Speech Resonance - Cleft Palate

 

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    Speech resonance services are offered to individuals with altered sound production and nasal speech often associated with cleft palate.  Speech-Language Pathologists are integral members of Stony Brook University Medical Center’s Cleft Palate/Craniofacial Team and provide a full range of evaluation and treatment services to children and adults with this condition.

    Cleft Palate
    A cleft is a separation in the skin, mucosa, muscle, and/or bone that is normally fused together during fetal development; however, no structures are missing. This lack of fusion may result in a cleft lip and/or cleft palate.  Hypernasal speech and articulation errors are often seen in the speech production of a patient with a cleft palate.

    Hypernasal speech refers to a “nasal” sound that is heard in speech production.  Nasal emission is audible air through the nose, which may also be present in someone with a cleft palate.  In the English language, there are only 3 sounds that allow air to pass through the nose (m, n, ng).  Some children may have weakness in closing off the nose from the mouth when speaking (sometimes even after surgical repair).  Therefore, sounds that require a lot of air pressure may pass through the nose and result in nasal sound of speech.  One may try to compensate for the inability with substituting or distorting sounds.  Speech errors may either be due to normal development, structural deviations related to a cleft palate or learned behaviors.

    Evaluation
    During a speech resonance evaluation, a Speech-Language Pathologist will assess the facial structures, speech sound productions and oral vs. nasal air flow across speech tasks. 

    Speech therapy
    Articulation and sound specific resonance treatment should be frequent and intensive.  Home carryover is essential to make necessary gains in speech production.  Therapy may include intensive drill work to:

    • Improve sound discrimination
    • Eliminate learned articulation errors
    • Focus on front speech sounds
    • Increase accuracy of articulation placement
    • Increase mouth opening
    • Eliminate sound specific hypernasality