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plosive quality of obstruent consonants in particular. Weak oral
pressures are related to, but separate from, nasal emission and are
usually associated with VP insufficiency or VP incompetency. In its
most severe form, weak oral pressure ability is reflected in nasal
consonant replacement or substitutions for the class of oral stops (the
nasal consonants replace /p, b, t, d, k, g/) as in “mall” for ball
,
“noll” for doll
, and so forth.
Combined Impact of Hypernasality, Nasal Air
Emission, and Weak Pressure Consonants
• In VP insufficiency, hypernasality may range in severity and pressure
consonants in the speaker's inventory lose power and are affected by
nasal emission.
The child speaker in Audio 5-5
has VP insufficiency with good
articulation. The youngster that you saw in Video 5-1 demonstrates VP
insufficiency and hypernasal speech but has very good articulatory
placements. As noted, he has nasal fricative realizations for /s, z/. You
may want to watch that video again.
• With an oronasal fistula of sufficient size (Shelton and Blank, 1984),
nasal emission is heard on pressure consonants whose place of
articulation is in or near (generally anterior to) the location of the
fistula. Henningsson and Isberg (1990) observed that even small
fistulas can contribute to nasal air emission and can negatively affect
speech. In contrast, not all openings that are identified on an orofacial
examination are actually patent through to the nose (which of course
means that they are not a true fistula) because the nasal and oral layers
are closed separately in surgery. Hypernasality may or may not be
perceptually evident, depending on fistula size, and it may also be
influenced by phonetic context, mouth opening, and tongue position.
• In VP incompetency, hypernasality is pervasive, and all pressure
consonants in the inventory lose power. Nasal emission may or may
not be perceived. This is because VP incompetency typically occurs in
the context of a more extensive dysarthria, and audible nasal emission
may not be realized or evident because of reduced respiratory capacity
to generate and sustain adequate airflow.
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The adult speaker in Audio 5-6
provides a clear example of acquired
dysarthria with VP incompetency.
• In VP mislearning, the presence and perceptual impact of
hypernasality, nasal emission, and weak pressure consonants will vary
in relation to the nature of the mislearning, as follows:
— Phoneme-specific nasal emission and learned
persisting postoperative nasal emission (typically
minimal to no hypernasality).
Audio 5-7
provides an example of a child speaker with PSNE.
— Gloal stops or pharyngeal fricative articulations, or
both, that cause the VP port to remain open during
production (hypernasality associated with gloal
stop and pharyngeal segments of speech and, to a
lesser degree, nasal air emission because any airflow
release below the port is dissipated and lacks
sufficient energy to reach the nasal cavity; the more
frequent or “abundant” the gloal and pharyngeal
articulations, the more pervasive the hypernasality)
(see next section).
Audio 5-8
presents a speaker with rampant gloal stops and
hypernasal resonance.
Compensatory Articulations
Compensatory articulations (CAs) associated with cleft palate are
learned articulation deviations and are, for the most part, errors in place of
articulation. The aberrant place is substituted for the target place or may
be coproduced simultaneously with the target place. (Coproductions
are described in detail later in this chapter.) The overriding paern
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imposed by CAs is one of backed or retracted articulatory placements
(see later). Compensatory articulations are learned early in the course of
speech acquisition and are believed to result from strategies developed
by the child with a cleft palate to offset the structural impediments
posed by the cleft (Huers and Bronsted, 1987) (Box 5-4).
Box 5-4
Origins of Compensatory Articulations
Different theories have been put forth to explain the origin of
compensatory articulations in cleft palate speech. According to some
authors, these articulations are the cleft palate speaker's early aempts
to mark phonological contrasts by using alternate articulatory placements
(Harding and Grunwell, 1998; Huers and Bronsted, 1987; Sell et al.,
1994, 1999; among others). Warren and colleagues (Warren, 1986;
Warren et al., 1990) proposed a “pressure regulation hypothesis” to
account for compensatory strategies involving gloal and pharyngeal
articulations. These investigators suggested that these strategies are
developed to meet the pressure-valving requirements of speech
articulation. In his commentary on the article by Warren et al. (1990),
Netsell suggested an “acoustic regulation hypothesis in which “… the
speaker valves the airstream at or below the velopharynx in order to
generate acoustic distinctions that cannot be produced anterior to the
velopharyngeal opening” (Warren et. al, 1990, p. 59). This last
explanation appears compatible with the goal of achieving
phonological contrasts. All three of these theoretical explanations are
plausible. Although we lack evidence to support one or another of
these theories, the shift to atypical and maladaptive articulatory
placements so characteristic of cleft palate speech can be accounted for
by all these explanations. Some children may recruit atypical
placements to meet the pressure valving requirements for speech, and
others may do so to match acoustic targets or create phonological
contrasts. And, as noted by Huers and Bronsted (1987), some children
may accept the hypernasality and nasal air escape, with good
underlying articulatory placements.
