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Cleft Palate > Lecture 5: Developmental Deficits > Flashcards

Lecture 5: Developmental Deficits Flashcards

1
Q

What are some Anomalies?

A 
Dental
ENT
Language 
Cognition
Psychosocial
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2
Q

What makes up Normal Dentition?

A 
Deciduous/Primary – 
- 20 teeth (10 maxillary arch, 10 mandibular arch) 
- by 29 mos.
Permanent – 
- 32 teeth (16 each arch) 
- from ~7yrs-20yrs
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3
Q

Types of occlusions/malocclusions

A
  • Class I occlusion – normal upper overlap
  • Class I malocclusion – incorrect line (teeth don’t match, are rotated, etc.)
  • Class II malocclusion – overbite
  • Class III malocclusion – underbite
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4
Q

What are dental anomalies with clefts?

A

Missing teeth – primary cleft palate>lisp
Supernumerary teeth – extra teeth>alveolars, interdentals, lateral lisp
Ectopic teeth – erupt in abnormal position>alveolars, interdentals, lateral lisp
Rotated teeth – primary cleft palate>lateral lisp
Crowding – lateral lisp, frontal lisp
Crossbite – cleft lip & palate>sound distortions, frontal lisp, lateral lisp
Class III malocclusion
Open bite – from missing teeth, finger/pacifier sucking, skeletal deformities>frontal lisp of fricatives, affricates; lateral lisp of sibilants
Protruding premaxilla – B cleft lip & palate>distortion of sibilants, sub labiodentals for bilabials

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5
Q

What are some speech problems?

A

Misarticulation/distortion of sibilants (/s/, /z/, /sh/, /ch/, /j/), labiodentals (/f/, /v/), alveolars (/t/, /d/, /l/, /n/), bilabials (/p/, /b/, /m/)
Labioversion - Overjet=horizontal overlap of incisors (norm 2mm)
- Lip closure probs
- Bilabial sound distortion
Linguoversion – underjet=upper incisors lingual to lowers
- Distorts sibilants and alveolars
Teeth crowding/narrow maxillary arch/macroglossia
- Lateral lisp – if opening is in line with cleft (air flows around)
- Frontal lisp – if maxillary central incisors missing

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6
Q

ENT anomalies include:

A 
Ear
Nose
Face
Oral Cavity
Throat/upper airway
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7
Q

Ear anomalies include:

A

Microtia – small, deformed pinna>conductive hearing loss
Aural atresia – abnormal EAM & tympanic membrane>conductive hearing loss
Abnormal ossicle formation/fusion>conductive hearing loss
Otitis media – malfunction of E-tube> tympanic membrane rupture, conductive hearing loss
Otic capsule abnormal development/ossification >sensorineural hearing loss

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8
Q

Nose anomalies include:

A

External deformities
- Facial cleft
Abnormalities of nasal base
- Cleft lip
- Cleft palate
Internal derangement
- Deviated septum (cleft palate)>hyponasality, cul-de-sac resonance
- Septum deflects into cleft side of nose
- Pyriform aperture stenosis=narrowed nares from overgrown maxilla
- Choanal stenosis/atresia=narrowed/blocked choanae>cholic, death

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9
Q

Face anomalies include:

A

Maxilla

Facial nerve

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10
Q

oral cavity anomalies include:

A 
Lips 
Mouth
Tongue
Palate
Tonsils & adenoids
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11
Q

Throat/upper airway anomalies include:

A

Adenotonsillar/Adenoid/Tonsillar hypertrophy

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12
Q

What are language deficits that occur?

A

Developmental factors

  • IQ and brain structure-rate of acquisition of all dev’tl milestones
    • No difference in cleft and normal
    • Cleft palate + syndrome are at risk
  • Environmental stimulation-dev’t of lang skills in language-rich environment under age of 5
    • No difference in cleft and normal
  • Hearing-perception>acquisition of oral lang skills
    • Cleft palate-high risk chronic otitis media
  • Motivation-need & desire to learn skill; “motivation to talk”
    • Cleft tend to revert to gestures b/c difficulty with speech production
  • Attention-attend to environment
    • ADHD in 3-5% of children; most carniofacial syndromes + neuro at risk
  • A & P-vocal tract, processes (respiration, phonation, resonance, artic), neuro fxn
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13
Q

Language development in cleft

A 
Language dev’t & learning
  - Early deficits in cognitive dev’t
  - Prelanguage skills
  - Lower expressive language
  - Common in syndromes
Phonological/Articulation dev’t
  - Disrupted tactile-kinesthetic-auditory feedback loop
  - Less vocalization
  - Predominant nasals for orals; glottals for plosives
  - Habitual compensatory productions
  - Age of palate repair is factor
  - Apraxia co-occurrence is factor
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14
Q

What are psychosocial aspects of cleft?

A

Family issues
School issues
Society issues

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15
Q

Family issues include:

A
  • Initial shock & adjustment

- Cleft as chronic medical condition

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16
Q

School issues include:

A
  • Knowledge & expectation of teachers
    • Learning ability & performance
    • Social interaction
    • Teasing
    • Self-perception
17
Q

Society issues include:

A
  • Physical attractiveness
    • Speech quality
    • Hearing impairment
    • Stigma
    • Behavioral issues

Cleft Palate (6 decks)

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