JCPSLP Vol 22 No 2 2020

Appendix B

Engaging in holistic, family-centred practice with toddlers with cleft palate: Ten steps for generalist speech-language pathologists

Engage in a case history interview discussing:

1

The family’s story of having a child with cleft palate Their previous experiences of engagement with intervention Their child’s areas of strength Their main concerns Desired outcomes of speech-language pathology intervention Preferences for service delivery (telehealth vs. face to face)

Seek multiple perspectives on the child’s communication and participation from (where relevant):

2

Parents Educators Extended family

Observe the child in their context allowing them to direct an exploration of their world (use teletherapy, for example to observe a mealtime, if home visits are not possible) Use standardised assessments only in conjunction with observation and interview data to gain a truly holistic picture of children’s communication

3

4 5

Assess children’s speech for active and passive cleft characteristics and

Cleft speech characteristic

How it might present Cause and treatment

Backing

Double articulation Glottal stop substitution Pharyngeal fricatives Active nasal fricatives

Typical intervention for a child with a speech sound disorder

n

Nasal realisation voiced sounds

Nasal emission or nasal turbulence on oral pressure sounds

t

may require surgery

Hypernasality Reduced phonemic inventory

May be caused by velopharyngeal

Gliding of fricatives

diagnostic therapy required

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Anna Cronin, Sarah Verdon and Sharynne McLeod

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JCPSLP Volume 22, Number 2 2020

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