Speech therapy helps in improving the speech, understanding the language skills, and also help in communicating in non-verbal ways such as listening and taking turns. Speech therapy treats various kinds of communication and swallowing problems.

Children with Cleft Palate are diagnosed with an opening in the upper tissue palate in the mouth. This condition causes Velopharyngeal dysfunction (VPD) which results in excessive airflow from the nose while speaking. Although it can be corrected with surgery, the patient will still be affected by VPD.

Speech therapists help in this condition by assisting the patient with speech and language skills. The speech therapy for such a patient can be categorized as auditory feedback and articulation practice.

Auditory Feedback

Before involving the patient with any speech therapy, it is essential for the patient to understand the difference between normal voice and nasal voice output.

For this purpose, the child is instructed to use a tube to listen to the voice of the normal person. To understand the difference, one end of the tube is then held near the ear of the child and the other is held near his nasal and then he is instructed to make sounds so that he understands the nasal voice.

After this understanding, the different approaches to speech therapy starts.

Articulation Practice

This is usually where speech therapy begins. In this practice, the different type of condition is understood that relates to different speech organs. The understanding of different vowels, consonants and related sounds is taught to the child for making the speaking sound less nasal.

Some of the methods for achieving these sounds are:

Pharyngeal Plosives: This sound is produced when the tongue is moving backward. The practice of making  ng  sound, and dropping the tongue and producing  k  sound.

Pharyngeal fricatives: When the tongue retracts but is not able to make contact with the pharyngeal wall is when this sound is produced. The speech therapists make the child learn the techniques of making sounds of  t ,  ts ,  ch , or  sh , and provide feedback for learning the proper positioning of the tongue.

Nasal Plosives: This sound usually occurs when the tongue is positioned improperly and it obstructs the vocal tract. A speech therapist may make the child yawn so that the back of the tongue is pushed down, and feel as the mouth stretches.

Palatal-Dorsal Productions: It occurs due to the malocclusion of the teeth. Practicing sounds like  t ,  d ,  n ,  k ,  g , and  ng  often helps in such condition.

Take Away
Cleft Palate is generally developed due to improper growth while the child was in the womb. The difficulty of producing proper sounds when there is excessive airflow in the mouth can be overcome by training and practicing certain sounds, as instructed by a speech therapist.

 Cleft Palate - How Efficient Is Speech Therapy?

Change in voice or voice mutilation happens when the voice breaks that commonly occur when a person reaches puberty. Before puberty, almost all the girls and boys have the same voice pitch. But after puberty, a boy s voice deepens an octave and the girl s voice deepens only several tones. Therefore, it becomes easy to identify the gender through voice. 

Another type of change in voice is known as voice crack. It happens when a person unintentionally enters a higher voice pitch zone for a brief period of time. It may be due to singing, shouting, talking in noise, and several other reasons. Also, there are several medical conditions leading to voice break or hoarseness. 

Medical Causes for Change in Voice

Acute Laryngitis: In this, the hoarseness or voice loss starts suddenly. One of the reasons can be a viral infection that causes swelling of vocal cords. Staying hydrated and less talk can treat it. 

Chronic Laryngitis: It can cause acid reflux disease. Exposure to irritating smoke, infections of vocal cords, or asthma can be some of the reasons. It can be cured only through medication.

Laryngopharyngeal Reflux Disease: This problem causes a change in voice. Due to this disease, people may also suffer from swelling issues, a lump in the throat, hoarseness in voice, and throat pain. 

Voice Misuse: Excessively loud voice, prolonged talking, and inefficient voice use can cause a change in voice and also known as voice misuse. 

Risk Factors That Can Cause Voice Disorder

Aging, alcohol use, and allergies are some of the major reasons for the voice disorder. Apart from these, smoking and throat cancer also results in a change in voice or voice disorders. All these are highly risky causes for the throat and may result in long-time problems. 

Some other risk factors are thyroid, psychological stress, and neurological disorder. 

How to Treat Voice Disorder?

One can use an air humidifier to keep the air of the surrounding moist because breathing moist air is a simple solution to the problem.

Giving rest to voice is also a solution.

One must drink plenty of liquids to keep the throat hydrated.

One must avoid whispering and decongestants to take care of the throat.

One must avoid shouting for a long time.

Avoid staying in a polluted area for a long time.

Gargling the throat every day with lukewarm water is good.

Staying warm during winters is also necessary.

