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Cleft Palate > Chapter Eleven > Flashcards

Chapter Eleven Flashcards

1
Q

Evaluation of resonance and velopharyngeal function begins with_______

A

perceptual speech assessment

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2
Q

Goals:
1.
2.

A
  1. To determine whether a speech/resonance disorder exists, and if so, the type, severity and possible cause
  2. To obtain enough information in order to make appropriate recommendations for treatment
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3
Q

In the first year speech pathologists should focus on:

A
  1. Feeding
  2. Language development
  3. Development of the prerequisites for speech
  4. Counseling parents regarding speech/language stimulation
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4
Q

Annual Screenings and Periodic Evaluations

A screening evaluation of speech/language skills should be done in early years:

At least…

At least…

A comprehensive evaluation of speech and resonance should be done around ____; a language evaluation should be done if ….

A ____and _____evaluation should be done before any surgery for VPI.

A

twice during first two years

annually until age 6

age 3; problems are suspected through screening or parent report

speech and resonance

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5
Q

Interview
Many good interview questions are listed in the book.

Rule of thumb:

A

If the caregiver is worried about speech, there is probably a valid reason for it.

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6
Q

Speech Samples

Single-word articulation test is _____.

We don’t ________

Single words …..

Target phoneme may be affected by _______

This kind of test is ______

Repetition of ______and ______is easier, faster and …..

For resonance and nasal emission, _______also provide information.

A

not advised

talk in single words.

place limited demands on the oral-motor system

phonemic context.

time-consuming.

syllables and sentences; provides more information

isolated sounds

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7
Q

Speech Samples for Informal Assessment

A
  1. Prolongation of sounds
  2. Repetition of syllables
  3. Repetition of sentences with pressure sensitive consonants
  4. Counting
  5. Connected Speech
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8
Q

Single Sounds

To test for hypernasality:

To test for nasal emission:

To test for hyponasality or cul-de-sac resonance:

A

Vowels, particularly low vowel /ɑ/ and high vowel /i/

Prolonged /s/

Prolonged /m/

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9
Q

Syllable Repetition

To test hypernasality and/or nasal emission (and to test articulation), use…

A

oral consonants with high and low vowels:

pɑ, pɑ, pɑ, pɑ, …
tɑ, tɑ, tɑ, tɑ, …
kɑ, kɑ, kɑ, kɑ, …
sɑ, sɑ, sɑ, sɑ, …
ʃɑ, ʃɑ, ʃɑ, ʃɑ, …
etc.
pi, pi, pi, pi,…
ti, ti, ti, ti,…
ki, ki, ki, ki,…
si, si, si, si,…
ʃi, ʃi, ʃi, ʃi, …
etc.
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10
Q

Syllable Repetition

To test for hyponasality,

A

use nasal consonants with high and low vowels

mɑ, mɑ, mɑ, mɑ, …
nɑ, nɑ, nɑ, nɑ, …

mi, mi, mi, mi,…
ni, ni, ni, ni, …

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11
Q

Sentence Repetition

A 
p/b—Popeye plays baseball.
t/d—Take Teddy to town. Do it for Daddy.
k/g—Kate eats the cake. Go get the wagon.
f/v—Fred has five fish. Drive the van.
s/z—I see the sun in the sky.
/ʃ/—She went shopping.
/ʧ/—I ride a choo-choo train.
/ʤ/—John told a joke to Jim.
/r/—Run down the road. I have a red fire truck.
/l/—Look at the lady.
Blends—splash, sprinkle, street
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12
Q

Counting

To test nasal emission:

A

Count from 60 to 70

Repeat 60 or 66 over and over

66 = /sɪksti sɪks/

Good combination of plosives and fricatives in blends

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13
Q

Counting

To test hyponasality:

A

Count from 90 to 99

Repeat 99 over and over

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14
Q

Connected Speech

Connected speech increases ___________to achieve and maintain closure.

_______and ________is more obvious.

More ________can occur.

A

demand on VP valve

Hypernasality and nasal emission; nasal emission

articulation errors

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15
Q 
What to Evaluate
1.
2.
3.
4.
5.
6.
7.
8.
A
  1. Speech sound production
  2. Stimulability
  3. Nasal emission
  4. Weak consonants
  5. Short utterance length
    6 Oral motor dysfunction
  6. Resonance
  7. Phonation
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16
Q

Speech Sound Production

Need to determine the presence of the following:
1.
2.
3.

With structural anomalies, need to also determine presence of the following:
1.
2.

A
  1. Placement errors
  2. Phonological errors
  3. Developmental errors
  4. Obligatory errors
  5. Compensatory errors
17
Q

Obligatory errors—

Compensatory errors—

A

articulation is normal, but the structural abnormality interferes; requires correction of structure only

articulation is altered due to structural abnormality; requires correction of structure and then correction of function through therapy

18
Q 
Obligatory Errors
1.
2.
3.
4.
5.
A
  1. Hypernasality
  2. Nasalization of oral phonemes (m/b, n/d, ŋ/g)
  3. Weak or omitted consonants
  4. Nasal emission
  5. Short utterance length
19
Q

Compensatory Errors

1.
2.
3.

