WHOLE LANGUAGE MODEL FOR PROVIDING SPEECH

THERAPY IN VCFS PATIENTS

CLINICAL RESEARCH IN SPEECH PATHOLOGY

EARLY SURGERY PREVENTS COMPENSATORY ARTICULATION

THE OLDER THE PATIENT IS WHEN PALATE IS REPAIRED, THE GREATER THE RISK FOR DEVELOPING COMPENSATORY ARTICULATION

THERE IS A NEGATIVE CORRELATION BETWEEN LINGUISTIC DEVELOPMENT AND THE DEVELOPMENT OF COMPENSATORY ARTICULATION DISORDER [CAD]

IVF GROUP WITHOUT

CAD [ 79% ] ADEQUATE LINGUISTIC

DEVELOPMENT

IVF GROUP WITH CAD

[ 62% ] ADEQUATE LINGUISTIC

DEVELOPMENT

CLINICAL RESEARCH IN SPEECH PATHOLOGY

WHOLE LANGUAGE MODEL IS EFFICIENT FOR THERAPY AIMED TO CORRECT COMPENSATORY ARTICULATION.

PHONETIC GROUP = 30 MONTHS

WHOLE LANGUAGE MODEL = 14.8 MONTHS

WHEN COMPENSATORY ARTICULATION IS CORRECTED, MOTION OF VELOPHARYNGEAL SPHINCTER DURING SPEECH IS MODIFIED (INCREASES)

WHEN COMPENSATORY ARTICULATION IS PRESENT, SPEECH THERAPY SHOULD BE INDICATED BEFORE SURGERY FOR VPI.

ESTRATEGIES FOR ENHANCING PHONOLOGIC DEVELOPMENT

EMPHASIZE USE OF SPEECH SOUNDS WITH COMMUNICATIVE PURPOSES MORE THAN

PRODUCTION AS A GOAL (FEY, 1992) MODIFICATION OF GROUPS OF SOUNDS

TREATED SIMILARLY BY THE CHILD (FEY, 1992) MODELING : RECONSTRUCTION OF ABNORMAL

EMISSIONS

ESTRATEGIES FOR ENHANCING PHONOLOGIC DEVELOPMENT

USE OF STRUCTURED ACTIVITIES WITHIN APPROPRIATE LINGUISTIC CONTEXT (HOFFMAN, 1992)

MODIFICATION OPHONOLOGIC PERFORMANCE IS INFLUENCED BY HIGHER LEVELS OF LINGUISTIC ORGANIZATION

CLOSING : ORGANIZATION OF EMISSIONS INCLUDING PHONOLOGIC INFORMATION

EXPANSIONS : INCREASE SEMANTIC, SINTAX & PHONOLOGIC COMPLEXITY (WARREN, 89)

VERBAL COMMUNICATION MODEL (LUNCH) (HOFFMAN, 1992)

MEANING (GOALS) – BE PREPARED, EAT, CLEAN PROPOSITIONAL (ACCTIONS WITHIN THE GOAL) –

EAT, DRINK CONCEPTUAL (ACTORS, OBJECTS, ACTIONS) –

JUICE, DAD, MOM LINGUISTIC MEANING (PHRASES, RELATIONSHIPS

AND CONCEPTS) – “I DRINK JUICE” SYLLABE PHONEME GESTURE : PLACEMENT & MANNER – TONGUE APEX,

RAISE, DECREASE

SPEECH

ARTICULATION

MOTOR PERIPHERAL PHONEME BASED EVALUATES USE OF

PHONEMES PART TO WHOLE

PHONOLOGY

COGNITIVE CENTRAL LINGUISTIC CODE PHONOLOGICAL

PROCESSES WHOLE TO PART

VCFS PATIENTS WITH VPI

SPEECH :

