COMPS: Treatment of Pts with VPI

Question 1

Speech therapy goals, after physical management of VPI: Discuss the steps for decreasing velopharyngeal patency.

Answer 1

• Explain landmarks
• Produce stimuli (phonemes) that elicit closure
• Produce stimuli associated with patency
• Work to match movement of closure on correct phonemes to incorrect phonemes
• Continue using only auditory feedback

Question 2

Speech therapy goals, after physical management of VPI: Discuss the steps for decreasing NAE/increasing oral pressure.

Answer 2

Use auditory feedback

• Use a listening tube or Octopus (best), See-Scape, mirror (kind of tricky)
• Produce sustained fricatives without NAE
• Add vowels (/i,u, /), then go to fricatives (CV and CVC), then other vowels. Criterion is 95%
• Introduce other pressure consonants
• Remove tactile visual aids. The client must monitor unaided. Criterion is 95%.
• Phrases with aided feedback, then with feedback removed. Criterion is 95%.
• Tactile feedback: fingers on the nose to feel vibration
• Cul-de-sac technique
• Light, quick contacts

Question 3

Speech therapy goals, after physical management of VPI: Discuss the steps for decreasing hypernasality (present on vowels).

Answer 3

Treatment for hypernasality:

• Auditory discrimination: Octopus or See-Scape
• Visual feedback:
• Tactile feedback
• Lower the back of the tongue
• Increase oral activity and volume

Question 4

Speech therapy goals, after physical management of VPI: Discuss the steps for decreasing compensatory errors.

Answer 4

• Articulation therapy for glottal/pharyngeal stops (whisper or breathy voice)
• Artic therapy for nasal fricatives (octopus or see-scape)
• Artic for pharyngeal fricatives (move production anteriorly, monitor w/ straw)
• Artic for mid-dorsum stops (tongue to lip, alveolar ridge)
• Best to conduct artic therapy early to prevent errors from occurring in first place