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CLINICAL RESEARCH IN SPEECH PATHOLOGY
EARLY SURGERY PREVENTS COMPENSATORY ARTICULATION
THE OLDER THE PATIENT IS WHEN PALATE IS REPAIRED, THE GREATER THE RISK FOR DEVELOPING COMPENSATORY ARTICULATION
THERE IS A NEGATIVE CORRELATION BETWEEN LINGUISTIC DEVELOPMENT AND THE DEVELOPMENT OF COMPENSATORY ARTICULATION DISORDER [CAD]
IVF GROUP WITHOUT
CAD [ 79% ] ADEQUATE LINGUISTIC
DEVELOPMENT
IVF GROUP WITH CAD
[ 62% ] ADEQUATE LINGUISTIC
DEVELOPMENT
CLINICAL RESEARCH IN SPEECH PATHOLOGY
WHOLE LANGUAGE MODEL IS EFFICIENT FOR THERAPY AIMED TO CORRECT COMPENSATORY ARTICULATION.
PHONETIC GROUP = 30 MONTHS
WHOLE LANGUAGE MODEL = 14.8 MONTHS
WHEN COMPENSATORY ARTICULATION IS CORRECTED, MOTION OF VELOPHARYNGEAL SPHINCTER DURING SPEECH IS MODIFIED (INCREASES)
WHEN COMPENSATORY ARTICULATION IS PRESENT, SPEECH THERAPY SHOULD BE INDICATED BEFORE SURGERY FOR VPI.
ESTRATEGIES FOR ENHANCING PHONOLOGIC DEVELOPMENT
EMPHASIZE USE OF SPEECH SOUNDS WITH COMMUNICATIVE PURPOSES MORE THAN
PRODUCTION AS A GOAL (FEY, 1992) MODIFICATION OF GROUPS OF SOUNDS
TREATED SIMILARLY BY THE CHILD (FEY, 1992) MODELING : RECONSTRUCTION OF ABNORMAL
EMISSIONS
ESTRATEGIES FOR ENHANCING PHONOLOGIC DEVELOPMENT
USE OF STRUCTURED ACTIVITIES WITHIN APPROPRIATE LINGUISTIC CONTEXT (HOFFMAN, 1992)
MODIFICATION OPHONOLOGIC PERFORMANCE IS INFLUENCED BY HIGHER LEVELS OF LINGUISTIC ORGANIZATION
CLOSING : ORGANIZATION OF EMISSIONS INCLUDING PHONOLOGIC INFORMATION
EXPANSIONS : INCREASE SEMANTIC, SINTAX & PHONOLOGIC COMPLEXITY (WARREN, 89)
VERBAL COMMUNICATION MODEL (LUNCH) (HOFFMAN, 1992)
MEANING (GOALS) – BE PREPARED, EAT, CLEAN PROPOSITIONAL (ACCTIONS WITHIN THE GOAL) –
EAT, DRINK CONCEPTUAL (ACTORS, OBJECTS, ACTIONS) –
JUICE, DAD, MOM LINGUISTIC MEANING (PHRASES, RELATIONSHIPS
AND CONCEPTS) – “I DRINK JUICE” SYLLABE PHONEME GESTURE : PLACEMENT & MANNER – TONGUE APEX,
RAISE, DECREASE
SPEECH
ARTICULATION
MOTOR PERIPHERAL PHONEME BASED EVALUATES USE OF
PHONEMES PART TO WHOLE
PHONOLOGY
COGNITIVE CENTRAL LINGUISTIC CODE PHONOLOGICAL
PROCESSES WHOLE TO PART
VCFS PATIENTS WITH VPI
SPEECH :
NASAL EMISSION HYPERNASALITY COMPENSATORY ARTICULATION : ABNORMAL
ARTICULATION PATTERNS
TEACHING – LEARNING CONTEX
STORY BOOKS USEFUL AT ANY LEVEL OF DEVELOPMENT
(WHEN APPROPRIATE) PROVIDE STABLE AND REDUNDANT CONTEXT
WHICH REMAINS THROUGH TIME KEEP ACTIVITIES STABLE (PROVIDES STABILITY) ENHANCE PARALELL WORK WITH ORAL &
WRITTEN LANGUAGE
TEACHING – LEARNING CONTEX
EVENT REPRESENTATION THE BASIC STRUCTURE OF KNOWLEDGE IS
ORGANIZED AROUND EVENTS PROVIDES A GUIDE FOR STRUCTURE AND
CONTENT OF LINGUISTIC & NON – LINGUISTIC ASPECTS
REDUCE COGNITIVE WORK ENHANCING COMMUNICATIVE PERFORMANCE
THE MORE A SCRIPT IS PERFORMED, IT CAN BE PROCESSED MORE EFFICIENTLY
TEACHING – LEARNING CONTEX
EVENT REPRESENTATION (CONT.) PHONOLOGIC FORMS WILL BE INCLUDED IN
GREATER UNITS PLAY IS AN EVENT REPRESENTATION. THE SPEECH PATHOLOGIST MUST KEEP THE
ORGANIZATION AND USE ESTRATEGIES FOR ENHANCING USE OF MORE COMPLEX LINGUISTIC – PHONOLOGIC LEVELS.
