Assessment
- Identify the nature of the neuromuscular impairments the client is exhibiting.
- Judge the degree to which those impairments are contributing to the speech and/or swallowing problems.
Treatment Planning
- Identify oral motor treatments that address the target impairments, taking into consideration any contraindications for techniques.
- Search the literature to assess the level of evidence supporting the use of the identified treatments in the management of the target speech/swallowing disorder(s). Given the paucity of research addressing most oral motor treatments, it is unlikely that such reviews will reveal strong evidence supporting their use.
- Determine whether adequate rationale exists for proceeding with the treatment in spite of inadequate evidence. Consider factors such as:
- severity of the neuromuscular impairments
- presence of contraindications or risks
- presence of peripheral evidentiary support (e.g., a parallel treatment has been shown to be beneficial for improving function of limb muscles)
- If OM treatments are used, design a treatment protocol that will critically assess treatment benefit (e.g., single subject design) and then disseminate findings to contribute to the evidence base.
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