Assessment

Question 1

Because resonance is a complex phenomenon, you should assess it in the contexts of:

Answer 1

• Controlled utterances
• Connected speech
• Standardized ax of the speech domains
• Instrumental ax - acoustic, aeromechanical, visual

Question 2

With regard to incoming referrals, what should you never do?

Answer 2

Take an incoming diagnosis for granted.

Question 3

What kinds of signs should you look for during the interview and other tasks?

Answer 3

Breathing (noisy? mouth breathing?)
Nasal grimacing
Nasal snorting, bubbling, frication
Overall loudness, loudness toward the end of utterance
Breath groups
Voice quality
Fluency

Question 4

What are some of the parameters of the problem that you should ask about during the interview?

Answer 4

Onset (since first words? sudden?)
Accompanying problems (swallowing? nasal regurg? speech hearing or voice? dental? etc)
Variability? (specific sounds?)
Family history?
Health history?

Question 5

In addition to examining for visual characteristics of clefting, you should…

Answer 5

Palpate the hard and soft palates with a gloved hand, and the uvula with a tongue blade

Question 6

Minimal pairs, counting, and specific word lists can reveal a resonance issue. What are the best number ranges to have the client count up?

Answer 6

1-10 (combination)
60-70 (oral sound-loaded)
90-100 (nasal sound-loaded)

Question 7

What is a useful reading passage for children that is filled with oral sounds and no nasal sounds?

Answer 7

The Zoo Passage

Question 8

What are some useful instruments to test for nasal air emission?

Answer 8

Mirror beneath the nose
Stethoscope
Straw
Commercial - e.g. “See ‘Scape” from Pro Ed

Question 9

List some speech sound tasks that could reveal hypernasality.

Answer 9

Prolong a vowel
CV repetition with pressure consonants
Prolong sibilant, e.g. /s/

Question 10

List a couple of speech sound tasks that could reveal hyponasality.

Answer 10

CV repetition with nasal consonants

Prolong nasals, /m/ or /n/

Question 11

What is a sign that you will be able to conduct some successful behavioural treatment?

Answer 11

The person is stimulable to produce high pressure consonants.

Question 12

What kinds of substitutions are common in children compensating for hypernasal resonance?

Answer 12

Pharyngeal substitutions

Glottal stops

Question 13

If a person is unintelligible out of context due to hypernasal resonance, how do we describe the severity?

Answer 13

Markedly (severely) hypernasal

Question 14

What are some important considerations regarding adenoid surgery in children?

Answer 14

• 1 in 1500 become hypernasal after removal
• any history or risk factors for clefting, including syndromes associated with clefting, or structural abnormality of VP
• any borderline resonance issues
• nasal air emission on all obstruents
• history of nasal regurgitation

Question 15

If the vagus, glossopharyngeal, or hypoglossal nerves are affected during tonsil removal, the result could be ___.

Answer 15

Hypernasality

Question 16

Enlarged tonsils can cause ____ or ____.

Answer 16

Hypernasality

Cul-de-sac resonance

Question 17

Nasalance is measured by a nasometer and represents…

Answer 17

The relative amounts of oral and nasal acoustic energy in connected speech.

Question 18

True or false: Acoustic measures of nasality are a good reflection of auditory perceptions of nasality of speech.

Answer 18

True

Question 19

The area of an orifice can be estimated if we know the ____ and the _____.

Answer 19

Differential pressure across the orifice

Rate of airflow through the orifice

Question 20

The PERCI measures the efficiency of VP closure through ______ and ______ signals.

Answer 20

Air pressure

Airflow

Question 21

What are three instrumental methods for visualizing the VPP?

Answer 21

Nasoendoscopy
Videofluoroscopy
MRI

Question 22

What are three important parameters of the voice to observe and rate in your assessment?

Answer 22

Quality (breathy, strained)
Pitch
Intensity