00-P2976-FM 7/20/04 7:03 AM Page vii
Contents
xvii
Contributors
xxi
-E
Section I General Aspects
nc .
D ,I
Preface
PR O
Chapter 1
m at er ia
lb y
Introduction to the Study of Communicative Disorders in Cleft Palate and Related Craniofacial Anomalies 3 Kenneth R. Bzoch
Simple Cleft Lip and Palate
ht ed
VPI Without Overt Clefts Craniofacial Disorders
5
10
11
py r
ig
Management over the Past Five Decades Text for a Course of Study
11
12
co
Rationale for the Need to Study Cleft Palate
©
The Goal of Preventing Speech Disorders
The Potential Efficacy of Early Intervention
15
17
19
Cleft Palate Speech as a Functional Learned Disorder Some Principles of Speech Pathology Related Basic Embryology
21
23
36
Useful and Preferred Cleft Classification Systems
42
Guidelines for the Best Care and Treatment of Children with Cleft Lip, Cleft Palate, and Craniofacial Anomalies
51
Treatment Protocols for Optimal Standards of Cleft Palate Care References
60
55
00-P2976-FM 7/20/04 7:03 AM Page viii
Contents
Chapter 2 Anatomy and Physiology of Normal and Disordered Velopharyngeal Function for Speech 67 Jerald B. Moon and David P. Kuehn
Normal Velopharyngeal Anatomy Cleft Palate Anatomy
68
79
Physiology of the Velopharyngeal Mechanism
nc .
92
Acknowledgments References
80
93
93
D ,I
Conclusion
PR O
-E
Chapter 3
lb y
Basic Genetic Concepts in Craniofacial Anomalies 99 Alison E. Winder, Robin Imagire, and Sally J. Peterson-Falzone
103
m at er ia
Terminology
Basic Human Genetics
Causes of Birth Defects
ht ed
Conclusion
References
109 112
143
145
py r
ig
Chapter 4
Social and Psychological Perspectives on Cleft Lip and Palate 149
co
©
viii
Ronald P. Strauss
Stigma and Appearance
150
Stigma and Treatment
153
Resilience and Health
156
Outcomes of Treatment Cultural Issues
157
159
Birth and Diagnosis
161
Psychological Issues and Care
163
Neuropsychological and Cognitive Issues Future Psychosocial Research Acknowledgment References
172
172
170
168
00-P2976-FM 7/20/04 7:03 AM Page ix
Contents
Chapter 5 Primary Surgical Correction of Cleft Lip and Palate 181 M. Brent Seagle
182
Timing of Surgery
Procedures
184
Complications References
183
190
191
nc .
Anatomy
D ,I
Chapter 6
PR O
-E
Secondary Surgical Procedures to Correct Postoperative Velopharyngeal Incompetencies Found After Primary Palatoplasties 193
lb y
John E. Riski
History
m at er ia
Nasopharyngeal Anatomy and Physiology Relative to Secondary Surgical Management 194 196
Secondary Pharyngeal Flap
198
ht ed
Posterior Pharyngeal Wall Augmentation by Muscle Transposition
Posterior Pharyngeal Wall Augmentation by Implants and Injections
ig
Palatal Lengthening
py r
co
Other Considerations in Managing VPI
218
219
©
Craniofacial Growth Following Pharyngoplasty Hearing and Middle Ear Function
References
222
223
Complications Secondary to Pharyngoplasties
216
Pharyngoplasty Procedures in Combination
Conclusion
206
223
227 229
Chapter 7 The Use of Prosthetic Speech Appliances in Cleft Palate Management 237 Morton S. Rosen and Kenneth R. Bzoch Purposes and Construction of Prosthetic Speech Appliances Types of Speech Appliances Counseling Parents
248
242
240
215
ix
00-P2976-FM 7/20/04 7:03 AM Page x
Contents
Special Prostheses
Conclusion
References
250
255 256
Chapter 8 The Craniofacial Team: Health Supervision and Coordination
259
John A. Nackashi, E. Rosellen Dedlow, and Virginia L. Dixon-Wood
260
Development of the Team Approach
263
264
The Cleft Lip and Palate Team
D ,I
The Clinical Team
nc .
