Lecture 5: Developmental Deficits Flashcards Preview

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Flashcards in Lecture 5: Developmental Deficits Deck (17)
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1

What are some Anomalies?

Dental
ENT
Language
Cognition
Psychosocial

2

What makes up Normal Dentition?

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

3

Types of occlusions/malocclusions

- 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

4

What are dental anomalies with clefts?

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

5

What are some speech problems?

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

6

ENT anomalies include:

Ear
Nose
Face
Oral Cavity
Throat/upper airway

7

Ear anomalies include:

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

8

Nose anomalies include:

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

9

Face anomalies include:

Maxilla
Facial nerve

10

oral cavity anomalies include:

Lips
Mouth
Tongue
Palate
Tonsils & adenoids

11

Throat/upper airway anomalies include:

Adenotonsillar/Adenoid/Tonsillar hypertrophy

12

What are language deficits that occur?

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

13

Language development in cleft

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

14

What are psychosocial aspects of cleft?

Family issues
School issues
Society issues

15

Family issues include:

- Initial shock & adjustment
- Cleft as chronic medical condition

16

School issues include:

- Knowledge & expectation of teachers
- Learning ability & performance
- Social interaction
- Teasing
- Self-perception

17

Society issues include:

- Physical attractiveness
- Speech quality
- Hearing impairment
- Stigma
- Behavioral issues