10th World Cleft Lip & Palate Congress of the International Cleft Lip and Palate Foundation (ICPF)

24-28 Oct 2016, Hyatt Regency Hotel, Chennai, India.www.cleft2016icpf.com

Symposium 3.Speech in Cleft Care: Challenges Facing the Speech Pathologist.

Compensatory errors of Speech, assessment and management

Thamizharasan S, MSc (Audiology & Speech Language Pathology)
Associate Prof. of Audiology & Speech Language Pathology, SRM Medical College, SRM University

Manuscript

Right at the time, the child seeks medical help from the Cleft care team, well before any surgical
intervention, the role of Speech Language Pathologist starts. He must identify specific
articulatory, resonance and language defects and plan a line of strategy. Early intervention
should be the motif. Atypical patterns of articulation have often observed in the speech of
individual with cleft palate. Some of these patterns to develop in compensation for VPI and
others develop in compensation in fistulae and /or malocclusion. Glottal stops, pharyngeal
fricatives, pharyngeal affricates, posterior nasal fricatives, velar fricatives, mid dorsum palatal
stop. In a compensatory co-production, the speaker simultaneously articulates at two places of
production and one manner of production. By contrast glottal substitution for target i.e. singles
place of stopping and the open lips. These productions both look different and sound different.
For example A, the /b/ in “bay” is realized as a compensatory co-production, that is, with lip
closure but with a simultaneous glottal stop production

Glottal stop: These are one of the most common compensatory errors observed on children with
cleft palate. Laryngeal production typically occurs as substitutions for oral consonant.

A voiced stop consonant with glottal place of production. Produced in the larynx with vocal fold
valving. Typically substituted for stop consonant but may substitute for any of the high pressure
consonant.
Pharyngeal stop:
It is a linguapharyngeal consonant articulation, it can be observed in both voice and voiceless
sounds.

Base of the tongue contacts the posterior wall of pharynx somewhere along its length, at any
point from the inferior pharynx up to the velum. Airflow is stopped and released, comparable to
oral stops. It can be a substitution for /k/ and /g/.

Pharyngeal fricatives:
Linguapharyngeal articulation and can be voiced or voiceless. A fricative sound is produced at
the level of pharynx. Tongue base approximates the posterior pharyngeal wall constricting but
not completely stopping the air flow in the oral cavity.

It can be comparable to constrictions associated with oral fricatives, substitution predominantly

observed with sibilant fricatives /s/, /z/ may also be substituted for oral affricates.

Pharyngeal affricates:
These combines both fricative and glottal stop. It is less likely to occur than glottal stop,
pharyngeal stop and pharyngeal fricatives. It can also be termed at velopharyngeal fricatives. A
turbulent velopharyngeal fricative articulation association with small VP openings.
Nasal fricatives:
It is also termed as active nasal fricatives. Non turbulent NE realized as a voiceless nasal
resulting in complete oral occlusion, with all air thus being emitted through nose. Typically
substituted for sibilant fricative targets and also may be substituted for any of the sop consonant.

Mid Dorsum Palatal Stop:

A voiced or voiceless stop consonant made in the approximate place of /j/, the mid palatal glide.
Airflow is stopped and released, comparable to other oral stops. Typically substituted for /t/ for
/k/ (voiceless) and /d/ or /g/ (voiced).

Treating maladaptive compensatory misarticulation:

To consider specific therapy procedure and techniques for eliminating or modifying maladaptive
compensatory misarticulation. Mostly these type of errors are seen in place of production and
most are backed non oral consonant that use pharyngeal and glottal articulatory valving. Our
general objectives are to establish oral place targets to bring back articulation forward and
therefore eliminate aberrant, atypical placements. Our emphasis is on providing you with specific
techniques to accomplish the following
• Teach concepts that underlie place learning.
• Ensure adequate speech discrimination skills
• Establish the oral target place and eliminate the non oral errors

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