Speech and Resonance Disorders Related to Cleft Palate and Velopharyngeal Dysfunction: A Guide to Evaluation and Treatment

2014 ◽  
Vol 15 (2) ◽  
pp. 57-74 ◽  
Author(s):  
Ann W. Kummer
Keyword(s):  
Oral Cavity ◽  
Cleft Palate ◽  
Speech Therapy ◽  
Surgical Intervention ◽  
Speech Language Pathologists ◽  
Practical Information ◽  
Nasal Emission ◽  
Structural Anomalies

Children with speech and/or resonance disorders due to structural anomalies present challenges for speech-language pathologists in all settings. The purpose of this article is to provide current, practical information regarding the evaluation and treatment of children with speech/resonance disorders secondary to cleft palate and noncleft causes of velopharyngeal dysfunction. Simple “no-tech” procedures for assessment will be described so that the reader will be able to determine which children will benefit from therapy and which will require surgical intervention. Finally, specific speech therapy techniques will be given for changing placement from the pharynx to the oral cavity, thus eliminating phoneme-specific nasal emission.

scholarly journals Quality of Speech Following Cleft Palate Surgery in Children

2018 ◽  
Vol 6 (2) ◽  
pp. 14
Author(s):  
Shahin Abdollahi Fakhim ◽  
Nikzad Shahidi ◽  
Gelavizh Karimi Javan
Keyword(s):  
Cleft Palate ◽  
Speech Therapy ◽  
Cross Sectional Study ◽  
Speech Disorders ◽  
First Year ◽  
Cross Sectional ◽  
Treatment Protocols ◽  
First Year Of Life ◽  
Nasal Emission

Background: Surgical treatment of cleft palate is accompanied with speech problems. Speech therapy in these children after surgery can improve their speech. In this study, we aimed to evaluate the quality of speaking in operated cleft palate patients and speech therapy effects in a small group of these patients. Methods: In this cross-sectional study, speech quality of 55 children with operated cleft palate was assessed regarding resonance, audible nasal emission, consonant production and speech acceptability. Speech outcomes after therapy were evaluated in 19 patients. Results: Cleft palate types were unilateral cleft and lip palate in 18 cases, bilateral cleft and lip palate in 4 cases, secondary cleft palate type in 30 cases and of mere-soft palate in 3 cases. Thirty-five children were operated during the first year of life and 20 were operated after the first year. More than 55% of patients had normal hypernasality with few cases of severe hypernasality and less than 45% had error in consonant production. Patients operated during first year of life had more speech problems. Speech parameters were improved in 19 patients after speech therapy. Conclusion: In conclusion, children with cleft palate have some degrees of speech disorders after repair surgery than could be improved by the speech therapy. Speech therapy should be considered as one of the main treatment protocols along with repair surgery in children with cleft palate.

Submucous Cleft Palate: Evaluation and Treatment Principles for Speech-Language Pathologists

2020 ◽  
Vol 5 (6) ◽  
pp. 1482-1491 ◽  
Author(s):  
Graham C. Schenck
Keyword(s):  
Cleft Palate ◽  
Best Practice ◽  
Speech Therapy ◽  
Craniofacial Anomalies ◽  
Review Of The Literature ◽  
Speech Language Pathologists ◽  
Unique Challenge ◽  
Perceptual Evaluation ◽  
Submucous Cleft Palate ◽  
Practical Recommendations

Purpose This clinical focus article intends to provide speech-language pathologists (SLPs) with a review of the literature and practical recommendations for the evaluation and treatment of individuals with submucous cleft palate (SMCP). Method A review of the literature focused on definition, incidence, and diagnostic recommendations for SMCP was completed. Descriptions of physical and auditory–perceptual features common during evaluation were described in detail. Guiding principles for clinical management related to surgery and/or speech therapy were provided. Results Several discrepancies in the definition, incidence, and outcomes across SMCP studies were discovered in the literature. The importance of a comprehensive perceptual evaluation, including an oral mechanism examination by an SLP trained in the assessment of individuals with craniofacial anomalies, was emphasized. Conclusions SMCP is a less understood subtype of cleft palate that presents a unique challenge for clinicians. A trained SLP's comprehensive perceptual evaluation and thorough oral mechanism examination are critical for diagnosis and treatment. SLPs can promote best practice for this population by initiating referrals to an accredited cleft palate–craniofacial team for further evaluation of their speech and assessment of surgical candidacy.

