Group 3

You are constructing a special

prosthesis for a patient with
speech problem.
Discuss the types of
speech problem this
patient may have.

WHAT IS SPEECH ?
The expression of or the
ability to express thoughts
and feelings by articulate
sounds.

WHAT IS
PROSTHESIS ?

An artificial device used

to replace a missing
body part, such as a
limb, palate, eye, or
heart valve.

There are two types of speech prostheses. Each has a different

purpose and works in a different way.

i) Palatal lift appliance

This acts by lifting the soft palate
upwards and backwards, which may
help to encourage movement of the
soft palate and the back of the
throat. We may recommend this type
of device if the soft palate does not
move very much during speech, but
appears long enough to reach the
back of the throat.

ii) Speech bulbs

If there is a significant gap between your soft
palate and your throat when you speak, we
may suggest attaching a speech bulb or speech
obturator to the basic plate appliance. The aim
of this is to "block up" the space. We may
recommend a speech bulb when surgery is not
possible because of medical or anaesthetic
risks, or sometimes when the gap is so large
that surgery is unlikely to work.

TYPE OF SPEECH
PROBLEM
Hypernasal speech
Dysarthria
Phonological Disorder

HYPERNASAL SPEECH
Medically known as Rhinolalia aperta
Is a disorder that cause abnormal
resonance in a humans voice due to
increased airflow through the nose
during speech.
Normally associated with
velopharyngeal dysfunction.

Velopharyngeal dysfunction can divide into 3

sub terms:i)
)
)
)

Velopharyngeal insufficiency
Caused by anatomical abnormality
Congenital or acquired
Example: cleft palate, submucous cleft, short
velum, adenoidectomy

ii) Velopharyngeal incompetance

) is a defective closure of the velopharyngeal
valve due to its lack of speed and precision
) Cause by neurologic disorder or injury
) Example: cerebral palsy, traumatic brain
injury

iii) Velopharyngeal mislearning

) no abnormalitity
) Child do not know how to articulate velum correctly.

DYSARTHRIA
Dysarthriais amotor speech disorder.
The muscles of the mouth, face, and
respiratory system may become weak,
move slowly, or not move at all after a
stroke or other brain injury.
The type and severity of dysarthria depend
on which area of the nervous system is
affected.

Types of Dysarthria
The three primary types of dysarthrias seen in children
are spastic, flaccid and ataxic.
i) Spastic dysarthria
Speech may be slow and labored, with poor articulation.
Voice is usually harsh or strained. The voice may sound
like the child is talking through his nose.
ii) Flaccid dysarthria
Hypernasality with nasal air escape is the main
characteristic. Articulation is poor, and speech often
sounds monotonal.
iii) Ataxic dysarthria
Speech is often very irregular in terms of breathing,
sound production, rate and rhythm.

Causes of Dysarthria
Amyotrophic lateral sclerosis (ALS, or Lou Gehrig's
disease)
Brain injury
Brain tumor
Cerebral palsy
Guillain-Barre syndrome
Head injury
stroke

PHONOLOGICAL
DISORDER
also known as articulation disorder.
Is an articulation disorder is a
developmental speech problem in which
an individual has difficulty producing
speech sounds (phonemes) correctly.
This may be due to imprecise placement,
timing, pressure, speed or flow of
movement of the lips, tongue or throat.

What causes articulation

disorders?
Articulation disorders may be the result of a structural
problem, such as in a child with cleft palate.
They may be caused by brain damage or neurological
dysfunction, as in a child with Down syndrome, fetal alcohol
syndrome, autism, etc.
Articulation disorders also may result from a childs inability
to coordinate or motor plan muscle movements to produce
speech (apraxia).
Faulty speech models during the crucial years for speech
and language development also may be a problem, as seen
in children with a history of chronic ear infections or hearing
problem.