Lingual-Alveolar Plosives Phoneme Specific Nasal AIR Emission By: Jane Delisio Faulty Advisor: Ann Kummer, PhD College of Allied Health Sciences, Communication Sciences and Disorders PURPOSE Possible causes characteristics Learn more about this understudied and under researched topic Delve deeper into the specific characteristics that make PSNAE unique Important for differential diagnosis and accurate therapy or surgical treatments Usually appears during the transitional stage between the initial production of fricatives and stops Unclear how the faultily learned error occurs Need specific terminology for VPD types in order to diagnosis and treat correctly and efficiently AKA: Pseudo VPI, posterior nasal fricative Abnormal articulation placement Co-articulation of oral stop & posterior nasal fricative that makes the soft palate stay open Substitution for a fricative, sibilant or affricate Typically affected phonemes: (/s, z, ʃ, ʒ, tʃ, dʒ/) May present hypernasality on adjacent vowels, like (/i/ ‘‘feet’’), which can be nasalized after abnormally high tongue position In most cases, sibilants are affected Oral stop is difficult to identify Perceptually, there may be a nasal snort or nasal grimace Defined Velopharyngeal dysfunction (VPD): insufficient , incomplete, or inconsistent functioning of the soft palate closure during oral speech production Velopharyngeal mislearning (PSNAE): type of VPD where the soft palate is open, allowing air and sound to escape into nasal cavity Escaped air and sound create nasality on certain phonemes Learned phonological error Speech sound is not produced in the mouth, but rather inappropriately in the pharynx Sound produced in the pharynx makes velopharyngeal valve stay open Velum (soft palate) Treatments SNAP Test-R gives normative data for speech phonemes in sentence samples Nasometer will show a normal range for most phonemes but will be abnormally high on others Straw technique on nostril to train ear to hear nasality and deter its future occurance Nasopharyngoscopy looks into function of soft palate and closure pattern and accuracy Trial period of speech therapy necessary , since PSNAE is the only type of VPI that will benefit from speech therapy patients Oral Passages Norms S.D. Score Bilabial Plosives 10 5 14 Lingual-Alveolar Plosives 15 Velar Plosives 12 6 13 Sibilant Fricatives 69 Nasals 59.55 6.65 56 History of speech therapy Other misarticulations have improved, but PSNAE has not Subtle previous or current structural anomalies Tonsillectomy/adeniodectomy Often referred to a cranio-facial team Patients tend to exhibit a conductive hearing loss REFERENCES Henningsson, G., et al. (2008). "Universal parameters for reporting speech outcomes in individuals with cleft palate." Cleft Palate Craniofac J 45(1): 1-17. Kummer, A. W., et al. (2015). "Non-cleft causes of velopharyngeal dysfunction: Implications for treatment." Int J Pediatr Otorhinolaryngol. Kummer, A. W., et al. (2003). "The relationship between the characteristics of speech and velopharyngeal gap size." Cleft Palate Craniofac J 40(6): 590-596. Peterson-Falzone, S. J. and M. S. Graham (1990). "Phoneme-specific nasal emission in children with and without physical anomalies of the velopharyngeal mechanism." J Speech Hear Disord 55(1): 132-139. Trost, J. E. (1981). "Articulatory additions to the classical description of the speech of persons with cleft palate." Cleft Palate J 18(3): 193-203. Zajac, D. J., et al. (1996). "Aerodynamic and acoustic characteristics of a speaker with turbulent nasal emission: a case report." Cleft Palate Craniofac J 33(5): 440-444.