All these remedies are simple and can be tried comfortably. A simple change in voice can turn out to be serious if not taken proactive measures. Therefore, one must not ignore any small unintentional change in the voice.

Conclusion
One must consult ENT doctor immediately for any sudden change in voice and if the problem lasts for a long period of time. 



Change In Voice - What Can Cause It?

Cerebral Palsy (CG) is a neurological disorder caused by an injury to the brain or a brain malformation that occurs while the child s brain is still developing   in the mother s womb before birth, during birth, or immediately after birth.

This disorder affects the child s movement and muscle coordination and control. It also affects his:

Reflexes
Balance
Posture
Motor skills and
Oral motor functions
In easy to understand language, CG can impact the child s ability to walk, talk, sit, do simple tasks like eating, combing hair, talking, and other activities we take for granted. The physical impairment caused by cerebral palsy can affect all limbs, the face and head, or it may just affect one limb. Since CG affects muscles and a child s ability to control them, common symptoms include muscles that contract too much, too little, or all at the same time, leading to limbs that are stiff and forced into awkward positions. Other complications also arise such as intellectual impairment, seizures, or vision/ hearing and speech impairment.

How does Speech Therapy help?
Speech problems affect more than half of all children with cerebral palsy as they have difficulty controlling the muscles in their face, throat, neck and head. Apart from speaking, this also affects chewing and swallowing. It can also cause drooling and the ability to learn, difficulty hearing and understanding spoken language.

This is where speech and language therapy comes in. Speech therapy improves a child s speech and communication by strengthening the muscles used for speech. It also improves understanding of speech and language as well as help with swallowing disorders, like dysphagia.

Speech therapy helps exponentially as when children improve their speech and communication, they are able to express their needs, share their thoughts and interact with others, leading to an overall improvement in their overall quality of life.

Speech therapy can help with the following:

Listening
Articulation of words
Pronunciation
Fluency
Sound and word formation
Language and vocabulary development
Breath control
Chewing
Swallowing
Speech muscle coordination
Apart from this, the other primary benefits are boosting self esteem, socialization, independence and reducing shyness. 

Exercises used in Speech Therapy
Speech therapy treatment usually consists of exercises tailored to a child s specific needs. Different exercises are used in speech therapy like:

Articulation therapy: The therapist uses language cards to help focus attention on specific sounds to encourage the child to make sounds while looking in the mirror to help him understand how his mouth moves.
Blowing exercises: The therapist encourages the child to blow bubbles or a whistle to train the mouth muscles to produce sounds.
Breathing exercises: Work is exclusively on inhalation and exhalation to strengthen the diaphragm.
Jaw exercises: The child is encouraged to eat foods that require extra chewing to strengthen jaw muscles.
Language and word association: The therapist uses flashcards with different words and sounds written on them.

Cerebral Palsy (CP) - How Speech Therapy Can Help You?

It might happen that you may not find your child, at twelve months to two years of age, at the same level as their peers in verbal communication. You think it's just a developmental problem they are facing and put off seeking professional advice; an intrinsically wrong step to take, because your child might be suffering from Speech Delay.
Delayed speech, or alalia, can be roughly defined as a delay in the development and use of the biological mechanisms that produce speech.
The symptoms of speech delay are roughly categorized into age related groups, generally beginning at the age of 12 months and continuing through the early adolescence, and they are:
1. Age-12 months
a. It is indeed a symptom if your child cannot point at objects or cannot manage gestures, such as waving good-bye.
b. Another symptom is that if your child does not prefer to communicate verbally as much as his/her peers.
2. Age-15-18 months
a. If your child is unable to pronounce familiar syllables or simply cannot call you even by this time, it's a worrying symptom.
b. You find your child unable to, or simply not reciprocating to 'no', 'hello', 'hi', 'bye'.
c. If your child is unable to extend his/her vocabulary up to 15 words by fifteen months, then it's a symptom.
3. Age-2-4 years
a. You find your child unable to spontaneously produce speech and words.
b. Another worrying symptom is if your child is lacking consonant sounds at the beginning and end of words while speaking.
c. If you still find your child unable to form simple sentences and words, then it is indeed a troubling symptom, confirming the disorder.
The causes for the speech delay disorder are:
1. A primary cause can be physical disruption in parts of the mouth such lips or palate, which may be deformed.
2. Another serious cause can be an oral-motor dysfunction which is the disruption in the creation of the specific area of the brain which deals with speech and communication.
3. The disorder can also be attributed to impairment in the development of the child's intellectual, receptive and expressive abilities.
4. There can also be psychological causes involving school environment and peer relationships which might lead to disruption of speech patterns and reluctance in speech expression and development.

