Mairel Bettes
Case Study: A 73 year old female with brainstem CVA resulting in severe dysarthria and dysphasia (acute inpatient)
Examples of Goals Targeting:
Impairment:
1) ROM
for overall oral motor skills
2) Improve speed, strength, and consistency of swallow
reflex
Activity:
1)
intelligibility for functional speech
2) Effectively communicate basic wants and needs
3) Use thermal stimulation to illicit the swallow reflex
Participation:
1) Contribute to plan of care and discharge plan
2) Safe, nutritionally adequate oral intake of thick
liquid diet, with independent
consistent
use of recommended swallowing/feedback techniques
Treatment Activities:
Purpose: Increase
sensory awareness of oral cavity
Decrease delay between oral/pharyngeal
swallow
Oral Motor Exercises:
(10minutes)
· Elevate tongue tip, stretching it to your
nose; Lower tongue tip, stretching it
to your chin.
· Rotate tongue from side to side under the
lower/upper lip while holding your
lips closed.
Purpose: Help to improve functioning of the mouth,
lips, tongue, and jaw
muscles. Do each exercise 10xs, twice daily. (May be helpful to use a mirror.)
Speech: (5minutes;throughout therapy)
· Over articulation and slow rate
Purpose: Improve intelligibility for functional
speech
S-Pts husband in room. Pt
already eating breakfast. O- Pt. responded inconsistently to thermal
stimulation. Able to complete all oral
motor tasks with limited cueing/prompting from ST. Mild improvement of speech intelligibility after prompting from
the clinician. Pt. is demonstrating
increase in functional level of oral motor skills for speech and swallowing. A- Pt.
continues to exhibit swallow delay and difficulty with speech intelligibility. P-
Continue ST. Recommend: pureed diet,
thin liquids.
Elizabeth Fenner, B.S., Graduate Clinician
Melanie Hicks, B.S., Graduate Clinician
Ashley Jones, B.S., Graduate Clinician