FINAL EXAM

Question 1

You should always have parents…

Answer 1

Sign a release allowing you to communicate with the treating team

Question 2

The neurologically normal child with a cleft palate is not born with a feeding disorder…

Answer 2

They have a structural difference which requires feeding modification

Question 3

Early feeding is handled by…

Answer 3

cleft-specialist nurses

Question 4

Disorders that might require feeding support include

Answer 4

Pierre Robin
Micrognathia disorders (small jaw)
Craniofacial syndromes
22q11.2 DS
Complex cardiac conditions
Complex airway issues
Premature babies with clefts

Question 5

NG feeding tube

Answer 5

nasogastric tube, through nose, more temporary

Question 6

G-tube, J-tube

Answer 6

more permanent, surgically implanted

Question 7

Feeding the child with cleft lip:

Answer 7

lip seal is the main issue. may often breast feed successfully.

Question 8

Feeding the child with cleft palate:

Answer 8

usually do well with feeding modifications. transition to open cup and spoon foods, learn to keep food out of nose.

Question 9

Long term feeding problems are:

Answer 9

rare in cleft palate population, related to issues other than cleft (cleft is complicating factor)

Question 10

Signs a specialty feeding team is needed:

Answer 10

baby is losing weight
baby isn’t gaining sufficient weight
baby is reusing feeds
toddler’s diet is not diverse
frequent coughing, choking, gagging
recurrent pneumonia

Question 11

Infant with cleft palate:

Answer 11

may have fluctuating conductive hearing loss.
the nasal and oral cavities are coupled causing decrease in intraoral pressure and variety of consonants.
shorter duration of vocalizations
different lingual contacts (alveolar and palatal)
delayed onset of canonical babbling
slower growth in expressive vocabulary

Question 12

How many children with cleft never need speech therapy

Answer 12

40-60%

Question 13

Expectation for a neurologically normal child with cleft lip and or palate:

Answer 13

completely normal speech and resonance!

Question 14

Most children with cleft palate and impaired intelligibility have (+types)

Answer 14

articulation disorder (developmental, adaptive, passive (obligatory), active (maladaptive))

Question 15

If teeth might be the issue..

Answer 15

Diagnostic therapy..often the issue is the way the tongue is being used

Question 16

If tongue tie may be the issue..

Answer 16

Listen for other sounds with similar places of articulation

Question 17

To verify a nasal fricative..

Answer 17

plug the nose!

Question 18

Potential preventative measures for artic

Answer 18

longer duration vowels for the infant
Cooing with baby
Long sighs
avoid modeling glottal stops

Question 19

Prevalence of resonance disorders in nonsyndromic population

Answer 19

20-25%

Question 20

Treatment of VPD

Answer 20

imaging
non imaging

Question 21

language disorder

Answer 21

usually comorbid, not common, treatment is not different because of cleft

Question 22

Evaluation in the first year of life

Answer 22

get a release signed, make contact with the team
obtain medical and family history
evaluate infant development
evaluate parental knowledge

Question 22

Voice disorder

Answer 22

can be comorbid with VPD, may result from same causes in regular pediatric population

Question 23

Art and science of the home visit

Answer 23

reconnect and review
address priorities
show the craft
assess and evaluate
reflect on the visit

Question 24

Enhanced milieu teaching with phonological emphasis

Answer 24

designed to teach language and speech sounds concurrently during play (teach model coach review for parents)

Question 25

Core team members

Answer 25

surgery, orthodontics, SLP