Note:

A
  1. Glottal stops
  2. Pharyngeal fricatives
  3. Pharyngeal plosives

These can also be due to mislearning in the absence of VPI

20
Q

Stimulability

Stimulability—

Need to determine…

Stimulability is…

A

the ability to correct an abnormal speech sound production when given minimal cues

whether change in placement eliminates nasal emission of hypernasality on that sound

a good prognostic indicator for improvement or correction with therapy

21
Q

Nasal Emission

Need to determine the ____:
1.
2.

Need to determine ______

Need to determine whether …

A

type

  1. Characteristics of a large gap
  2. Characteristics of a small gap

consistency

nasal emission is phoneme specific

22
Q

Nasal Emission
Large gap:

Usually _____or even ______to naked ear

Associated characteristics include:
1.
2.
3.

A

barely audible; inaudible

Weak or omitted consonants
Short utterance length
Nasal grimace

23
Q

Nasal Emission

Small gap:
Usually in the form of _______

Can be due to …

A

a nasal rustle

abnormal structure or can be phoneme-specific due to use of glottal or pharyngeal articulation

24
Q

Nasal Rustle Consistency

Nasal rustle can be due to…

To determine cause, _______must be tested.

A

abnormal structure or abnormal function.

consistency

25
Q

Nasal Rustle Consistency

Abnormal Structure:

A

Small gap

Inconsistent

Occurs in pressure-sensitive sounds (including /p, t, k/)

26
Q

Abnormal Function:

A

Articulation error

Consistent

Only occurs on certain phonemes, particularly s/z

27
Q

Weak Consonants

Due to …

Associated with…

Caused by

Test by…

A

inadequate oral air pressure

nasal air emission and hypernasality

a large VP opening

having the individual repeat sentences loaded with pressure-sensitive consonants

28
Q

Short Utterance Length

Leak of air through the nose causes…

This ….

A

the person to have to take more frequent breaths to replenish the airflow.

shortens utterance length.

29
Q

Oral-Motor Dysfunction

May be more common with…

To test use the following:
1.
2.
3.

A

craniofacial syndromes (e.g., velocardiofacial syndrome)

  1. Published tests
  2. Diadochokinetic exercises (e.g., /pʌtʌkʌ, pʌtʌkʌ, pʌtʌkʌ, pʌtʌkʌ/)
  3. Rapid and repeated production of multisyllabic words (e.g., “baseball bat,” “kitty cat,” “puppy dog,” etc.)
30
Q

Resonance

Most important to determine the type:

A 
Normal resonance
Hypernasality
Hyponasality
Cul-de-sac resonance
Mixed resonance
31
Q

Resonance Severity

Rating scales can be used:
1.
2.
3.

Usually, severity rating doesn’t matter because it doesn’t…

A

Seven-point scale

Normal, mild, moderate, severe

Present or absent

affect treatment decisions.

32
Q

Phonation

Evaluate for signs of _______:
1.
2.
3.

Judge

A

dysphonia

Hoarseness
Breathiness
Low pitch or high pitch

ability to sustain phonation for 10 seconds or longer.

33
Q

Supplemental Evaluation Procedures

Use same type of speech samples:

A

Visual detection: See it

Tactile detection: Feel it

Auditory detection: Hear it

Note: See text for description of methods and interpretation

34
Q

Visual Detection

A

Dental mirror

Air paddle

See-Scape

35
Q

Tactile Detection

A

Feel the sides of the nose

36
Q

Auditory detection:

A

Cul-de-sac test

Stethoscope

Listening tube

Straw

37
Q

Differential Diagnosis

Determine whether ___________(due to misarticulation) or occurs on many sounds

To determine whether nasal emission is due to VPI or a fistula:

A

nasality is phoneme specific

  1. Test the difference between the /k/ sound (which is usually behind the fistula) and /t/.
  2. If nasal emission is not heard on /k/, the fistula is the source.
  3. If it occurs on both, but more on the /t/, there is both VPI and a symptomatic fistula.
38
Q

Speech Characteristics and Size of Gap

Hypernasality, inaudible nasal emission, weak consonants, short utterance length, low volume

Hypernasality, audible nasal emission

Nasal emission with essentially normal resonance

Nasal rustle (turbulence) with normal resonance

A

Largest

Large

Medium

Small

39
Q

Summary

The ____remains the best method for judging abnormal speech and resonance.

To augment the perceptual assessment, use a…

Assessment results should result in a ________ of cause so that appropriate treatment recommendations can be made.

A

ear

straw (or other type of tube).

differential diagnosis

Cleft Palate (19 decks)

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