Cleft Palate Exam 3
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| Types of Cleft VPI | Velopharyngeal insufficiency
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| Types of Non-Cleft VPI | Velopharyngeal mislearning, velopharyngeal incompetency, velopharyngeal insufficiency
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| Example of Velopharyngeal incompetency | Dysarthria or Apraxia
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| Example of Velopharyngeal mislearning | Phoneme specific NAE
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| Example of Velopharyngeal insufficiency (non-cleft) | Mechanmial interference (ex. tonsils too big, adenoids removed, etc.)
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| Clinical Paradigm number 1 | Perceptual analysis (clinical judgement)
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| Clinical Paradigm number 2 | Perceptual leading to assumptions (clinical skill)
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| Clincial Paradigm number 3 | Instrumental analysis confirms perceptual
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| What is the gold standard? | Perceptual judgment
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| 3 people from care team | Audiologist, pediatric dentist, pediatrician
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| Assessment in the first year | Monitoring feeding, development, and speech/language
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| A type of language screener | MacArther Communicative Developmental Inventory
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| A type of language screener | Receptive-Expressive Emergent Language Scale (REEL)
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| A type of language screener that can be used birth to 3yr | Rossetti Infant-Toddler Language Scale
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| A type of language screener that can be used 2 to 6 yr | Fluhasty Preschool speech and language screening test
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| What should be done when assessing a preschool age child's language? | Take informal observations and gather parent interview
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| Speech assessments for preschool age | Speech Sample, articulation tests
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| What do you assess during perceptual assessment? | Nasality, phone specific NAE, NAE, compensatory errors, arctic/phonology (omissions, distortions, etc.), Voice issues
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| How to assess nasality? | Nasal pinching for vocalic sounds, Popeye plays baseball
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| What happens if you perceive a change in nasality during nasal pinching? | Hypernasal
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| No fog during production of nasal consonants means.... | Hyponasality
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| A nasalized sentence | Mom's name is Nancy
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| Other ways to assess NAE | Straw, See Scape, oralized sentences with plosives
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| Phonene specific | Only on specific phonemes
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| Sentences for phone specific | Should have lots of sibilants
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| Obligatory test for velopharyngeal | Artic. test with plugged and unplugged nose
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| Obligatory test for fistula | Artic. test with plugged and unplugged fistula
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| Maladaptive test for dental | Diagnostic therapy to see if changing tongue placement alters distortion
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| If you use a rating scale you must.... | Explain what is means
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| How to know if fistula or hypernasality? | Close off fistula, if anterior sounds (t, d) and posterior (k, g) are not different then NAE to VPI
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| Indicates NAE is due to fistula | Nasal emissions stronger on anterior sounds than posterior
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| Small Palatal (oronasal) fistula | Nasal turbulence and NAE
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| Large Palatal (oronasal) fistula | Inaudible, weak consonants, short utterance length, hyper nasal
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| What happens if fistula is symptomatic? | Surgery typically
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| Toosl for orafacial | Gloves, flashlight, mirror, tongue blade, "ahhh,"
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| What are you looking for when you palpate the palate? | Notch
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| What are you looking for on hard palate? | Vault low/flat, fistulas, any devices that impact speech
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| What are you looking for on velum? | Bifid ubula, zona pellucids, length, mobility
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| What are you looking for on pharynx? | Movement of lateral/posterior PW, Passavant's Ridge
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| What are you looking for on tonsils? | Enlarged
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| What are you looking for with lips? | Movement, (I to ooo)
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| What are you looking for with eyes? | Hypertelorism or hypo, epicentral folds
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| What are you looking for with ears? | Microtia, anotia, atresia
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| What are you looking for with nose? | What of each nostril
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| What are you looking got with maxilla? | Micro/macrognathia, mico/macrostoenia
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| What are you looking for with tongue? | Tongue tie (ankyloglossia)
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| Parts of oral motor function | Oral motor exam, sequence speech (diadochokinetic)
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