Term
| why do babies with clefts have trouble generating appropriate pressure? |
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Definition
| because swallowing is pressure-driven and babies with clefts have trouble generating appropriate pressure |
|
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Term
| velopharyngeal closure is supposed to prevent what? how does this effect babies with frequent episodes? |
|
Definition
| it is supposed to prevent nasal regurgitation, but babies with clefts may experience frequent episodes |
|
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Term
| what are five feeding problems associated with cleft palates? |
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Definition
1. poor suction
2. slow feeding
3. inadequate liquid intake
4. taking in too much air
5. airway protection |
|
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Term
| what is the highest priority for a baby with feeding problems as a result of a cleft? |
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Definition
| protecting the airway/keeping food and liquids out of the airway |
|
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Term
| what are things that can heighten a baby's risk of food getting into the airway? |
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Definition
| fighting feeding, taking longer to feed, resisting feeding, etc. (Babies with a cleft do all of these things because feeding is harder for them) |
|
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Term
| Which feeding stage is intact when a baby has a feeding problem? which is disorganized? |
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Definition
| pharyngeal phase is intact but oral stage is disorganized |
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Term
| why is breastfeeding easier for babies with a cleft? |
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Definition
| the breast tissue is more pliable and it is easier to occlude the cleft lip |
|
|
Term
| is feeding more difficult with a soft palate cleft or hard palate cleft? |
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Definition
|
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Term
| human milk provides what three extremely important immunological protections to babies with clefts? |
|
Definition
1. protection against otitis media
2. protection against respiratory infections
3. protection against GI infections |
|
|
Term
| will breast feeding work if there is a cleft of the hard palate? |
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Definition
| only if it is small and anterior (if the velum closes in the front of the cleft there isn't a problem, but if it's a cleft in the middle of the palate it will make it hard to breast feed. |
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|
Term
| are non-syndromic clefts associated with cognitive impairment? |
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Definition
|
|
Term
| what does new research say about brain differences in adult men with non-syndromic clefts? |
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Definition
| it says that there are brain differences in adult men with non-syndromic clefts |
|
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Term
| what does older research say about cleft palates? Why? |
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Definition
| whether or not it is part of a syndrome, many of these children aren't able to keep up with their peers. - why: maybe because pragmatic skills impacted the inability to produce speech sounds, exposure to infections in the hospital, inability to keep up with peers, etc. |
|
|
Term
| what are other factors that may influence a cognitive impairment in a child with a non-syndrome cleft? (6) |
|
Definition
1. neurologic anomalies
2. conductive/sensorineual hearing loss
3. velopharyngeal dysfunction
4. attention deficits
5. frequent hospitalizations
6. social isolation |
|
|
Term
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Definition
| a condition where the sutures of the skull close too fast and don't allow the brain to expand - this puts pressure on the brain and it can't grow the way it needs to |
|
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Term
| what four skills undergrid language? |
|
Definition
1. social interaction: hard to interact in the hospital
2. hearing: may be chronically impaired
3. attention: ADD is more common in cleft-related syndromes and toxin exposure
4. sound sequencing: difficult for kids with clefts because high pressure phonemes are hard |
|
|
Term
| What kind of sounds do kids with clefts produce more often? Are these typical or atypical? |
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Definition
| posterior fricatives, this is atypical: they make sounds that are not used in the English language. |
|
|
Term
| what are phonological characteristics of a cleft? |
|
Definition
1. preponderance of nasal phonemes
2. high frequency of glottal stops |
|
|
Term
| an unrepaired cleft can result in what phonological problem? |
|
Definition
| atypical sound production |
|
|
Term
| what problems can continue to impair sound intelligibility? |
|
Definition
|
|
Term
| why is there a lingering nasality once the cleft is repaired? |
|
Definition
