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SSD Final > Facial/cleft > Flashcards

Facial/cleft Flashcards

1
Q

true or false: do not worry about therapy until after the surgical repair of the palate

A

false

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2
Q

true or false: treatment does not need to begin until palatal surgery

A

false

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3
Q

true or false: stops cannot be produced before palatal surgery

A

false

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4
Q

true or false: glottal stops always persist because of VPI

A

false, can be a learned compensatory error

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5
Q

true or false: post surgery nasal substitutions always indicate VPI

A

false

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6
Q

true or false: a child with cleft palate cannot be expected to have perfectly normal speech

A

false

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7
Q

approximately what percentage of children with cleft will need speech therapy?

A

25-50%

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8
Q

according to Golding-Kushner (2001), when should children with cleft palate be evaluated for speech + language?

A

by at least 8 months if not sooner

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9
Q

what are general early intervention principles that we should consider for the cleft population?

A
  1. increase frequency + diversity of vocal development
  2. increase communicative opportunities
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10
Q

in terms of cleft, how can we increase frequency and diversity of vocal development

A

imitate
reinforce oral stops
encourage CV syllables that babies can easily produce

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11
Q

in terms of cleft, how can we increase communicative opportunities

A

EMT
Modeling
Recasting
parent coaching

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12
Q

what are two speech behaviors of particular concern that we want to address if observed (cleft)?

A

glottal stops
-address early or ASAP

phonemic specific nasal emission

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13
Q

why do we want to address glottal stopping in clients with cleft ASAP?

A

it’s easier to eliminate if treated earlier

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14
Q

what are the three types of VPI?

A

velopharyngeal mislearning

velopharnygeal insufficiency

velopharyngeal incompetency

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15
Q

what is VP mislearning

A

learned
compensatory errors
can treat with speech therapy

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16
Q

what is VP insufficiency

A

structural/anatomy
surgery

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17
Q

what is VP incompetency

A

function/neurological

18
Q

if both VPD and learned/compensatory errors are present what should we consider to determine if speech therapy to address articulation or surgery to address VPI/S should come first?

A

VP surgery may be more conservative if compensatory errors are eliminated first

VPD diagnosis is more unclear when compensatory errors are present so speech therapy may help with a differential diagnosis

19
Q

cleft: what are the goals for therapy?

A

intelligible speech
age appropriate speech skills
age appropriate language skills
socially acceptable skills

20
Q

cleft: what are examples of what we can treat with speech therapy?

A

placement, pressure, manner, and voicing errors (+ language if needed)

articulation and phonological errors
(compensatory errors)

21
Q

what are two general intervention approaches that have been recommended for cleft

A

motor learning
-teach identity, location, and action or oral movement

phonological intervention approaches
- MO, minimal pairs

22
Q

what are three techniques that are often useful in speech therapy for cleft

A

cul-de-sac
shaping
whispered speech
-sustained /h/, over aspiration

23
Q

define cul de sac technique

A

nose pinching to teach airflow

redirects nasal airflow and teach oral airflow direction

24
Q

define the shaping technique

A

produce /m/ and /n/ and plug your nose to teach new phoneme sound

use something they have to get something they don’t

25
Q

define whispered speech technique

A

can’t produce glottal stops with whispers so whisper helps with bilabial stops

whisper can help facilitate voiceless sounds

26
Q

what are some general recommendations for techniques for cleft palate

A

may work on eliciting and stabilizing 1 sound in hierarchical progression

aim for higher accuracy (90+) to solidify new sounds
-teach more visible first
-voiceless before voiced

27
Q

how does the need for orthodontics impact plans for speech therapy

A

myth: therapy shouldn’t start until after fixed

if tongue placement is limited by teeth then may need orthodontic work first

28
Q

is non speech oral motor therapy effective for addressing speech errors in this population (cleft)

A

no

29
Q

hypernasality may be…

A

structural, functional, or learned

30
Q

hyponasality is usually

A

structural

31
Q

what is the most common syndrome associated with cleft palate

A

velocardiofacial syndrome

32
Q

what are the 6 common charactieristics of VCFS

A

cleft palate
communication disorder
VPD
neurological abnormalities
facial abnormalities
early feeding problems

33
Q

hypernasality VCFS may be present. what should the clinician and team be aware of and consider before recommending surgery to address VPI

A

what is the cause of the hypernasality bc if it’s apraxia surgery may not totally correct hypernasality

is it due to VPI or apraxia

34
Q

define apert

A

abnormal growth of the skull and face due to premature fusion of certain skull bones

facial features:
perturbing wide set eyes
dental misalignment

35
Q

define charge

A

cause: unknown
heart disease
atresia of choanae
coloboma- hole in eye

36
Q

define teacher collins

A

cause by altered chromosome 5
some bones are not formed typically
underdeveloped jaw and cheek bone
usually normal IQ

37
Q

define couzon syndrome

A

two associated genes FGFR 2 + 3

premature fusion of certain skull bones

abnormal growth of skull and face

abnormal growth of mid face (bulging eyes, protruding jaw)

normal IQ

38
Q

define goldenhar syndrome

A

cause is unknown

wide range of bone abnormalities affecting the face and sometimes the neck

lower half of one side of the face does not grow normally

partially formed or total absence of ear

39
Q

define Pierre robin sequence

A

may be attributed to DNA

small lower jaw, tongue falling backward into throat (insufficient tongue space), may have cleft

40
Q

define stickler syndrome

A

due to a change in one of 3 genes related to connective tissue

breathing and feeding difficulties

flat face, epicanthal fold, small nose, hearing loss, may have cleft

SSD Final (4 decks)

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