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?

Voice results from the air that comes out of the lungs and passes through the vocal cords. The latter is also known as the voice box. Speech results from the vibration of the chords. Voice disorder might occur for various reasons such as tone, pitch, and volume of the if the voice. The roots of all problems boil down to the malfunctioning of the cords.

Voice disorder examples:

Laryngitis: Laryngitis results from the swelling of the vocal cords. It can lead to a temporary halt of voice or a voice with hoarseness. It often occurs due to a viral attack in the respiratory tract. It can last from a few days to a few weeks. The treatment suggested for cases like these include resting the voice and intake of a lot of fluids. Some common causes that are responsible for laryngitis are GERD, chronic cough, and asthma.
Vocal cord paralysis: Paralysis of the vocal cord can be temporary or permanent. The possible cause of this scenario can be from viral infection, cancer, surgical injury to the nerve etc. In the case of a paralysis of the vocal cord, a person might find difficulty in breathing, can result in weak voice etc. While this condition improves for many people with voice therapy and surgery, for some they permanently lose their ability to speak.
Spasmodic dysphonia: The vocal cord spasm due to a problem with the nerve. This condition can lead to a quivery, hoarse, groaning or jerky voice. In this condition, a person might find it easy to speak at times and have difficulty in speaking later. Botulinum toxin and speech therapy help to improve this condition.
Possible causes of voice disorders:

Growth: Extra tissue formation on the vocal cords might stop the vocal cords to work properly leading to voice disorders. The growth can be treated with injection, medicine or surgery.
Swelling and inflammation: Exposure to chemicals, vocal and alcohol abuse, surgery-related complications can lead to inflammation or swelling of the vocal cords resulting in voice-related problems.
Hormone: Disorder of the male, female and thyroid hormone can lead to voice related disorders affecting speech.
Symptoms of voice disorders:

The harshness of the voice
Voice is breathy, weak and whispery
The voice sounds like choppy or strained
A quivering sound while speaking
The voice sounds harsh or rough while speaking
Diagnosis of Voice related disorders:
Voice related disorders can be detected through a process known as Laryngoscopy. This helps a doctor to view the throat region and find out the possible culprit that may be causing the problem. Some other popular methods are stroboscopy, EMG and imaging tests such as MRI and X-Ray of the throat.

Voice Disorders - Signs You Are Suffering From It!

Just as children grow at different speeds, they respond to a speech therapist at different paces. Some children may need only one or two classes to master a sound, while others may need much longer. Some of the ways to make working with a speech therapist more productive are:

Have Clear Goals: When a speech therapist enters your family, the parents, therapist and child should have the same goals. Therapy would not help if the parents and therapists wanted to focus on different things. For example, the parents might be concerned with the child s vocabulary while the therapist may want to focus on articulations. Similarly, if the child does not understand the goal, he or she may not show much improvement. Ideally, a goal should be clear, measurable, realistic and be associated with a time frame. It should also be challenging but not out of reach.
Homework: A therapist has a limited amount of time to spend with the child. A majority of this time must be spent in learning something new each session. However, this will not be possible unless the child has made progress since the last class. Hence, it becomes important for the therapist to give the child homework and for the parents to oversee this. Video tutorials can be very helpful here. This helps parents know exactly what the child is supposed to practise.
Trust: A speech therapist may be an outsider to the family but he or she must be trusted to do their job in the way they think best. Very often, parents and therapists may not have the same views about how the child should be taught. Here, it is important to remember that the therapist is the expert and knows what he or she is doing. This is another reason why it is important to set clear goals together at the onset of therapy.
Speak Up: While the therapist may be an expert on how to build vocabulary and improve speech patterns, parents are experts on their child. Thus, it is important to communicate openly with the therapist. Answering therapist questions honestly can help him or her assess where the problem lies and in turn address it. Similarly, if you have questions, do not be afraid to speak to your therapist about them. Share the child s progress and changes that you have noted so that the therapist can adjust the lessons accordingly. 

Tips To Make The Speech Therapy More Effective!

When it comes to speech, every child has a different pace of learning. In the first year, they should be able to recognize and respond to their own names and simple directions like  come , etc. By a child s second birthday, he or she should be able to use a single word or two-word phrases and understand simple questions. If a child s speech development seems atypical for his or her age, you may need to consult a speech therapist. Some of the things you should look out for are:

Mispronouncing vowels: Many children have problems with pronunciation. Pronouncing  bath  as  baf  or  animal  as  amal  is normal. However, if they cannot pronounce vowels correctly, they may be having problems with articulation. For example, your child might say  coo  instead of  cow .
Using only single words: Part of a speech therapist s job is to teach a child to join words together to create phrases and sentences. If even after your child s second birthday, they still prefer using single words instead of phrases, you should consult a speech therapist. For example, they may just say  water  instead of  i want water .
Stuttering: Many children are shy and hesitant of speaking especially in front of strangers. However, stuttering is a more serious problem. This could be in the form of repeating syllables or prolonging words. For example,  s-s-s-s-s-stop  or  mmmmmm me . If this is not nipped in the bud, it could continue into the child s adult life as well.
Answering a question by repeating part of it: By the age of three years, a child should be able to understand and answer simple questions. If the child answers a question by repeating part of it, such as answering  do you want food  with  you want food , it could be a sign of a bigger problem. This is known as echolalia and might be an early symptom of autism.
Limited vocabulary: Each child s vocabulary grows at a different rate but it is important to be able to notice an increase in the child s vocabulary from month to month. If the child uses only a finite set of words and does not catch on to new words, you may need a speech therapist. They can help the child expand their vocabulary and become more receptive to new words.
Other factors you should watch out for include difficulty with pronouns, not being able to follow instructions and understand prepositions and confusion with gender.

When Does My Child Need Speech Therapy?

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?

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