Cleft Palate Exam 2
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| What affects social issues for kids with cleft? | Speech, hearing, Facial differences, and range of severity
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| Does CL&P mean delayed IQ? | Not pure cleft, sometimes associated with syndrome
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| Why is it important teachers understand cleft? | So they understand the students performance abilities
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| What should we do to help teachers understand? | Correct and show EBP
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| Social Skills that can be affect | Shyness b/d of noticeable difference, socially inhibited (more with girls), difficultly w/ maintain/initiating friendships
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| What affects the level of social isolation? | Severity of cleft and asymmetry (draws attention)
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| Adults with cleft... | Date less, marry later in life, have lower expectations in relationships
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| What should we as SLP do to help social issues of cleft? | Eliminate stigma, research needed to improve appearance and reduce scarring, improve speech
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| Velopharyngeal Dysfunction | VP valve does not close consistently during oral sounds
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| Velopharyngeal Insufficiency | Anatomical/structural deficit
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| Velopharyngeal Incompetence | Neuromotor/physiological disorder
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| Velopharyngeal Mislearning | Faulty development of articulation patterns leads
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| Hypernasality | Excessive nasal resonance particularly noted on vocalic sounds, always assess in connected speech
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| Cause of hypernasality | VPI or Fistula
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| Hyponasality | Lack of normal nasal resonance on speech affecting nasal sounds,
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| Cause of hypo nasality | Obstruction, hypertrophic adenoids/tonsils (speech bulb or too much secondary palate repair)
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| Cul de Sac Resonance | Sound resonates in the pharynx or oral cavity due to obstruction, muffled speech/low volume
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| Mixed Resonance | Hypernasality or NAE + hypo nasality, result of obstruction or Apraxia
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| What is often the cause of mixed resonance? | Apraxia b/c of lack of velum control
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| Nasal Air Emissions | Inappropriate release of air pressure though nasal air cavity, can assess at word level, especially see during high pressure consonants
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| When is NAE most often seen? | Large VP opening
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| What can you sometimes hear with NAE? | Whistling sound, nasal snort on s-blends. nasal grimace
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| 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
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| What else can affect VP function? | Adnoidectomy, neuromuscular disorder, dysarthria, apraxia, velar paralysis or paresis, poor movement of muscle after surgery
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| Dsyphonia | Hoarseness, breathiness, low intensity, glottal fry
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| Why do you sometimes see dysphonia with cleft? | VFs are slamming against one another, glottal stops are most common syndrome
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| Why are utterances often short with VP dysfunction? | Air loss and breathiness
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| Causes or abnormal resonance | VPI or VP, Fistula, vocal tract obstruction
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| Birth-3 yards delays | Deletion of final consonants, syllable reduction, backing
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| Birth - 3yrs artic/phonatory errors | Vocalize less, babble later, restricted and fewer consonants, more glottal production, distorted feedback, delayed lexicon
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| Why does glottal stop occur commonly with cleft? | they are the most common arctic error for cleft kiddos b/c nasals develop easier
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| Something that shows VP issue | Growling
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| Language delays birth -3 | Language initially delayed but often catches up, but degree of impairment can impact
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| 3- 5s articulation development | Nasal distortions, Nasal air emission (NAE), substations, omissions, compensatory articulation patterns,
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| Glottal stop | most common, forceful adduction of VF and buildup of air pressure under glottis
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| Pharyngeal stop | Base of tongue moves backwards to articulation to PPW, typically for velar stops
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| Mid-dental stops | Dorsum of toned against palate (t, d, n, l, & k, g, ng)
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| Pharyngeal fricatives | Same as pharyngeal stops but in substitution for fricative sounds (air escaping)
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| Velar fricatives | Fricatives made back in velar palate, often in place of sibilant fricative (s, z, sh, ch)
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| Posterior nasal fricative | nasala snotring, rustle at port- flutter of velum
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| Compensatory errors are | Always learned, not structural so if they're not making speech better use therapy to treat
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| How to ensure development | Monitore early milestones, work on lang. comprehension and building play skills, assess oromotor and speech mechanism (structural vs speech)
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| What is the goal standard? | Perceptual, imaging to confirm
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| What affects development | Speech, Hearing (OM), facial differences, range of severity, syndromes
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