Once learned, compensatory articulations tend to remain in the
phonetic inventory and may become part of the child's phonology. As
presented in Chapter 4, they become integrated into the child's lexicon.
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p p y g
It is significant that CAs usually persist even after physically successful
surgical repair or appliance management of VPI. Therefore, they can
coexist with a physiologically adequate closure mechanism.
For a more comprehensive discussion of the nature and development
of compensatory articulations, see Morley (1970), Trost (1981),
Peterson-Falzone et al. (2010, Chapter 7), and Trost-Cardamone (2013).
Compensatory articulations are cleft-related errors that we believe
have the greatest impact on speech understandability and speech
acceptability (Box 5-5).
Box 5-5
Speech Understandability and Speech
Acceptability
Whitehill (2002) brought our aention to the limitations in rating
intelligibility by using traditional rating scales, although intelligibility
is the parameter used in most speech outcome studies. Speech
understandability is a global speech measure that is closely related to
intelligibility and is more easily scaled using clear descriptors
(Henningsson et al., 2008), as presented in Chapter 8, in which we also
define speech acceptability. Wiel (1995) distinguished between
intelligibility, “… how well a listener understands [speech]” and
acceptability “… the subjective impression of the pleasingness of
speech” (p. 147).
The CAs addressed here have been modified from Trost's (1981)
original publication and the first edition of this text, as well as from
Peterson-Falzone et al., 2010. They include gloal stop, pharyngeal stop,
pharyngeal fricative, pharyngeal affricate, nasal fricative, and middorsum palatal stop. Description of the nasal fricative has been updated
and expanded to include both nonturbulent and turbulent productions,
and associated terminology and phonetic transcription have been
clarified.
Researchers in Japan described a laryngeal fricative (Kawano et al.,
1985). They considered the laryngeal fricative to be a distinct laryngeal
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) y y g y g
articulation. At this time, we believe that more evidence is needed in
support of this concept. The laryngeal fricative may be a variant of the
pharyngeal fricative, one that is produced very low in the pharynx
(Trost-Cardamone, 1997). Because of the linkage between tongue,
hyoid, and larynx, activity of the inferior tongue base may “pull” the
larynx upward and forward, passively engaging it in this
linguapharyngeal articulation.
Brief bulleted descriptions and schematic illustrations based on
radiographic imaging data of each of these CA types are presented here.
Glottal Stop
FIGURE 5-7 Glottal stop.
• A stop consonant made in gloal place of production
• Usually described as unvoiced because there is no sustained vocal
fold vibration
• Produced in the larynx with vocal fold closure
• Bypasses the VP port, thus leaving it open during articulation of
affected consonant and surrounding vowels
• Typically substituted for stop consonants but may substitute for any
of the oral high pressure consonants
• Also occurs as a coproduction, mainly with stops and affricates
At this point, you may wish to view Video 5-3,
which shows a schoolage youngster who has Robin sequence with a repaired cleft of the
secondary palate and who is producing gloal stops. You may also
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wish to watch Video 5-2 again, the preschooler with a repaired cleft lip
and palate who is hyponasal and uses rampant gloal stops. Audio 5-9
provides another example of a speaker who uses gloal stops.
Pharyngeal Stop
FIGURE 5-8 Pharyngeal stop.
• A stop consonant articulation made in the pharynx; a
linguapharyngeal articulation
• Voiced or unvoiced
• Base of the tongue contacts the posterior wall of pharynx somewhere
along its length, at any point from the superior larynx up to the velum
• Airflow is stopped and released pharyngeally, comparable to oral
stops
• Used as a substitution or replacement for /k/ and /g/
• Does not occur as a coproduction
Now listen to the speaker in Audio 5-10
who uses pharyngeal stops
for /k/ and /g/ and is also hypernasal.
Pharyngeal Fricative
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FIGURE 5-9 Pharyngeal fricative.
• A fricative consonant made in the pharynx; a linguapharyngeal
articulation
• Voiced or unvoiced
• Lingual base approximates the PPW
• Airflow constricted but not completely stopped, comparable to oral
fricatives
• Substituted predominantly for the sibilant fricatives /s, z,
, /; may
also be substituted for oral affricates /
/ and / /
• Also occurs as a coproduction; mainly with sibilant fricatives
You can hear a speaker using pharyngeal fricatives in Audio 5-11
.
