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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_1120_Библиотеки_им_академика_М_И_Перельмана
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• Ongoing orthodontic care and monitoring of facial growth as the
child progresses through the preteen and teen-age years
• Final lip-nose revision after child has reached full growth (around
age 17 in boys, earlier in girls)
• Final team evaluation around age 18 (patient will have to be
prepared to say good-bye to the team, and parents will have to get
a new job)
This book was wrien by four experienced speech-language
pathologists who have devoted most of their careers to the diagnosis
and therapeutic management of speech problems in speakers with
cleft palate (with or without cleft lip) and noncleft velopharyngeal
inadequacy. The authors strongly encourage those of you who may
feel intimidated by the task of providing therapy for this patient
population to keep in mind that this therapy is not magic. We
provide you with interventional approaches in early speech
development to prevent the takeover of the notorious maladaptive
compensatory misarticulations that can sabotage the child's early
phonological development and compromise his intelligibility so that
early speech aempts are met with failure. We also provide you with
techniques for replacing gloal stops, pharyngeal fricatives, and
other compensatory misarticulations with appropriately produced
consonants. The goal for all of us is to eradicate the stigmata of “cleft
palate speech.”
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Reference
Dailey S, Wilson K. Communicating with a cleft palate team:
improving coordination of care across treatment seings.
Perspectives on Speech Science and Orofacial Disorders.
2015;25:35–38.
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Acknowledgments
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From Sally Peterson-Falzone
It seems unlikely that I will ever write about cleft palate without
having the faces and souls of Samuel Pruzansky, Donna Pruzansky,
and Hughle L. Morris pop to the front of my brain. They are
forever with me. HL Morris is still here to monitor me. Just ask him.
An additional “presence” for me is the late Katy Hufnagle. I
cannot grasp that I will never again hear her voice on the end of the
phone, with an enthusiastic new observation (“Bet you've never seen
THIS!”) or a clinical predicament. She loved predicaments, and the
solutions got her even more excited.
My co-authors know that I respect and love them. That's why I
picked them.
My husband Nicholas has now suffered through two books and
two major revisions. He has many stories to tell. Ironically, he is the
one who convinced me that it was important “not to let the lile
book disappear.”
We have had the blessing of working with many Elsevier editors
over the years. Their patience has always been amazing and their
skills enviable. For this edition, we are particularly aware of what we
owe Jolynn Gower, Penny Rudolph, Kellie White, Jaime Pendill,
David Stein, and Nathan Wurm-Cuer.
As clinicians, all four of the authors of this book are forever
indebted to our patients and their families for what they have taught
us. We know we cannot waste that knowledge or assume that we
were naturally entitled to it. The smiles on our faces are for the kids.
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From Judith Trost-Cardamone (aka
Doc T-C)
First and foremost my thanks go to Sally Peterson-Falzone, whose
leadership and persistence have made this text come to fruition, now
in its second edition. Deepest appreciation goes to my many
colleagues who have indirectly contributed to this book through
their mentoring, teaching, and our collaborative work. Chief among
these are Mary O'Gara, Lynn Grames, Kathy Chapman, Mary
Hardin-Jones, Rodger Dalston, David Kuehn, and Michael Karnell.
A special thanks also goes to Penny Wheeler Davis who encouraged
me to take the “part-time” position she was vacating at the
Northwestern University Cleft Lip and Palate Institute (in 1973) to
have her first child. Thus began my lifelong passion for the study
and care of individuals with cleft palate speech disorders. And to my
many graduate students, thank you for meeting the challenges of a
“tough course” and thank you for challenging me to continuously
upgrade my teaching skills. Last, but by no means least, my deepest
love and respect go to my husband, Frank Cardamone, for his
selfless devotion to me and my work.
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From Michael P. Karnell
I echo and amplify previously stated gratitude to my co-authors, the
editorial board at Elsevier, and the patients we have been privileged
to serve. I would expand that gratitude to include the many
members of the cleft palate-craniofacial teams with whom we have
worked.
