TONGUE SENSORY - 1 Finger Manipulation Center Front. Hold tongue tip by placing thumb under tongue and two fingers on top of tongue at tip. Squeeze.
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1 TONGUE SENSORY - 1 Finger Manipulation Center Front tongue tip by placing thumb under tongue and two fingers on top of tongue at tip. Squeeze. TONGUE SENSORY - 2 Finger Manipulation Center Middle tongue in middle by placing thumb under tongue and two fingers on top in middle. Squeeze. Page 1 of 5
2 TONGUE SENSORY - 3 Finger Manipulation: Side tongue on side by placing thumb under tongue and two fingers on top of tongue. Squeeze. Gauze may be used to assist hold. TONGUE SENSORY - 4 Finger Manipulation tongue approximately two inches in from front edge by placing thumb under tongue and two fingers on top. Squeeze. Release tongue and move fingers forward in small steps to front edge of tongue. Squeeze seconds per movement. Page 2 of 5
3 TONGUE SENSORY - 5 Finger Manipulation Side to Front Place thumb under side of tongue and two fingers on top. Squeeze edge of tongue. Release tongue and move thumb and fingers forward in small steps to tip of tongue. Squeeze seconds per movement. TONGUE SENSORY - 6 Thermal and / or Apparatus Stimulation: Center Middle Keep tongue inside mouth. Use rounded part of spoon to press down on center/middle of tongue. Page 3 of 5
4 TONGUE SENSORY - 7 Thermal and / or Apparatus Stimulation: Push tongue forward or pull with tongue depressor so middle is between teeth. With one tongue depressor under tongue and other on top, press together. Alternate, press and release while pulling depressors to end of tongue in small steps. Press TONGUE SENSORY - 8 Teeth Stimulation: Center Front Push tongue forward slightly so edge is between teeth. May pull tongue into position with fingers. Bite down so Page 4 of 5
5 TONGUE SENSORY - 9 Teeth Stimulation: Center Middle between teeth. May manually assist placement of tongue. Bite down so TONGUE SENSORY - 10 Teeth Stimulation between teeth. Bite down so pressure is felt but without hurting or May manually assist placement of tongue. Alternate, release and bite, while pulling tongue back into mouth in small steps. Page 5 of 5
6 CHART COPY TONGUE SENSORY - 1 Finger Manipulation Center Front TONGUE SENSORY - 2 Finger Manipulation Center Middle TONGUE SENSORY - 3 Finger Manipulation: Side tongue tip by placing thumb under tongue and two fingers on top of tongue at tip. Squeeze. tongue in middle by placing thumb under tongue and two fingers on top in middle. Squeeze. tongue on side by placing thumb under tongue and two fingers on top of tongue. Squeeze. Gauze may be used to assist hold. TONGUE SENSORY - 4 Finger Manipulation TONGUE SENSORY - 5 Finger Manipulation Side to Front TONGUE SENSORY - 6 Thermal and / or Apparatus Stimulation: Center Middle tongue approximately two inches in from front edge by placing thumb under tongue and two fingers on top. Squeeze. Release tongue and move fingers forward in small steps to front edge of tongue. Keep tongue inside mouth. Use rounded part of spoon to press down on center/middle of tongue. Squeeze seconds per movement. Place thumb under side of tongue and two fingers on top. Squeeze edge of tongue. Release tongue and move thumb and fingers forward in small steps to tip of tongue. Squeeze seconds per movement. TONGUE SENSORY - 7 Thermal and / or Apparatus Stimulation: TONGUE SENSORY - 8 Teeth Stimulation: Center Front TONGUE SENSORY - 9 Teeth Stimulation: Center Middle Push tongue forward or pull with tongue depressor so middle is between teeth. With one tongue depressor under tongue and other on top, press together. Alternate, press and release while pulling depressors to end of tongue in small steps. Push tongue forward slightly so edge is between teeth. May pull tongue into position with fingers. Bite down so between teeth. May manually assist placement of tongue. Bite down so Press TONGUE SENSORY - 10 Teeth Stimulation between teeth. Bite down so pressure is felt but without hurting or May manually assist placement of tongue. Alternate, release and bite, while pulling tongue back into mouth in small steps. COMMENTS: Patient Name/Number: Clinician Name/Signature: Date: Page 1 of 1
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