Orofacial anomalies
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| What general communication problems do children with CL+P have? | expressive/receptive lang, artic, resonance
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| 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
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| Child may make distortion errors due to what problems? | dental/occlusal
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| At what age are children without syndroms & only mild speech/lang problems able to catch up to peers? | 4-5
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| Children are at risk for late phoneme acquisition due to what reasons? | surgeries, illnesses, lack of socialization, and other deficits accompanying syndrome
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| What is resonance? | frequency being transmitted thru a cavity
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| What is resonance also referred to as? | oral-nasal balance
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| Does some nasality exist on normal resonance? | yes
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| How does hypernasality occur? | sound waves are diverted through nasal passage and sounds as if coming from nose
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| What is the definition of hypernasality? | Resonance alteration in vowels and vocalic consonants when oral/nasal cavities are abnormally coupled
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| Why does nasal emission occur? | because the VP port doesn't close; high pressure consonants are accompanied by audible and visible nasal air escape
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| 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
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| What do "m, n, ing" sound like with hyponasality? | b, d, g
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| 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
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| Mixed nasality occurs more with _____ or ______ if it does occur. | pharyngeal flap, prosthetics
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| 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
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| 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
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| What does inaudible nasal emission indicate? | inadequate VP valving or oronasal fistula
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| What are 3 compensatory artic patterns kids make? | 1. Do nothing; 2. Compensate with substitution sounds; 3. Camouflage-mask VPI thru weak artic
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| What % of children with CL/P will use compensatory artic? | at least 25%
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| What patterns of misarticulation are most frequent? | omissions and substitutions
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| Which sound is most frequent in error? | /s/
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| What are factors that influence resonance and articulation? (4) | type of cleft, context, rate, fatigue
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| Early speech sound development is the same or different in babies with clefts? | qualitatively and quantitatively different
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| The development of what prelinguistic skill is probably related to later language skills? | babbling
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| Developmental issues stay after palatoplasty and influence ____ and ____ development. | phonetic, lexical; phonological development needs to be monitored
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| Decreased babbling limits opportunity to establish what? | feedback system needed to produce and monitor speech
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| What affects language skills? (6) | intelligence, environmental stim and exp, sensory perception, motivation, attention, and anatomy & physiology
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| Later language problems being caused by ___ still controversial. | OME; no 1:1 correspondence proven
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| 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
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| Greater environmental stimulation = ___. | greater lang devel
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| 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
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| Children with craniofacial anomalies and neurological disorders are at great risk for ____ and ____. | attention problems, learning disabilities
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| Decrease in what skills create global developmental delays? | intellectual
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| Why is CPO more risk for intell problems? | CPO often part of a syndrome
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| Articulation increases with age, the most improvement seen until age ___. | 10
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| By age 16, ___% may still have speech errors especially on fricatives & affricates usually due to dental/occlusal problems. | 20
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| Phonetic errors are present because of what kind of problem? | structural; children may also use phonologic substitutions
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| What % of older children use nasal replacement? | 19
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| What is a major etiologic factor influencing speech prod with CL/P? | VPI
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| Reasons for predominance of oral breathing may be due to what? (4) | constricted maxilla, large tonsils, posterior pharyngeal flap, scarring on faucial pillars
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| What problems occur as a result of oronasal/palatal fistula? (3) | nasal emission, hypernasality, decreased pressure consonants
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| Where do most fistulas occur? | around the incisive foramen and affect /t,d,s,z,p,b/ - those sounds anterior to the opening
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| 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
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| When should you not treat hypernasality in a child until etiology of VPI is determined? | when child exhibits symptoms of voice disorder
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| What decreases intensity of vowels? | excess nasal resonance
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| 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
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