The Assessment of lingual tactile sensation and perception (1970)

as a speech pathologist I have had considerable clinical and research interest in the role of stic sensory feedback and speech motor Behavior a relationship between abnormal somatic sensory functioning and abnormal oral motor behavior is being noted increasingly by both clinicians and researchers in attempting to understand this relationship it seems to me that we should be interested in the oral facial sensory system in general and in the manner in which it provides an individual with the types of integrated information needed for learning movements used in speaking chewing and swallowing the perception of motion of the articulators probably is a synthesis of different Sensations principally kesis and touch researchers such as Boyd CER and law have called attention to the probable role of oral touch receptors observing a proceptive function as Boyd theorized it is possible that superficial Sensations in the oral area have come to play a particular role in proceptive functioning perhaps acting vicariously for specialized muscular prop receptors based on current knowledge of oral physiology we can postulate at least four tactial sensory skills that appear to have a priority relevance to the acts of speaking chewing and swallowing one detection of the presence of tactial stimula and appreciation of minimal changes in tactial stimulation two spatial discrimination and localization of tacal stimula three temporal resolution and discrimination of tctl stimula and four appreciation of simultaneous bilateral tctl stimul test procedures that appear to be appropriate for some degree of independent assessment of a number of these sensory skills have been described along with guidelines to expected performance by normal persons in an article entitled the assessment of lingual sensation and perception this article was published in the Journal of speech and hearing disorders volume 34 issue number two in May 1969 the purpose of this film is to demonstrate the administration of these test procedures although adaptable for the assessment of sensation in various parts of the oral facial sensory system I have employed the procedures principally for the assessment of lingual sensation and perception [Music] oh I [Music] materials required for the administration of the tests are available commercially or can be readily fabricated the subject is told that a series of tests will be administered to a assess her sense of touch Specific Instructions will be given prior to the administration of each test the subject is told that her tongue will be marked with a non-toxic coloring agent to identify specific areas where stimula will be presented these points of stimulation are marked on the tongue tip in midline the blade of the tongue in midline the lateral margin of the blade of the tongue on each side of the body and on the lateral margin of the tongue tip on each side of the body tactile sensitivity refers to the detection of the presence of a tactile stimulus although a wisp of cotton is gross it is employed as the traditional instrument for assessing tactile sensitivity on the tongue stimula are presented to a subject on the tongue tip at midline and the lateral margin of the blade of the tongue on each side of the body the subject is informed that her task is to indicate when she is aware of being touched a schedule of randomized stimulus presentations is employed so that 10 stimuli are presented to a subject on each of the three specified tongue areas the subject's performance on the test is scored by Computing the percent of stimula perceived on each of the three areas of the tongue tactile Acuity denotes the ability to appreciate minimal changes in tactile stimulation a person's ability to detect a Groove engraved on the otherwise smooth surface of a plastic plate is used as a measure of tactial Acuity all but one of 11 plates contain an engraved groove of uniform width and length but varied in depth the plates are passed in a vertical Direction Over the tongue tip the subject is told that she is to report report her perception of each plate as smooth or grooved employing the method of minimal change through threshold is measured by averaging the groove depth required for perception on five ascending and five descending runs the ability to perceive two simultaneous points of stimulation is used as a measure of tactial spatial discrimination a modified caliper adapted for sensory testing is used as the instrument for assessing two-o discrimination ability thresholds for two-point discrimination are established on the tongue tip at midline and on both lateral margins of the blade of the tongue the subject is informed that when stimulated she is to report her perception of one or two points she is instructed to report two points only when she perceives two clearly distinct stimuli again the method of minimal change is employed threshold being measured by averaging the distance between two points required for twoo perception on each of five ascending and five descending runs increments of 025 in are used for each run observations are made of the two-point Linens for each test area in addition the degree of asymmetry and linman values for the lateral margins of the tongue on each side of the body is noted tactile localization ability refers to the spatial localization of tactile stimuli a stylus is used to stimulate the tongue stimuli are presented to a subject at six points on the tip and the blade of the tongue the subject is instructed to identify the the perceived area of stimulation on a schematic drawing of the tongue a schedule of randomized stimulus presentations is employed so that 10 stimuli are presented to a subject on each of the six specified tongue areas the subject's performance on the test is scored by noting the percent of stimula localized correctly observations are also made on the direction and consistency of Mis localizations and the degree of asymmetry and localization ability indicated for the two sides of the tongue tactial Extinction is the inability to appreciate simultaneous bilateral tactial stimuli two applicator sticks are used to stimulate the tongue the subject is stimulated unilaterally on each lateral margin of the blade of the tongue and simultaneously on both tongue margins the subject is instructed to indicate the side or sides of the tongue stimulated a randomized schedule is employed so that 10 stimuli are presented unilaterally to each tongue margin and 10 bilaterally to both tongue margins the subject's performance is evaluated by noting the percent of perceived simultaneous bilateral stimula [Music]