Question

Articulation case study:

Sam, now a 6 year old male was recently adopted from Vietnam. He was born with a bilateral complete cleft lip and palate. The cleft lip was repaired in Vietnam, but the cleft palate was left unrepaired. Due to the cleft palate, he has velopharyngeal dysfunction i.e. his velum does not retract and meet the posterior pharyngeal wall to close off the nasal cavity.

1. Which anatomical structures are missing/affected in a complete bilateral cleft palate?

2. Which anatomical structures are missing/affected in a complete bilateral cleft lip?

3. How do you think Sam sounds i.e. what is his vocal quality? Why? Hint: Think about how the velopharyngeal insufficiency is affecting his overall articulation. 4. Despite his velopharyngeal insufficiency, there are certain phonemes of the English language that he can produce effectively. What are those phonemes?

5. What affects might Sam’s cleft palate have on swallowing?

Please answer all 5 questions

Answer 1

Please find answer as follows:-

Ans 1) Cleft palate is caused by arrested development of maxilla during embryogenic development resulting in midline defect that allows communication between oral and nasal cavities . in complete bilateral cleft palate results in incomplete or absent fusion of lateral palatine processes medial palatine process or nasal sector .

Ans2) both right and left philtral columns and peaks of the cupid’s bow are absent in completer bilateral cleft lip .

Ans 3) cleft palate affect the voice tract and the voice quality ,the speech is characterized by a typical consonant productions , abnormal nasal resonance ,abnormal nasal airflow altered laryngeal voice quality and nasal or facial grimaces.

Ans 4) in cleft palate children they have difficulty in building pressure in mouth for certain sounds. These synonyms are called pressure consonants it includes T ,D,K ,P ,G, F ,V ,S ,Z, SH, CH ,DG and TH . Cleft palate children can effectively speak vowels ,nasal consonants and low pressure consonants like M ,N ,H ,L ,W ,Y ,R ,NG and the vowel sounds

Ans 5) in Cleft palate babies major problem occur transitory phase of food and pharyngeal phase . Babies with cleft will swallow more air than normal during feeding and leads to flow of food . There is chance of food going to nasal cavity and coming through nostrils. Therefore there should be assistance given for feeding like tubes ,special bottle etc.