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?

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!

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

Aphasia is a communication disability that can result from damage or injury to those parts of the brain that process language. It can happen due to stroke, brain tumors, accidents, or brain infection. A brain injury which damages parts of the brain that deal with language can also bring on Aphasia. Aphasia can also be caused by dementia such as Alzheimer s disease. Aphasia is sometimes also a symptom of epilepsy or other neurological disorders.

It s more common in older adults, especially after a stroke. What happens in Aphasia is that the affected person is unable to understand or use words. He or she may also:

Have difficulty speaking and finding the "right" words to express themselves verbally
Have problems understanding conversation
Have problems reading and comprehending written words
Have problems writing words
Is unable to calculate or use numbers
Has a tendency to use gibberish words as a part of speech
There are various types of Aphasia, differing in certain important ways from each other.
Aphasia can also be mild or severe. With mild Aphasia, the patient is able to converse, though he may not be able to find the right word or may not understand complex conversations.
However, in severe Aphasia, a person may lose his ability to communicate completely which means he can t speak or understand any conversation and may also not be able to read or write.

Three things that aid Aphasia recovery are

Speech Therapy
Family Support
Persistence
Treatment for Aphasia depends on factors like:

Age
Cause of brain injury which causes Aphasia
Type of Aphasia
Position and size of the brain lesion causing Aphasia
If the Aphasia is due to a brain tumor, surgery to remove the tumor affecting the language centre can treat Aphasia.
For a person who s got Aphasia due to a stroke, sessions with a speech-language specialist are very effective. The therapist teaches the patient ways to communicate using stuff that doesn t involve speech.
He uses the following to help the patient communicate without words:

Props
Drawings and pictures
Teaching patient to speak slowly and be calm when talking.
Treatment techniques
The speech therapist uses these two main techniques to tackle Aphasia:

Substitute skill model: This uses a prop like a writing board to help with spoken language.
Direct treatment model: This approach uses specific exercises to help patients
Copy and recall therapy (CART): This approach uses repetition and recall of certain words during speech therapy.
Visual communication therapy (VIC): This involves the use of index cards to represent various components of speech.
In addition, Aphasia patients are also trained in the use of hand gestures to aid in communication as a part of  Visual Action Therapy (VAT) .

Aphasia - Factors That Put You At Risk!

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?

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