Cleft Speech 2 - Evaluation

Summary

In this educational video, Dr. James Seaward, a pediatric plastic and cleft surgeon, discusses speech errors in children with clefts. He differentiates between resonance and articulation errors, explaining how the former involves excess nasal airflow and often requires surgery, while the latter is due to incorrect positioning of speech organs. Dr. Seaward highlights common articulation issues related to teeth, jaw position, and compensatory errors. He introduces the role of speech pathologists in assessing and recommending treatments, such as bone grafting, orthodontics, or speech therapy. The video concludes with a teaser for the next installment, which will cover speech imaging studies to determine the need for surgery.

Takeaways

• 👨‍⚕️ James Seaward is a pediatric plastic and cleft surgeon at UT Southwestern Medical Center in Dallas, Texas.
• 🗣️ Speech errors in children with clefts can be categorized into resonance and articulation errors.
• 🌀 Resonance errors involve an inappropriate amount of air escaping from the mouth or nose, often requiring surgical intervention.
• 👄 Articulation errors occur when children use incorrect positions of their lips, tongue, and teeth to produce sounds.
• 🦷 Dental issues, such as missing teeth and gaps in the upper jaw, can lead to articulation errors, often improving with bone grafting and orthodontic treatment.
• 🔄 Jaw position discrepancies can affect the production of certain sounds, with treatment potentially involving orthodontic or orthopedic interventions.
• 💡 Compensatory articulation errors arise as children learn new ways to make sounds to compensate for other speech issues.
• 👩‍🏫 Cleft team speech pathologists play a crucial role in evaluating speech errors and recommending appropriate treatments, such as speech therapy or surgery.
• 🎥 Speech imaging studies are conducted to determine if surgery would benefit a child's speech and to decide on the most suitable operation.
• 🔗 For more information about Dr. Seaward and his practice, visit his website at www.drseaward.org.

Q & A

What is the main topic of the video by James Seaward?

The main topic of the video is discussing different types of speech errors in children born with a cleft and how they are evaluated and treated to help them achieve normal speech.

What is the role of James Seaward in the context of the video?

James Seaward is a pediatric plastic and cleft surgeon at UT Southwestern Medical Center in Dallas, Texas, and he is discussing the evaluation and treatment of speech errors in children with clefts.

What is the difference between resonance and articulation speech errors as mentioned in the video?

Resonance errors involve an inappropriate amount of air coming out of the mouth or nose for the sounds the child is trying to make, often due to too much air escaping through the nose. Articulation errors are caused by the child using the wrong position of their lips, tongue, and teeth for the sounds they are trying to make.

Why might children with a cleft have resonance speech errors?

Children with a cleft may have resonance speech errors because of the structural differences in their facial anatomy, which can cause too much air to escape through the nose, affecting the quality of their speech sounds.

How do dental issues contribute to articulation errors in children with clefts?

Dental issues such as missing teeth at the location of the cleft and a gap in the bony arch of the upper jaw can make it difficult for children to create the correct airflow for certain sounds, like 'f' and 'v', leading to articulation errors.

What role does the jaw position play in articulation errors for children with clefts?

The jaw position can affect articulation because certain sounds require the tongue to touch the roof of the mouth behind the top teeth. If the upper jaw grows slower or is positioned behind the lower jaw, it can be challenging for children with clefts to produce sounds like 't' and 'd' correctly.

What is the third type of articulation error mentioned in the video?

The third type of articulation error is compensatory errors, which occur when children learn new ways to make sounds to compensate for another speech error, such as a resonance error or other articulation errors.

How do speech pathologists contribute to the evaluation of speech errors in children with clefts?

Speech pathologists listen to children with clefts to determine the type of speech errors they have. They may recommend speech therapy or arrange for speech imaging if they suspect a resonance problem.

What is the purpose of speech imaging in the context of evaluating speech errors in children with clefts?

Speech imaging is used to determine whether a child would benefit from surgery to help with speech and to decide which operation is most appropriate for the individual child.

What are the potential treatments for resonance and articulation errors in children with clefts as discussed in the video?

Potential treatments for resonance errors may include surgery, while articulation errors might improve with bone grafting, orthodontic treatment, or speech therapy.

