Speech therapy for compensatory articulations and velopharyngeal function: a case report
The objective of this study was to describe the process of intensive speech therapy for a 6-year-old child using compensatory articulations while presenting with velopharyngeal insufficiency (VPI) and a history of cleft lip and palate. The correction of VPI was temporarily done with a pharyngeal obt...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
University of São Paulo
2011-12-01
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| Series: | Journal of Applied Oral Science |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-77572011000600023 |
| _version_ | 1818173888493780992 |
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| author | Nachale Helen Maciel Bispo Melina Evangelista Whitaker Homero Carneiro Aferri Josiane Denardi Alves Neves Jeniffer de Cássia Rillo Dutka Maria Inês Pegoraro-Krook |
| author_facet | Nachale Helen Maciel Bispo Melina Evangelista Whitaker Homero Carneiro Aferri Josiane Denardi Alves Neves Jeniffer de Cássia Rillo Dutka Maria Inês Pegoraro-Krook |
| author_sort | Nachale Helen Maciel Bispo |
| collection | DOAJ |
| description | The objective of this study was to describe the process of intensive speech therapy for a 6-year-old child using compensatory articulations while presenting with velopharyngeal insufficiency (VPI) and a history of cleft lip and palate. The correction of VPI was temporarily done with a pharyngeal obturator since the child presented with very little movement of the pharyngeal walls during speech, compromising the outcome of a possible pharyngeal flap procedure (pharyngoplasty). The program of intensive speech therapy involved 3 phases, each for duration of 2 weeks incorporating 2 daily sessions of 50 minutes of therapy. A total of 60 sessions of intervention were done with the initial goal of eliminating the use of compensatory articulations. Evaluation before the program indicated the use of co-productions (coarticulations) of voiceless plosive and fricative sounds with glottal stops (simultaneous production of 2 places of productions), along with weak intraoral pressure and hypernasality, all compromising speech intelligibility. To address place of articulation, strategies to increase intraoral air pressure were used along with visual, auditory and tactile feedback, emphasizing the therapy target and the air pressure and airflow during plosive and fricative sound productions. After the first two phases of the program, oral place of articulation of the targets were achieved consistently. During the third phase, velopharyngeal closure during speech was systematically addressed using a bulb reduction program with the objective of achieving velopharyngeal closure during speech consistently. After the intensive speech therapy program involving the use of a pharyngeal obturator, we observed absence of hypernasality and compensatory articulation with improved speech intelligibility. |
| first_indexed | 2024-12-11T19:35:40Z |
| format | Article |
| id | doaj.art-f7aa786337564308bd7e04b41bdbfdac |
| institution | Directory Open Access Journal |
| issn | 1678-7757 1678-7765 |
| language | English |
| last_indexed | 2024-12-11T19:35:40Z |
| publishDate | 2011-12-01 |
| publisher | University of São Paulo |
| record_format | Article |
| series | Journal of Applied Oral Science |
| spelling | doaj.art-f7aa786337564308bd7e04b41bdbfdac2022-12-22T00:53:10ZengUniversity of São PauloJournal of Applied Oral Science1678-77571678-77652011-12-0119667968410.1590/S1678-77572011000600023Speech therapy for compensatory articulations and velopharyngeal function: a case reportNachale Helen Maciel BispoMelina Evangelista WhitakerHomero Carneiro AferriJosiane Denardi Alves NevesJeniffer de Cássia Rillo DutkaMaria Inês Pegoraro-KrookThe objective of this study was to describe the process of intensive speech therapy for a 6-year-old child using compensatory articulations while presenting with velopharyngeal insufficiency (VPI) and a history of cleft lip and palate. The correction of VPI was temporarily done with a pharyngeal obturator since the child presented with very little movement of the pharyngeal walls during speech, compromising the outcome of a possible pharyngeal flap procedure (pharyngoplasty). The program of intensive speech therapy involved 3 phases, each for duration of 2 weeks incorporating 2 daily sessions of 50 minutes of therapy. A total of 60 sessions of intervention were done with the initial goal of eliminating the use of compensatory articulations. Evaluation before the program indicated the use of co-productions (coarticulations) of voiceless plosive and fricative sounds with glottal stops (simultaneous production of 2 places of productions), along with weak intraoral pressure and hypernasality, all compromising speech intelligibility. To address place of articulation, strategies to increase intraoral air pressure were used along with visual, auditory and tactile feedback, emphasizing the therapy target and the air pressure and airflow during plosive and fricative sound productions. After the first two phases of the program, oral place of articulation of the targets were achieved consistently. During the third phase, velopharyngeal closure during speech was systematically addressed using a bulb reduction program with the objective of achieving velopharyngeal closure during speech consistently. After the intensive speech therapy program involving the use of a pharyngeal obturator, we observed absence of hypernasality and compensatory articulation with improved speech intelligibility.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-77572011000600023Cleft palateChildrenSpeech bulbSpeech therapy |
| spellingShingle | Nachale Helen Maciel Bispo Melina Evangelista Whitaker Homero Carneiro Aferri Josiane Denardi Alves Neves Jeniffer de Cássia Rillo Dutka Maria Inês Pegoraro-Krook Speech therapy for compensatory articulations and velopharyngeal function: a case report Journal of Applied Oral Science Cleft palate Children Speech bulb Speech therapy |
| title | Speech therapy for compensatory articulations and velopharyngeal function: a case report |
| title_full | Speech therapy for compensatory articulations and velopharyngeal function: a case report |
| title_fullStr | Speech therapy for compensatory articulations and velopharyngeal function: a case report |
| title_full_unstemmed | Speech therapy for compensatory articulations and velopharyngeal function: a case report |
| title_short | Speech therapy for compensatory articulations and velopharyngeal function: a case report |
| title_sort | speech therapy for compensatory articulations and velopharyngeal function a case report |
| topic | Cleft palate Children Speech bulb Speech therapy |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-77572011000600023 |
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