Orofacial Myofunctional Evaluation
[YOUR COMPANY NAME]
Date: March 20, 2050
Patient's Information:
Name: |
Age: |
Gender: |
Date of Birth: |
Contact Information: |
Introduction: The enclosed document provides a structured template for an Orofacial Myofunctional Evaluation. This tool is designed for integral evaluation purposes.
Overview: This evaluation is focused on assessing the function of orofacial muscles and oral habits. The results can be used to guide therapeutic planning and monitor improvement.
Evaluation Criteria:
Lip Function: Assessing lip strength, range of motion, and coordination.
Tongue Function: Evaluating tongue strength, mobility, and positioning during rest and movement.
Oral Rest Posture: Examining the resting position of the tongue, lips, and jaw.
Swallowing Function: Assessing the swallow pattern, including any signs of dysfunction or deviations.
Speech Function: Evaluating articulation, phonation, and resonance.
Oral Habits: Identifying any deleterious oral habits such as thumb sucking, tongue thrust, or bruxism.
Instructions:
Criteria: Review each criterion listed below to assess various aspects of orofacial myofunctional function.
Description: Familiarize yourself with the description provided for each criterion to understand what aspects of orofacial myofunctional function they cover.
Score: Assign a score to each criterion based on the individual's performance. Utilize the provided score scale to indicate the level of achievement observed.
Comments: Provide any additional comments or observations related to the individual's performance in each criterion. Offer specific feedback to support the assigned score.
Score Scale:
1: Poor
2: Below Average
3: Average
4: Above Average
5: Excellent
Evaluation Table:
Criteria | Description | Score | Comments |
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Lip Function | Assess lip strength, range of motion, and coordination. | | |
Tongue Function | Evaluate tongue strength, mobility, and positioning. | | |
Oral Rest Posture | Examine the resting position of the tongue, lips, and jaw. | | |
Swallowing Function | Assess swallow pattern and any signs of dysfunction. | | |
Speech Function | Evaluate articulation, phonation, and resonance. | | |
Oral Habits | Identify deleterious oral habits such as thumb sucking or tongue thrust. | | |
Additional Notes and Comments:
Additional notes and comments |
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Evaluation Templates @ Template.net
