June 25 Slides Flashcards
Name an evaluation used for clinical diagnosis.
low-tech perceptual speech evaluation
What 2 questions you should ask yourself when administering a low tech perceptual speech evaluation?
What can be treated medically? What can be treated therapeutically?
What does the evaluate of perceptual characteristics of speech tell you about the evaluation?
informs you about every other aspect of the evaluation
Is it enough to notice hypernasality in a low tech perceptual speech evaluation?
NO
What are 2 reasons why it is it NOT enough to notice hypernasality in a low tech perceptual speech evaluation?
- There are some speech characteristics which can trick your ear into thinking a velopharyngeal problem is present, when in fact the velopharynx is normal.
- There are some speech characteristics which can make velopharyngeal function sound worse than it is.
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?
During the perceptual speech exam
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?
inappropriate care
True or False: The velopharynx is an articulator.
TRUE
What CAN happen to the velopharynx when an articulation disorder is present.
the velopharynx CAN behave in a disordered way
What can disordered articulation involving the velpharynz sound like?
velopharyngeal dysfunction
It is important to rule out true velopharyngeal dysfunction from what?
an articulation disorder
What should a perceptual speech assessment always include?
careful assessment of articulation
What needs to be determined for further instrumental assessment if it is needed.
Readiness: child is as prepared as possible via therapy prior to imaging
Should you treat an articulation disorder with surgery.
NEVER!!!!!
Before low tech perceptual speech evaluation is given, what 2 subjects do we need to know about?
- nasal consonants
2. oral production
What do we need to know about nasal consonants prior to giving the low tech speech perception examination?
- [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
What do we need to know about oral productions prior to giving the low tech speech perception examination?
- 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
List the 4 articulation error types.
- Developmental
- Adaptive
- Obligatory
- Compensatory/Maladaptive
Describe developmental error.
- May not necessarily be related to the cleft
* Will respond to the same treatment as non-cleft children on your caseload
Describe adaptive error.
- Difference in production caused by structural difference
- May be acoustically appropriate
- Examples: [p,b,m] with macroglossia – [f,v] with anterior crossbite
Describe an obligatory error.
- 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
How can I tell if a distortion is obligatory, caused by dental malocclusion?
Diagnostic therapy
How can I tell if a distortion is obligatory, due to velopharyngeal dysfunction?
plug the nose
Describe compensatory/maladaptive (active) error.
- 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.