Heartfelt thanks to Lucy Hynds Karnell for her support, brilliance,
and wisdom throughout 30+ years of life together. I am particularly
grateful for her taste in spouses.
This text was wrien primarily for graduate students in speechlanguage pathology. The authors owe our sincere thanks to the
hundreds of students who have helped us learn how to teach the
topics covered in these pages.
Special thanks to the patients and families who have given consent
for us to include some of their stories in the media content
supporting this text.
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From Mary Hardin-Jones
Thanks go out to the many collaborators who shared my journey
throughout the years and contributed to my professional growth
(including but not limited to Kathy Chapman, Michael Karnell, Sally
Peterson-Falzone, Nancy Scherer, and Judith Trost-Cardamone). I
am particularly grateful to my cherished colleague and spouse,
David Jones, for the many years of encouragement, advice, and
support. As always, I am indebted to the many patients, families,
and students who have taught me so much throughout the years.
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Video and Audio Contents
Audio 4-1 Oral stops in babbling
Video 4-1 Severely limited phonological development
Video 4-2 Limited phonological development
Audio 5-1 Samples of hypernasal speech
Audio 5-2 Samples of hypernasal speech
Audio 5-3 Samples of hypernasal speech
Audio 5-4 Samples of three speakers with different sources of nasal
air emission
Audio 5-5 Child with VP insufficiency but good articulation
Audio 5-6 Adult with VP incompetency secondary to acquired
dysarthria
Audio 5-7 Child with phoneme-specific nasal emission
Audio 5-8 Speaker with hypernasality and rampant gloal stops
Audio 5-9 Speaker using gloal stops
Audio 5-10 Hypernasal speaker who substitutes pharyngeal stops for
velar stops
Audio 5-11 Speaker using pharyngeal fricatives
Audio 5-12 Child with VPI but also substitution of nasal fricatives for
/s/ with no oral placement
Video 5-1 Pervasive hypernasality and nasal emission in a school-age
boy with good articulation
Video 5-2 Preschooler with hyponasality (due to adenoid
hypertrophy) and gloal stops
Video 5-3 Child with a repaired cleft palate in the presence of Robin
sequence who exhibits pervasive use of gloal stops
Video 5-4 Phoneme-specific nasal emission in a noncleft child
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Video 5-5 Boy using ingressive airflow (primarily on stop-plosives,
less so on sibilants) as a compensatory articulation
Video 5-6 Demonstration of compensatory (mis)articulations
Video 5-7 School-age boy using velar fricatives for sibilants
Video 5-8 School-age boy using velar fricatives for sibilants but also
inconsistently using gloal stops
Video 8-1 Testing for nasal emission (mirror fogging) and
hypernasality (resonance shift)
Video 8-2 A quick verification of phoneme-specific nasal emission
(PSNE)
Video 8-3 VPI with associated ingressive airflow (often heard as
clicks) and nasal grimace
Video 8-4 Modeling the target and a quick stimulability check
Video 8-5 EC assessment excerpts to accompany Appendix 8-H
Video 8-6 Fistula-based nasal air emission
Video 9-1 Velopharyngeal inadequacy in 3-year-old with bilateral
cleft lip and palate
Video 9-2 Marginal velopharyngeal inadequacy
Video 9-3 Marginal velopharyngeal inadequacy
Video 9-4 Videofluoroscopy, lateral view
Video 9-5 Videofluoroscopy, anterior-posterior view
Video 9-6 Videofluoroscopy, Towne's view
Video 9-7 7-year-old with 22q deletion syndrome (mild to moderate
hypernasality)
Video 9-8 Persistent VPI after physical management
Video 10-1 Pharyngeal flap check
Video 10-2 Sphincter pharyngoplasty check
Video 11-1 Limited consonant development
Video 11-2 Modeling simple speech targets
Video 12-1 Monitoring nasal versus oral air emission
Video 12-2 Phonetic placement: /k/ production
Video 12-3 Phonetic placement: /t/ production
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