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Comm Disorders
Orofacial anomalies
Question | Answer |
---|---|
What general communication problems do children with CL+P have? | expressive/receptive lang, artic, resonance |
What are the worst problems of general communication a child with CL+P can have? | VPI, nasal emission, hypernasality, weak pressure consonants, & compensatory artic erros |
Child may make distortion errors due to what problems? | dental/occlusal |
At what age are children without syndroms & only mild speech/lang problems able to catch up to peers? | 4-5 |
Children are at risk for late phoneme acquisition due to what reasons? | surgeries, illnesses, lack of socialization, and other deficits accompanying syndrome |
What is resonance? | frequency being transmitted thru a cavity |
What is resonance also referred to as? | oral-nasal balance |
Does some nasality exist on normal resonance? | yes |
How does hypernasality occur? | sound waves are diverted through nasal passage and sounds as if coming from nose |
What is the definition of hypernasality? | Resonance alteration in vowels and vocalic consonants when oral/nasal cavities are abnormally coupled |
Why does nasal emission occur? | because the VP port doesn't close; high pressure consonants are accompanied by audible and visible nasal air escape |
What is hyponasality? | the reduction of nasal resonance when nasal airway is partially blocked or entrance to nasal passages is partially occluded (such as from large adenoids |
What do "m, n, ing" sound like with hyponasality? | b, d, g |
What is mixed nasality? | nasality with hyper and hypo characteristics; VPI with increased nasal resistance that doesn't eliminate nasal resonance but decreases integrity of nasal consonants |
Mixed nasality occurs more with _____ or ______ if it does occur. | pharyngeal flap, prosthetics |
How does cul-de-sac resonance occur? | airstream enters nasal cavity but is blocked anteriorly; sounds like /mimimi/ with nares occluded; speech sounds muffled; variation of hyponasality |
Normal artic was found in what % of preschoolers who had routine team care? | 25%; significan number have problems into adolescence especially those w/out team management |
What does inaudible nasal emission indicate? | inadequate VP valving or oronasal fistula |
What are 3 compensatory artic patterns kids make? | 1. Do nothing; 2. Compensate with substitution sounds; 3. Camouflage-mask VPI thru weak artic |
What % of children with CL/P will use compensatory artic? | at least 25% |
What patterns of misarticulation are most frequent? | omissions and substitutions |
Which sound is most frequent in error? | /s/ |
What are factors that influence resonance and articulation? (4) | type of cleft, context, rate, fatigue |
Early speech sound development is the same or different in babies with clefts? | qualitatively and quantitatively different |
The development of what prelinguistic skill is probably related to later language skills? | babbling |
Developmental issues stay after palatoplasty and influence ____ and ____ development. | phonetic, lexical; phonological development needs to be monitored |
Decreased babbling limits opportunity to establish what? | feedback system needed to produce and monitor speech |
What affects language skills? (6) | intelligence, environmental stim and exp, sensory perception, motivation, attention, and anatomy & physiology |
Later language problems being caused by ___ still controversial. | OME; no 1:1 correspondence proven |
No intelligence problems expected in children with clefts unless have ___. | CPO + other anomalies; these individuals more likely to have a syndrome w/ co-occuring MR |
Greater environmental stimulation = ___. | greater lang devel |
Why will a child with a cleft have an advantage with lang devel with a team? | the team will educate the parents on lang stim; child may qualify for EI b/c of diagnosis & parents may be extra diligent in helping their child's development |
Children with craniofacial anomalies and neurological disorders are at great risk for ____ and ____. | attention problems, learning disabilities |
Decrease in what skills create global developmental delays? | intellectual |
Why is CPO more risk for intell problems? | CPO often part of a syndrome |
Articulation increases with age, the most improvement seen until age ___. | 10 |
By age 16, ___% may still have speech errors especially on fricatives & affricates usually due to dental/occlusal problems. | 20 |
Phonetic errors are present because of what kind of problem? | structural; children may also use phonologic substitutions |
What % of older children use nasal replacement? | 19 |
What is a major etiologic factor influencing speech prod with CL/P? | VPI |
Reasons for predominance of oral breathing may be due to what? (4) | constricted maxilla, large tonsils, posterior pharyngeal flap, scarring on faucial pillars |
What problems occur as a result of oronasal/palatal fistula? (3) | nasal emission, hypernasality, decreased pressure consonants |
Where do most fistulas occur? | around the incisive foramen and affect /t,d,s,z,p,b/ - those sounds anterior to the opening |
How might compensatory artic errors be reinforced by what factors? (4) | Failure to reinforce early speech efforts; Discouraging speech prior to surgery; Acceptance of poor speech; Anticipating the child’s needs, feeling sorry for them because of facial differences |
When should you not treat hypernasality in a child until etiology of VPI is determined? | when child exhibits symptoms of voice disorder |
What decreases intensity of vowels? | excess nasal resonance |
Why does a child have to increase subglottal pressure to be loud enough to be heard? | increased subglottal pressure increases hypernasality and NE and this extra effort is lost through open VP port |