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Treatment of Speech/Resonance Disorders Associated With Velopharyngeal Dysfunction

presented by Ann W. Kummer, PhD, CCC-SLP, F-ASHA

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Disclosure Statement:

Financial— Ann Kummer receives compensation from MedBridge for the production of this course. She also receives royalites from - Book: Kummer, AW. Cleft Palate and Craniofacial Conditions: A Comprehensive Guide to Clinical Management, 4th edition, Jones & Bartlett Learning, 2020, Clinical Device: Oral and Nasal Listener (ONL), Super Duper Publications (Patent: Nasoscope). She receives Honoraria: for seminars on cleft palate, craniofacial anomalies, resonance disorders, and velopharyngeal dysfunction and consulting: payment for consulting on business practices of speech-language pathology programs Nonfinancial— No relevant nonfinancial relationship exists.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Children with speech and resonance disorders (hypernasality, hyponasality, and cul-de-sac resonance) and/or nasal emission present challenges for speech-language pathologists (SLPs) in all settings. This course is designed to provide current, practical information for SLPs who frequently or occasionally see clients with speech resonance disorders and/or nasal emission due to cleft palate, non-cleft velopharyngeal dysfunction, or other causes.
This course will cover the appropriate treatment of VPI (velopharyngeal insufficiency or incompetence). As such, the various surgical procedures typically used will be described. In addition, prosthetic devices (which are used when surgery is not an option) will be shown and discussed. Specific speech therapy techniques, including effective techniques to correct abnormal velar placement, a lateral lisp, and even distortion of /r/, will be described and illustrated through videos. Finally, methods for achieving fast carryover using motor learning principles will be explained.

Meet Your Instructor

Ann W. Kummer, PhD, CCC-SLP, F-ASHA

Dr. Ann W. Kummer retired as senior director of the Division of Speech-Language Pathology at Cincinnati Children's Hospital in September 2017. Under her direction, the speech-language pathology program at Cincinnati Children's became the largest pediatric program in the nation and one of the most respected. Dr. Kummer remains clinically and academically active as a professor…

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Chapters & Learning Objectives

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1. Physical Management

Velopharyngeal insufficiency (VPI) is caused by an abnormal structure of the velopharyngeal valve. In contrast, velopharyngeal incompetence (also VPI) is caused by a neuromotor disorder. In all cases of velopharyngeal insufficiency and in most cases of velopharyngeal incompetence, physical management is needed for correction.This chapter will cover different surgical procedures that can be used for both forms of VPI, and prosthetic devices that can be used if surgery is not an option.

2. Speech Therapy

Speech-language pathologists need effective speech therapy techniques to achieve appropriate placement for children who demonstrate abnormal articulation placement. This chapter will cover effective techniques for correction of compensatory speech sound productions due to VPI. These techniques are equally effective for achieving correct placement of other speech sound errors. Video examples of the techniques to correct placement for a variety of sounds will be shown, including techniques to correct velars, lateralization of sibilants, and even an effective technique for correcting /r/.

3. Carryover

Many speech-language pathologists find that they are able to correct a child’s placement with speech therapy but are challenged to achieve carryover in connected speech. As a result, some children are in therapy for many months, or even years, just to work on carryover. This chapter will cover the reasons that carryover is not achieved quickly with therapy, and methods to achieve carryover more quickly through the use of motor learning principles.

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