| the levator veli palatini fibers attach to the bony structures so it's still hard to move it after the velum is closed |
|
|
Term
| what are mid-dorsum palatal stops substituted for? |
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Definition
|
|
Term
| what would a child with an anterior cleft do? |
|
Definition
|
|
Term
| velopharyngeal dysfunction |
|
Definition
the velum and pharyngeal walls are not working together appropriately to do their job
EG: letting too much air through |
|
|
Term
| abnormal resonance is caused by what? |
|
Definition
| anything that disrupts the transmission of a sound in the cavity of the vocal tract |
|
|
Term
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Definition
a hold in the oral-nasal cavity/ a hold anterior to the business end of the velum
EG: your velum can't keep the air out of your nose |
|
|
Term
| what is a resonance problem due to obstruction? |
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Definition
| adenoids can swell and you have pads of tissue that block the appropriate flow if air through the nose during speech (hyponasal speech) |
|
|
Term
| what do you check for if the patient is hyponasal? |
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Definition
|
|
Term
| what do you check for if the patient is hypernasal? |
|
Definition
|
|
Term
| what is velopharyngeal insufficiency/incompetence? |
|
Definition
| not having enough structure left to have the velum reach the pharyngeal wall |
|
|
Term
| What is appropriate therapy for a person with VPI? |
|
Definition
| NOTHING - WE CANNOT FIX THIS WITH THERAPY |
|
|
Term
| how do we determine if there is a VPI? |
|
Definition
|
|
Term
| VPI results in hypernasality/hyponasality |
|
Definition
|
|
Term
| what is velopharyngeal mislearning? |
|
Definition
| someone who has a good mechanism but doesn't use it appropriately |
|
|
Term
| what do we do in therapy for a person who has velopharyngeal mislearning? |
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Definition
| we help patients figure out how to get the velum where it needs to be and when it needs to be there - they have the structures they just need help executing it |
|
|
Term
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Definition
|
|
Term
|
Definition
| potato-in-the-mouth speech/obstruction- the sound isn't coming out loudly or clearly |
|
|
Term
| what are six signs to watch for? |
|
Definition
1. nasal emission
2. nasal grimace
3. weak or absent consonants
4. short utterances
5. alterations in speech rate and speech segment length
6. longer voice onset times |
|
|
Term
|
Definition
| space between the teeth (most commonly the upper central incisors) |
|
|
Term
| what are five types of dental problems? |
|
Definition
1. diastema
2. missing teeth
3. rotated teeth
4. supernumerary teeth
5. ectopic teeth |
|
|
Term
|
Definition
| having extra teeth in a normal sized dental arch |
|
|
Term
|
Definition
normal teeth in an abnormal position
EG: an incisor where a molar should be |
|
|
Term
| what are angle's three classifications? |
|
Definition
1. Class 1: normal
2. Class 2: overbite
3. Class 3: underbite |
|
|
Term
|
Definition
|
|
Term
| what are four ear problems that could occur in a client with a cleft? |
|
Definition
1. microtia: tiny pinna
2. auditory atresia: abnormally narrow ear canal
3. ossicle malformation
4. otitis media |
|
|
Term
|
Definition
|
|
Term
|
Definition
| abnormally narrow ear canal |
|
|
Term
| what are three nose problems that occur from a cleft palate |
|
Definition
external malformations: (EG) bifid nose
abnormalities of the nasal base
deviated septum |
|
|
Term
| what are three mouth/throat problems? |
|
Definition
1. maxillary retrusion: maxilla is too small and the mandible is normal
2. tongue anomalies
3. tonsil/adenoid hypertrophy |
|
|
Term
| tonsil/adenoid hypertrophy |
|
Definition
| tissue gets vigorous in its development |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| tongue tie (normal size but the movement is restricted/frenum is too tight) |
|
|
Term
| with a small pinna, what is common? |
|
Definition
|
|
Term
| what are psychosocial problems for families? |
|
Definition
1. grief
2. family adjustment
3. managing complex medical needs
4. acceptance of chronic medical condition |
|
|
Term
| what are psychosocial problems for patients? |
|
Definition
1. physical appearance
2. communication
3. behavior
4. teacher expectations
5. peer interactions |
|
|
Term
|
Definition
| single cause -> multiple anomalies |
|
|
Term
|
Definition
| single cause -> first anomaly -> further anomaly/anomalies |
|
|
Term
| what does the term "dysmorphic" mean? |
|
Definition
| atypical features that suggest a diagnosis |
|
|
Term
| what is the pierre robin sequence? (3 steps) |
|
Definition
| mandible doesn't develop properly -> so the tongue can't drop into its proper position (tongue is too high) -> so the palate can't close because the tongue is in the way |
|
|
Term
| what are physical features of pierre robin sequence? |
|
Definition
| micrognathia (small jaw) and glossoptosis (tongue drop) |
|
|
Term
| what are the effects of pierre robin sequence? |
|
Definition
| feeding problems and respiratory problems |
|
|
Term
| is pierre robin sequence independent or part of a syndrome? |
|
Definition
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