How can viewers get more information about James Seaward and his practice?

Viewers can get more information about James Seaward and his practice by visiting his website at www.drseaward.org.

Outlines

00:00

🗣️ Speech Errors in Children with Clefts

Dr. James Seaward, a pediatric plastic and cleft surgeon, introduces the topic of speech errors in children born with clefts. He differentiates between resonance and articulation errors. Resonance errors involve an inappropriate amount of air escaping from the mouth or nose, often requiring surgical correction. Articulation errors stem from the incorrect positioning of the lips, tongue, and teeth. Dr. Seaward explains three main reasons for articulation errors in cleft children: missing teeth leading to improper sound production, jaw misalignment affecting certain sounds, and compensatory articulation errors due to other speech issues. He emphasizes the role of the cleft team, particularly speech pathologists, in evaluating and recommending treatments, which may include speech therapy or surgery.

Keywords

💡Speech errors

Speech errors refer to any deviation from standard or expected speech patterns. In the context of the video, these errors are specifically related to children born with clefts and can be categorized into resonance and articulation errors. The video aims to discuss these errors to help diagnose and treat children's speech issues, emphasizing the importance of proper evaluation and intervention.

💡Resonance

Resonance in speech refers to the quality and richness of sound produced by the vocal tract. A resonance error, as mentioned in the video, occurs when there is an inappropriate amount of air escaping through the mouth or nose, affecting the clarity of speech sounds. This is particularly relevant for children with clefts, as it often requires surgical intervention to correct the anatomical issues causing the excessive nasal airflow.

💡Articulation

Articulation pertains to the manner in which an individual forms speech sounds using the lips, tongue, teeth, and other speech organs. In the video, articulation errors are discussed as a common issue for children with clefts, where they may use incorrect positions of these organs, leading to mispronunciation of certain sounds. The video highlights that these errors can stem from dental issues, jaw position, or compensatory mechanisms.

💡Cleft

A cleft refers to a congenital condition where there is a gap or split in the structures of the face, such as the lip or palate. The video discusses how children born with clefts often struggle with speech due to the anatomical abnormalities affecting their speech production. The video's theme revolves around understanding and addressing speech issues in these children to help them achieve normal speech.

💡Pediatric plastic and cleft surgeon

A pediatric plastic and cleft surgeon is a medical professional who specializes in surgical procedures for children, particularly those involving clefts and other congenital anomalies. Dr. James Seaward, as introduced in the video, is such a surgeon and discusses his role in evaluating and treating speech issues in children with clefts, emphasizing the interdisciplinary approach involving surgery and speech therapy.

💡Bone grafting

Bone grafting is a surgical procedure where bone tissue is transplanted from one part of the body to another to repair defects or to stimulate growth. In the context of the video, bone grafting is mentioned as a treatment option for children with clefts who have dental issues, such as missing teeth or gaps in the upper jaw bone, which can contribute to articulation errors in speech.

💡Orthodontic treatment

Orthodontic treatment involves the use of dental appliances to correct misaligned teeth and jaws. The video discusses how orthodontic treatment can help improve speech in children with clefts by addressing dental and jaw alignment issues that contribute to articulation errors. This treatment can be crucial for long-term oral health and speech clarity.

💡Speech therapy

Speech therapy, also known as speech-language pathology, is a treatment method that helps individuals with speech and language disorders to improve their communication skills. The video mentions that speech therapy is often necessary for children with clefts to address compensatory articulation errors or to refine their speech after surgical interventions.

💡Speech imaging

Speech imaging refers to the use of various imaging techniques to visualize the structures and movements involved in speech production. The video hints at the use of speech imaging studies to determine whether a child with a cleft would benefit from surgery to improve their speech. These studies can provide valuable insights into the functional aspects of speech and guide treatment decisions.

💡Cleft team

A cleft team is a multidisciplinary group of healthcare professionals who work together to provide comprehensive care for individuals with clefts. The video introduces the role of the cleft team, particularly speech pathologists, in evaluating speech errors in children with clefts. This team approach ensures that each child receives personalized care tailored to their specific needs and conditions.

