Final answer:
The best way to assess for co-occurring oral apraxia is to ask the patient to alternately smile and pucker their lips, as this task requires the rapid, alternating movements with their facial muscles that are difficult for individuals with oral apraxia.
Step-by-step explanation:
To assess a patient for co-occurring oral apraxia, which involves difficulty in coordinating muscle movements needed to articulate words, the clinician should look for difficulty in performing voluntary motor tasks. The best option to test oral apraxia is option d, asking the patient to alternately smile and pucker their lips. This examination checks for the patient's ability to perform rapid, alternating movements with their facial muscles, similar to how rapidly alternating movements of fingers are assessed in neurological exams. This task requires coordination and sequencing of movements, which can be affected in oral apraxia. Option b, asking a patient to stick out their tongue, does not assess for the alternating movements characteristic of oral apraxia. Options a and c, asking a patient to repeat /putuku/ or to swallow repeatedly, are less specific tests and do not directly assess the ability to perform rapid alternating movements with the facial muscles.