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?

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?

Speech therapy is a very distinct form of science that is often misunderstood by people in general. While the benefits of such a therapy is countless, people misinterpret what the therapy actually involves and what it does not. If you are avoiding speech therapy due to the following reasons, you should stop doing so as these are nothing but fabricated myths.

Speech therapy is all about talking: Do not think that speech therapy only involves talking with the therapist. The therapy focuses on the overall communication skills of a person, which definitely involves the speech but also the intricacies of articulation and body language. Sign aids and comprehension skills are also paid attention to in such a therapy session. So, if you feel that you have a problem regarding any one of these aspects, you need to visit a speech therapist.
Speech therapy is uninteresting: Nothing can be further from the truth than this. In fact, a visit to a dentist can be boring, but a visit to a speech therapist will always involve interesting activities such as tongue twisters. The therapists often treat children, which means that their offices, house toys, and other games designed to indulge the minds of infants as well.
A qualified speech therapist is needed for the therapy: Another myth, which needs to be dispelled, is that only a qualified speech therapist can help improve the speech of a person. In fact, any person who has a vast knowledge of diction, linguistic insight, and knowledge of grammar can help people with speech impairment. So, before visiting the doctor, the adults in the family should try and clear out the impairment themselves.
Speech therapy fixes issues in the snap of a finger: As with any kind of treatment, speech therapy does not work like magic. It is a continuous and long process that needs to be followed through. The pace of this treatment depends on the patient. Some patients are more receptive to this therapy than others. So, there is no guideline for the treatment of all speech-impaired individuals and one needs to be treated and allowed to get better at their own pace.
Your child will automatically learn perfect speech: If your child suffers from a speech impairment, do not delay a therapy session by thinking that he/she will automatically learn to speak better as they grow up. This way of thinking is not beneficial and hinders the eventual treatment for the impairment. The speech therapist can help you better if you bring your child to him/her as soon as you detect an issue. 

Don't Let These Myths Turn You Off From Speech Therapy

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

Sound travels through different parts of the hearing system to produce the ultimate sense of sound in the brain. People can hear when a sound wave stimulates the neurological component of the inner ear and takes the sound signals to the brain.

When there is a problem with the ear, human beings cannot hear, or hear garbled sounds. Hearing loss may have different reasons. There may be a tumor in the ear, a problem with the eardrum, the inner ear or the neurological structure. Different conditions can plague the hearing system and cause hearing loss. Some of these conditions can be serious and require medical intervention.

Let us discuss 3 such conditions where the intervention of an audiologist is a must.

Tinnitus and Vertigo

 Tinnitus is a medical term for a sense of ringing in the ears. It s annoying, to say the least. But more importantly, it could be a sign of hearing loss. This is why people need to see an audiologist if they have a sense of Tinnitus for a prolonged time. An audiologist can first diagnose the condition, and can then treat this problem with the help of specialized hearing aids.

 Vertigo and dizziness are the other two problems that result from a hearing system problem. It may create balance disorders. It is said that vertigo originates in the inner ear. Vertigo can also be treated with the help of physical therapy and medicine.

 Sudden Hearing Loss

 The human ear cannot hear sounds greater than 85 dB in intensity and 20,000 Hertz in tone. If the sound tone is less than 20 Hertz, then too the human ear is not able to hear anything. Between these two polarities, the human ear is able to catch all types of sounds. If human beings are exposed to sound waves of more than 85 dB in intensity, the ears may get damaged. In that case one may suffer from hearing loss. If a person has recently experienced huge changes in air pressure, exposed to blaring music or noise at close quarters, or had an accident causing loss of hearing, one needs to see an audiologist. The ears need to be assessed for trauma, if any, and treated quickly. However, hearing loss may have other reasons too such as reactions to medicines, head injury or some kind of illness that affects the hearing system. An audiologist would be able to make the right determination.

 Recurrent Ear Infections

This is common in children, but that does not mean that adults are immune to it. If there is chronic ear pain, difficulty in hearing along with drainage and fever or a feeling of pressure, an ear infection is most likely. Any doctor can detect an ear infection, however, if it is a recurrent one needs to see an audiologist. He has the wherewithal to evaluate the middle ear with different tests. A person may need treatment that only an audiologist can do.

There can be many situations in which a visit to an Audiologist is warranted; the above 3 are just a tip of the iceberg.

Audiologist - Why To Visit One?

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?

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