Facilitating Parental Involvement in Speech Therapy for Children With Speech Sound Disorders: A Survey of Speech-Language Pathologists' Practices, Perspectives, and Strategies

2020 ◽  
Vol 29 (4) ◽  
pp. 1987-1996
Author(s):  
Sherine R. Tambyraja
Keyword(s):  
Parental Involvement ◽  
Online Survey ◽  
Speech Therapy ◽  
Speech Sound ◽  
Speech Sound Disorders ◽  
Speech Sound Disorder ◽  
Speech Language Pathologists ◽  
School Based ◽  
Homework Completion

Purpose This study investigated the extent to which speech-language pathologists (SLPs) facilitate parents' completion of homework activities for children with speech sound disorder (SSD). In addition, this study explored factors related to more consistent communication about homework completion and strategies considered particularly effective for supporting this element of parental involvement. Method Licensed SLPs serving at least one child with SSD were invited to participate in an online survey. Questions relevant to this study gathered information regarding (a) frequency of communication about homework distribution and follow-up, (b) demographic and workplace characteristics, and (c) an open-ended question about the specific strategies used to support parental involvement and completion of homework activities. Results Descriptive results indicated considerable variability with respect to how frequently SLPs engaged in communication about homework completion, but that school-based SLPs were significantly less likely to engage in this type of follow-up. Strategies considered effective, however, were similar across therapy contexts. Conclusion These results suggest potentially important differences between school-based services and therapy in other contexts with respect to this particular aspect of service provision for children with SSD.

Holistic Communication Assessment for Young Children With Cleft Palate Using the International Classification of Functioning, Disability and Health:Children and Youth

2020 ◽  
Vol 51 (4) ◽  
pp. 914-938
Author(s):  
Anna Cronin ◽  
Sharynne McLeod ◽  
Sarah Verdon
Keyword(s):  
Young Children ◽  
Cleft Palate ◽  
Case History ◽  
Significant Others ◽  
International Classification ◽  
Assessment Tools ◽  
International Classification Of Functioning ◽  
Speech Language Pathologists ◽  
Holistic Assessment

Purpose Children with a cleft palate (± cleft lip; CP±L) can have difficulties communicating and participating in daily life, yet speech-language pathologists typically focus on speech production during routine assessments. The International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY; World Health Organization, 2007 ) provides a framework for holistic assessment. This tutorial describes holistic assessment of children with CP±L illustrated by data collected from a nonclinical sample of seven 2- to 3-year-old children, 13 parents, and 12 significant others (e.g., educators and grandparents). Method Data were collected during visits to participants' homes and early childhood education and care centers. Assessment tools applicable to domains of the ICF-CY were used to collect and analyze data. Child participants' Body Functions including speech, language, and cognitive development were assessed using screening and standardized assessments. Participants' Body Structures were assessed via oral motor examination, case history questionnaires, and observation. Participants' Activities and Participation as well as Environmental and Personal Factors were examined through case history questionnaires, interviews with significant others, parent report measures, and observations. Results Valuable insights can be gained from undertaking holistic speech-language pathology assessments with children with CP±L. Using multiple tools allowed for triangulation of data and privileging different viewpoints, to better understand the children and their contexts. Several children demonstrated speech error patterns outside of what are considered cleft speech characteristics, which underscores the importance of a broader assessment. Conclusion Speech-language pathologists can consider incorporating evaluation of all components and contextual factors of the ICF-CY when assessing and working with young children with CP±L to inform intervention and management practices.

Perceptual Speech Outcomes After Early Primary Palatal Repair in Ugandan Patients With Cleft Palate

2020 ◽  
pp. 105566562098024
Author(s):  
Kim Bettens ◽  
Laura Bruneel ◽  
Cassandra Alighieri ◽  
Daniel Sseremba ◽  
Duncan Musasizib ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
English Speaking ◽  
And Gender ◽  
Early Primary ◽  
Velopharyngeal Function ◽  
Normal Speech

Objective: To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). Design: Prospective case–control study. Setting: Referral hospital for patients with cleft lip and palate in Uganda. Participants: Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. Interventions: Comparison of speech outcomes of the patient and control group. Main Outcome Measures: Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. Results: Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children ( P < .05). Conclusions: Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research.

An Innovative Collaborative Treatment Model: The Community-Based Speech-Language Pathologist and Cleft Palate Team

2017 ◽  
Vol 54 (2) ◽  
pp. 242-244 ◽  
Author(s):  
Lynn Marty Grames ◽  
Mary Blount Stahl
Keyword(s):  
Cleft Palate ◽  
Continuing Education ◽  
Collaborative Care ◽  
Speech Therapy ◽  
Care Program ◽  
Speech Pathology ◽  
Treatment Model ◽  
Community Based ◽  
Speech Language Pathologist ◽  
Articulation Disorders

Problem Children with cleft-related articulation disorders receive ineffectual or inappropriate speech therapy locally due to lack of training and a disconnect between the team and local speech-language pathologists. Solution A collaborative care program that is billable for the team allows the local speech-language pathologist to earn continuing education units and facilitates effective local speech therapy. This program is the first of its kind, according to the American Speech-Language-Hearing Association Continuing Education Board for Speech Pathology.

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