How to Assess Palatal Strength

Excessively nasal sounding speech, poor speech intelligibility or difficulties in eating or swallowing can all be symptoms of a soft palate weakness. The soft palate is located at the back of the oral cavity and is a highly flexible muscle that is used to seal off the nasal from the oral cavity. When raised, it prevents air and liquids passing into the nose. Assessment of soft palate strength is an important part of speech and swallowing problem diagnosis.

Things You'll Need

• Flashlight
• Tongue depressor
• Small, dry cookie
• Small glass of water or milk

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Instructions

• 1

  Ask the client if he has any difficulties eating, drinking or with speech. Ask if he sneezes frequently during or immediately after eating or drinking. Ask if he ever notices liquid leaking from the nose during or after drinking. Finally ask if he or anyone has noticed excessive nasality when he speaks. These symptoms should all be absent if the soft palate is operating normally.

• 2

  Direct the client to open his mouth wide and, using the tongue depressor, press down the front of the tongue. Tell the client to make a long "ar" sound and observe the soft palate movement. Use the flashlight to illuminate the back of the mouth if necessary. The soft palate should lift smoothly to seal the nasal cavity. Observe any lesions or deviation from the mid-line.

• 3

  Instruct the client to say "m b," "m b," "m b" six times. Repeat using different sound combinations such as "n d" and "ng g." Listen for nasality on the "b," "d" and "g" sounds because these should have no nasal resonance. Also listen for any additional air leakage from the nose.

• 4

  Tell the client to say the word "ink" forcefully several times. Repeat with other words such as "and," "pink," "under," "bank," "Monday," "lank" and "handy." The aim is that only nasal sounds, such as "m," "n" and "ng," are produced through the nose. Listen carefully for any other nasality.

• 5

  Direct the client to read aloud a short passage from a book or magazine. Note any excessive nasality as this could be a sign of soft palate weakness. Remember that North American accents are typically more nasal than British ones.

• 6

  Give the client a small, dry cookie and ask him to eat it. Observe any sneezing that occurs during or after eating. If the soft palate is operating normally, there should be none.

• 7

  Give the client a small glass of water or milk to drink. Observe any nasal emissions either during or after drinking. If the soft palate is operating normally, there should be none.