Pharyngeal Affricate /
/ / /
• Combines pharyngeal fricative and gloal stop (as with the oral
affricate combination of alveolar stop and palatal fricative)
• Less frequently occurring than gloal and pharyngeal stops and
pharyngeal fricatives.
• Tends to be substituted exclusively for the oral affricates /
/ and / /
Nonturbulent Nasal Fricative
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FIGURE 5-10 Nonturbulent nasal fricative.
• An unvoiced nasal produced with complete oral occlusion (closure)
and exclusive audible (nonturbulent) nasal emission (the nonoral
component)
• Oral placement that creates the occlusion may be any of four nasals:
bilabial /m/, alveolar /n/, velar /
/, or labiodental / /
• The VP port is widely open, and frication is generated anterior to the VP
port
• Typically replaces sibilant fricative targets, less often affricates; also
may replace any of the stop consonants
• May be obligatory (passive) or learned (active), but it is the active nasal
fricative, characterized by intentional nasal emission, that is a compensatory
articulation
Obligatory/passive nasal fricatives may occur as part of a pervasive
paern of nasal emission with accompanying hypernasality that signals
physically based VPI.
• Learned or active nasal fricatives typically are realized in a phonemespecific or class-specific paern in which there is no to minimal
hypernasality and other pressure consonants in the inventory are
produced orally; that is, usually affects one or two targets (e.g., /s, z/)
but may replace a class of consonants (e.g., fricatives) (also see
Grunwell and Harding, 1998; Sell et al., 1999)
Notes on “Posterior Nasal Fricative”
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Clarification of Terminology.
As shown earlier in Table 5-1, several terms have been used to label
perceived nasal turbulence. These include posterior nasal fricative,
velopharyngeal fricative, nasal rustle, nasopharyngeal snort. Trost
(1981) identified the articulatory behavior at the VP port associated with
the perceived turbulence and the exclusive nasal airflow and called the
articulation a “posterior nasal fricative.” Posterior nasal fricative and
the other terms listed capture or identify only the turbulence generated
at the VP port. All these terms were offered before clarification of the
oral occlusive components of any nasal fricative provided by Sell et al.
(1999). “Posterior nasal fricative” (Trost, 1981) was used in the 2006
edition of this text to label the turbulent nasal fricative, thus focusing
only on the behavior at the VP port that generated the turbulence and
without appreciation of the concurrent oral placements. This text
corrects that incomplete description by replacing the posterior nasal
fricative label with “turbulent nasal fricative” and distinguishing it from
the nasal fricative that, by definition, is nonturbulent.
Phonetic Transcription for Turbulence.
Also at the time of Trost's (1981) publication, there was no ExtIPA and
no symbol or diacritic for turbulence. The symbol
was created to
transcribe the (posterior) nasal fricative and was also used as a diacritic
placed above the target for coproduced turbulence. The ExtIPA diacritic
for turbulence,
, is in standard use throughout the United Kingdom
and by many SLPs experienced in cleft palate speech in the United
States and Canada, and it replaces the
used in the first edition of this
text.
Turbulent Nasal Fricative
• An unvoiced nasal produced with complete oral occlusion (closure)
and nasal turbulence—the nonoral component (Fig. 5-11)
• As with the nasal fricative, the oral placement that creates the
occlusion may be any of four nasals: bilabial /m/, alveolar /n/, velar /
/,
or labiodental /
/
• Associated with a small or narrow VP opening that is the source of the
turbulence
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• Turbulence may be created by variable articulatory gestures at and
around the VP port, for example:
— Velum approximates but does not fully contact the
PPW
— Tendency of the velum to “fluer” against the PPW
(or adenoid), thus creating constricted airflow and
turbulent frication or snorting
— In some speakers, tongue base may move back and
up to help occlude the VP port (provide a lingual
assist to closure) resulting in a constricted VP
opening
• Turbulent nasal fricatives that are obligatory or passive have not been
well described or frequently reported; more often, turbulent nasal
fricatives are compensatory or active and characterized by intentional
nasal turbulence
• Typically replaces sibilant fricative targets, less often affricates
• Tends to be realized in a phoneme-specific paern (affecting one or
two targets, e.g., /s, z/) or a class-specific paern (e.g., fricatives) with
no to minimal hypernasality
Remember … because the nasal fricative articulation replaces the target
phoneme, it is distinguished from audible nasal emission or nasal
turbulence that is coproduced with or accompanies the consonant
phoneme.
The child in Video 5-4
has no cleft or other type of VPI, but exhibits
inconsistent substitution of nasal fricatives (or coproduced nasal
emission with oral placement) on /s/ and /z/. This is phoneme-specific
nasal emission (PSNE). The child in Audio 5-12
has VPI but also a
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