Speech Intervention for Correcting Compensatory Articulation in Children with Cleft Palate
Velopharyngeal Insufficiency (VPI) is a disorder of resonance and speech which affect all individuals with cleft palate. VPI can occur with or without compensatory articulation errors. Several intervention methods have been reported for treating compensatory articulation errors in patients with cleft palate. Two of the most commonly used of these intervention modalities are a phonologic based intervention and a phonetic or articulatory intervention. Although both modalities have been reported as being effective, it seems that a phonologically based intervention can more readily enhance to carry over the adequate articulation placement into connected speech. The reason for this advantage is that phonology addresses not only the peripheral aspects of speech production but higher levels of linguistic organization. Thus, addressing compensatory articulation errors in a more linguistically based context, can usually be more effective for acquiring and using an adequate articulation placement during connected speech./ It is necessary to appropriately classify the severity of the compensatory articulation errors, with especial focus on the response to speech pathology intervention strategies. Also, the selection of phonologically based strategies to be used during the speech intervention, seem to enhance effectiveness of the specific strategies for correcting articulation placement./ This chapter addresses how an approach based on phonological principles can be a reliable method for the speech intervention in children with cleft palate and compensatory articulation errors. In this chapter, a categorically stratified scale for classifying compensatory articulation errors according to severity and response to therapy is described. Finally, some strategies for speech intervention which are more suitable for a phonological and linguistic intervention are presented. The chapter explains how is that selecting the strategies to be used during the intervention according to the severity of the articulation errors seem to increase their effectiveness.