3.1 Intro Flashcards
What are the high incidence problems?
- Articulation
- Language
- Swallowing
What are the low incidence problems?
- Voice
- Resonance
- Fluency
_________ supply of patients to a _______ demand of training programs and a _________ demand for clinical experts.
Low
Low
Low
What is the world rate of clefting?
11k/hour
What is the clefting incidence per live births (world)?
1 : 595-1000
What is the US rate of children born with cleft?
2
1/66 minutes
6,000 per year
What is the US rate of cleft palate (only) caused by a syndrome?
25-30%
What is the US rate of cleft lip/palate caused by a syndrome?
5-10%
Children born with cleft palate are at an inherently higher risk of developing __________ .
Velopharyngeal dysfunction (VPD)
What percentage of children with repaired clefts will need a pharyngoplasty to manage VPD?
20%
What percentage of pharyngoplasties required for children without clefts?
30%
How many causes are there of velopharyngeal dysfunction?
numerous
What is the cumulative incidence of VPD?
8
- 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
Resonance and voice disorders have a _________ degree of medical impact?
High
Is the high degree of medical impact only associated with resonance and voice disorders?
NO
What kind of training do you need to work with resonance and voice disorders?
Is this training required?
Specialized training
It is not required
In regards to resonance and voice disorders, what does a complete evaluation require?
(4)
- Instrumentation
- Imaging
- Close association with medical, surgical and allied health
- Specialists
VPD and clefting has are relatively ______ incidence disorders?
Low
According to ASHA, VPD and clefting make up _____% incidence of voice disorders in schools?
6%
Do we know the incidence of resonance disorder?
We don’t know the percentage of incidence
Is hypernasality a voice disorder?
No
What kind of disorder is hypernasality?
Disorder of Velopharyngeal function
“Labeling a speech disorder should ____________ reflect the anatomical nature of the disorder and avoid ______________ or ambiguous connotations”
Accurately
Erroneous
What was hypernasality previously known as?
A voice disorder
The new scope of practice separates “voice” (layngeal) from what?
“resonance disorders” (velopharyngeal) disorders
The standard practice for children who are hypernasal and present with a cleft palate is what?
To label them as VPI and refer to specialists at a craniofacial center
Children who are hypernasal and Do Not present with a cleft palate are labeled as “voice disordered” and referred to who?
To an individual Ear Nose and Throat specialist (who may or may not have experience evaluating VPI) which is an inappropriate referral
What is the more appropriate refer for an individual with a cleft palate?
craniofacial team
Cleft lip/plate may be identified when?
perinatally or prenatality
Cleft palate closure is before when?
One year of age
Pharyngoplasties for residual VPI are often completed before when?
five years of age
Children with Non-cleft hypernasality from 22q11.2 deletion (velo-cardio syndrome) was when?
9.2 years
VPD and cleft and craniofacial disorders are ________ incidence.
Low
____ - ____% of hypernasal patients who require a pharyngeal do not have a cleft?
25 - 30%
Is hypernasality a voice disorder?
No
VPI incidence is ____% post-palatoplasty
20%
Delayed identification leads to delayed management resulting in what?
Poorer outcomes
