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Comm Disorders

Orofacial anomalies

QuestionAnswer
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
Created by: imbatgirl