Cleft Palate and Voice Disorders Study Guide

Fluency

Effortless, rhythmical, evenly flowing speech.

Voice

Sound produced by vocal folds.

Cleft Palate

Congenital split in the roof of the mouth.

Oral-Facial Cleft Stats

1 in 750 live births among European Americans.

• fourth most frequent birth defect

• 50% have clefts on both the lip and palate

• 25% of affected individuals have clefts involving either one side (unilateral) or both sides (bilateral) of the lip

• 25% of affected individuals have clefts of the palate only

• 50% have clefts on both the lip and palate

Pitch

Perceived highness or lowness of a voice.

Loudness

Perceived strength of a sound, from quiet to loud

Disfluency

Speech marked by phrase repetitions, interjections, pauses, and revisions

Atypical Disfluencies

Single syllable, syllable, or sound repetitions.

Quality

Sound characteristics of a person's voice, which is a combination of the long-term characteristics of their speech patterns and the auditory coloring of their voice

Palate Development

Formation of the palate between 6-9 weeks.

• the premaxilla (housing for 4 front teeth) joins with the palatine processes, which then fuse with each other front to back to form the palate

Types of Cleft Lip

Partial/incomplete: no alveolar ridge involvement

complete: alveolar ridge involved

Types of Cleft Palate

Complete cleft: affects the hard and soft palate

incomplete cleft: affects only the soft palate

submucous: notch in the hard palate

occult clefts: malformation of palatal musculature

Voice Quality Characteristics

1. Breathy: sound of air is apparent

2. strained: effort apparent

3. harsh: excessive muscle tension

4. tough: uneven, harsh

5. aphonia: loss of voice

6. dysphonia: voice disorder

Surgical Care Timeline

cleft Lip repaired by 3 months; cleft palate by 12 months.

Prolongations

Holding a sound longer than normal.

Voice Disorder Causes

edema: vocal folds tissues swollen

atrophy: reduction in tissue

hyperfunction: increased muscle

hypofunction: decrease in muslcle activity

abuse/misuse: screaming, excessive use

medical: nervous system damage, cancer, virus

psychogenic: emotional stress, unresolved psychological issues

Stuttering

Most common form of fluency impairment.

Contact Ulcers

Ulcers on vocal processes of arytenoid cartilages.

Papillomas

Wart-like growths from human papilloma virus.

Nodules

Most common vocal fold abnormality.

Secondary Behaviors

Counterproductive actions to avoid stuttering.

Assessment Team

Includes SLPs, surgeons, and dentists.

Psychological Stuttering

Stuttering related to psychological factors.

Acquired Stuttering

Neurogenic stuttering due to brain injury.

Developmental Stuttering

Common speech fluency issue in children.

Voice Problems

Affects 20% of patients with voice issues.

Neurologist

Specialist involved in voice problem assessment.

Prosthodontist

Dental specialist who may assist with voice issues.

Vocal Fold Abuse

Can lead to voice disorders over time.

Speech-Language Pathologist (SLP)

Provides intensive therapy post-surgery for voice issues.

Polyps

Softer, pliable growths on vocal folds.

Voice Quality

Describes breathy or hoarse vocal characteristics.

Carcinoma

Cancer affecting the larynx.

Stuttering Incidence

Percentage of people who stuttered in life.

Cluttering

Rapid, unintelligible bursts of speech.

Spasmodic Dysphonia

Voice disorder from basal ganglia disturbances.

Adductor SD

Most common type, causes strain-strangle voice.

Abductor SD

Involves inappropriate contraction of abductor muscles.

Mixed SD

Least common spasmodic dysphonia type.

Aphonia

Total loss of voice without organic cause.

Dysphonia

Abnormal voice quality without identifiable cause.

Assessment Process

Includes case history and speech sample evaluation.

MIDVAS

Stuttering modification process: motivation to stabilization.

Fluency Shaping

Aims for stutter-free speech through controlled techniques.

GILCU

Gradual increase in utterance length and complexity.

Voice Therapy

Tailored to specific voice disorder types.

Listener Responsibilities

Guidelines for interacting with individuals who stutter.

Disfluency Count

Measurement of speech interruptions during assessment.

Eye Blinks

Non-verbal cues that may accompany speech issues.

Laryngeal Removal

May require alternative voice sources post-surgery.