3.1 Intro

Question 1

What are the high incidence problems?

Answer 1

• Articulation
• Language
• Swallowing

Question 2

What are the low incidence problems?

Answer 2

• Voice
• Resonance
• Fluency

Question 3

_________ supply of patients to a _______ demand of training programs and a _________ demand for clinical experts.

Answer 3

Low
Low
Low

Question 4

What is the world rate of clefting?

Answer 4

11k/hour

Question 5

What is the clefting incidence per live births (world)?

Answer 5

1 : 595-1000

Question 6

What is the US rate of children born with cleft?

2

Answer 6

1/66 minutes

6,000 per year

Question 7

What is the US rate of cleft palate (only) caused by a syndrome?

Answer 7

25-30%

Question 8

What is the US rate of cleft lip/palate caused by a syndrome?

Answer 8

5-10%

Question 9

Children born with cleft palate are at an inherently higher risk of developing __________ .

Answer 9

Velopharyngeal dysfunction (VPD)

Question 10

What percentage of children with repaired clefts will need a pharyngoplasty to manage VPD?

Answer 10

20%

Question 11

What percentage of pharyngoplasties required for children without clefts?

Answer 11

30%

Question 12

How many causes are there of velopharyngeal dysfunction?

Answer 12

numerous

Question 13

What is the cumulative incidence of VPD?

8

Answer 13

• Cleft palate and craniofacial anomalies
• Congenital palatal insufficiency
• Nasopharyngeal obstruction
• Nasal obstruction
• Upper motor lesions: brain injury, stroke, etc.
• Lower motor lesions
• Oral surgery
• Nasopharyngeal irradiation
• Orofacial Trauma
• “functional” or “sound specific” VPI

Question 14

Resonance and voice disorders have a _________ degree of medical impact?

Answer 14

High

Question 15

Is the high degree of medical impact only associated with resonance and voice disorders?

Answer 15

NO

Question 16

What kind of training do you need to work with resonance and voice disorders?

Is this training required?

Answer 16

Specialized training

It is not required

Question 17

In regards to resonance and voice disorders, what does a complete evaluation require?

(4)

Answer 17

• Instrumentation
• Imaging
• Close association with medical, surgical and allied health
• Specialists

Question 18

VPD and clefting has are relatively ______ incidence disorders?

Answer 18

Low

Question 19

According to ASHA, VPD and clefting make up _____% incidence of voice disorders in schools?

Answer 19

6%

Question 20

Do we know the incidence of resonance disorder?

Answer 20

We don’t know the percentage of incidence

Question 21

Is hypernasality a voice disorder?

Answer 21

No

Question 22

What kind of disorder is hypernasality?

Answer 22

Disorder of Velopharyngeal function

Question 23

“Labeling a speech disorder should ____________ reflect the anatomical nature of the disorder and avoid ______________ or ambiguous connotations”

Answer 23

Accurately

Erroneous

Question 24

What was hypernasality previously known as?

Answer 24

A voice disorder

Question 25

The new scope of practice separates "voice" (layngeal) from what?

Answer 25

"resonance disorders" (velopharyngeal) disorders

Question 26

The standard practice for children who are hypernasal and present with a cleft palate is what?

Answer 26

To label them as VPI and refer to specialists at a craniofacial center

Question 27

Children who are hypernasal and Do Not present with a cleft palate are labeled as "voice disordered" and referred to who?

Answer 27

To an individual Ear Nose and Throat specialist (who may or may not have experience evaluating VPI) which is an inappropriate referral

Question 28

What is the more appropriate refer for an individual with a cleft palate?

Answer 28

craniofacial team

Question 29

Cleft lip/plate may be identified when?

Answer 29

perinatally or prenatality

Question 30

Cleft palate closure is before when?

Answer 30

One year of age

Question 31

Pharyngoplasties for residual VPI are often completed before when?

Answer 31

five years of age

Question 32

Children with Non-cleft hypernasality from 22q11.2 deletion (velo-cardio syndrome) was when?

Answer 32

9.2 years

Question 33

VPD and cleft and craniofacial disorders are ________ incidence.

Answer 33

Low

Question 34

____ - ____% of hypernasal patients who require a pharyngeal do not have a cleft?

Answer 34

25 - 30%

Question 35

Is hypernasality a voice disorder?

Answer 35

No

Question 36

VPI incidence is ____% post-palatoplasty

Answer 36

20%

Question 37

Delayed identification leads to delayed management resulting in what?

Answer 37

Poorer outcomes