Table 1 Scoring instructions and interpretation for each Neonatal Oral-Motor Assessment Scale cluster (reproduced with permission from Yi et al. [9])

1

Normal sucking pattern

2

Disorganized sucking pattern

Only an arrhythmical sucking pattern, without the observation of “unable to sustain” or “incoordination of suck/swallow and respiration” sucking patterns

3

Disorganized sucking pattern

An arrhythmical and “unable to sustain” suckle pattern.

The “unable to sustain” suckle pattern includes the following:

1. The infant ceases sucking completely during the first 2 min of nutritive sucking, or

2. The pauses are longer than the burst, or

3. The bursts are shorter than three sucking phases

4

Disorganized sucking pattern

An arrhythmical and “incoordination of suck/swallow and respiration” sucking pattern that causes stress signals; the “unable to sustain” suckle pattern may or may not be present.

“Incoordination of suck/swallow and respiration” includes all the following stress signals: nasal flaring, head turning, head bobbing, extraneous movements of the body or limbs, gagging, choking, coughing, yelping, and grunting.

5

Dysfunctional sucking pattern

The interruption of sucking activity owing to abnormal movements of the tongue and jaw which includes the following:

1. Excessively wide excursions of the jaw, or

2. Minimal excursions: clenching, or

3. Flaccid tongue with absent tongue groove, or

4. Retracted tongue with posterior humping