Guest guest Posted March 8, 2003 Report Share Posted March 8, 2003 No experience with this, but good luck, hope all goes well. maria speech eval > Aubrie had a speech eval at St. Louis Children's Hospital today. We have been concerned about the hypernasal quality of her speech and her difficulty in producing consonants. She has great language but is quite unintelligible. The therapist we saw specializes in cleft palate and hypernasal speech. > > She verified that Aubrie has a submucous cleft and that seems to be her biggest obstacle to intelligible speech. She made some specific recommendations for therapy at school and also suggested some testing. She wants to do velopharyngial imaging. Has anyone had this done? > > My understanding is that there are 2 tests. In one, a small camera is inserted through the nostril to record the function of the palate while the child makes specific speech sounds. In the other, barium is squirted up the nose and a sideview video is taken while the child speech. The 2 tests combined can give detailed info about the lack of closure at the palate. Once we know the size, shape, etc of the space, we can determine what prosthetic or surgical options might help. > > Anyone been down this road? I'm a bit nervous. I can't imagine Aubrie tolerating either test awake. She doesn't sit still for her teeth cleanings or echos. I expect we'll be doing it by the end of the month or mid April. > > The eval today was fascinating. The therapist recommended working with Aubrie during therapy with her nose plugged so that she can better learn how to get the air through her mouth. Anyone try that approach? > > Thanks in advance for your helpful input. I'll let you guys know how things develop. > > On another note -- the OT is working on some HANDLE-type exercises for Aubrie. She and the speech supervisor have been involved in Neuronet training. It seems to me that the 2 approaches are very similar. I'm excited about starting the Neuronet exercises with Aubrie. I'll let you know about that too when I have more info. > > Michele W > mom to Aubrie (5 yrs) > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2003 Report Share Posted March 10, 2003 Michele, My daughter also is very hypernasal. She had the nasal endoscopy test done (inserting the camera through the nostril). It was relatively painless, they numb the nostril before placing the small tube like camera down there. They had her say certain words and sounds while the camera was inserted and it was recorded on video, we also watched it while the test was going on, which my daughter thought was kinda neet. She is usually very good at sitting still, she realizes the more you cooperate, the faster it will get done. speech eval Aubrie had a speech eval at St. Louis Children's Hospital today. We have been concerned about the hypernasal quality of her speech and her difficulty in producing consonants. She has great language but is quite unintelligible. The therapist we saw specializes in cleft palate and hypernasal speech. She verified that Aubrie has a submucous cleft and that seems to be her biggest obstacle to intelligible speech. She made some specific recommendations for therapy at school and also suggested some testing. She wants to do velopharyngial imaging. Has anyone had this done? My understanding is that there are 2 tests. In one, a small camera is inserted through the nostril to record the function of the palate while the child makes specific speech sounds. In the other, barium is squirted up the nose and a sideview video is taken while the child speech. The 2 tests combined can give detailed info about the lack of closure at the palate. Once we know the size, shape, etc of the space, we can determine what prosthetic or surgical options might help. Anyone been down this road? I'm a bit nervous. I can't imagine Aubrie tolerating either test awake. She doesn't sit still for her teeth cleanings or echos. I expect we'll be doing it by the end of the month or mid April. The eval today was fascinating. The therapist recommended working with Aubrie during therapy with her nose plugged so that she can better learn how to get the air through her mouth. Anyone try that approach? Thanks in advance for your helpful input. I'll let you guys know how things develop. On another note -- the OT is working on some HANDLE-type exercises for Aubrie. She and the speech supervisor have been involved in Neuronet training. It seems to me that the 2 approaches are very similar. I'm excited about starting the Neuronet exercises with Aubrie. I'll let you know about that too when I have more info. Michele W mom to Aubrie (5 yrs) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2003 Report Share Posted March 10, 2003 " She is usually very good at sitting still, she realizes the more you cooperate, the faster it will get done. " I'm glad to hear someone else has done this. Your description is just what the therapist said. However, Aubrie does not sound like your daughter at all. A month or so ago, we went for a heart echo. She saw her brother do it, she knew exactly how it worked, saw the monitor image, knew that if she didn't sit still and do it we'd have to come back and do it with sleepy medicine -- her reply, " We will come back. " So I can't imagine her tolerating either of these new tests, but I guess we'll give it a whirl. When we schedule, they will send her a coloring book describing the procedure. Maybe that will help. Did your daughter have any prosthesis or surgery as a result of the test? What did they find and what was the course of treatment? Michele W Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2003 Report Share Posted March 11, 2003 My daughter Jodie has been all through this. At the age of 6 she would not have the camera passed through her nose - what with the choanal atresia the area is narrower than most anyway and I think tubes in this area held horrible memories for her from suctioning. However with the barium x-rays they got enough information to determine that she did have a sub mucous cleft palate that did need surgery. After the operation to repair the palate her surgeon told me he did not know if it would be succesful as the muscle annatomy he had to deal with was significantly different to the norm - quite unlike any he'd dealt with before. ( this is a top surgeon over here with heaps of experience in all types of palates). So we'd have to wait and see what the improvement would be. Jodies 11 now - she has tolerated the camera since then (I think she was 9 the first time) - though the repair has given her greater closure the muscles are still weak and the function is not the best. Speech is still very hypernasal and unintelligeable to most. Her team here say that the prosthetic device is not a good option for Jodie as with all the other swaloing difficulties(poor co-ordination, pooling etc.) this will be made worse. So there is nothing further they can do. Recently I made them assess her again as Jodie is very frustrated with her speech - but they are still convinced there is nothing they can do to help. Good Luck with Aubrie. Vicky England speech eval > Aubrie had a speech eval at St. Louis Children's Hospital today. We have been concerned about the hypernasal quality of her speech and her difficulty in producing consonants. She has great language but is quite unintelligible. The therapist we saw specializes in cleft palate and hypernasal speech. > > She verified that Aubrie has a submucous cleft and that seems to be her biggest obstacle to intelligible speech. She made some specific recommendations for therapy at school and also suggested some testing. She wants to do velopharyngial imaging. Has anyone had this done? > > My understanding is that there are 2 tests. In one, a small camera is inserted through the nostril to record the function of the palate while the child makes specific speech sounds. In the other, barium is squirted up the nose and a sideview video is taken while the child speech. The 2 tests combined can give detailed info about the lack of closure at the palate. Once we know the size, shape, etc of the space, we can determine what prosthetic or surgical options might help. > > Anyone been down this road? I'm a bit nervous. I can't imagine Aubrie tolerating either test awake. She doesn't sit still for her teeth cleanings or echos. I expect we'll be doing it by the end of the month or mid April. > > The eval today was fascinating. The therapist recommended working with Aubrie during therapy with her nose plugged so that she can better learn how to get the air through her mouth. Anyone try that approach? > > Thanks in advance for your helpful input. I'll let you guys know how things develop. > > On another note -- the OT is working on some HANDLE-type exercises for Aubrie. She and the speech supervisor have been involved in Neuronet training. It seems to me that the 2 approaches are very similar. I'm excited about starting the Neuronet exercises with Aubrie. I'll let you know about that too when I have more info. > > Michele W > mom to Aubrie (5 yrs) > > Quote Link to comment Share on other sites More sharing options...
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