Formal Report from Oral-Motor Evaluation

Here is the summary from Truman's full report:

" ... Truman's articulation skills are severely disordered with a developmental as well as a sensory-motor component. Truman's speech disorder may be indicative of dysarthria, given his previous diagnosis of Cerebral Palsy, and in combination with his oral motor weaknesses ....

Truman presents with a severe mixed sensory-motor feeding disorder characterized by mixed oral sensitivity, poor oral motor strength and coordination, and resulting emotional reactions to food presentation. Observations about the motoric and sensory function of the oral mechanism included the need for increase sensory input as a result of reduced oral exploration in infancy, a hyperactive gag reflex (emotional and tactile) due to previous negative experiences with food as well as discomfort resulting from poor bolus control, poor jaw strength and stability, poor tongue lateralization, poor lip strength, poor bolus formation, and poor tongue elevation. Informal observations of Truman's receptive language skills indicated skills grossly within normal limits, and observation revealed severely disordered expressive language skills for his chronological age ....

Diagnoses:

Speech Disturbance (possible Dysarthria)
Feeding Difficulties and Mismanagement
Oral Phase Dysphagia"

I did some background research on Dysarthria. It basically means a speech and/or feeding disorder resulting from brain injury. Something interesting I learned is that both hyper- or hypokineses (either too much or too little muscle function/strength) of the oral-motor muscles can be caused by damage to the basal ganglia of the brain. Those of you who are long-time readers of our blog will remember that Truman was diagnosed with three brain bleeds while in NICU--bi-lateral inventricular hemorrhages and a bleed in the basal ganglia. We did not give that specificity to the evaluator. It seems to us to be a confirmation of that diagnosis -- or at least another piece of the puzzle that is Truman.

Dysphagia is the medical term for difficulty swallowing.