APPRAISAL 189

APPENDIX 6.1
Speech-Motor Assessment Screening Form

Each of the following parameters is assessed using the following system:

Pass Within normal limits
Deviant Deviant from norm, divided into “slight” or “marked” deviancy
Not Passing Clearly outside of normal limits

STRUCTURE
Head/Face
Sitting opposite the client, evaluate head and facial structures Deviant Not
according to the categories provided. Pass Slight Marked Passing
Size, shape of head
Symmetry of facial features:
Left half vs. right half
Absence of drooping or spasticity
Mandible/maxilla relationship
Appearance of lips (contact at rest; vermilion)
Appearance of nose (septum; nares)
Appearance of philtrum/columella
Absence of any striking features (e.g., adenoid facies, facial
dimensions)
Comments:

Breathing
Observe and evaluate the client’s breathing behavior (as
“structural” prerequisite for speaking and voice production)
during normal (silent) breathing and during speaking. During
silent breathing the client’s mouth should be closed and no Deviant Not
clavicular movement should be noticeable. Pass Slight Marked Passing
Silent breathing
Mouth closed (mouth open would indicate a deviancy)
Relationship for the time of inspiration versus expiration
is about 1:1
Lack of clavicular breathing
190 CHAPTER 6

Deviant Not
Breathing Pass Slight Marked Passing
Breathing during speaking
Breathing through nose (exclusive mouth breathing
is a deviancy)
Relationship for the time of inspiration versus expiration
is 1:2!
Lack of clavicular breathing
Comments:

Oral/Pharyngeal Cavity
The head should be bent back slightly for inspection of the palatal areas.
A few reminders:
Missing frontal teeth might have a direct effect on sibilant
production.
Dentition:
Class I (normal) occlusion: lower molars (or canine for
children without molars) half a tooth ahead of upper molars.
Class II malocclusion (overbite): Maxilla protruded in relation
to mandible, measured by the positions of the first (maxillary
and mandibular) molars.
Class III malocclusion (underbite): Mandibular molar more
than half a tooth ahead of maxillary molar.
Open bite: Gap between biting surfaces. Especially frontally
open bites might influence articulation negatively.
Cross bite: Misalignment of the teeth characterized by a
crossing of the rows of teeth.
Macroglossia " tongue appears too large
Microglossia " tongue appears too small
Shrinkage, i.e., a “shriveled” tongue area, might indicate a
paralytic condition.
The midline of the hard and soft palates appears normally pink
and white; a blue tint suggests a submucous cleft. Deviant Not
Redness of fauces and pharynx might indicate inflammation. Pass Slight Marked Passing
Dentition
Front teeth present
Spacing of teeth adequate
Axial orientation of teeth is adequate
Dentition
Class I normal occlusion
If a malocclusion is noted, indicate the type:
 APPRAISAL 191

Deviant Not
Oral/Pharyngeal Cavity Pass Slight Marked Passing
Tongue
Normal size in relationship to oral cavity
Normal color
No shrinkage
Absence of fissures, lesions, fasciculations
Normal resting position
Palate (hard and soft)
Normal color
Normal width of vault
Absence of fistulas, fissures
Absence of clefts
If cleft, circle one: Repaired Unrepaired
Normal uvula
If abnormal, circle one: Bifid Other deviations
Normal length of uvula
Appearances of fauces, pharynx
Comments:

FUNCTION
For older children and adults, these tasks can be elicited by asking the client to complete the task. For
younger children (preschool age and below), imitation may be required.
Deviant Not
Head/Face Pass Slight Marked Passing
Eyes/facial appearance
Raising of eyebrows is symmetrical
Can smile, frown on command
Smiling, frowning symmetrical
Lips
Can protrude lips with mouth closed
Can protrude lips with mouth slightly open
Can protrude lips to left/right side
192 CHAPTER 6

Deviant Not
Head/Face Pass Slight Marked Passing
Can protrude and spread lips ([u]–[i])
Demonstrates rapid lip movements
(“pa-pa-pa”)
Mandible
Can lower mandible on command
Can move mandible to left/right side
Comments:

Deviant Not
Oral/Pharyngeal Cavity Pass Slight Marked Passing
Tongue
Can stick out tongue
Can move tongue upward (try to touch nose with tip of
tongue)
Can move tongue downward (try to touch chin with tip
of tongue)
Can move the tip of the tongue from the left to the right
corner of the mouth
Can move the tongue quickly and smoothly from the
right to the left corner of mouth
Can move tongue smoothly around the vermilion of lips
(lick around lips) clockwise and counterclockwise
Can move the tongue from left to right on the outside/
inside of the upper teeth
Can move the tongue from left to right on the outside/
inside of the lower teeth
Can say “pa-pa-pa” quickly, smoothly
Can say “ta-ta-ta” quickly, smoothly
 APPRAISAL 193

Deviant Not
Oral/Pharyngeal Cavity Pass Slight Marked Passing
Tongue
Can say “ka-ka-ka” quickly, smoothly
Can alternate between quick repetitions of “pa-ta”
and “ta-pa”
Can alternate between quick repetitions of “pa-ta-ka,”
“ka-ta-pa,” and “ta-pa-ka”
Velopharyngeal function
During short, repeated “ah” phonation adequate velar
movement is noted
Can puff up cheeks
Can maintain intraoral air (puffed cheeks) when slight
pressure is applied to cheeks
Absence of nasal emission

Deviant Not
Breathing Pass Slight Marked Passing
Silent breathing
During quick inspiration breath intake is through nose
During quick inspiration breath intake is thoracic/
abdominal
Breathing during speaking
Can sustain “ah” for 5 seconds
Comments: