Resources for Clients With Cranio-Facial Abnormalities

by Judith Maginnis Kuster

In the past, children with velo-pharyngeal insufficiency (VPI) performed oral-motor exercises such as blowing ping-pong or cotton balls. Although such oral-motor exercises for these children are available online and are probably harmless, this type of intervention is no longer considered a treatment protocol for individuals with VPI. Here are a few articles about oral-motor exercises:

Logic, Theory and Evidence Against the Use of Non-Speech Oral Motor Exercises to Change Speech Sound Production - by Gregory Lof (www.speech-language-therapy.com/Lof-2006-ASHA-06-Handout.pdf)
Oral-motor therapy by Caroline Bowen (http://members.tripod.com/caroline_bowen/oralmotortherapy.htm)
McCauley, Strand, Lof, Schooling, and Frymark, Evidence-Based Systematic Review: Effects of Nonspeech Oral Motor Exercises on Speech, AJSLP 18: 343-360, November 2009 (http://ajslp.asha.org/cgi/content/full/18/4/343)

Bedwinek, Kummer, Rice, and Grames, in "Current Training and Continuing Education Needs of Preschool and School-Based Speech-Language Pathologists Regarding Children With Cleft Lip/Palate" (LSHSS Vol.41 405-415 October 2010) conclude that when treating children with craniofacial abnormalities, SLPs want "communication with the cleft/craniofacial team, accessible continuing education through Web sites and conferences, and clinically practical information relevant to the school setting." This column responds to that plea by identifying websites with clinically practical information.

Assessment and Intervention

Handouts from Ann Kummer
- Cleft Palate, Resonance Disorders and Velopharyngeal Dysfunction: Assessment and Intervention (www.cincinnatichildrens.org/assets/0/78/759/781/1c27d9ec-5991-4e25-a68c-ebf46440cf64.pdf)
- Resonance Disorders and Velopharyngeal Dysfunction: Assessment and Intervention (www.cincinnatichildrens.org/assets/0/78/759/781/dc326032-96d1-4a4a-8aa5-e79c52c9a5d7.pdf)
- Evaluation and Treatment: Using low tech and "no tech" procedures (www.cincinnatichildrens.org/assets/0/78/759/781/6ed974b9-da12-492e-a7b2-a5fe294da284.pdf)
Current Imaging Research and Clinical Practices in the Management of Resonance Disorders and Velopharyngeal Dysfunctions - by Jamie Perry (www.ishail.org/isha/uploadedFiles/Educational_Development/2009%20Session%2017%20-%20Perry.pdf)
Speech Evaluation and Treatment for Patients With Cleft Palate by David Kuehn and Lisa Henne, AJSLP, Feb 2003; 12: 103-109. Full text available (also in Spanish) to ASHA members, (http://ajslp.asha.org/cgi/reprint/12/1/103.pdf).

Assessment Resources

Screening Protocols for Cleft Palate Team Speech-Language Pathologists (www.eshow2000.com/asha/2006/handouts/855_1232Pyle_Elaine_090792_111406091003.pdf)
Oral peripheral examination for cleft palate/velopharyngeal dysfunction (www.eshow2000.com/asha/2009/handouts/1645_2608Carson_Cecyle_107501_Nov04_2009_Time_010429PM.doc)
How To Develop Your Non-Instrumental Clinical Skills for Assessing Velopharyngeal Function by John Riski, Ph.D. (www.choa.org/default.aspx?id=764)
Evaluation of articulation and resonance: Age 3 and beyond by Tara Whitehill (www.acpa-cpf.org/EducMeetings/CoreCur/speech_Whitehill_evalArticRes_ASHA08.pps)

