Velopharyngeal Insufficiency

[Guest guest]

Hi Everyone,

My son has just turned 3 and has been diagnosed with high functioning ASD and

apraxia. He's a unique case in that he does not stop talking and has incredible

language skills. Our big issue is that his articulation is terrible (doesn't

have all consonants yet) and many sounds are coming out of his nose- mainly /S/,

/F/, /CH/ and /Z/.

We've been advised to get him evaluated for a hidden cleft palate and VPI. He

does meet some of the criteria for VPI, but deep down I think it's just

mislearning from the apraxia. He developed this speech pattern early on because

I think to him, it's the closest he can some to making the above sounds.

We will get him checked out, but I was wondering if anyone else here on the

boards have experienced this with their children and if this kind of mislearning

can be overcome.

Any advice or thoughts would be greatly appreciated. If we could solve this

piece of the puzzle for him, I think his articulation would improve so

dramatically. PROMPTs for these sounds have not been enough, but I think his

age has been the cause for that. He's not a huge fan of physical prompts just

yet.

Thanks so much,

Kim

[Guest guest]

Hi Barbara,

Thank you SO much for the reply. When you say you worked on OPE, what does that

stand for exactly? And can you believe there are NO PROMPT therapists in my

area? We are in eastern Pennsylvania on the NJ border (Lehigh Valley area). I

am praying someone exists that has managed to fly under the radar, but I have

turned over most stones.

I think we are going to take him to a cleft palate clinic for the eval. They

seem to be the most versed about VPI and have SLPs on staff. There is a pretty

good one in Lancaster, PA.

Again, thanks so much for the help. Although the word surgery throws me into a

total panic, I think it would be wonderful to have an explanation associated

with these nasal emissions- and hope that the sounds could be rectified.

Kind Regards,

Kim

>

> Kim,

>

> I have a client similar to your son who has apraxia. She's now 6 and I have

> worked with her since she was 2. She had significant frustration at 2ys

> whenever we tackled an oral placement exercise (OPE)-whether she could do it

> or not. I had concerns that she had VPI (due to dysarthria & apraxia) but

> could not examine her palate & velum at that age. Even though she loved

> coming to speech, she did not want me to look in her mouth. So, we took it

> slowly and worked on OPE, PROMPT and play. She has made great strides and

> was finally able to tolerate getting an exam for VPI at our local hospital.

> This week she is having surgery on her velum since one side retracts better

> than the other. I am excited to see her in a few weeks post surgery!

>

>

>

> So, my thoughts on your son are that his difficulties could be a combo of

> VPI and apraxia. Find a good ENT who is patient w/kids (no pun intended)

> and who has an SLP on staff or as part of the hospital team. Get the exam

> done sooner rather than later.

>

>

>

> Also, find an excellent SLP who is trained in the many aspects of apraxia:

> graded abdominal respiration, structured oral placement exercises (Talk

> Tools), PROMPT (and who will take it slowly---I can get all of my clients to

> allow me-not via force-to us PROMPT on their faces), Beckman stretches, and

> Kaufman technique.

>

>

>

> Let me know what state you are in and I can help you find out where to find

> the best person. J

>

>

>

> Warmest wishes,

>

> Barbara

>

> Barbara A. , M.S., CCC-SLP

>

> Executive Director/ Help Me Speak, LLC

>

> <http://www.helpmespeak.com/> http://www.helpmespeak.com

>

> (o) 410-442-9791 (f) 410-442-9783

>

> 2500 Wallington Way; Suite 103

>

> Marriottsville, MD 21104

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> 32

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>

>

>

> From:

> [mailto: ] On Behalf Of kallison23

> Sent: Thursday, July 22, 2010 2:03 PM

>

> Subject: [ ] Velopharyngeal Insufficiency

>

>

>

>

>

> Hi Everyone,

>

> My son has just turned 3 and has been diagnosed with high functioning ASD

> and apraxia. He's a unique case in that he does not stop talking and has

> incredible language skills. Our big issue is that his articulation is

> terrible (doesn't have all consonants yet) and many sounds are coming out of

> his nose- mainly /S/, /F/, /CH/ and /Z/.

>

> We've been advised to get him evaluated for a hidden cleft palate and VPI.

> He does meet some of the criteria for VPI, but deep down I think it's just

> mislearning from the apraxia. He developed this speech pattern early on

> because I think to him, it's the closest he can some to making the above

> sounds.

>

> We will get him checked out, but I was wondering if anyone else here on the

> boards have experienced this with their children and if this kind of

> mislearning can be overcome.

>

> Any advice or thoughts would be greatly appreciated. If we could solve this

> piece of the puzzle for him, I think his articulation would improve so

> dramatically. PROMPTs for these sounds have not been enough, but I think his

> age has been the cause for that. He's not a huge fan of physical prompts

> just yet.

>

> Thanks so much,

> Kim

>

>

>

>

>

>