Speech therapy for compensatory articulations and velopharyngeal function: a case report
J. appl. oral sci
;
19(6): 679-684, Nov.-Dec. 2011. ilus, tab
Artigo
em Inglês
| LILACS
| ID: lil-610887
ABSTRACT
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.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Transtornos da Articulação
/
Fonoterapia
/
Insuficiência Velofaríngea
/
Fenda Labial
/
Fissura Palatina
Limite:
Criança
/
Feminino
/
Humanos
Idioma:
Inglês
Revista:
J. appl. oral sci
Assunto da revista:
Odontologia
Ano de publicação:
2011
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
University of São Paulo/BR
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