Causes and symptoms of Delayed Speech

Speech therapy is a very specific field of medicine where the therapists deal with speech disorders in children and adults, which may be a result of certain mental or personality disorders. These doctors can be essential when it comes to teaching a child how to articulate better and also to be more expressive of his/her feelings. Here is a look at a few of the benefits of a speech therapist in the life of a child suffering from speech impairment.

Improvement of articulation skills: Articulation refers to the movement of the mouth, lips and tongue in such a manner so as to form and pronounce a word properly. Aside from the movement of the mouth, voice modulation also falls within the purview of articulation. A child suffering from speech impairment cannot perform this activity as easily as a healthy child does. This is where a speech therapist comes into play. These specialists can ensure that the child s mouth movement and voice modulation can be in perfect harmony to form words normally.
Language skills: Some form of mental disorders severely limit the number of new words or grammar rules that a child can learn. A speech therapist can aid such children in learning the basic rules of grammar and apply these rules when they speak out. So, it is quite likely that the therapists may also act as teachers for the children and improve their overall vocabulary.
Improvement of listening skills: Difficulty in speaking can sometimes also lead to difficulty in understanding what others are saying. So, if your child has a speech impairment, it may mean that he has problems understanding what you say to him. In such a circumstance, the speech therapist can, for instance, help your child understand the difference between a question and a statement. In the long run, the listening skill will help your child comprehend you better.
Reduction of stammering: Stuttering and stammering are forms of speech impairment that many children suffer from. However, such impairments can be easily rectified by undergoing a few sessions with a speech therapist. The therapist can clear your child s speech and ensure that the stammering disappears by the time he/she grows up.
Treat certain vocal conditions: Your child may be unable to speak clearly due to an issue with his/her vocal chords. If that is the case, speech therapists can sometimes help your child with the same. Abnormal vocal resonance can also be corrected by these specialists. 

How Speech Therapy Can Help Your Child Be More Expressive?

There are instances when a kid doesn t show the usual signs of development compared to their peers. Most parents take it casually thinking that their child will catch up in due course only to find a larger problem associated with it. It is therefore extremely important to discuss speech and language related delays with a medical practitioner to find out whether a child is immature or has a genuine problem which requires medical help. A child can show different signs as per age:

Different age group:

Within the first 12 months, a baby should be able to relate to his environment and make babbling and cooing sound. It is often observed that by month 9, a baby is capable of stringing sounds after seeing things. If a baby is intently watching objects, but is unable to make any sound, this may be an early symptom of speech or language related problem.
Between the 12th and the 15th month, a baby should be capable of making a wide array of sounds including few commonly used words. Babies should also be able to take few basic instructions and oblige those.
Between the age of 18th and 24th months, a baby becomes smart enough to pronounce anywhere in the range of 20 to 50 words. They also start combining words and make simple sentences. They should be capable of identifying common objects and remember their names.
By the age of 3, a toddler should be smart enough to combine 4-5 words and form sentences. Kids of this age also become smart enough to take straightforward instructions and perform them comfortably. Any deviation on this should be immediately reported to the Doctor.
What are the warning signs?
If a child between the age of 1-2 is not able to do the following things:

Fails to use gesture
Use more gesture than vocalising by the age of 18 months
Produce no voice by 18th-month
Fails to perform simple instructions
A child between the age of 2-3 needs evaluation if:

Capable of imitating words but isn t spontaneous in vocalising
Repeats certain words multiple times
The tone of voice is unusual compared to his peers
Possible causes of speech and language delay:

Problems with palate leading to oral impairments
Short frenulum restricting sufficient tongue movement to produce speech
Oral-motor problems leading to speech limitation
Problems related to hearing
Chronic infection of the ear leading to speech delay
What does the pathologist assess?

What can the child speak?
What can the child understand?
Oral-motor status
Clarity of speech
Post the above evaluation a pathologist directs a plan of action. Sometimes speech therapy sessions are recommended in order to improve kids  skill. For a motor related problem, a doctor can state a plan of action and limit the expectation of parents.

Speech & Language Delay - Spot The Signs!

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