Treating Children With Cleft Palate: Case Examples

2019 ◽  
Vol 4 (1) ◽  
pp. 130-139
Author(s):  
Kristina Wilson ◽  
Angela J. Dixon
Keyword(s):  
Cleft Palate ◽  
Speech Disorders ◽  
Speech Development ◽  
Specialty Training ◽  
Treatment Approaches ◽  
Case Examples ◽  
Cleft Palate Speech ◽  
Similarities And Differences ◽  
Study Format

Purpose Treatment of a child with cleft palate is often complex and requires collaboration between treating speech-language pathologists (SLPs) and members of the cleft palate team. This article uses a case study format to facilitate discussion between 2 SLPs with specialty training in cleft palate speech disorders. The purpose of this article is to use a case study and response approach to facilitate a conversation that explores challenges faced and differing treatment approaches to reach the same goal of typical speech development for a child with cleft palate. Conclusion The discussion between the treating SLP and the responding SLP provides examples of meeting comparable goals in different ways, highlighting similarities and differences in treatment approaches, while encouraging continued conversations and community among cleft palate speech specialists.

scholarly journals Effect of Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT) on Compensatory Articulation in Children With Cleft Palate/Lip

2019 ◽  
Vol 6 ◽  
pp. 2333794X1985141 ◽  
Author(s):  
Raúl Herreras Mercado ◽  
Kenneth Simpson ◽  
Kristen H. Bellom-Rohrbacher
Keyword(s):  
Cleft Palate ◽  
Speech Intelligibility ◽  
Cleft Lip ◽  
Sound Production ◽  
Cleft Lip And Palate ◽  
Speech Disorders ◽  
Outpatient Rehabilitation ◽  
Single Subject ◽  
Positive Effects ◽  
Cleft Palate Speech

Objective. This investigation researched the effectiveness of the PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) method to address compensatory articulation errors in children with cleft palate. Design. Single-subject AB multiple baselines across participants and behaviors. Setting. Pediatric outpatient rehabilitation department in a local hospital in a metropolitan city. Participants. The investigation consisted of 3 participants (ages = 4:4 to 12:8) born with bilateral complete cleft lip and palate. All participants underwent several reconstructive surgeries to repair their lips and palates. Interventions. The PROMPT treatment was provided for 45 minutes 3 times a week for 4 weeks (3 weeks for Participant 2). Main Outcome Measure. Therapy sessions addressed anterior lingual speech motor phonemes across 3 tiers (syllables, words, and phrases). Results. Direct visual observation of data obtained throughout this investigation indicate potential positive effects and significant correlation between improvements in sound production at 3 tiers and the implementation of the PROMPT technique. Speech intelligibility was judged by 3 blinded listeners who were unfamiliar with children with speech disorders or with cleft palate speech. All listeners identified and judged improvement in overall speech intelligibility over the course of this investigation. Listeners examined speech samples selected from sessions 3, 6, 9, and 12. Conclusion. The findings in this investigation provide a potential relationship on the effectiveness of the PROMPT method and attainment of accurate speech productions in children with cleft palate producing compensatory articulation errors, resulting in improvement in overall speech intelligibility.

Facilitating Communication among Speech Pathologists Treating Children with Cleft Palate

2005 ◽  
Vol 42 (6) ◽  
pp. 585-588 ◽  
Author(s):  
Michael P. Karnell ◽  
Philip Bailey ◽  
Lynn Johnson ◽  
Ariel Dragan ◽  
John W. Canady
Keyword(s):  
Cleft Palate ◽  
Speech Therapy ◽  
Speech Disorders ◽  
Craniofacial Anomalies ◽  
Web Based ◽  
Video Clips ◽  
Cleft Palate Speech ◽  
Speech Pathologists ◽  
Web Based System

An interactive web-based system was designed to facilitate communication between nonspecialist speech pathologists who provide therapy for individuals with speech disorders associated with cleft palate or craniofacial anomalies and specialist speech pathologists who provide physiologically based assessments of speech production. The web site includes instructional presentations, streaming video clips of endoscopic examinations, and exchange of information about the nature of therapy as recommended by the specialist and as provided by the nonspecialist. The approach demonstrates use of web-based computer facilities to improve the quality of communication among professionals with the goal of improving the outcomes of speech therapy. Information from the site can also be used in academic training programs as a teaching tool in courses on cleft palate speech.

English-Only Treatment of Compensatory Speech Errors in a Bilingual Adoptee With Repaired Cleft Palate: A Descriptive Case Study

2021 ◽  
pp. 1-15
Author(s):  
Eshan Pua Schleif ◽  
Kazlin Mason ◽  
Jamie L. Perry
Keyword(s):  
Second Language ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Speech Errors ◽  
Descriptive Case Study ◽  
Therapy Approach ◽  
Cleft Palate Speech ◽  
English Second Language

Purpose The purpose of this clinical focus article is to provide a descriptive case study of a late-adopted, bilingual adolescent with cleft palate speech errors. Specifically, we examined the cross-linguistic generalization of remediated compensatory cleft errors, following treatment in English (second language) only. The overarching goal of this study is to gain insights into the complexity of speech intervention for the adopted population with delayed cleft palate repair. Method A 14-year-old female adopted from China with a repaired unilateral cleft lip and palate and maladaptive articulation errors underwent 55 one-hour sessions of a motor-based, speech therapy approach over a 15-month span, targeting English phonemes only. Pre-, mid-, and posttreatment evaluation included perceptual and instrumental assessment of speech and resonance. Outcome measures at each time point included perceptual speech and resonance ratings, nasometry scores, and percent consonants correct (PCC) in both English and Mandarin. Results PCC in English improved from 60% in single words and 35% in sentences pretreatment to 100% in single words and sentences during posttreatment assessment. Without direct treatment in Mandarin, PCC in Mandarin improved from 56% in single words and 50% in sentences pretreatment to 100% in single words and 99% in sentences during posttreatment assessment. Posttreatment nasometry scores decreased by 20% for the nasal sample and 17% for the oral sample compared to pretreatment. Conclusions This descriptive case study demonstrated successful remediation of cleft palate speech errors, following 15 months of treatment in a late-adopted bilingual adolescent using a motor-based therapy approach. Treatment of errors in English (second language) led to generalization of correct productions in Mandarin (first language). This study presents the potential for bilingual late adoptees to achieve intelligible speech in both languages when motor-based therapy principles are applied to intervention.

