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32 Cards in this Set
- Front
- Back
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3 categories of neurological impairment
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1) Isolated- congenital suprabulbar paresis
2) Dysarthria- flaccid, spastic, ataxic, hypokinetic 3) Apraxia- motor programming |
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Ways to measure air pressure
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Oral: place sensing catheter in mouth and connect to pressure transducer; avg is 3-8 cm of water for non-nansal consonants
Nasal: place nasal olive in nose and connect to pressure transducer |
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5 factors necessary for successful examination
(Sphrintzen's 5) |
1) compliance
2) as much visual field as possible 3) good light 4) good optical quality 5) wide cone acceptance |
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What work did Subtelni and Subtelni do?
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Normed palatal growth and development so we have some frame of reference
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The Osborn Study
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Found a higher percentage of cervical spinal defects in submucous clefts and non cleft VPI
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Reasons cervical spine defects may contribute to/cause VPI
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1) lateral dimension of pharynx may be wider
2) cervical spine anomalies cause decreased motion of the neck 3) may have flattened cranial base 4) may have short, hard palate |
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Nasometer
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used to obtain objective acoustic measurements that correlate with perception of hypernasal resonance
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Nasometer: pros and cons
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PROS: objective, easy to set uo, easy to interpret, non invasice
CONS: variables may change interpretation, can't differentiate b/n nasal emission and hypernasality, does not respond to suprasegmentals |
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Accelerometers
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sensitive to vibrations; placed on naris and layrnx to study sound energy
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Spectography
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Provides visual display of changes in frequency and intensity of speech over time
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Videoflouroscopy: pros and cons
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PROS: shows motion of structures, not invasive, can use any speech sample, easy with children
CONS: difficult to get a good judgent of lateral wall movement, measurements are NOT absolute, only 2-D |
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Lateral Cephalometric X-ray: pros
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Gives you absolute measurements to plot growth, is easy to use, not expensive, gives you the clearest image, is good to evaluate structural relationships
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Lateral Cephalometric X-ray: cons
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only 2-D, is static: only gives you one instant in time, can only use limited speech sample, has a high error rate so can't be used for diagnosis
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Lateral Cephalometric X-ray: measures
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1) palatal length
2) pharyngeal depth 3) need ratio: avg=66% 4) velar gap 5) velar height 6) velar contact |
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Types of abnormal VP function
(4) |
1) hyponasality
2) hypernasality 3) audible nasal emission 4) reduced aspiration and frication |
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Direct techniques
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Subjective and primary; look at structure and movement, requires judgement from clinician
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Indirect assessment techniques
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Objective and secondary; provides data used to make inferences about VP movement
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Etiologies of VPI (3)
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1) neurological impairments
2) craniofacial anomoalies 3) related to disease process |
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Phone specific nasal emission
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only occurs on some phonemes, most commonly /s,z/; usually responds to therapy
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Possibilities for mechanical obstruction in non-cleft VPI
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1) tonsillar tissue
2) irregularly shaped adenoid pads 3) irregularly shaped faucillar pillars 4) lack of movement |
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How does speech development in children with clefting compare to those without?
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- they vocalize less
- they produce fewer consonants - they produce more nasals, glides, and glottal fricatives - often use backing - often nasalize consonants |
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Language
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only recently has language been assessed;
-poorer receptive and expressive skills -smaller MLU -fewer expressive language structures |
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Cul-de-Sac resonance
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variation of hyponasality; blind passage with only one outlet for air so speech is muffled
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Are most compensatory articulation produced anterior or posterior to VP port?
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posterior. they can be anterior but these are most likely "learned" errors
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Study findings on articulation errors
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variable (of course) but most agree that scores on articulation are BELOW that of matched peer group
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Dalston's study
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- children 4-5.11 and adolescents 14-15.11
- 75% of younger kids had some type of comm. disorder - 25% of older kids had some type of comm. disorder |
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Peterson-Falzone's study
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- children 4-10.11
- 95% of younger children had artic errors - only 3% had normal artic - excluded pts who had secondary sx |
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What structural factors can cause VPI?
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- Palate is too short
- Pharynx is too deep |
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What functional factors can cause VPI?
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- Palate does not move
- lateral walls don't move - posterior wall doesn't move |
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What is the most common compesatory articulation?
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Glottal stops followed by mid-dorsum palatal stops
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Aside from structural and functional problems, what other factor can cause VPI?
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Timing of structural movement
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What sounds are glottal stops most often subbed for?
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oral stops: p, b, t, d, k, g
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