SLPs who see a few children with craniofacial conditions and SLPs who are new to the craniofacial team will be well-prepared to assess and treat such children with this comprehensive resource!
- Effectively assess the speech problems exhibited by children with cleft palate and/or craniofacial anomalies
- Eliminate compensatory articulation errors with phonetically-controlled stimuli
- Reduce the symptoms of velopharyngeal dysfunction and improve intelligibility
- the unique speech needs of infants and children with cleft palate and/or craniofacial anomalies
- what speech skills to address at each stage of development
- how to prevent faulty learning of compensatory errors of speech
- how to differentiate speech symptoms due to physical limitations from speech symptoms due to learned patterns (which require speech therapy)
- how to treat compensatory errors of speech with a step-by-step, phonetically-controlled approach
- how to manage and reduce the symptoms of velopharyngeal dysfunction
- The Cleft Palate and Craniofacial Speech Assessment (CPCSA) consisting of:
- Articulation Screening (for compensatory errors of speech)
- Cleft Palate and Craniofacial Case History
- Oral Peripheral Evaluation
- Velopharyngeal Functioning Scale
- Auditory-Perceptual Evaluation
- 79 pages of pictures and scenes with phonetically-controlled stimuli to eliminate compensatory errors of speech
- 19 pages of pictures and scenes with phonetically-controlled stimuli to improve intelligibility by reducing symptoms of velopharyngeal dysfunction
- 18 pages of word, phrase, and sentence lists for the treatment of compensatory errors of speech
- 6 pages of word, phrase, and sentence lists for the management of velopharyngeal functioning
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- Management of patients with craniofacial anomalies is best provided by an interdisciplinary team of specialists (including speech-language pathologists, plastic surgeons, orthodontists, maxillofacial surgeons, audiologists, otolaryngologists, dentists, geneticists, pediatricians, nurses, nutritionists, audiologists, social workers) to comprehensively monitor the child's development through facial growth maturity (ACPA, 2007b).
- The speech-language pathologist works within the framework of an interdisciplinary cleft palate team, extending its network into the community (Taylor-Goh, 2005).
- Cleft palate and craniofacial disorders may adversely affect normal resonance and speech, and/or typical language development (Peterson-Falzone, Trost-Cardamone, Karnell, & Hardin-Jones, 2006).
- Assessing characteristics of cleft palate and/or craniofacial speech involves evaluating nasality and nasal air emissions, resonance, compensatory articulations, and obligatory articulations (ACPA, 2007a).
- The perceptual assessment of speech is the gold standard and has a central position in the assessmentof velopharyngeal dysfunction (Taylor-Goh, 2005).
- Speech characteristics are typically evaluated through a combination of auditory-perceptual, aero-dynamic, and instrumental measures to accurately describe and quantify the child's resonance and speech (ACPA, 2007a).
- If compensatory errors of speech are habituated and/or imbedded into the child's phonological system, the errors may persist after initial palate surgery, and intensive speech therapy is warranted (Peterson-Falzone, Trost-Cardamone, Karnell, & Hardin-Jones, 2006).
- Dysfunction of the velopharyngeal valving mechanism can be the result of compensatory articulation errors, and improvement in the velopharyngeal valving can occur through speech therapy aimed at elimination of compensatory articulation errors (Hoch, Golding-Kushner, Siegel-Sadewitz, & Shprintzen, 1986).
- Treatment includes remediating compensatory errors using a multi-sensory (visual, tactile, auditory) articulation approach, not an oral-motor approach (which is ineffective in treating velopharyngeal dysfunction or compensatory errors of speech) (Taylor-Goh, 2005; Lass & Pannbacker, 2008).
- Blowing exercises and oral-motor therapy are not useful in treating velopharyngeal dysfunction. (ACPA, 2007a).
The Source for Cleft Palate and Craniofacial Speech Disorders incorporates these principles and is also based on expert professional practice.
American Cleft Palate-Craniofacial Association (ACPA). (2007a). Core curriculum for cleft palate and other craniofacial anomalies. Retrieved September 11, 2009, from http://www.acpa-cpf.org/educMeetings/CoreCur/index.html
American Cleft Palate-Craniofacial Association (ACPA). (2007b). Parameters for evaluation and treatment of patients with cleft lip/palate or other craniofacial anomalies. Retrieved September 11, 2009, from www.acpa-cpf.org/teamcare/Parameters07rev.pdf
Hoch, L., Golding-Kushner, K., Siegel-Sadewitz, V.L., & Shprintzen, R.J. (1986). Speech therapy. Seminars in Speech Language, 7, 313-325.
Lass, N.J., & Pannbacker, M. (2008). The application of evidence-based practice to nonspeech oral motor treatments. Language, Speech, and Hearing Services in Schools, 39(3), 408-421.
Peterson-Falzone, S.J., Trost-Cardamone, J., Karnell, M.P., & Hardin-Jones, M.A. (2006). The clinician's guide to treating cleft palate speech. St. Louis, MO: Mosby.
Taylor-Goh, S. (2005). Royal college of speech and language therapists: Clinical guidelines. United Kingdom: Speechmark.