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Psychological/Social
Cleft Palate Exam 2
| Term | Definition |
|---|---|
| What affects social issues for kids with cleft? | Speech, hearing, Facial differences, and range of severity |
| Does CL&P mean delayed IQ? | Not pure cleft, sometimes associated with syndrome |
| Why is it important teachers understand cleft? | So they understand the students performance abilities |
| What should we do to help teachers understand? | Correct and show EBP |
| Social Skills that can be affect | Shyness b/d of noticeable difference, socially inhibited (more with girls), difficultly w/ maintain/initiating friendships |
| What affects the level of social isolation? | Severity of cleft and asymmetry (draws attention) |
| Adults with cleft... | Date less, marry later in life, have lower expectations in relationships |
| What should we as SLP do to help social issues of cleft? | Eliminate stigma, research needed to improve appearance and reduce scarring, improve speech |
| Velopharyngeal Dysfunction | VP valve does not close consistently during oral sounds |
| Velopharyngeal Insufficiency | Anatomical/structural deficit |
| Velopharyngeal Incompetence | Neuromotor/physiological disorder |
| Velopharyngeal Mislearning | Faulty development of articulation patterns leads |
| Hypernasality | Excessive nasal resonance particularly noted on vocalic sounds, always assess in connected speech |
| Cause of hypernasality | VPI or Fistula |
| Hyponasality | Lack of normal nasal resonance on speech affecting nasal sounds, |
| Cause of hypo nasality | Obstruction, hypertrophic adenoids/tonsils (speech bulb or too much secondary palate repair) |
| Cul de Sac Resonance | Sound resonates in the pharynx or oral cavity due to obstruction, muffled speech/low volume |
| Mixed Resonance | Hypernasality or NAE + hypo nasality, result of obstruction or Apraxia |
| What is often the cause of mixed resonance? | Apraxia b/c of lack of velum control |
| Nasal Air Emissions | Inappropriate release of air pressure though nasal air cavity, can assess at word level, especially see during high pressure consonants |
| When is NAE most often seen? | Large VP opening |
| What can you sometimes hear with NAE? | Whistling sound, nasal snort on s-blends. nasal grimace |
| Phone specific nasal air emission | Produce a posterior nasal fricative in substitution usually for s/z, velum lowed and pressure creates nasal air emission, not generalized - no surgery |
| What else can affect VP function? | Adnoidectomy, neuromuscular disorder, dysarthria, apraxia, velar paralysis or paresis, poor movement of muscle after surgery |
| Dsyphonia | Hoarseness, breathiness, low intensity, glottal fry |
| Why do you sometimes see dysphonia with cleft? | VFs are slamming against one another, glottal stops are most common syndrome |
| Why are utterances often short with VP dysfunction? | Air loss and breathiness |
| Causes or abnormal resonance | VPI or VP, Fistula, vocal tract obstruction |
| Birth-3 yards delays | Deletion of final consonants, syllable reduction, backing |
| Birth - 3yrs artic/phonatory errors | Vocalize less, babble later, restricted and fewer consonants, more glottal production, distorted feedback, delayed lexicon |
| Why does glottal stop occur commonly with cleft? | they are the most common arctic error for cleft kiddos b/c nasals develop easier |
| Something that shows VP issue | Growling |
| Language delays birth -3 | Language initially delayed but often catches up, but degree of impairment can impact |
| 3- 5s articulation development | Nasal distortions, Nasal air emission (NAE), substations, omissions, compensatory articulation patterns, |
| Glottal stop | most common, forceful adduction of VF and buildup of air pressure under glottis |
| Pharyngeal stop | Base of tongue moves backwards to articulation to PPW, typically for velar stops |
| Mid-dental stops | Dorsum of toned against palate (t, d, n, l, & k, g, ng) |
| Pharyngeal fricatives | Same as pharyngeal stops but in substitution for fricative sounds (air escaping) |
| Velar fricatives | Fricatives made back in velar palate, often in place of sibilant fricative (s, z, sh, ch) |
| Posterior nasal fricative | nasala snotring, rustle at port- flutter of velum |
| Compensatory errors are | Always learned, not structural so if they're not making speech better use therapy to treat |
| How to ensure development | Monitore early milestones, work on lang. comprehension and building play skills, assess oromotor and speech mechanism (structural vs speech) |
| What is the goal standard? | Perceptual, imaging to confirm |
| What affects development | Speech, Hearing (OM), facial differences, range of severity, syndromes |
Created by:
morganmc3
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