VPI
MECHANICAL
PLAN : SURGERY
WITH COMPENSATORY ARTICULATION
DISORDER FUNCTIONAL ENTIRE VOCAL TRACT
IS INVOLVED
PLAN : SPEECH THERAPY
WITHOUT COMPENSATORY ARTICULATION
DISORDER
SPEECH THERAPY
APPROACH – TREAT :
PHONOLOGICAL DISORDER COMPENSATORY ARTICULATION LINGUISTIC ORGANIZATION
COMPENSATORY ARTICULATION
STARTS AS A CONSEQUENCE OF VPI (CLEFT PALATE)
IN TIME, THE ERRORS ARE INCORPORATED INTO THE LINGUISTIC RULES SYSTEM
COMPENSATORY ARTICULATION
GLOTTIC STOPS
ARTICULATION AT GLOTTIS LEVEL
SUSTITUTION OF : /K/, /P/, /T/
PHARYNGEAL FRICATIVE
PHARYNGEAL PLACEMENT OF ARTICULATION
SUSTITUTION OF : /S/
WHOLE LANGUAGE
LANGUAGE IS AN INTEGRATED SYSTEM ALL COMPONENTS ARE SIMULTANEOUSLY
PRESENT AND INTERACTING USE OF LANGUAGE OCCURS WITHIN A
CONTEXT OR SITUATION LEARNING IS ACHIEVED FROM GENERAL
TO PARTICULAR (WHOLE TO PART)
TEACHING – LEARNING CONTEX
GRAPHIC ORGANIZERS PROVIDE VISUAL TOOLS FOR EFFECTIVE
TEACHING VISUAL TOOLS ARE USEFUL FOR VISUAL
AND MIXED LEARNERS (MOST OF POPULATION)
FORGET, DISMISS, CANCEL “EXERCISES” !!!!!
THE ONLY USEFUL EXERCISE FOR SPEECH IS SPEECH
ELECTROMYOGRAPHY AND VIDEOFLUOROSCOPY DEMONSTRATES THAT VOCAL TRACT MOTION DURING SPEECH IS QUITE COMPLEX (SEVERAL STRUCTURES MOVING SIMULTANEOUSLY IN A COORDINATED FASHION). BESIDES, FREQUENCY OF MUSCLE ACTIVITY DURING SPEECH IS SIGNIFICANTLY HIGHER THAN BLOWING, SWALLOWING, ASPIRATING, ETC. THESE ACTIONS SHOW ENTIRELY AND COMPLETELY DIFFERENT PATTERNS OF ACTIVITY.
THERAPY MODALITIES
“SUMER CAMP” NATURAL ENVIRONMENT PLAY AND STORY TELLING MORE EFFECTIVE (4 HOURS PER DAY AND
FOR 3 – 4 WEEKS)
THERAPY MODALITIES
“SUMER CAMP” CAREFUL PLANNING OF ACTIVIES ADEQUATE “GROUPING” CLASSIFICATION
OF PATIENTS IN GROUPS ASSEMBLE HOMOGENEOUS GROUPS