When evaluating a patient’s swallowing, the therapist must test for abnormalities in the basic oral reflexes. Normal infants have five basic oral reflexes when eating: (1) Rooting reflex (2) Bite reflex (3) Suckling reflex (4) Gag reflex (5) Cough reflex, but the first three of these basic reflexes disappear with age. However, the first three of these basic reflexes will disappear with age, and it is not normal for adults to have the degraded basic reflexes during feeding. (Rooting Reflex This reflex is present from birth and is characterized by the fact that touching the corner of the baby’s mouth or cheek causes the baby to look up and down for the nipple, and the rooting reflex lasts until three months after birth before it disappears. In adults, foraging reflex is abnormal and is commonly seen in patients with bilateral stroke and traumatic brain injury. (BiteReflex This reflex is present in infants since birth and is characterized by the phenomenon that touching the gums of infants causes the masticatory muscles to close. The bite reflex lasts until nine to twelve months after birth and disappears. This reflex is so strong that the patient may experience teeth grinding, and when food is put into the mouth, the patient will continue to bite the food without letting go of the mouth, thus interfering with normal eating. (C) Suckling reflex This reflex is present since birth and is characterized by the sucking action that can be induced by placing a finger into the mouth of infants from zero to six months of age. The sucking reflex disappears from the sixth month of life and is replaced by a sucking action. The sucking reflex is common in adults with brain injury. (Gag reflex This reflex is a basic protective reflex that prevents foreign objects from entering the voice box or lungs. The gag reflex is a simultaneous lifting of the soft palate, uvula, and pharyngeal wall to vomit. The reaction time of this reflex is an indicator of muscle function. The absence of the gag reflex does not mean that the patient is unable to eat. Test: Stimulate the base of the tongue with a cotton swab and observe the patient’s response. Hyperactive: The patient will want to escape, with an unhappy expression. Usually, the patient will want to vomit when the cotton swab is only touched to the front of the mouth, and the patient will be unresponsive or have a low response. Hypoactive: The patient has no response to stimulation with a cotton swab. During the treatment, use a frozen cotton swab to stimulate the base of the tongue or teach the patient to say “Hypoactive: the patient has no response to the stimulation of the cotton swab. (E) CoughReflex This reflex is the basic protection of the reflex function, when a foreign body enters the vocal folds, a normal person will immediately cough out the foreign body with a strong and powerful cough outside the vocal folds. Test: Ask the patient to cough hard and listen to the strength and clarity of the patient’s cough, if the patient coughs weakly or hoarsely, it may indicate that the patient’s lung capacity is insufficient, or the ability to close the vocal folds is insufficient.