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[Dysphagia] velopharyngeal incompetence
Colleen -
Has the child been evaluated by a Craniofacial/Cleft Palate team? Do you
know for sure if it's not structural (ie. submucous cleft). Obviously, it
is abnormal for food to flow into the nasal cavity, so that symtom alone is
enough to refer the child. Take a look in his mouth while he is phonating
"ah" - sometimes you can see a "blue-ish/white" shadow with a SMC -
sometimes, you can even see the light from the flashlight coming out of the
nasal cavity. Also feel the juncture of the primary and secondary palate
for any notching, which is also an indicator of a SMC.
Is his resonance hypernasal? And if so, is it hypernasal across all
pressure consonants or is it sound specific? Direct treatment for
hypernasality is only indicated (without other intervention) for sound
specific hypernasality.
If the team feels it is warranted, they can refer him for a speech
videofluoroscopy and/or nasoendoscopy to objectively assess the competence
of the velo-pharyngeal mechanism. Make sure you send him to someone who has
done this and knows the protocol. The team will then have enough
information to make appropriate recommendations for this child.
Kathy
----- Original Message -----
From: "Wade, Colleen" <WadeC@rvh.on.ca>
To: <dysphagia@b9.com>
Sent: Thursday, September 30, 2004 2:33 PM
Subject: [Dysphagia] velopharyngeal incompetence
> Hi All,
>
> I just finished reading a recent article from AJSLP on velopharyngeal
> incompetence. In the case of food entering the nasopharynx due to
> reduced soft palate elevation/strength and not structure, what
> treatments are clinicians using to help strengthen/elevate the soft
> palate. Aside from medical procedures/prosthetics, are there any
> techniques being used successfully?
>
> Thanks for any/all suggestions.
>
> Colleen Wade
> Speech-Language Pathologist
>
>
>
>
>
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