Intro 2 Comm Ch. 9

Front 1

Cleft

Back 1

areopenings that pass through one or more structures that are normally closed

Front 2

Hard Palate

Back 2

fused of two bones

Front 3

Velum

Back 3

Thevelum hangs down in the back of the oral cavity at the juncture of theoropharynx and the nasopharynx.

Front 4

Types of Cleft

Back 4

-Unilateral

-Bilateral

-Complete

-Incomplete

-Submucous Cleft

-Congenital Palatopharyngeal Incomplete

Front 5

Unilateral Cleft

Back 5

onone side of the nose

Front 6

Bilateral Cleft

Back 6

on both sides of the nose

Front 7

Complete Cleft

Back 7

-the two palatal shelves aretotally separated.

Front 8

Incomplete Cleft

Back 8

-the shelves are partially fused.

Front 9

Submucous Cleft

Back 9

the palate appears normal becausethe tissue covering the palate hides a cleft of the hard palate, the softpalate, or both.

Front 10

Congenital Palatopharyngeal Incomplete

Back 10

no cleft of any kind
-A condition in which the velopharyngealmechanism is not adequate to achieve velopharyngeal closure because:
-Thenasopharynx is too deep,
-or the hard palate is too short.
-Musclesare of adequate bulk but still do not function to close the velopharyngealport.

Front 11

Craniofacial Anomalies

Back 11

abnormalities of the skull and face;
-facial clefts are a part ofthese anomalies.

Front 12

Nasal Emissions

Back 12

-friction noise created by the stream of air rushing out of the nasal passage.

Front 13

Feeding/Swallowing Problems associated with Clefts

Back 13

-inadequate velopharyngeal mechanism, the opening in the hard palate, and a deformed upper lip create feeding problems.

-food and fluids enter nasal cavity.

-proper instructed, mothers are able to handle the feeding problems by careful and patient feeding.

Front 14

Hearing Impairment Problems associated with Clefts

Back 14

-Children suffer from otitis media (middle ear disease)

-fluctuating mild to moderate hearing problem known as conductive hearing loss, cause language delay and speech problems.

Front 15

Dental Problems associated with Clefts

Back 15

Children with clefts of the alveolar ridge have more dental problems than do children with cleft of the hard and soft palates.

-most common abnormalities include malocclusion, insufficient growth of the teeth and the gum tissue (hypoplasia), cross bite, protruding premaxilla in case of bilateral cleft, and the growth of extra teeth.

Front 16

Language Problems associated with Clefts

Back 16

-slow acquisition of language

-smaller and less varied vocabulary

-shorter and simpler sentences

-limited spontaneous speech

-delayed answers to questions

-grammatical errors

Front 17

Articulation Problems associated with Clefts

Back 17

-distorted speech sounds

-omission of speech sounds

-substitution of speech sounds

-nasal emission

-Achild’s (or an adult’s) attempt to produce speech sounds in unusual ways(because of an organic defect) is called compensatory articulation.

Front 18

Pharyngeal flap Surgery

Back 18

-secondary operation may be necessary for children with wide and complete clefts.

-who still have an inadequate velopharyngeal mechanism.

-In this procedure, a muscular flap is raised from the back wall of the throat and attached to the velum. The flap helps close the velopharyngeal port

Front 19

Pharyngoplasty Surgery

Back 19

-changes the shape of the velopharyngeal space

-surgeon makes incisions along each side of the throat in order to create two flaps of tissue.

-pulled up and attached to the sides and back of the throat.

-permanent ring of tissue that lines the walls of the upper throat and makes the velopharyngeal space smaller creates two holes near the sides of the throat for air to pass through, sphincter pharyngoplasty creates one hole in the middle of the throat surrounded by the new ridge of tissue. As the soft palate elevates during speech, it will make contact with this ridge to close the smaller velopharyngeal space. This procedure tends to work best for patients who have good soft palate movement and poor movement of the side walls of the upper throat.

Front 20

Cleft Palate Team

Back 20

-Agroup of specialists,plan and implement a treatment and rehabilitative program

-plasticsurgeon

-speech–languagepathologist

-dentist

-orthodontist

-otologist(medically trained ear specialist)

-audiologist

-psychologist

-pediatrician

-socialworker

-educationalspecialists

Front 21

Treatment of Language Disorder

Back 21

Slight delays in language, corrected by home language stimulation programs the parents conduct.

-formal treatment, SLP uses language structures the child is not able to produce, including words, phrases, sentences, and aspects of syntax and morphological elements, are trained with standard procedures

Front 22

Treatment of Articulation Disorder

Back 22

directing the flow of air out of the mouth instead of the nose

-producing speech with less force making gentle contact of articulators

-opening the mouth wider during speech production

-help reduce nasal resonance

-treating the articulation disorders of the child with a cleft are not different from those described in Chapter 5.

-maximum visual and auditory cues to the child,

-teaches the sounds that are produced in the front of the mouth (e.g., /p/ and/b/) and then those produced in the back of the mouth (/k/ and /g/). In gradual steps, the training is shifted to more complex levels, including words,phrases, sentences, and conversational speech.

Front 23

Treatment of Voice and Resonance Problems

Back 23

-socially appropriate loudness and relaxed speech are targeted

-to compensate for the inadequate velopharyngeal mechanism.

-talk too softly or with excessive muscular effort to close the velopharyngealport.

Front 24

Treatment of Hypernasality Problems

Back 24

-clinician develops practice trials starting with the least nasal sounds and moving on to the most nasal sounds.The sounds are eventually produced in words and phrases. -Biofeedback instruments, such as the Nasometer, maybe used in treatment.