Teeth_Decay
PX201601230000 Rate the structure of teeth based on: decay N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Teeth_Gaps
PX201601250000 Rate the structure of teeth based on: gaps N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Teeth_Missing
PX201601260000 Rate the structure of teeth based on: missing N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Teeth_Occlusion
PX201601270000 Rate the structure of teeth based on: more
occlusion (re: maxillary teeth) show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Tongue_Atrophy
PX201601320000 Rate the structure of the tongue at rest more
based on: atrophy show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Tongue_Carriage
PX201601290000 Rate the structure of the tongue at rest more
based on: carriage show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Tongue_Fasciculations
PX201601300000 Rate the structure of the tongue at rest more
based on: fasciculations show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Tongue_Furrowing
PX201601310000 Rate the structure of the tongue at rest more
based on: furrowing show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Tongue_Hypertrophy
PX201601330000 Rate the structure of the tongue at rest more
based on: hypertrophy show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Tongue_Symmetry
PX201601280000 Rate the structure of the tongue at rest more
based on: symmetry show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Velopharynx_Palatal_Juncture
PX201601460000 Rate the structure of the velopharynx at more
rest based on: palatal juncture (palpate) show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Velopharynx_Symmetry
PX201601420000 Rate the structure of the velopharynx at more
rest based on: symmetry show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Velopharynx_Tonsils
PX201601440000 Rate the structure of the velopharynx at more
rest based on: tonsils show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Velopharynx_Uvula
PX201601430000 Rate the structure of the velopharynx at more
rest based on: uvula show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Rate_Structure_Velopharynx_Vault_Height
PX201601450000 Rate the structure of the velopharynx at more
rest based on: vault height show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Larynx_Respiration_Ha
PX201601550000 Rate the speech function of the more
larynx-respiration based on: /ha.ha.ha/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Larynx_Respiration_Loudness_Variation
PX201601540000 Rate the speech function of the more
larynx-respiration based on: loudness variation show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Larynx_Respiration_Pitch_Variation
PX201601530000 Rate the speech function of the more
larynx-respiration based on: pitch variation show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Lips_Alternate
PX201601140000 Rate the speech function of the lips based more
on: alternate /u i/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Lips_Bite_Lower
PX201601150000 Rate the speech function of the lips based more
on: bite lower lip /f/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Lips_Open_Close
PX201601160000 Rate the speech function of the lips based more
on: open & close lips /ma/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Lips_Protrusion
PX201601120000 Rate the speech function of the lips based more
on: protrusion /u:/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Lips_Retraction
PX201601130000 Rate the speech function of the lips based more
on: retraction /i:/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Lips_Rounding
PX201601110000 Rate the speech function of the lips based more
on: rounding /o:/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Tongue_Elevation_Alveolar_Ridge
PX201601380000 Rate the speech function of the tongue based more
on: elevation to alveolar ridge /n/, /t/, or /l/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Tongue_Interdental
PX201601400000 Rate the speech function of the tongue based more
on: interdental /?/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Tongue_Posterior_Tongue_Palate
PX201601410000 Rate the speech function of the tongue based more
on: posterior tongue to palate /k/ or /g/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Tongue_Touch_Lateral_Edges
PX201601390000 Rate the speech function of the tongue based more
on: touch lateral edges of tongue to teeth /s/ or /?/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Velopharynx_Ha
PX201601500000 Rate the speech function of the velopharynx more
based on: /ha.ha.ha/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Function_Velopharynx_Vowel
PX201601490000 Rate the speech function of the velopharynx more
based on: /a:/ show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Sample_Prosody_Intonation
PX201601760000 Rate the speech sample of prosody based on: more
intonation show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Sample_Prosody_Rate
PX201601750000 Rate the speech sample of prosody based on: rate N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Sample_Voice_Loudness
PX201601780000 Rate the speech sample of voice based on: loudness N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Sample_Voice_Nasal_Resonance
PX201601800000 Rate the speech sample of voice based on: more
nasal resonance show less
N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Sample_Voice_Pitch
PX201601770000 Rate the speech sample of voice based on: pitch N/A
PX201601_Oral_Mechanism_Cranial_Nerve_Examination_Young_Children_Speech_Sample_Voice_Quality
PX201601790000 Rate the speech sample of voice based on: quality N/A
Speech, Language and Hearing
Measure Name:

Oral Mechanism/Cranial Nerve Examination for Young Children

Release Date:

June 4, 2019

Definition

A clinical assessment of an individual’s oral and facial structures and functions, including the functionality of the cranial nerves.

Purpose

An orofacial and motor speech assessment to determine if deficits in oral structures or functions can explain speech difficulties in a young child.

Keywords

Oral, orofacial, speech, motor speech, oral motor, cranial nerves, phonological, articulation