NASAL EMISSION HYPERNASALITY COMPENSATORY ARTICULATION : ABNORMAL

ARTICULATION PATTERNS

TEACHING – LEARNING CONTEX

STORY BOOKS USEFUL AT ANY LEVEL OF DEVELOPMENT

(WHEN APPROPRIATE) PROVIDE STABLE AND REDUNDANT CONTEXT

WHICH REMAINS THROUGH TIME KEEP ACTIVITIES STABLE (PROVIDES STABILITY) ENHANCE PARALELL WORK WITH ORAL &

WRITTEN LANGUAGE

TEACHING – LEARNING CONTEX

EVENT REPRESENTATION THE BASIC STRUCTURE OF KNOWLEDGE IS

ORGANIZED AROUND EVENTS PROVIDES A GUIDE FOR STRUCTURE AND

CONTENT OF LINGUISTIC & NON – LINGUISTIC ASPECTS

REDUCE COGNITIVE WORK ENHANCING COMMUNICATIVE PERFORMANCE

THE MORE A SCRIPT IS PERFORMED, IT CAN BE PROCESSED MORE EFFICIENTLY

TEACHING – LEARNING CONTEX

EVENT REPRESENTATION (CONT.) PHONOLOGIC FORMS WILL BE INCLUDED IN

GREATER UNITS PLAY IS AN EVENT REPRESENTATION. THE SPEECH PATHOLOGIST MUST KEEP THE

ORGANIZATION AND USE ESTRATEGIES FOR ENHANCING USE OF MORE COMPLEX LINGUISTIC – PHONOLOGIC LEVELS.

VPI

MECHANICAL

PLAN : SURGERY

WITH COMPENSATORY ARTICULATION

DISORDER FUNCTIONAL ENTIRE VOCAL TRACT

IS INVOLVED

PLAN : SPEECH THERAPY

WITHOUT COMPENSATORY ARTICULATION

DISORDER

SPEECH THERAPY

APPROACH – TREAT :

PHONOLOGICAL DISORDER COMPENSATORY ARTICULATION LINGUISTIC ORGANIZATION

COMPENSATORY ARTICULATION

STARTS AS A CONSEQUENCE OF VPI (CLEFT PALATE)

IN TIME, THE ERRORS ARE INCORPORATED INTO THE LINGUISTIC RULES SYSTEM

COMPENSATORY ARTICULATION

GLOTTIC STOPS

ARTICULATION AT GLOTTIS LEVEL

SUSTITUTION OF : /K/, /P/, /T/

PHARYNGEAL FRICATIVE

PHARYNGEAL PLACEMENT OF ARTICULATION

SUSTITUTION OF : /S/

WHOLE LANGUAGE

LANGUAGE IS AN INTEGRATED SYSTEM ALL COMPONENTS ARE SIMULTANEOUSLY

PRESENT AND INTERACTING USE OF LANGUAGE OCCURS WITHIN A

CONTEXT OR SITUATION LEARNING IS ACHIEVED FROM GENERAL

TO PARTICULAR (WHOLE TO PART)

TEACHING – LEARNING CONTEX

GRAPHIC ORGANIZERS PROVIDE VISUAL TOOLS FOR EFFECTIVE

TEACHING VISUAL TOOLS ARE USEFUL FOR VISUAL

AND MIXED LEARNERS (MOST OF POPULATION)

FORGET, DISMISS, CANCEL “EXERCISES” !!!!!

THE ONLY USEFUL EXERCISE FOR SPEECH IS SPEECH

ELECTROMYOGRAPHY AND VIDEOFLUOROSCOPY DEMONSTRATES THAT VOCAL TRACT MOTION DURING SPEECH IS QUITE COMPLEX (SEVERAL STRUCTURES MOVING SIMULTANEOUSLY IN A COORDINATED FASHION). BESIDES, FREQUENCY OF MUSCLE ACTIVITY DURING SPEECH IS SIGNIFICANTLY HIGHER THAN BLOWING, SWALLOWING, ASPIRATING, ETC. THESE ACTIONS SHOW ENTIRELY AND COMPLETELY DIFFERENT PATTERNS OF ACTIVITY.

THERAPY MODALITIES

CONVENTIONAL (AS FREQUENT AS POSSIBLE)

“SPEECH SUMMER CAMP”

THERAPY MODALITIES

“SUMER CAMP” NATURAL ENVIRONMENT PLAY AND STORY TELLING MORE EFFECTIVE (4 HOURS PER DAY AND

FOR 3 – 4 WEEKS)

THERAPY MODALITIES

“SUMER CAMP” CAREFUL PLANNING OF ACTIVIES ADEQUATE “GROUPING” CLASSIFICATION

OF PATIENTS IN GROUPS ASSEMBLE HOMOGENEOUS GROUPS

THERAPY MODALITIES

“SUMER CAMP” INCLUDE MOM & DAD (AT LEAST MOM) : MODIFY STYLE OF INTERACTION, RECRUIT

THEM AS “ALLIES” INCLUDE VISITING SPEECH PATHOLOGISTS