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Ultrasound Images of the Tongue: A Tutorial for Assessment and Remediation of Speech Sound Errors

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Speech therapy for compensatory articulations and velopharyngeal function: a case report.

Nachale Helen Maciel Bispo¹, Melina Evangelista Whitaker, Homero Carneiro Aferri

¹Department of Speach-Patology and Audiology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.

Journal of Applied Oral Science : Revista FOB

|January 11, 2012

Summary

This study details intensive speech therapy for a child with velopharyngeal insufficiency (VPI) and cleft palate, successfully eliminating compensatory articulations and hypernasality. The child achieved improved speech intelligibility through targeted therapy and a pharyngeal obturator.

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Area of Science:

Speech-Language Pathology
Pediatric Otolaryngology
Craniofacial Anomalies

Background:

Velopharyngeal insufficiency (VPI) significantly impacts speech intelligibility in children with cleft lip and palate.
Compensatory articulations and hypernasality are common sequelae of VPI, requiring specialized intervention.
Pharyngeal flap surgery (pharyngoplasty) may be compromised by poor pharyngeal wall movement, necessitating alternative strategies.

Observation:

The child exhibited co-productions of sounds with glottal stops and weak intraoral pressure, significantly impacting speech clarity.
Intensive speech therapy focused on increasing intraoral air pressure and utilizing multimodal feedback (visual, auditory, tactile) to correct articulation errors.

Findings:

Following two phases of therapy, correct oral place of articulation for target sounds was consistently achieved.
A subsequent phase utilizing a bulb reduction program successfully addressed velopharyngeal closure during speech.
Post-therapy evaluation revealed the absence of hypernasality and compensatory articulations, with marked improvement in speech intelligibility.

Implications:

Intensive speech therapy, combined with a pharyngeal obturator, can effectively manage VPI and compensatory articulations in children with cleft palate.
This approach offers a viable alternative or precursor to surgical intervention, improving functional communication outcomes.
The findings highlight the importance of addressing both articulation and velopharyngeal function for enhanced speech intelligibility in pediatric populations.