Conceptual Health Care Models
269
-E
Primary Care Needs of Children with Cleft Lip and Palate
279
Appendix 8A
287
289
m at er ia
References
286
280
lb y
Conclusion
PR O
Overview of Health Supervision for Children with Cleft Lip and Palate
Chapter 9
ht ed
Collaborative Clinical Research and the Craniofacial Outcomes Registry References
305
co
py r
ig
Betty Jane Phillips
©
x
Section II Diagnostic Aspects Chapter 10
Etiological Factors of Cleft Palate Speech Disorders 309 Kenneth R. Bzoch Basic Causal Factors for Evaluation Major Organic Factors Functional Factors
313
317
339
Speech Pathologist’s Role on a Cleft Palate Team References
347
346
291
00-P2976-FM 7/20/04 7:03 AM Page xi
Contents
Chapter 11 Audiologic Management of Patients with Cleft Palate and Related Disorders 353 Brett E. Kemker and Patrick J. Antonelli
Hearing Loss and Otitis Media
355
Eustachian Tube and Auditory Pathology Disorders
Extent of Hearing Loss
357
Nature of Hearing Loss
358
Hearing Loss as a Function of Type of Cleft
Sequelae of Hearing Loss
361
Audiological Testing Procedures
360
-E
Age at Surgery and Hearing Loss
D ,I
359
359
PR O
Pre- and Postsurgical Findings
361
lb y
Method of Audiological Test Procedure
362
Recommendations Regarding Audiological Tests References
m at er ia
Management of Hearing Problems
356
nc .
Incidence of Hearing Loss and Auditory Pathology
356
365
366
370
Chapter 12
©
co
py r
ig
ht ed
A Battery of Clinical Perceptual Tests, Techniques, and Observations for the Reliable Clinical Assessment, Evaluation, and Management of 11 Categorical Aspects of Cleft Palate Speech Disorders 375 Kenneth R. Bzoch
Clinical Perceptual Tests That Can Quickly Diagnose Velopharyngeal Insufficiency 377 Energy Forms Involved in Speech Production
388
Measurement of Emergent Language Development
393
Evaluation of Receptive, Expressive, and Inner Language Developmental Functions 395 Pragmatic Patterns and Stages of Emergent Language Development Problems in Classification and Terminology of Speech Errors Categorical Aspects of Cleft Palate Speech Disorders Recommended Clinical Test Battery
410
408
403
396
xi
00-P2976-FM 7/20/04 7:03 AM Page xii
xii
Contents
Diagnostic Error Pattern Articulation Test
432
Management of Categorical Aspects of Cleft Palate Speech Disorders
Recording of Clinical Diagnostic Judgments References
436
456
458
Chapter 13 Diagnosis of Specific Cleft Palate Speech Error Patterns for Planning Therapy or Physical Management Needs 463
Cleft Palate Misarticulations
Cleft Palate Speech Assessment References
485
468
PR O
Appendix 13A
465
D ,I
464
-E
A Note on Terminology
nc .
Judith E. Trost-Cardamone
489
lb y
Chapter 14
m at er ia
The Use of Nasometry in the Assessment and Remediation of Velopharyngeal Inadequacy 493 Rodger M. Dalston
ht ed
Listener Judgments
©
co
py r
ig
Acoustic Analysis Summary
497
510
Appendix 14A
511
Appendix 14B
511
References
495
511
Chapter 15 Radiographic Assessment of Velopharyngeal Function for Speech 517 William N. Williams, Gunilla Henningsson, and Maria Inês Pegoraro-Krook Normal Velopharyngeal Function Velopharyngeal Insufficiency
518
519
Importance of Perceptual Measures and the Oral Exam
519
The Speech–Language Pathologist’s Role in the Radiographic Assessment Early History of Speech Research with Radiography
522
521
00-P2976-FM 7/20/04 7:03 AM Page xiii
Contents
Fluoroscopy and Speech Research
524
Radiation Exposure, Compliance, Positioning, and Contrast Materials
Normal Pattern
Velar Stretch
528
531
Passavant’s Pad
531
Speech Sample
534
Velopharyngeal Insufficiency
535
Factors That Can Impair VP Function
535
Standardization for Reporting Observations of VP Function
541
544
nc .
