This is a comprehensive Motor Speech Examination Protocol obtained and adapted from information compiled from my coursework textbooks and other manuals during my undergrad and graduate courses in Communication Sciences and Disorders. This is information obtained from reliable sources (not invented by me) and it includes citation and references for ALL sources of information: Ballard (2009), Duffy (2013), Freed (2012), Hixon, Hawley, & Wilson (1982), Andrews (2006), Colton, Casper, & Leonard (2011), Hixon, Hawley, & Wilson (1982), Seif-Workinger (2005), Shipley & McAfee (2009), Yorkston, Beukelman, Strand, & Bell (1999), Hedge (2007)
UPDATED (2/7/16) with info from Hardy & Morton Robinson, 2004.
This project has taken me months and months of referencing resources and combining information in an organized and quickly to reference format. I created this for my own personal use for (1) a comprehensive evaluation to be used with my own clients, (2) a study guide to memorize components and details of a comprehensive evaluation to become very efficient and thorough at administering a MSE, (3) a manner to organize normal and significant findings.
In clinical practice, I have found that it can be administered quicker by initially only noting abnormal findings (and grading each) on the forms. Later I go back and mark a line indicating within normal limits (WNL) on acceptable findings so that it is noted in the patient's chart that these areas were assessed and found to be normal.
Note: this is the PDF version to use if you do not have Excel. The PDF version is NOT editable. If looking for an editable version, see my Excel version.
This is specific to the Speech Language Pathologist. It contains comprehensive information for the SLP to memorize and refer to during assessment, especially when working in a clinical or hospital setting. It contains observational items to be transferred to the MANN MASA. The directions in the tasks are worded for adults, but the tasks could be adapted for children. It contains norms from pediatrics through geriatrics. It also contains items in bold type from each section to be used as a shortened assessment.
It provides an organized manner (charts and checklists) to evaluate the structures of the face, jaw, tongue, velopharynx, larynx and it evaluates these structures at rest, during sustained postures, during voluntary movements, during spontaneous movements. Plus it evaluates the acoustic functioning of the speech mechanism (Respiratory, Phonatory, Resonatory, Articulatory systems). It contains sections to evaluate the Apraxias (nonverbal and AOS).
Note: it contains charts with Right and Left pertaining to the client sitting facing the clinician to lesson confusion during the eval (thus the right side of the chart is on the left side of the paper and the left side of the chart is on the right side of the paper because this is how the client is facing the clinician). This is editable (in the Excel version only).
(aka Orofacial/Oral-facial Examination, Oral-Mech or Oral-Mechanism Exam, Oral Motor Speech Evaluation).
It contains the following sections that include images to sketch deviancies, cranial nerve involvement, directions on how to test, significant findings, and norms (when applicable):
I. Structural-Functional Speech Mechanism Exam
A. Face at rest: face, eyes, lips, oral cavity + face image to sketch deviencies (pg 1-2)
Face at rest: occlusion & dentition + occlusion images + dentition images (child & adult) to mark missing/abnormal teeth (pg 3)
B. Face in Sustained Positions (pg 4)
C. Face in Nonspeech Voluntary Movement
D. Face in Spontaneous and Emotional Responses
E. Jaw at Rest (pg 5)
F. Jaw in Sustained Positions
G. Jaw in Nonspeech Voluntary Movement
H. Jaw in Spontaneous Movement
I. Tongue at Rest (pg 6)
J. Tongue during Sustained Positions
K. Tongue in Nonspeech Voluntary Movement + image to sketch deviancies (pg 7)
L. Tongue in Spontaneous Speech
M. Velopharynx at Rest (pg 8)
N. Velopharynx during Movement + image to sketch deviencies
O. Larynx in Nonspeech Voluntary Movement (pg 8)
- explains meaning of (1) weak cough w/sharp glottal coup, (2) sharp cough w/weak coup, (3) weak coup w/normal cough, (4) weak coup w/weak cough, (5) stridor
II. Acoustic Motor Speech Examination
A. Resonatory System (pg 9)
explains tasks for assessing velopharyngeal port
B. Respiration & Related Observations (pg 9)
1. Quiet Breathing
2. Speech Breathing
C. Phonatory-Respiratory System (pg 10-11)
includes tasks and norms for children – elderly adults (s/z ratio, speaking and oral reading rates, MPT), perceptual rating scale on tasks
Water Glass Manometer (directions on how to make and use one along with pressures sufficient for typical speech and yelling + image)
D. Combined Systems (Phonatory, Respiratory, Resonatory, Artic) (pg 12-13)
Note: AMR & SMR tasks and norms for infant – adult, plus includes DDK and “patty-cake” norms for children, perceptual rating scale on tasks, stress testing
1. Pathologic (primitive) Reflexes (pg 14)
Jaw Jerk/bite, Sucking/suckling/suck-swallow, Rooting, Snout, Palmomental (how to test, what to look for, what’s significant, what’s not important)
2. Absence of Normal Reflex (pg 15)
Gag reflex, palatal, cough (how to test, what to look for, what’s significant, what’s not important)
IV. Testing for Apraxia
A. Nonverbal Oral Apraxia (pg 16)
tasks & key to grade responses
B. Apraxia of Speech (AOS) aka Oral Verbal Apraxia (pas 17-18)
multiple tasks to eval words to sentences and rote passages
V. Contextual Speech
A. Narration (pg 19) to be used with “Cookie Theft” or other picture for continuous speech sample to compare perceptual ratings to reading
B. Reading Passage (pg 20) perceptual rating scale to be used with “The Grandfather Passage” or other reading passage.
Additional Comments & References (pg 21)
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