Assessment of Speech and Resonance Disorders/ Cleft Lip and Palate Care

Birth to 3

A language or feedinf eval whenever problems are suspected

Ages 3-4

A comprehensive speech, resonance, VP function eval

Annually

Screening eval of speech/resonance until around puberty (after adenoid involution)

After puberty to 18

Screening evaluation at least every 2 years until dental and orthognathic tx is completed

BEFORE 3 years old we focus on ______ _______ _______.

QUANTITY of Language

AFTER 3 years old we focus on ______ ________ _______.

QUALITY of Language

Why wait until 3-4 for assessment of speech/resonance/VP function?

The child needs to have connected speech abilities and longer conversations in order to assess these areas.

Assessement areas

- Diagnostic interview (present concern, medical history, developmental history, feeding skills)

- Language screening (informal if child is meeting expectations of age, or go standardized if not)

- Intra-oral Exam (evaluate oral structures and function - /ae/ as in "hat" and look in mouth)

- Oral motor dysfunction (apraxia, DDK, multisyllabic phrases)

- Voice phonation assessment (Listen for dysphonia, sustain phonation for 10 secs)

- Speech assessment (prolongation, repeition, counting, connected speech, stimulability testing)

To test for hypernasality

- Vowels: low vowels/a/ and high vowel /i/ (Voice consonants or vowels)

- Sentence repetition

- Connected speech is more obvious to detect

To test for nasal emission

- Prolonged /s/ (voicless consonant)

- Counting 60-70, 60-66

- sentence repetition

- Connected speech is more obvious to detect

To test for hyponasality, cul-de-sac resonance, or airway obstruction

- Prolong nasal (/m/, /n/)

- Syllable reps: nasal consonants with high and low vowel "ma ma ma, na na na, mi mi mi, ni ni ni

- Counting 90-99, or 99 over and over

- sentence repetition

Why is connected speech the best sample for evaluating artic and resonance?

It's more natural and VPI port demand is higher, so easier to view if the port is working correctly.

Nasometry normative data: Bilabial plosives

Score: 12

M = 11

SD = 5

Nasometry normative data: Lingual-Alveolar plosives

Score: 11

M = 11

SD = 5

Nasometry normative data: Velar Plosives

Score: 12

M = 13

SD = 6

Nasometry normative data: Sibilant fricatives

Score: 14

M = 12

SD = 15

Nasometry normative data: Nasals

Score: 54

M = 54

SD = 9

Visual detection example (SEE IT)

Mirror

Tactile detection example (FEEL IT)

Feel sides of nose (vibration will be felt on nasal sides)

auditory detection example (HEAR IT)

- Cul-de-sac test (hold nose and see if quality of sounds change)

- Listening tube, oral and Nasal listener, and straw