The Pediatric Oral Mechanism Exam
Oral Mechanism Exams (OME) are important because they can help provide more information on the structure and function of a child’s oral mechanism. For example, they are often crucial in examining a child’s motor planning abilities (e.g. CAS) or checking to see if there are any structural abnormalities affecting a child’s speech (e.g. cleft palate). In my SLP training, I was able to practice OME’s on both adults and children and let me tell you… they are a lot easier on adults!!! Over the years, experienced SLPs have taught me various tips and tricks for making this a lot easier that I have complied in a list below.
Wait. If you don’t need to complete an OME on your first session with a child, then don’t. My mentor gave me this advice recently and I think it is important. OME’s can feel invasive and intense for kiddos. Ideally, the first few SLP sessions should focus on building rapport and assessing a child’s strengths and needs. So if you can, wait to do the OME once the child is feeling more comfortable with you - this might take a few sessions and that’s okay. We want children to feel comfortable attending therapy and this might require a few positive experiences first. Of course, gauge the child - some children might feel more comfortable with an OME sooner.
Show. So many of us are visual learners and therefore, it can be so helpful to see how something is done before we do it or before it is done to us. A great way to show a child what we want them to do is through puppets. There are two types of puppets I like to use. One is my handy dandy mouth puppet and the other is an animal puppet. On the mouth puppet I can very specifically show the child what I need them to do (e.g. stick their tongue out) and on the animal puppet I can more broadly show them what I want them to do (e.g. open their mouth, sit still etc.). I also find playing with the puppets before or after the OME can be a lot of fun for kids and a highly requested activity on their part. The puppets can also follow along with what the child is doing so the child doesn’t feel like they are doing the OME all alone.
Reward. Since an OME is not usually motivating for children to complete, try and make sure there is a reward afterwards. Whether this be stickers or bubbles - have some fun after and praise them for their efforts!
Other ideas. Lastly, feel free to use things like flavoured tongue depressors, silly mirrors and colourful pen lights to make the process even more fun. You can also give a token (sticker, colourful dot) as each part of the OME is completed if sitting still for a few minutes is really challenging for kids.
You can find the mouth puppet on amazon.ca by clicking here and amazon.com by clicking here.
-Shannon
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