THE OBJECTIVE RATING OF ORAL-MOTOR FUNCTIONS DURING FEEDING

The Schedule for Oral Motor Assessment (SOMA) was developed to record oral-motor skills objectively in infants between ages 8 and 24 months postnatal. Its aim is to identify areas of dysfunction that could cont ribute to feeding difficulties. The procedure takes approximately 20 m in to administer, and is intended to be rated largely from a videoreco rding of a structured feeding session. A series of foodstuffs of varyi ng textures, including liquids, is presented to the child in a standar dized manner. Oral-motor skills are evaluated in terms of discrete ora l-motor movements. The schedule distinguishes these from skills at mor e aggregated levels of functioning such as jaw, lip, and tongue contro l. A total of 127 children have been studied with the instrument, incl uding normal healthy infants and samples with nonorganic failure to th rive, and cerebral palsy. Interrater and test-retest reliabilities wer e determined on a subset of 10 infants who each took part in three tri als rated by 2 therapists. Excellent levels of interrater reliability (kappa > 0.75) were obtained for the presence/absence of 69% of discre te oral-motor behaviors. Test-retest reliability was similarly excelle nt for 85% of ratable behaviors. For the first time an assessment of o ral-motor functioning has been shown to have adequate reliability for children aged 8-24 months. The validation of the SOMA on a large sampl e of normally developing infants and its application to clinical group s is presented in an accompanying paper [1].