Lecture 4

Question 1

VP insufficiency is ________.

Answer 1

structural

Question 2

VP incompetence is _______

Answer 2

motor related

Question 3

VP mislearning is _______

Answer 3

learned wrong, only nasalizing some phonemes

Question 4

T or F: VP insufficiency, incompetence and mislearning can all be seen in Non-Cleft VPI

Answer 4

True

Question 5

Of all the resonance disorders ________ really affects speech intelligibility and acceptability.

Answer 5

hypernasality

Question 6

Three reasons accurate assessment is important:

Answer 6

• assessment of treatment outcomes
• comparison of treatment outcomes
• Decisions for: SLP, palatal or VP surgery, maxillofacial surgery and prostheodontic devices

Question 7

T or F: Perceptual assessments of resonance are great and accurate

Answer 7

False - difficult, subjective and poor reliability

Question 8

Inter-rater reliability of perceptual resonance assessment was found to be between ____% accurate on a 5-point scale.

Answer 8

33-96% - TERRIBLE

Question 9

Intra-rater reliability of perceptual resonance assessment was found to be between ____% accurate on a 5-point scale.

Answer 9

25-100%

Question 10

Does training improve perceptual assessment?

Answer 10

Unclear.

• The research is specific to one feature.
• Half-life is unknown (does it last?).
• It isn’t realistic for non-specialized clinicians

Question 11

T or F: hyponasality is the invisible gorrilla of speech assessment.

Answer 11

True -very easy to miss

Question 12

T or F: Facial appearance can influence severity juegements

Answer 12

True

Question 13

In SLP resonance is defined as :

Answer 13

Oral-nasal balance disorder

Question 14

Only ___________ can be measured other aspects of oro-pharyngeal resonance need to be assessed perceptually

Answer 14

oral-nasal balance

Question 15

List the three oral balance disorders:

Answer 15

• hypernasality
• hyponasality
• mixed nasality

Question 16

Describe hypernasality:

Answer 16

• Too much air and sound through the nose

- non-nasal vowels and consonants are nasalized

Question 17

The organic etiology that could result in hypernasality is _________ while the functional etiology is ________.

Answer 17

organic: velopharyngeal insufficiency
functional: velopharyngeal incompetence

Question 18

Describe Hyponasality:

Answer 18

• Too little air and sound through the nose

- Nasal consonants (and vowels) are denasalized

Question 19

______ and ________ are organic etiology that could result in hyponasality.

Answer 19

Septum deviation and hypertrophic turbinates

Question 20

It is _____ for functional etiology to cause hyponasality. One possible cause is a reaction to ________ (abnormal hearing of their own voice).

Answer 20

rare

autophonia

Question 21

Mixed nasality is frequent in_______.

Answer 21

unilateral cleft lip and palate (VPI and septum deviation).

Question 22

Describe mixed nasality:

Answer 22

a combination of velopharyngeal dysfunction and a blocked nasal passage. It may be possible to distinguish between the anterior and posterior form.

Question 23

Describe cul-de-sac resonance:

Answer 23

• not a very helpful term it means different things to different clinicians
• describes a muffled sound quality
  - maybe severe anterior hyponasality
  - maybe mixed nasality

Question 24

Describe alternating nasality:

Answer 24

• rarely used diagnostic category
• suggested as a symptom of neurogenic disorders (dysarthria)
• The VP mech. is out of sync with other articulators
• nasalization occur in a random fashion

Question 25

Types of Nasal emission:
_______ vs ________
and
______ vs _________

Answer 25

inaudible vs audible (non-turbulent and turbulent)

obligatory vs learned

Question 26

How could you identify inaudible nasal emission?

Answer 26

mirror test

Question 27

List the types of audible nasal emission:

Answer 27

• Audible non turbulent emission

- Nasal turbulence

Question 28

Audible non-turbulent emission is usually related to a _____ VP gap while nasal turbulence may indicate _______ VP gap.

Answer 28

larger

close

Question 29

_______ is often interpreted as a counter indication for secondary velopharyngeal surgery (pharyngeal flap, pharyngoplasty). Instead they should try ______

Answer 29

Nasal turbulence

Speech therapy

Question 30

List three reasons for obligatory nasal emission:

Answer 30

1) structural VPI
2) Oro-nasal fistula
3) VPI related to neurological damage

Question 31

List three types of Learned nasal emission:

Answer 31

1) VP mislearning
2) Phoneme specific nasal emission
3) Persisting postoperative nasal emission

Question 32

Describe nasal grimace:

Answer 32

visually distracting and unflavourable flaring of the nares

Question 33

Nasal grimace is seen in many _______ speakers with cleft lip and palate. It is interpreted as ________

Answer 33

hypernasal

a subconscious compensatory attempt to reduce nasal escape

Question 34

T or F: Variable agreement between nasalance scores and perceptual hypernasality.

Answer 34

True

- up to an 8% retest difference

Question 35

How does nasometric pre-classification before perceptual analysis help?

Answer 35

yes

Question 36

Without the nasalance prompt 3 SLPs agreed with ____% of nasalance based classifications with interlistener agreeability of 37%.

With nasalance prompting they ageed with ___% of the classifications with ___% interlistener agreement.

Answer 36

45%
37%

78%
87%