The final outcome of cleft palate surgery on communication impairments of people with cleft palate mostly depends on nasal emission correction and hypernasality in these patients. However, articulation errors work as a barrier for velopharyngeal valve to show its real movement in instrumental assessment which are done as a diagnostic tool in order to determine the need for secondary surgeries. The aim of the present study was to determine the effect of articulation therapy on nasometery and perceptual assessments in a cleft palate patient.
A single-subject study with A-B-A design was carried out to study the effect of articulation therapy on a child with unrepaired submucosal cleft palate, hypernasality, and nasal turbulence. The participant received articulation therapy for 24 sessions (each session for half hour) during 3 months in order to eliminate non oral compensatory articulation errors. Perceptual assessment and nasometery were performed at baseline, during intervention, and in follow up phases. Visual analysis and improvement rate difference (IRD) were used to analyze data. Also, videofluoroscopic and nasoendoscopic assessments were described before and after intervention.
Articulation therapy was effective in this case and decreased the hypernasality and nasalance scores (IRD=0/75). Also, the velopharyngeal gap size decreased and velopharyngeal closure ratio has increased.
The present study showed that articulation therapy seems to reduce velopharyngeal gap size and increase the valve closure ratio. It shows that articulation therapy with correcting the phonetic placement of sounds during the speech makes the velopharyngeal valve show its real movement and has positive effect on its function. Velopharyngeal changes in this patient led to reduction in hypernasality and nasalance scores, but nasal turbulence increased. In addition, the achievements were remained unchanged for three weeks after intervention.
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