1. Craniofacial speech disorders include those due to?
    • structural deviations
    • neurological VP dysfunction
    • Phonologic patterns
  2. Craniofacial speech disorders:
    orofacial/craniofacial complex (VP insufficiencies)?
    structural deviations
  3. Craniofacial speech disorders:
    VP incompetencies?
    neurologic VP dysfunction
  4. Craniofacial speech disorders:
    "cleft palate speech" (VP mislearning)
    Phonologic patterns
  5. Phonological disorder includes:
    *key issue in cleft?
    and ?
    • phonetic/articulatory
    • Phonemic/linguistic
  6. Obligatory (passive) Errors are
    due to?

    structural or neurological problems

    physical management
  7. Optional/learned (active) errors:


    errors that are the result of early mislearning

    despite adequate VP closure

    speech remediation
  8. Sources of Early speech mislearning? (3)
    Deficient VP valve

    Absent or structurally aberrant bony partition

    Hearing loss 2 degree MEE
  9. Prevalence of articulation problems in preschoolers with clefts is?
  10. Effects of VPI on Speech:
    Cleft palate Speech includes deviations in? (4)
    • Resonance
    • airflow
    • air pressure
    • articulation
  11. Cleft palate speech deviation:
    leads to hypernasality?
  12. Cleft palate speech deviation:
    leads to nasal air emission?
  13. Cleft palate speech deviation:
    leads to weak oral pressures/weal pressure consonants?
    air pressure
  14. Cleft palate speech deviation:
    leads to maladaptive compensatory misarticulations?
  15. The resonance deviation that is hears on vowels and vocalic consonants (glides and liquids/oral sonorants)?
  16. Hypernasality is resonance distortion that results from ?
    abnormal coupling of oral and nasal cavities
  17. Hypernasality is NOT associated with?
  18. Organically based Hypernasality =?
    obligatory deviation
  19. Hypernasality in cleft palate speakers usually due to ?
    Persisting VP insufficiency

    Oronasal fistula(s)
  20. Aggravated by closed mouth speaking posture?
  21. Hypernasality (HN) resonance is ____ that has a range of acceptability?
    speech parameter
  22. HN is perceived ?

    transription for HN?
    along a continuum

    ~ above the glide or vowel.
  23. Resonance deviation:
    too little nasal resonance; cold-in-th-head sound

    affects vowels, sonorants and nasal consonants

    perceptually mask a VPI
  24. Resonance deviation:
    elements of both hyper/hypo nasality

    is increased nasal cavity resistance
    Mixed nasality
  25. Resonance deviations:
    sound is trapped by anterior nasal cavity constriction

    e.g. deviated septum
    Cul-de-sac resonance
  26. Airflow deviation characterized by speech airflow and emission through the nose?
    Nasal air emission (NAE/NE)
  27. Nasal air emission (NAE/NE) is inaapropriate coupling of oral and nasal cavities? (2)
    1) coupling at the VP port due to true VPI or to mislearning

    2) coupling via the oral cavity due to a fistula
  28. Nasal air Emission accompanies and distorts production of ?
    HPS/ obstruent consonants (stops, fricatives, affricates)
  29. Nasal air emission comes in a variety of forms?
    Can be audible or inaudible

    audible NE can be turbulent or non-turbulent

    Can be obligatory (passive) or learned (active)
  30. Not heard but is visibly detected-dental mirror or reflector

    Not perceptually disruptive to speech

    Diagnostically significant because it may be an indicator of incipient VP inadequacy or airflow through an oronasal fistula?
    Inaudible NE
  31. Nasal turbulence is more of a "snorting" sound
    has been referred to as(posterior nasal frication, nasal snort, nasal rustle)

    Has bee associated with small VP gaps, implicating the VP port as the source of turbulence?
    Audible NE
  32. Audible NE with or without turbulence is NE that accompanies?
    is co-produced with any or all HPCs of a language
  33. Obligatory NE may result from?
    • VP insufficiency
    • VP incompetency
    • Fistulas
  34. Obligatory NE requires physical management?
    • Surgery
    • Speech appliance
  35. Learned NE can be realized in different forms: (2)?
    Nasal fricative substitution with or without turbulence

    NE that is co-produced with the target, with or without turbulence
  36. Learned NE: two error patterns you are likely to encounter in clinical practice are:?

    Persisting post-operative nasal emission
  37. Perceptually it can be realized as a nasal fricative:
    audible turbulence; place of production is velopharyngeal ?
    posterior nasal fricative
  38. PSNE:
    no audible turbulence; place of production is nasal cavity?
    nasal fricative
  39. PSNE not associated with ? (occasional assimilation nasality)?

