CHEEK SENSORY-MOTOR - 1 Proprioceptive (Touch and Move): Lift Side
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1 CHEEK SENSORY-MOTOR - 1 Proprioceptive (Touch and Move): Lift Side Touch cheek, then press fingers into cheek to assist lift. Lift cheek without fingers. CHEEK SENSORY-MOTOR - 2 Proprioceptive (Touch and Move): Lift Sides lift. Lift cheeks without fingers. Page 1 of 5
2 CHEEK SENSORY-MOTOR - 3 Proprioceptive (Touch and Move): Lower Side Touch cheek, then press fingers into cheek to assist pull down. Lower cheek without fingers. CHEEK SENSORY-MOTOR - 4 Proprioceptive (Touch and Move): Lower Sides pull down. Lower cheeks without fingers. Page 2 of 5
3 CHEEK SENSORY-MOTOR - 5 Proprioceptive (Touch and Move): Pull Back Side Touch cheek, then press fingers into cheek and pull back toward ear. Pull back cheek without fingers. CHEEK SENSORY-MOTOR - 6 Proprioceptive (Touch and Move): Pull Back Sides Touch both cheeks, then press fingers into cheeks and pull back toward ear. Pull back cheeks without fingers. Page 3 of 5
4 CHEEK SENSORY-MOTOR - 7 Seriation (Move in Sequence): Back to Upper / Side 1. Touch cheek in front of ear. 2. Touch upper cheek. Without fingers: 3. Pull back cheek. 4. Lift cheek. CHEEK SENSORY-MOTOR - 8 Seriation (Move in Sequence): Back to Upper / Sides 1. Touch cheeks in front of ears. 2. Touch upper cheeks. Without fingers: 3. Pull back cheeks. 4. Lift cheeks. Page 4 of 5
5 CHEEK SENSORY-MOTOR - 9 Resistive (Press vs Push): Side Suck air into mouth and puff out cheek.. At same time apply finger pressure in center of same cheek. lips tightly together so air does not escape. CHEEK SENSORY-MOTOR - 10 Resistive (Press vs Push): Sides Suck air into mouth and puff out both cheeks.. At same time, apply finger pressure in center of both cheeks. lips tightly together so air does not escape. Page 5 of 5
6 CHART COPY CHEEK SENSORY-MOTOR - 1 Proprioceptive (Touch and Move): Lift Side CHEEK SENSORY-MOTOR - 2 Proprioceptive (Touch and Move): Lift Sides CHEEK SENSORY-MOTOR - 3 Proprioceptive (Touch and Move): Lower Side Touch cheek, then press fingers into cheek to assist lift. Lift cheek without fingers. lift. Lift cheeks without fingers. Touch cheek, then press fingers into cheek to assist pull down. Lower cheek without fingers. CHEEK SENSORY-MOTOR - 4 Proprioceptive (Touch and Move): Lower Sides CHEEK SENSORY-MOTOR - 5 Proprioceptive (Touch and Move): Pull Back Side CHEEK SENSORY-MOTOR - 6 Proprioceptive (Touch and Move): Pull Back Sides pull down. Lower cheeks without fingers. Touch cheek, then press fingers into cheek and pull back toward ear. Pull back cheek without fingers. Touch both cheeks, then press fingers into cheeks and pull back toward ear. Pull back cheeks without fingers. CHEEK SENSORY-MOTOR - 7 Seriation (Move in Sequence): Back to Upper / Side CHEEK SENSORY-MOTOR - 8 Seriation (Move in Sequence): Back to Upper / Sides CHEEK SENSORY-MOTOR - 9 Resistive (Press vs Push): Side Suck air into mouth and puff out cheek.. At same time apply finger pressure in center of same cheek. lips tightly together so air does not escape. 1. Touch cheek in front of ear. 2. Touch upper cheek. Without fingers: 3. Pull back cheek. 4. Lift cheek. 1. Touch cheeks in front of ears. 2. Touch upper cheeks. Without fingers: 3. Pull back cheeks. 4. Lift cheeks. CHEEK SENSORY-MOTOR - 10 Resistive (Press vs Push): Sides Suck air into mouth and puff out both cheeks.. At same time, apply finger pressure in center of both cheeks. lips tightly together so air does not escape. COMMENTS: Patient Name/Number: Clinician Name/Signature: Date: Page 1 of 1
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