Quantifiable Measurements of VP Function
561
PR O
References
561
-E
D ,I
Treatment Recommendations and Rationales Based on Videofluoroscopic Assessment 549 Summary
Chapter 16
lb y
Nasopharyngoscopy
569
m at er ia
Robert J. Shprintzen
Conceptual Basis for Nasopharyngoscopy
Instrumentation and Technique
ht ed
Procedural Recommendations Examination Interpretation
ig
Summary
py r
References
570
571
575
580
591 592
©
co
Chapter 17
Aerodynamic Assessments and Procedures to Determine Extent of Velopharyngeal Inadequacy 595 Donald W. Warren Measurement of Pressure and Airflow
596
Application of Aerodynamic Principles for Measurement of Velopharyngeal Function 605 References
626
525
xiii
00-P2976-FM 7/20/04 7:03 AM Page xiv
Contents
Section III Cleft Palate Speech Therapy: Early Preventive and Later Rehabilitative Aspects Chapter 18 Rationale, Methods, and Techniques of Cleft Palate Speech Therapy 631 635
Early Case Studies
D ,I
635
Recent Preventive Therapy Techniques
649
-E
Methods
nc .
Kenneth R. Bzoch
PR O
Group Data from 50 Case Studies (1980–1983)
Evaluation of Language Development Data
References
655
657 660
664
m at er ia
Recent Group Statistics
lb y
Further Recent Case Studies (1990s to 2000) 666
Chapter 19
co
py r
ig
ht ed
Counseling and Early Management of Feeding and Language Skill Development for Infants and Toddlers with Cleft Palate 669
©
xiv
Virginia L. Dixon-Wood
Feeding
Counseling
670
675
Early Language Development References
679
681
Chapter 20 Correcting Retracted Articulation Error Patterns: Recent Techniques 683 Virginia L. Dixon-Wood Myths About Treating Children with VPI
684
Phonologic Development of Children with Cleft Palate
686
Speech Therapy Techniques for Patients with VPI and Compensatory Articulation 688
00-P2976-FM 7/20/04 7:03 AM Page xv
Contents
Step-by-Step Therapy Procedures for Correcting Compensatory Articulation 689 Therapy for the Young Child with Delayed Language and Nasal Substitutions Without Compensatory Articulation 695 Impact of Articulation on Palatal Function
696
Recent Case Study Examples of Therapy to Correct and Prevent Compensatory Articulation Disorders 697
Appendix 20A References
703
703
nc .
Chapter 21
PR O
-E
D ,I
Therapy Considerations for Preschool-Age Children with Cleft Palate and Other Craniofacial Anomalies 705 Jane Scheuerle
lb y
Basic Knowledge of Child Development During Preschool Years (36 to 60 Months) 707 Clinical Decision Making Conclusion
735 736
ht ed
References
710
m at er ia
Preschool Differences Associated with CLP or CFA General Health 723
Chapter 22
co
py r
ig
Speech and Voice Therapy Techniques for School-Age and Adult Patients with Remaining Cleft Palate Speech Disorders 741
©
D. R. Van Demark
What Is the Goal? Diagnostic Process
Diagnostic Evaluation
742 744
746
Articulation Therapy for Patients with Velopharyngeal Competence Speech Therapy for Individuals with Borderline Velopharyngeal Competence 750 Speech Therapy for Individuals Who Exhibit Velopharyngeal Incompetence 755 Therapy for Resonance Disorders Summary References
759 760
756
748
xv
00-P2976-FM 7/20/04 7:03 AM Page xvi
Contents
Chapter 23 Considerations for Behavioral Treatment of Velopharyngeal Closure for Speech 763 Dennis M. Ruscello
Neurophysiology Treatment Studies
765 770
Critique of Palatal Training Studies
Implications for Future Research
781
784
787
nc .
References
788
D ,I
Summary
-E
Chapter 24
lb y
PR O
Research Considerations for Behavioral Treatments of Velopharyngeal Impairment 797 Lucrezia A. Tomes, David P. Kuehn, and Sally J. Peterson-Falzone
798
m at er ia
Goals of Behavioral Treatments
History of Behavioral Treatments
799
ht ed
Overview of Current Opinions and Evidence Concerning Behavioral Treatments to Improve Velopharyngeal Function 822
ig
Why Continue to Search for Effective Behavioral Treatments of Velopharyngeal Impairment? 825
py r
Clinical and Research Considerations for Testing the Effectiveness of Behavioral Treatments 830
co
Conclusion
835
Acknowledgments
©
xvi
References
836
836
About the Editor Index
849
847
