Cleft 6

Question 1

Factors Important for Normal Speech, Language, and Cognitive Development

Answer 1

Brain structure and function 
Environmental stimulation 
Hearing and vision
Motivation 
Attention
Normal anatomy and physiology

Question 2

Brain Structure and Function

Intelligence—

Intelligence and cognitive function are…

Answer 2

Intelligence—ability to perceive, comprehend, assimilate, analyze, categorize, imitate, and generate language

Intelligence and cognitive function are dependent on the structure and function of the brain and central nervous system.

Question 3

Brain Structure and Function

• There may be a relationship between …
• Children with __ ___often have early deficits and delays.
  1. Deficits usually disappear with…
• Children with ___ __ and __ __ only often have more serious, long-lasting deficits.

Answer 3

-There may be a relationship between outside (facial) development and inside (brain) development

• Children with nonsyndromic clefts often have early deficits and delays.
  1. Deficits usually disappear with treatment (PE tubes, speech therapy, surgery) and age.

-Children with syndromic clefts or cleft palate only often have more serious, long-lasting deficits.

Question 4

environmental stimulation

• Children may receive more stimulation due to __ __, but
  1. …
  2. They may have….

Answer 4

• Children may receive more stimulation due to early intervention, but
  1. Many surgical procedures and frequent hospitalizations can cause less stimulation.
  2. They may have less interaction with peers or have more social isolation due to anomalies.

Question 5

Hearing and Vision

• Cleft palate increases risk for …
• Many craniofacial syndromes include …
• Hearing loss can affect …

Answer 5

Cleft palate increases risk for chronic middle-ear effusion and conductive hearing loss due to Eustachian tube malfunction.
Many craniofacial syndromes include conductive and/or sensorineural hearing loss as a phenotypic feature.
Hearing loss can affect articulation, language, and resonance.

Question 6

Hearing and Vision

• Some craniofacial syndromes affect the …
• Vision is used during…
• Vision is important for …

Answer 6

• Some craniofacial syndromes affect the eyes and visual perception.
• Vision is used during speech development.
• Vision is important for associating words with objects, verbs, adjectives, etc.

Question 7

Motivation

• Some families respond by ___ the child, which results in less demands for __ ___.
• If speech intelligibility is poor…

Answer 7

• Some families respond by overprotecting the child, which results in less demands for verbal communication.
• If speech intelligibility is poor, verbal language may be an ineffective means of communication, and child may rely on gestures instead.

Question 8

Attention

• Craniofacial syndromes often include …
• ___ and ___ are common co-occurring problems.
• Distractibility and a high activity level decreases ….

Answer 8

• Craniofacial syndromes often include ADHD and language delay.
• Language impairment and ADHD are common co-occurring problems.
• Distractibility and a high activity level decreases perception and processing of language.

Question 9

Vocal Tract Anatomy and Physiology

• Need…
• Need normal physiology of …

Answer 9

• Need normal anatomy of entire vocal tract
• Need normal physiology of subsystems of speech (respiration, phonation, velopharyngeal function, articulation, and neurological function)

Question 10

Language and Cognitive Development

Cleft Lip with and without Cleft Palate:

• There may be early deficits in …
• In early years, child has lower scores on ….
• Child may show early __ ___ difficulties (due to production errors)
• In most cases, these delays disappear with time, unless there are __ __.

Answer 10

• Cleft Lip with and without Cleft Palate:
• There may be early deficits in prelanguage and early skills.
• In early years, child has lower scores on verbal performance than nonverbal performance on standardized tests.
• Child may show early expressive language difficulties (due to production errors)
• In most cases, these delays disappear with time, unless there are neurological issues.

Question 11

Language and Cognitive Development

Cleft Palate Only
Carries an increased risk for:

Answer 11

Cleft Palate Only 
 Carries an increased risk for:
Syndromes and other craniofacial anomalies
Developmental or cognitive deficits
Attention deficits
Learning disabilities language delay
Other forms of neurological or motor dysfunction
Sensorineural hearing loss
Velopharyngeal insufficiency
Frequent hospitalizations
Social isolation

Question 12

Speech Sound Development

-Many causes of problems include:
1.
2.
3.

• Structural problems may result in the development of __ __.
• The longer the structure is abnormal…

Answer 12

• Many causes of problems include:
  1. Structural problems (VPI, fistula, malocclusion)
  2. Neurological problems (apraxia, cognitive delays)
  3. Hearing loss (conductive and sensorineural)
• Structural problems may result in the development of compensatory productions.
• The longer the structure is abnormal, the harder it is to correct the child’s speech.

Question 13

Summary

• Children with clefts may have developmental delays in __ and___.
• In most cases, these delays…
• Serious developmental delays are a greater risk for children with cleft palate only or syndromes.
• It is important to monitor the child’s speech and language development throughout the early years.

Answer 13

• Children with clefts may have developmental delays in speech and language.
• In most cases, these delays disappear with time.
• Serious developmental delays are a greater risk for children with cleft palate only or syndromes.
• It is important to monitor the child’s speech and language development throughout the early years.