Normal values of orofacial motor skills in children from 2 to 8 years

The Department of rehabilitation/speech therapy of the Radboudumc (Amalia
children's Hospital) is involved in the Outpatient Clinic *Zeldzaam* (*rare*).
In this outpatient clinic children with rare genetic syndromes are seen. Based
on the increased possibilities for DNA testing in which all genes can be
mapped, young children with developmental problems are more and more diagnosed
with a (relatively) unknown condition. The purpose of the Poli Zeldzaam is to
identify the problems of children with a rare condition. In this way, children
can be well described with a particular condition or syndrome. This might
support the knowledge about the disorder and its possible treatment.
The assessments of these children, performed by the speech language therapist
(SLT), are focused on the development of eating and swallowing, saliva
control, language, speech and orofacial motor skills. The last item is related
to the performance of conscious movements of face and mouth area, such as eye
closing, pouting lips, sticking out the tongue, blowing and sucking. A list was
composed: the Orofacial Motor Observation in Kids (OMOK) (see appendix 1 of the
research protocol for the different items). This list is based on different
assessments, such as the Dyspraxieprogramma [1] and other 'oral motor'
assessments [2] [3]. In addition, elements from the Radboud Oral Assessment
(adults) were incorporated [4].
Because the data from the various assessments (speech, eating and drinking,
swallowing and orofaciale motor skills) give a complete picture of what a child
can, all these elements are included in the SLT assessment. For most of those
parts normal values are available, so that the scores or results of the SLT
assessment can be compared with these normal values. However, this is not the
case for the development of the orofacial motor skills. Also for other groups
of children it may be important to have these normal values.

The collection of data of the orofacial motor skills with the OMOK in healthy
children between 2 and 8 years.

1. In Nijmegen and surroundings day care centers, preschools and elementary
schools will be approached with the question to announce the study in their
newsletter or via their website. Via the email address, mentioned in this post
(see appendix 2), parents can register their child, after they have read the
information. Also Child health care centres will be asked to spread the
information.
2. The researchers (students of the SLT department of the HAN, Nijmegen) will
make a planning in collaboration with the child care centers, preschools and
elementary schools to assess the children, after receiving the mail and the
permission statement from the parents (informed consent),
3. The privacy of the participants is protected to the highest possible degree,
based on The Persona Data Protection Act and privacy rules of the Radboudumc.
Registration of research data takes place anonymously. A unique fictive code is
used to trace back data. The encryption key is secured and only the
coordinating researcher has access to the key.
4. The OMOK is conducted by one of the researchers. In young children it is
allowed that parents or caregivers are present at the investigation.
5. The administration of the OMOK will take about 10 minutes. Children are
asked to perform movements of face and oral area.
6. To measure the interrater reliability 10% of the children (minimum N = 27),
divided across the age groups, will be a videotaped. Parents or caregivers are
asked to agree with the making of a videotape (on the informed consent). The
tapes will be numbered and be linked to the numbers of the children and be
included in a data file. The video recordings are scored directly by the
researcher, at a different time by one of the other researchers, and by one of
the members of the research group
Besides data of the OMOK data on age and gender are collected.

After the obtained information parents/caregivers decide whether their child
might participate in the study. They are asked to send an email to the research
group if they agree. The parents/caregivers will be asked to sign an informed
consent. The data will be processed anonymously.
The children will be assessed according to the OMOK described in appendix 1.
For the children it will take about 10 minutes. In young children the
assessment can be performed at home, for other children the assessment will
take place in the day care centers, preschools or elementary schools
Because this study is development related (when are young children able to
perform these orofacial motor skills) the OMOK cannot be tested with adults.