Cleft Palate Intervention

Question 1

When do we treat? When don’t we?

Answer 1

Yes for kids with orofacial anomalies, treatment for dev phonological or comp articulation errors can be very effective. No if abnormal structure is only cause of kid’s obligatory articulation errors/resonance probs- can’t help it.

Question 2

When can hypernasality or nasal emission due to VPI can be improved or corrected by SLP if…

Answer 2

Mild
Inconsistent, esp when child tired
Related to compensatory errors (tongue place)
OM dysfunction (apraxia, dysarthia)
Surgical or prosthetic correction of VP port is completed- child must learn to use newly modified structures

Question 3

When does art treatment start after surgery?

Answer 3

2-3 wks after if no phys discomfot, feels well enough, parent and child willing, med clearance

Question 4

Can compensatory art errors be corrected?

Answer 4

Yes! In months if child’s errors stimulable and recieve early intervention. Target sounds can be taught in simple words in 1-2 treatment ssns. Words-phrases in months

Question 5

How to choose goals for compensatory errors?

Answer 5

Should follow normal sequence, be easy to stim, front before back, vl before voiced, next goal vary by only one feature…

Question 6

What is goal chunking?

Answer 6

Teach more than one if able! t,d , n

Question 7

Six principles of therapy planning

Answer 7

1. Be sure parent and patient understand nature of prob- good for age, education
2. Begin treatment with gentle whisper or sustained /h/ regardless of age
3. Move quickly from nonsense syll to meaningful open syll and monosyll words nons-CV-CVC
4. Elicit multiple reps of goal from client after each sounds presentation by clinician
5. Obligatory errors can’t be eliminated
6. Direct and specific in instructions- tongue teeth air

Question 8

Why teach /h/ first?

Answer 8

/h/ develops childs concept and production of oral air flow, which is basis of treatment for all of childs other comp errors. Precludes glottal stop

Question 9

What is exception to syllable to word rules?

Answer 9

If nonpressure consonants are needed in word like /r/ /l/

Question 10

When do we move to next level?

Answer 10

achieve at least 30 percent accuracy during initial reps, otherwise drop back. 90% and up at word level before moving to next level.

Question 11

At every stage, emphasize…

Answer 11

Need to use articulators to control air stream

Question 12

What feedback should be used while teaching goals?

Answer 12

Visual and tactile- must see and hear what is happening to air flow. Kleenex, confetti

Question 13

What else needs to be done in therapy

Answer 13

HW to rehearse review therapy