Highlights

Introduction to speech errors in children with clefts by James Seaward, a pediatric plastic and cleft surgeon.

Differentiation between speech errors caused by resonance and articulation.

Explanation of resonance errors as inappropriate air flow during speech sounds.

Typically, resonance errors in cleft children involve excessive nasal air escape.

Resonance errors often require surgical intervention for correction.

Description of articulatory speech errors due to incorrect positioning of speech organs.

Three main reasons for articulatory errors in children with clefts.

Impact of dental anomalies on the production of 'f' and 'v' sounds.

Bone grafting and orthodontic treatment as solutions for dental-related speech issues.

Jaw position's role in the production of 't' and 'd' sounds and its challenges in cleft children.

Orthodontic or orthographic treatment's potential to improve jaw-related articulation errors.

Compensatory articulation errors as a response to other speech issues.

The necessity of speech therapy for compensatory articulation errors.

Methodology for determining the type of speech error and appropriate treatment.

Introduction of cleft team speech pathologists and their role in evaluating speech errors.

Process of speech evaluation by speech pathologists, including recording for clinical records.

Recommendations by speech pathologists for speech therapy or further speech imaging.

Anticipation of the next video discussing speech imaging studies for surgical decision-making.

Invitation for more information and contact through Dr. Seaward's website.

Transcripts

Hello. Today I would like to discuss different types of speech errors and how

we evaluate children born with a cleft who are struggling with their speech to

help to try to get that child to normal speech. I am James Seaward a pediatric

plastic and cleft surgeon at UT Southwestern Medical Center in Dallas

Texas. In this video I would like to start with the difference between speech

errors caused by resonance and by articulation. Let's go back to looking at

the face from the side. If we project our view so we're still looking in the same

direction but now we're looking at the middle of the face, it will look

something like this. A resonance error is a type of speech error in which there is

an inappropriate amount of air coming out of the mouth or nose for the speech

sounds the child is trying to make. For children born with a cleft, this is most

commonly but not always too much air escaping out of the nose

and this typically needs to be treated with surgery. An articulatory speech

error is a type of speech error caused by the child using the wrong position of

their lips, tongue and teeth for the sound they're trying to make, and there

are three main reasons why children born with a cleft are more likely to have

articulatory errors in their speech. The first is to do with the teeth: let's

consider the F and the V sounds 'f' and'v'. We make these sounds by touching our

bottom lip to our top teeth to create a thin stream of air but children born

with a cleft often have a missing tooth at the location of the cleft together

with a gap in the bony arch of the upper jaw. This means that they can struggle to

make the right sized hole in order to make this sound correctly. These errors

often improve with bone grafting and orthodontic treatment. The second is to

do with the jaw position let's consider the T and D sounds 't' and 'd'. These

sounds are made by the tongue touching the roof of the mouth behind the top

teeth, building up pressure behind the tongue

and releasing it suddenly. Children born with a cleft may have an upper jaw that

grows at a slower rate than the lower jaw and is positioned behind the lower

jaw. In this case they can struggle with moving the tongue so it can reach the

roof of the mouth behind at the top teeth and this often improves when

orthodontic or orthographic treatment is complete. The third type of articulation

area is learning new ways to make sounds to compensate for another speech error

like a resonance error or the articulations we just discussed. These

compensatory errors often need to be addressed using speech therapy. So how do

we work out whether the child has a resonance error that will need surgery

to improve, an articulation error that will likely improve on its own, an

articulation error that needs speech therapy to improve or a combination of

these? Well at this point I would like to introduce you to our cleft team speech

pathologists. These ladies are experienced in listening to children

born with a cleft to determine which type of speech errors a child has. They

will typically listen to the child in clinic and take a recording of the

speech for the clinical records. Based on what they hear, they will either

recommend a program of speech therapy or if they suspect a resonance problem they

will arrange for speech imaging. In my next video, I will discuss the different

types of speech imaging studies we do to determine whether a child would benefit

from surgery to help with speech and to help decide which operation is the most

appropriate for that individual child. Thank you for watching and if you would

like any more information about me and my practice please visit my website at

www.drseaward.org