Intervention Resources

From John Riski
- Treatment for Child Speech Disorders (www.choa.org/default.aspx?id=761)
- Strategies and Facilitating Techniques (www.choa.org/default.aspx?id=8412)
From Ann Kummer
- Feeding the Baby with Cleft Lip and Palate (www.cincinnatichildrens.org/assets/0/78/759/781/9c3837a6-d930-4587-b113-c55390488457.pdf)
- Speech Therapy for Cleft Palate or Velopharyngeal Dysfunction (www.cincinnatichildrens.org/assets/0/78/759/781/65e90133-9243-4926-a065-8a97951944fb.pdf)
Treatment of Articulation Disorders Related to Cleft Palate by Lynn Marty Grames, (PPT) (www.acpa-cpf.org/EducMeetings/CoreCur/speech_grames_ArticDisord_ASHA08.pps)
Hardin-Jones, M., Chapman, K., & Scherer, N. J. Early intervention in children with cleft palate The ASHA Leader, 11(8), 8-9, 32. (www.asha.org/Publications/leader/2006/060613/f060613b/) suggests strategies for increasing consonant inventories, working on vocabulary, and increasing awareness of airflow
Meet Your Speech Helpers (www.home-speech-home.com/support-files/speech-helpers.pdf)
Cleft Palate Foundation (www.cleftline.org/) baby-feeding videos (www.cleftline.org/parents/feeding_your_baby)
Cleft Palate Feeding Video (www.neworleanscleftteam.org/videos.html)

Other Important Resources

Smile Train (www.smiletrain.org/)
- Videos of cleft lip and palate repair to train physicians (http://medpro.smiletrain.org/medpro/training/training_library.htm)
- 3-D virtual surgery environment (www.biodigital.com/smiletrain/download.htm)
- Cleft Library (http://medpro.smiletrain.org/library/Library.html) - with a "medical library" designed primarily for physicians and a "public" library worth exploring for articles relating to therapy
American Cleft Palate-Craniofacial Association (ACPCA) (www.acpa-cpf.org) for information in English and Spanish on treatment and research of birth defects of the head and face.
Core Curriculum for Cleft Palate & Other Craniofacial Anomalies (www.acpa-cpf.org/EducMeetings/CoreCur/index.html)
- Parameters For Evaluation and Treatment of Patients with Cleft Lip/Palate or Other Craniofacial Anomalies (www.acpa-cpf.org/teamcare/Parameters%20Rev.2009.pdf)
- Speech Samples for Normal and Hypernasal Speech (www.acpa-cpf.org/EducMeetings/speechSamples/index.htm)
- Professional Enhancement Resources for Speech-Language Pathologists (www.acpa-cpf.org/Resources/slp.html)
The ACPCA also has a "public service arm," The Cleft Palate Foundation (www.cleftline.org) that offers Free booklets (www.cleftline.org/what_we_do/cpf_booklets) and Factsheets (www.cleftline.org/what_we_do/cpf_fs)
The National Craniofacial Association's FACES (www.faces-cranio.org/) offers information and support network references for cranio-facial anomalies (www.faces-cranio.org/Disord.htm)
Wide Smiles (www.widesmiles.org/) includes links to information about speech (www.widesmiles2.org/cleftlinks/speech.html) and feeding issues (www.widesmiles2.org/cleftlinks/feeding.html)

A final important resource is ASHA's Special Interest Division 5, Speech Science and Orofacial Disorders which made several suggestions for this column. The division publishes Perspectives and hosts a discussion forum for members (www.asha.org/Members/divs/div_5.htm).

Judith Maginnis Kuster , MS, CCC-SLP, is an emeritus professor in the Department of Speech, Hearing, and Rehabilitation Services at Minnesota State University, Mankato. Contact her at judith.kuster@mnsu.edu. An archive of all of Kuster's columns can be found at www.mnsu.edu/comdis/kuster4/leader.html. URLs change, however, and there is no guarantee that links from previous columns are still functional.

cite as: Kuster , J. M. (2010, December 21). Resources for Clients With Cranio-Facial Abnormalities. The ASHA Leader.p. 26