This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Q: I just started working with toddlers and preschool children and my colleague says that you can’t do an oral-peripheral exam on these little guys. What do you say? Do you do it and if so how?
An examination of the oral mechanism’s structure certainly can be done on little kids. Come on people! Let’s get creative!
I do oral exams on all clients regardless of age. With infants I just poke around in there and prop the mouth open myself using my sanitized fingers. With toddlers and preschool children I find I have to be a little sneakier. These are the things I have found work for me––
I try to look straight in while feeding them a few bites of cracker or cookie. The old “open wide” game works well. I linger and tease them a little with the food so they hold their mouth open wide for a 5-10 seconds while I look around.
Then I pass the food back-and-forth, left-and-right, in front of their eyes while their mouth is open so I can get a good look at both sides of the inside.
I also make a big deal about their teeth, counting them, looking in the mirror together at them, poking around with fingers in the mouth to feel them, etc. This can get their mouth open wide.
Then, when I really want to get a good look at the palates, I get the child upside-down. I lay the child on his back over a large therapy ball or on the edge of a bed, sofa, or ottoman. The child inevitably opens his mouth wide when he is upside down. They love it!
I don’t usually use a flashlight for any of this because it’s too distracting. I just make sure we are in good light––at a good window––and I keep re-positioning the child so I get the maximum light on and in their mouth.
Here are a few pictures to give you the idea (above and below). I found these with a quick google search: