Cleft Palate Speech

List of Contributors xi Preface xvii Part One Speech Production and Development 1 Sara Howard and Anette Lohmander 1 Physical Structure and Function and Speech Production Associated with Cleft Palate 5 Martin Atkinson and Sara Howard 1.1 Introduction 5 1.2 The Hard and Soft Palates and the Velopharynx 6 1.3 The Tonsils and Adenoids 9 1.4 The Larynx 11 1.5 The Jaws, Dentition and Occlusion 12 1.6 Symmetry: Structure and Function 15 1.7 The Tongue 16 1.8 The Lips 18 1.9 Summary: Compensations Across Systems 19 References 19 2 The Development of Speech in Children with Cleft Palate 23 Kathy L. Chapman and Elisabeth Willadsen 2.1 Overview 23 2.2 The Impact of Clefting on Speech Production 24 2.3 Variables Impacting Speech Development for Young Children with Cleft Palate 25 2.4 Speech Development: Birth to Age Five 26 2.5 Conclusion 35 References 36 3 The Influence of Related Conditions on Speech and Communication 41 Christina Persson and Lotta Sjögreen 3.1 Introduction 41 3.2 Conditions Related to Structural Etiologies 42 3.3 Conditions Related to Neurological Aetiology 47 3.4 Conditions Related to a Combination of Structural and Neurological Aetiology 49 3.5 Clinical Implications 50 References 50 4 Surgical Intervention and Speech Outcomes in Cleft Lip and Palate 55 Anette Lohmander 4.1 Introduction 55 4.2 Basics of Surgery on Cleft Palate 57 4.3 Basics of Outcomes 64 4.4 Speech Outcomes 65 4.5 Conclusion 69 Appendix 4.A Review of Evidence and Methodology in Studies of Speech Outcome in Individuals Born with Cleft Lip and Palate 70 References 82 5 Secondary Management and Speech Outcome 87 John E. Riski 5.1 Introduction 87 5.2 Secondary Surgical Management of Velopharyngeal Incompetence 88 5.3 Secondary Pharyngeal Flap 88 5.4 Posterior Pharyngeal Wall Augmentation by Muscle Transposition 91 5.5 Studies Comparing Treatments of VPI 94 5.6 Posterior Pharyngeal Wall Augmentation by Implants and Injections 95 5.7 Velarplasty 96 5.8 Other Considerations in Managing VPI 97 5.9 Complications Secondary to Pharyngoplasties 99 5.10 Conclusions 99 References 100 6 Cleft Palate Speech in the Majority World: Models of Intervention and Speech Outcomes in Diverse Cultural and Language Contexts 105 Debbie Sell, Roopa Nagarajan and Mary Wickenden 6.1 Introduction 105 6.2 Speech Outcomes in a Majority World Context 106 6.3 Different Models of Provision 109 6.4 Attitudes/Cultural Aspects 115 6.5 Conclusion 119 References 119 Part Two Speech Assessment and Intervention 123 Anette Lohmander and Sara Howard 7 Phonetic Transcription for Speech Related to Cleft Palate 127 Sara Howard 7.1 Introduction 127 7.2 What is Phonetic Transcription? 128 7.3 Why Transcribe? 129 7.4 What to Transcribe and How to Transcribe It 130 7.5 Features of Cleft Speech Production 131 7.6 Pitfalls of Transcription 134 7.7 Conclusion 138 Appendices 139 References 142 8 Instrumentation in the Analysis of the Structure and Function of the Velopharyngeal Mechanism 145 Debbie Sell and Valerie Pereira 8.1 Introduction 145 8.2 Visualization of the Velopharyngeal Mechanism 147 8.3 Multiview Videofl uoroscopy 147 8.4 Nasendoscopy Procedure 151 8.5 Magnetic Resonance Imaging (MRI) 155 8.6 Variability in Practice 158 8.7 Future 162 References 162 9 Cross Linguistic Perspectives on Speech Assessment in Cleft Palate 167 Gunilla Henningsson and Elisabeth Willadsen 9.1 Introduction 167 9.2 Vulnerable Speech Sounds 168 9.3 Language Background of the Listener Assessing the Speech of Children with Cleft Palate 170 9.4 What Is Known about More Unfamiliar Languages? 173 9.5 Cross Linguistic Speech Samples 173 9.6 Infl uence on Assessment of Language Acquisition in the Young Child with Cleft Palate 176 9.7 Conclusion 177 References 177 10 Voice Assessment and Intervention 181 Lesley Cavalli 10.1 Introduction 181 10.2 Defi ning a Voice Disorder 181 10.3 Assessment 184 10.4 Instrumental Assessment 189 10.5 Vocal Handicap Measures 190 10.6 Treatment 191 10.7 Conclusion 195 References 196 11 Nasality - Assessment and Intervention 199 Triona Sweeney 11.1 Introduction 199 11.2 Perceptual Assessment of Nasality and Nasal Airfl ow Errors 205 11.3 Instrumental Assessment of Nasality and Nasal Airfl ow Errors 207 11.4 Interpreting Results 211 11.5 Intervention 214 11.6 Conclusion 216 Appendix 11.A Temple Street Scale of Nasality and Nasal Airfl ow Errors 217 References 217 12 Articulation - Instruments for Research and Clinical Practice 221 Fiona E. Gibbon and Alice Lee 12.1 Introduction 221 12.2 Electropalatography (EPG) 222 12.3 Imaging Techniques 228 12.4 Motion Tracking 233 12.5 Conclusion 235 Acknowledgement 235 References 235 13 Psycholinguistic Assessment and Intervention 239 Joy Stackhouse 13.1 Introduction 239 13.2 What is a Psycholinguistic Approach? 240 13.3 A Psycholinguistic Assessment Framework 242 13.4 Intervention from a Psycholinguistic Perspective 245 13.5 Literacy: Phonological Awareness and Spelling 250 13.6 Summary 254 References 255 14 Early Communication Assessment and Intervention 259 Nancy Scherer and Brenda Louw 14.1 Introduction 259 14.2 Assessment 260 14.3 Intervention 267 References 272 15 Phonological Approaches to Speech Difficulties Associated with Cleft Palate 275 Anne Harding-Bell and Sara Howard 15.1 Introduction 275 15.2 Variability, Variation and Compensation 277 15.3 Classification of Speech Difficulties Related to Cleft Palate 278 15.4 Phonological Assessment of Speech Data Related to Cleft Palate 278 15.5 Phonological Consequences of Speech Production Related to Cleft Palate 279 15.6 Intervention 283 15.7 Summary 287 References 288 16 Speech Intelligibility 293 Tara L. Whitehill, Carrie L. Gotzke and Megan Hodge 16.1 Introduction 293 16.2 Defi nition of Intelligibility and Related Concepts 294 16.3 Measurement Issues 294 16.4 Studies of Intelligibility in Speakers with Cleft Palate 296 16.5 Current and Future Developments 298 16.6 Conclusion 300 References 301 17 Communicative Participation 305 Christina Havstam and Anette Lohmander 17.1 Introduction 305 17.2 ICF 306 17.3 Communicative Participation 307 17.4 Conclusions and Clinical Implications 312 References 312 18 Evaluation and Evidence-Based Practice 317 Linda D. Vallino-Napoli 18.1 Introduction 317 18.2 Intervention for Speech Disorders 318 18.3 Evidence-Based Practice 319 18.4 The Systematic Review Process 323 18.5 Evidence Findings Establishing Therapy Effectiveness 325 18.6 Instrumentation - Visual Feedback 349 18.7 Surgery 350 18.8 Comments about Intervention Effectiveness 351 18.9 Intervention and the International Classifi cation of Function (ICF) 352 18.10 Research Designs for Intervention Studies 352 18.11 Conclusions 352 Appendix 18.A Commonly Used Evidence Hierarchies for Intervention Studies 354 References 354 Index 359