scholarly journals Speech-aid prosthesis in velopharyngeal incompetency patient with cleft palate: can speech aids be applicable for adult patient?

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Dong-Cheol Kang ◽  
Jung-Ho Park ◽  
Hyun Seok ◽  
Jin-A Baek ◽  
Da-Wa Kim ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Speech Therapy ◽  
Combined Therapy ◽  
Speech Disorders ◽  
Adult Patients ◽  
Cleft Palate Speech ◽  
Articulation Disorder ◽  
Velopharyngeal Incompetence ◽  
Short Period ◽  
Reduction Program

Abstract Background Velopharyngeal incompetence (VPI) therapy for cleft palate (speech therapy alone, speech therapy using speech aids, or combined therapy such as speech therapy using a pharyngeal flap), is more effective in younger patients than in adult patients. Speech therapy is known as very difficult for patients who still have VPI as an adult. Because of the possibility of subsequent speech disorders, the timing of surgery for cleft palate is accelerating. Herein, we present a case of an adult with articulation disorder due to VPI who was treated by speech therapy and a speech-aid prosthesis. Case presentation A woman who underwent cleft palate surgery at 8 years of age still had difficulty with articulation due to VPI as a 24-year-old adult because of a lack of continuous speech therapy. We decided to use a speech-aid application using palatal lift, and a reduction program was conducted four times, along with simultaneous speech therapy, over a period of 1 year and 7 months. During the therapy period, she was able to speak normally within a relatively short period of time, and after implementation of the reduction program, the therapy was completed by completely removing the device. Long-term observations have shown normal speech function without recurrence, even after the device was removed. Conclusion As seen in this case, speech therapy using speech aids can show a good result for adult patients with cleft palate who missed the usual timing for the treatment of articulation disorders, depending on the situation. Therefore, it is hereby reported as a therapy option worthy of consideration.

Reliability of Outcome Measures to Assess Consonant Proficiency Following Cleft Palate Speech Intervention: The Percentage of Consonants Correct Metric and the Probe Scoring System

2021 ◽  
pp. 1-18
Author(s):  
Cassandra Alighieri ◽  
Kim Bettens ◽  
Laura Bruneel ◽  
Evelien D'haeseleer ◽  
Ellen Van Gaever ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Outcome Measures ◽  
Scoring System ◽  
Interrater Reliability ◽  
Phase 1 ◽  
Speech Disorders ◽  
Years Of Experience ◽  
Cleft Palate Speech ◽  
Data Points ◽  
Speech Intervention

Purpose This study compared the inter- and intrarater reliability of the percentage of consonants correct (PCC) metrics and the probe scoring system between an experienced and a less experienced rater and between two experienced raters. In addition, these outcome measures' ability to reflect changes following speech intervention was measured. Method During Phase 1, two raters (Rater 1 with 5 years of experience in cleft-related speech disorders and Rater 2 with limited experience in cleft-related speech disorders) independently assessed 134 speech samples at the word and sentence levels, which were collected on different data points before, during, and following a cleft palate speech intervention. During Phase 2, a third rater (with 8 years of experience) analyzed 34 speech samples. The percentage of consonants correct–revised, the percentage of correct places and manners, and probe scores at the word and sentence levels were measured. Results Poor-to-moderate interreliability between Raters 1 and 2 was found due to differences in error classification. Interrater reliability between Raters 1 and 3 was very good for both the PCC metrics and the probe scores. The interrater reliability for the amount of targets elicited was lower compared to the interrater reliability for the amount of targets correct. The probe scoring system demonstrated a greater ability to detect changes toward the correct production of the target consonant compared to the PCC metrics. Conclusions Having an experience with the assessment of cleft-related speech disorders is a crucial factor to gain reliable results. The interrater reliability for the PCC metrics and the probe scoring system between two experienced raters did not differ, suggesting that both outcome measures can be used in cleft palate speech intervention studies. Despite the ability of the probe scoring system to detect changes, further research should provide insight in the benefits of this system both for research and clinical purposes.

Classroom Teacher and Speech Clinician Severity Ratings of Different Speech Disorders

1975 ◽  
Vol 6 (3) ◽  
pp. 119-124 ◽  
Author(s):  
Robert T. Wertz ◽  
Michael D. Mead
Keyword(s):  
Public School ◽  
Cleft Palate ◽  
Classroom Teacher ◽  
First Grade ◽  
Speech Disorders ◽  
Third Grade ◽  
Second Grade ◽  
Classroom Teachers

Typical examples of four different speech disorders—voice, cleft palate, articulation, and stuttering—were ranked for severity by kindergarten, first-grade, second-grade, and third-grade teachers and by public school speech clinicians. Results indicated that classroom teachers, as a group, moderately agreed with speech clinicians regarding the severity of different speech disorders, and classroom teachers displayed significantly more agreement among themselves than did the speech clinicians.

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