    Corrected through?

    speech therapy
  40. PSNE has a notable occurrence in?
    non-cleft individuals with normal VP closure ability
  41. PSNE: clinicians unfamiliar with this pattern often misdiagnose the problem as?
  42. NE that persists that repaired CP speakers who have the physiologic ability to attain closure?
    Persisting post-operative NE
  43. Persisting post-op NE speakers continue?
    the old pattern of directing air into the nasal cavity
  44. Persiting post-op NE is not restricted to ?
    any certain sounds, sound groups
  45. Persisitng post-op NE perceptually realized as?
    co-produced NE or as a nasal fricative
  46. Weak pressure consonants are the result of?
    Reduced oral pressures
  47. Weak pressure consonats are due to?
    abnormal coupling of oral and nasal cavities
  48. Weak pressure consonants reduces or eliminates ?
    plosive quality
  49. Weak pressure consonants usually ___ and requires ___?
    organically based

    physical management
  50. Weak pressure consonants in most severe form this will result in?
    nasal consonant substitutions for the class of oral stops: /p,b,t,d,k,g/
  51. Combined impact of HN, NAE, and weak pressure consonants?
    • In VP insufficiency
    • with an oronasal fistula
    • In VP incompetency
    • In VP mislearning
  52. *Learned articulatory deviations
    *Substitution errors in place of articulation
    *Predominantly backed articulatory placements-(post-uvular placements)
    *Persist after successful physical management
    *Coexist with physiologically adequate closure mechanism
    Compensatory Misarticulations (CMAs)
  53. Maladaptive Compensatory Misarticulations include? (7)
    • *glottal stop
    • *pharyngeal stop
    • *mid-dorsum palatal stop
    • *pharyngeal fricative
    • *pharyngeal affricate
    • *posterior nasal fricative (turbulence)
    • *nasal fricative (no turbulence)
  54. Glottal stop substitutes?
    any pressure consonant (typically stops)
  55. Glottal stop co-produces?
    Any pressure consonant (typically stops)
  56. Pharyngeal affricate substitutes?
    Oral affricates
  57. Pharyngeal affricate co-produces?
  58. Pharyngeal fricative substitutes?
    sibilant fricatives +/- oral affricates
  59. Pharyngeal fricative co-produces?
    Sibilant fricatives, affricates
  60. Pharyngeal stop substitutes?
    /k/ /g/
  61. Pharyngeal stop co-produces?
  62. Posterior nasal fricative (velopharyngeal fricative/"snort") substitutes?
    Any pressure consonant
  63. Posterior nasal fricative (velopharyngeal fricative/"snort") co-prodcues?
    any pressure consonant
  64. Nasal frivatives substitute?
    sibilant fricatives +/- oral stops
  65. Nasal fricative co-produces?
  66. Mid-dorsum palatal stop substitutes?
    /t/ /d/ /k/ /g/
  67. Mid-dorsum palatal stop co-prodcues?
  68. Backed oral productions?
    • Mid-dorsum palatal fricative
    • Velar fricative
    • Velarized tip alveolar sonorants
    • Velarized or uvular sonorant
  69. Mid-dorsum palatal fricative voiced or unvoiced fricative consonant made in the approximate place of ?
  70. Mid-dorsum palatal fricative similar in configuration to?
    mid-dorsum palatal stop
  71. Lingual mid-dorsum approximates?
  72. Mid-dorsum palatal fricative distinguishes it from?
    the BLADE alveolar palatal fricatives /s/ and /z/
  73. Mid-dorsum palatal fricative more often heard?
    in voiceless form
  74. Mid-dorsum palatal fricatives sound like?
    a 'cat hiss'
  75. Mid-dorsum palatal fricative substutes for?
    sibilant fricatives, especially /s/ and /z/ and affricates
  76. Velar fricative a voiced or unvoiced fricative made in the same place as?
    the velar stops /k,g/
  77. Velar fricative fricative manner produced in ___ place?
  78. Velar fricative typically substituted for? and sometimes ? due to ___for these sounds?
    sibilant fricatives and affricates

    backing of target place
  79. Velar fricative perceptually it is distinct from?
    pharyngeal fricative
  80. Velar fricative sounds like ?
    • sustained /k:/ /g:/
    • this is almost like a cat hiss except it is a little further back
  81. Velarized tip alveolar sonorants?
    /n/ /l/
  82. Tip alveolar sonorants become?
    • velar sonorants
    • nasal sonorant /n/ to "ng"
    • liquid sonorant /l/ to /L/
  83. Velarized tip alveolar sonorants also observed in otherwise ?
    normal, non-cleft speakers
  84. Velarized or uvular sonorant?
  85. Velarized or uvular sonorant observed in?
    normal, non-cleft speakers
  86. Adaptive oral misarticulations are?
  87. Adaptive oral misarticulations include speech sound errors because of?
    • Dental deviations
    • Occlusal deviations
    • Lip incompetency secondary malocclusion, surgery or both
  88. Adaptive oral misarticulations observed more often in?
    CL +/- CP
  89. Impact of VPI on phonation is ___ problem vs ___ problem?

  90. Impact of VPI on phonation:
    Voice problems in cleft palate?
    Hoarseness secondary to vocal nodules

    soft voice syndrome
  91. Impact of VPI on phonation:
    Voice problem?
    abuse due to compensatory VF valving
    Hoarseness secondary to vocal nodules
  92. Impact of VPI on phonation:
    voice problem in cleft palate:

    CP speaker may intentionally talk more softly to minimize or disguise HN and NE

    It is another compensatory strategy

    Distinguished from the reduced vocal intensity caused by VPI
    Soft Voice syndrome
Card Set
Mod 15 speech deviations and related craniofacial disorders