oral motor dysfunction and limb & postural control impairments

oral motor dysfunction eval

• modify consistency, amount, and pacing

• postural interventions

• specific swallowing adaptations

postural interventions

• chin tuck

• forward head tilt/chin tuck

• head turn

swallowing adaptations

• supraglottic swallow to voluntarily close/protect airway during food intake

• mendelsohns maneuver: voluntary prolonging the rise of the larynx by prolonging tongue contraction

indirect therapy

• cold stimulation via a chilled dental examination mirror to elicits a swallow reflex

• reflex facilitation

• strengthening, facilitation, and coordination of oral movements

• airway adduction procedures

• positioning to maintain the trunk/head/neck in correct postures

constraint induced movement therapy (CIMT) criteria

• 20 extension of wrist and 10 extension of each finger

• 10 extension of wrist, 10 abduction of thumb, 10 extension of any other 2 digits

• able to lift a washrag off a tabletop using any type of prehension then release it

CIMT 3 major components

• massed practice and shaping of affected limb

  • little breaks; supervised activities to be graded for increased challenge

• restraint

• transfer package