June 25 Slides

Question 1

Name an evaluation used for clinical diagnosis.

Answer 1

low-tech perceptual speech evaluation

Question 2

What 2 questions you should ask yourself when administering a low tech perceptual speech evaluation?

Answer 2

What can be treated medically? What can be treated therapeutically?

Question 3

What does the evaluate of perceptual characteristics of speech tell you about the evaluation?

Answer 3

informs you about every other aspect of the evaluation

Question 4

Is it enough to notice hypernasality in a low tech perceptual speech evaluation?

Answer 4

NO

Question 5

What are 2 reasons why it is it NOT enough to notice hypernasality in a low tech perceptual speech evaluation?

Answer 5

1. There are some speech characteristics which can trick your ear into thinking a velopharyngeal problem is present, when in fact the velopharynx is normal.
2. There are some speech characteristics which can make velopharyngeal function sound worse than it is.

Question 6

When should you distinguish differences between a speech error made because of a velopharyngeal problem and a speech error made that is not related to a velopharyngeal problem?

Answer 6

During the perceptual speech exam

Question 7

What can happen if you do not distinguish differences between a speech error made because of a velopharyngeal problem and a speech error made that is not related to a velopharyngeal problem?

Answer 7

inappropriate care

Question 8

True or False: The velopharynx is an articulator.

Answer 8

TRUE

Question 9

What CAN happen to the velopharynx when an articulation disorder is present.

Answer 9

the velopharynx CAN behave in a disordered way

Question 10

What can disordered articulation involving the velpharynz sound like?

Answer 10

velopharyngeal dysfunction

Question 11

It is important to rule out true velopharyngeal dysfunction from what?

Answer 11

an articulation disorder

Question 12

What should a perceptual speech assessment always include?

Answer 12

careful assessment of articulation

Question 13

What needs to be determined for further instrumental assessment if it is needed.

Answer 13

Readiness: child is as prepared as possible via therapy prior to imaging

Question 14

Should you treat an articulation disorder with surgery.

Answer 14

NEVER!!!!!

Question 15

Before low tech perceptual speech evaluation is given, what 2 subjects do we need to know about?

Answer 15

1. nasal consonants

2. oral production

Question 16

What do we need to know about nasal consonants prior to giving the low tech speech perception examination?

Answer 16

• [m,n,ŋ]
• The velopharyx is open
• These consonants are resonated in the nose
• Do not use these consonants to assess velopharyngeal closure!
• Use these to assess velopharyngeal opening

Question 17

What do we need to know about oral productions prior to giving the low tech speech perception examination?

Answer 17

• All other consonants
• Vowels
• The velopharynx is closed
• Highest intraoral pressures: fricatives [s,z,ʃ,ʧ,ʤ ] and stops [p,b,t,d,k,g]
• Use these to evaluate velopharyngeal closure

Question 18

List the 4 articulation error types.

Answer 18

1. Developmental
2. Adaptive
3. Obligatory
4. Compensatory/Maladaptive

Question 19

Describe developmental error.

Answer 19

• May not necessarily be related to the cleft

* Will respond to the same treatment as non-cleft children on your caseload

Question 20

Describe adaptive error.

Answer 20

• Difference in production caused by structural difference
• May be acoustically appropriate
• Examples: [p,b,m] with macroglossia – [f,v] with anterior crossbite

Question 21

Describe an obligatory error.

Answer 21

• Distortion caused by a structural anomaly
• Will not respond to articulation therapy
• Examples: nasalization, weakened pressure consonants, accompanying nasal emission, turbulence, or grimacing, sibilant distortions

Question 22

How can I tell if a distortion is obligatory, caused by dental malocclusion?

Answer 22

Diagnostic therapy

Question 23

How can I tell if a distortion is obligatory, due to velopharyngeal dysfunction?

Answer 23

plug the nose

Question 24

Describe compensatory/maladaptive (active) error.

Answer 24

• Comprehensively described by Trost in 1981
• Further delineated by Peterson-Falzone and others
• Believed to develop as a compensation for defect of mechanism, often before the palate is repaired.

Question 25

Name 3 kinds of compensatory/maladaptive errors.

Answer 25

1. glottal stop
2. posterior nasal fricative
3. pharyngeal stops and fricatives

Question 26

Pharyngeal fricative

Answer 26

Producing a fricative sound in the throat with the roof of the tongue instead of in the mouth with the front of the tongue.

Question 27

Pharyngeal stop

Answer 27

tongue moves posteriorly to meet the pharyngeal wall or the walls of the pharynx move inward to meet the tongue, air then moves through the limited airway to make the sound

Question 28

glottal stop

Answer 28

when true and false vocal folds adduct as a substitute for blocking the airflow of the vocal tract

Question 29

How can I tell if an error is compensatory (maladaptive, active?) because of the structures in a child with a cleft?

Answer 29

plug the nose

Question 30

Why worry about glottal stop, pharyngeal stop, and pharyngeal fricative articulations?

Answer 30

these may cause the velopharynx to open inappropriately

Question 31

Velopharyngeal closure was significantly reduces with what kind of articulation? And what was it compared to?

Answer 31

• glottal articulations

- appropriate articulations

Question 32

Some patients can have velopharyngeal closure significantly reduced with what 2 kinds of articulations?

Does this mean that these patients can never have velopharngeal closure with appropriate articuations? Why?

Answer 32

1. glottal articulations
2. glottal co-articulations

• NO because these compensatory articulations will not teach us about velopharyngeal closure