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Cleft Palate- Early Intervention

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Lisa Schwartz

on 22 July 2013

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Transcript of Cleft Palate- Early Intervention

Cleft Palate: The Effects of Early Intervention on Children born with Cleft Palate
By: Lisa Schwartz
Surgical Interventions/Strategies
Behavioral Treatment
Treatment/assessment starts at birth and continues throughout adulthood
The SLP must determine the need for speech & language intervention around 18 months of age
Throughout the child's adolescent years and possibly into adulthood, the SLP must continue to monitor the child's speech and resonance
Timeline for Treatment
Introduction
Cleft lip and cleft palate make up the most common birth defect in the U.S.
One in every 600 newborns is affected
These children are at risk for developing speech and lexical delays
Research backing early intervention is scarce
Future Research/Continuing Education
Survey by Bedwinek, et al in 2010
KASA revision in 2006
SIG 5: Speech Science & Orofacial Disorders
Communication & collaboration between team and school-based SLPs is important
SLPs have an ethical responsibility to recognize professional limitations
References
Bedwinek, A.P., Kummer, A.W., Rice, G.B., & Grames, L.M. (2009). Current training and continuing education needs of preschool and school-based speech-language pathologists regarding children with cleft lip/palate. Language, Speech and Hearing Services in Schools, 41, 405-415.

Blakeley, R.W. & Brockman, J.H. (1995). Normal speech and hearing by age 5 as a goal for children with cleft palate: A demonstration project. American Journal of Speech-Language Pathology, 4(1), 25-32.

Brodsky, L., Holt, L., & Ritter-Schmidt, D.H. (1992). Craniofacial anomalies. Missouri: Mosby, Inc.

Bzoch, K.R. (1989). Communicative disorders related to cleft lip and palate. Massachusetts: College-Hill Press.

Carneol, S.O., Marks, S.M., & Weik, L. (1999). The speech-language pathologist: Key role in the diagnosis of velocardiofacial syndrome. American Journal of Speech-Language Pathology, 8, 23-32.

Cleft Palate Foundation. (2012). Parents and Individuals Information. Cleft Palate Foundation.
Retrieved from http://www.cleftline.org/parents-individuals/

Fullman, L.I, & Boyer, V.E. (2012). Velocardiofacial syndrome and early intervention. Contemporary Issues in Communication Science and Disorders, 39, 21-29.
Primary palatal surgery: around 5-6 months of age
Secondary surgery: on a as-needed basis
Prosthetic devices: Speech bulb or palatal lift
http://www.gosh.nhs.uk/medical-conditions/procedures-and-treatments/speech-prostheses-in-the-management-of-nasal-speech/
Speech bulb
http://www.dryvonna.com/PhotoGallery_4.aspx?gid=282028
Palatal Lift
References
Grunwell, P., Crystal, D., Lesser, R., & Snowling, M. (1993). Anaylsing cleft palate speech. London: Whurr Publishers.
Hardin-Jones, M.A. & Chapman, K.L. (2008). The impact of early intervention on speech and lexical development for toddlers with cleft palate: A retrospective look at outcome. Language, Speech and Hearing Services in Schools, 39(1), 89-96.
Hardin-Jones, M.A., Chapman, K.L., & Scherer, N.J. (2006). Early intervention in children with cleft palate. The ASHA Leader.
Hardin-Jones, M.A., & Jones, D.L. (2004). Speech production of preschoolers with cleft palate. The Cleft Palate-Craniofacial Journal, 42(1). 7-13.
Jones, C.E., Chapman, K.L., & Hardin-Jones, M.A. (2002). Speech development of children with cleft palate before and after palatal surgery. The Cleft Palate-Craniofacial Journal, 40(1), 19-31.
Kummer, A.W. (2011). Speech therapy for cleft palate or velopharyngeal dysfunction (VPD). 2011 ASHA Convention.
Kummer, A.W. (2001). Cleft palate and craniofacial anomalies: Effects on speech and resonance. Albany, NY: Delmar-Thomson Learning.
Kuehn, D.P., & Henne, L.J. (2003). Speech evaluation and treatment for patients with cleft palate. American Journal of Speech-Language Pathology, 12, 103-109.
Kuehn, D.P., Kummer, A.W., D’Antonio, L.L., & Karnell, M.P. (2006). Cleft palate and speech: Three models of focused education. Perspectives on Speech Science and Orofacial Disorders, 16(2), 17-21.
References
Peterson-Falzone, S.J., Trost-Cardamone, J.E., Karnell, M.P., & Hardin-Jones, M.A. (2006). The clinician’s guide to treating cleft palate speech. Missouri: Mosby, Inc.

Poburka, B. (2011). Medical Issues Course. Cleft palate timetable.

Scherer, N. (1999). The speech and language status of toddlers with cleft lip and/or palate following early vocabulary intervention. American Journal of Speech-Language Pathology, 8, 81-93.

Shprintzen, R.J. & Bardach, J. (1995). Cleft palate speech management: A multidisciplinary approach. Missouri: Mosby, Inc.

Snelling, T. M. (2010). Play-based speech intervention for the infant, toddler, and preschooler with cleft palate. ASHA 2010 Convention Handouts. Retrieved from www.asha.org
Auditory feedback
listening tube or straw
Visual feedback
Nasometer
Nasopharyngoscopy
Air paddle
See Scape
Tactile feedback
No blowing or sucking excercises!
Nasometer
http://www.pediastaff.com/resources-treatment-of-hypernasality-in-children-with-down-syndrome-featured-september-12-2011
Nasopharyngoscopy
http://www.sciencedirect.com/science/article/pii/S0011853208000505
See Scape
http://www.proedinc.com/customer/productView.aspx?ID=1720
Conclusion
Early intervention is essential for the child born with cleft lip and/or palate
Early intervention needs to include surgical procedures and speech therapy, among other disciplines
Further research needs to be conducted in order to show evidence of the effectiveness of repairing the palate at an earlier stage of development
Full transcript