Assessment of orofacial dysfunction using the NOT-S method in a group of Turkish children with cerebral palsy



A healthy determination of orofacial findings of children with cerebral palsy is important as this will lead us to utilize perfect multidisciplinary therapies of orofacial dysfunctions (OFD). Nordic Orofacial Test-Screening (NOT-S) is a comprehensive screening method of OFD which consists of a structured interview and clinical examination. The aim of our study was to evaluate the orofacial dysfunctions in a group of Turkish children with cerebral palsy using Nordic Orofacial Test-Screening (NOT-S) and find out the factors associated with OFD comparatively with a healthy group.

Materials and methods

NOT-S was applied to 84 children aged 3–16 years. Forty-two children with cerebral palsy were included in the study group and 42 healthy children were randomly selected for the control group. Two trained and calibrated examiners who were experienced on NOT-S interview and examination of the validity and reliability of the Turkish version performed screening and interpreted the results.


NOT-S interview and clinical examination subscale scores of children with cerebral palsy were higher and found to be statistically significant (Mann–Whitney U test; p < 0.001). The total scale score of the cerebral palsy group was also statistically significant (p < 0.001). The most common dysfunctions were in the facial expression area (55.9%) and in the chewing and swallowing area (52.4%) following in sensory function area (47.6%).


The results of this study indicated that the NOT-S protocol was an effective and valuable tool for the comprehensive screening of orofacial dysfunctions in a group of Turkish children with cerebral palsy.

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Correspondence to Buket Ceylan Çalık Yılmaz.

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There is no conflict of interest. In this article, none of the authors have any relation, connection or monetary interest with regard to the subject or material mentioned in the study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed child assent and written, informed parental consent to the research procedures and publication of results were obtained. Informed consent of the participants or their families was also collected.

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Alaçam, A., Çalık Yılmaz, B.C. & Incioğlu, A.S. Assessment of orofacial dysfunction using the NOT-S method in a group of Turkish children with cerebral palsy. Eur Arch Paediatr Dent 21, 215–221 (2020).

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  • Cerebral palsy
  • Nordic orofacial test-screening
  • Orofacial dysfunction