Chapter 21 Flashcards
Chapter 21Speech Therapy
Important**
Speech Therapy
Individuals with clefts or craniofacial anomalies are at risk for ___________ secondary to velopharyngeal insufficiency or incompetence (VPI), oral anomalies, and dental malocclusion.
Speech therapy will not correct…
Speech therapy WILL correct …
speech and resonance disorders
VPI or other structural disorders.
abnormal function (speech sound placement) that may result from these disorders.
Obligatory Distortions
Obligatory distortions—
_______is not indicated for obligatory distortions.
Obligatory distortions can only be eliminated by…
occur when function (i.e., articulation) is normal, but structure is abnormal
Speech therapy
correcting structure (i.e., through surgery or prosthetic management).
Compensatory Errors
Compensatory errors—
Common compensatory productions for VPI include
1.
2.
3.
Compensatory productions can be corrected with…
occur when articulation placement (function) is altered due to abnormal structure
1.pharyngeal fricatives, 2.pharyngeal plosives, and 3.glottal stops (most common)
speech therapy, preferably after correction of structure.
Speech Therapy with an Oronasal Fistula
Compensatory productions due to a symptomatic fistula …
A ______can be used until the fistula is surgically closed.
cannot be easily corrected with speech therapy until the fistula is closed.
palatal obturator
Speech Therapy before VPI Surgery
Speech therapy can be done while _________. However, placement is VERY hard to achieve without _______. Therefore…
1.
2.
waiting for surgery or a prosthesis; oral air flow
Nose plugging should be used to give the child increased oral air flow to convert to air pressure through articulation.
Child should wear nose plug at home as much as possible, not just during practice.
Speech Therapy after VPI Surgery
Changing structure ….
Speech therapy is appropriate for…
_______ and ______,can be effective in getting the new structures to function normally (e.g., to increase lateral wall movement around a new pharyngeal flap).
does not change function.
correction of compensatory errors after surgery.
Speech therapy, using auditory feedback
Speech for Velopharyngeal Mislearning
Velopharyngeal mislearning—
Speech therapy is effective in…
a cause of misarticulations that cause nasal emission and sometimes hypernasality, despite normal velopharyngeal structure and physiology
normalizing placement and thus, eliminating phoneme-specific nasal emission or phoneme-specific hypernasality.
When in Doubt
When in doubt about the need for surgical correction, it is always best to…
It usually only takes…
If nasality is noted with normal articulation….
do a short trial period of speech therapy.
a few weeks to determine whether therapy will be effective
surgical intervention will likely be needed.
General Principles of Speech Therapy***
Select sounds in which the child is stimulable.
Select sounds that will have the biggest impact on intelligibility.
Select anterior sounds before posterior sounds (except with /r/).
Select continuant cognate before a movement sounds (e.g., /n/ before /d/).
Select the voiceless sound before the voiced cognate.
General Principles of Speech Therapy***
Be sure the child can discriminate between the correct versus incorrect sound.
Establish placement of production before the manner.
Work on continuants and voiceless phonemes first without the vowel.
Work on voiced plosives in syllables with the vowel.
Begin with the sound in the initial position.
Use /h/ to transition consonant to the vowel.
General Principles of Speech Therapy
Once placement is obtained, work on _______
Determine whether _____________
For medial position, ________
The ________of a medial sound can change its production.
Example: In American English, the /t/ in words that end with /n/ (e.g., “kitten,” “button,” “mitten,” etc.) is usually not aspirated but instead is co-articulated with a glottal stop)
sound in initial position.
the medial or final position is easiest.
break the word up into syllables.
phonemic context
General Principles of Speech Therapy
When working on final position, _______.
When working on final word position, …
Work on sounds in _______.
When moving to the next sound in a category, __________
break up the word
combine word with a word that starts with a vowel (e.g., bake it).
categories
change one feature at a time.(so either change the placement or the manner, not both)
General Principles of Speech Therapy
Divide the consonant blends into __________.
When /s/ is combined with a typically voiceless consonant, the voiceless consonant becomes voiced (e.g., “spell” becomes “sss … bell”).
Work on the sound in _____
Work on the sound in ______
individual components
carrier phrases.
novel sentences.
General Principles of Speech Therapy
Obtain as many …
Work on carryover _____
Involve the _____and ______.
There should be ______________ each day whenever possible.
correct productions of the sound in the session as possible. ***
using unstructured speech.
parents and caregiver
several short (a few minutes at a time)practice sessions
