SpeechPathology.com Phone: 800-242-5183


Prime Healthcare Staffing

Velar Apraxia

Ann Kummer, Ph.D

April 24, 2006

Share:

Question

I have just recently started working with a client who has been diagnosed with Velar apraxia - or inconsistent Velopharyngeal closure. He has tested negative on genetic tests and craniofacial clinic does not recommend treatment at this time. What are some

Answer

Apraxia of speech is characterized by difficulty coordinating and sequencing the motor movements required for speech. Although we typically think of apraxia as affecting the anterior articulators (lips, tongue and jaws), it can also affect the posterior articulators (velopharyngeal valve) and other subsystems of speech (respiration and phonation).

When there is apraxia of speech, inconsistent hypernasality may be noted because the individual is unable to coordinate rapid anterior articulation movement with velopharyngeal movement. As a result, the velum stays in the resting position inappropriately. (At times there may even be some hyponasality if the velopharyngeal valve closes inappropriately on nasal sounds.) As with other errors, the hypernasality will tend to increase in severity with an increase in utterance length and phonemic complexity.

The treatment of hypernasality due to apraxia is standard articulation therapy. The only exception is that you will not tell the individual how to achieve placement. Instead, you work on oral sounds, words and sentences with increasing levels of complexity, and use the child's auditory feedback skills for monitoring. One way to help the individual to monitor his/her own production is to place one end of a straw or tube in one nostril and the other end in his ear. Have him work on oral sounds, and then words and sentences that are devoid of nasal sounds. If he hears sound in his ear, he should try again. When there is nasality, the sound in the ear is usually very loud, thus it serves as negative reinforcement as well.

For more information, see Kummer, AW. Cleft Palate and Craniofacial Anomalies: The Effects on Speech and Resonance, Thomson Delmar Learning, 2001.

Dr. Kummer is Senior Director of the Speech Pathology Department at Cincinnati Children's and Professor of Clinical Pediatrics at the University of Cincinnati Medical Center. She is the current Coordinator of ASHA's Division 5: Speech Science and Orofacial Anomalies and is an active member of the American Cleft Palate-Craniofacial Association. She does many lectures and seminars on a national and international level. She is the author of many professional articles and 11 book chapters. She is also the author of the text entitled Cleft Palate and Craniofacial Anomalies: The Effects on Speech and Resonance, Thomson Delmar Learning, 2001. She is an ASHA Fellow.


Ann Kummer, Ph.D


Related Courses

20Q: Evaluation and Treatment of Speech/Resonance Disorders and Velopharyngeal Dysfunction
Presented by Ann W. Kummer, PhD, CCC-SLP
Text

Presenter

Ann W. Kummer, PhD, CCC-SLP
Course: #8729Level: Intermediate1 Hour
  'Information was concise and organized well'   Read Reviews
Children with speech and resonance disorders (hypernasality, hyponasality, and cul-de-sac resonance) and/or nasal emission present challenges for speech-language pathologists (SLPs) in all settings. This article will help participants to recognize resonance disorders and the characteristics of velopharyngeal dysfunction, and provide appropriate management.

20Q: Using Speech Science in Clinical Practice
Presented by Amy T. Neel, PhD, CCC-SLP
Text

Presenter

Amy T. Neel, PhD, CCC-SLP
Course: #10326Level: Intermediate1 Hour
  'Good resource for utilizing speech science tools in a variety of ways throughout treatment and evaluation'   Read Reviews
Many speech-language pathology clinicians find speech science daunting and not applicable to their clinical practice. This course discusses why and how speech science is useful in understanding speech disorders and differences. Examples are provided of how to assess and treat speech disorders using speech science-based principles and techniques such as the source-filter theory and acoustic, physiologic and biofeedback measures.

DIRFloortime®: Beyond Playing on the Floor
Presented by Joleen R. Fernald, PhD, CCC-SLP, BCS-CL
Video

Presenter

Joleen R. Fernald, PhD, CCC-SLP, BCS-CL
Course: #9642Level: Advanced4 Hours
  'Excellent material and examples'   Read Reviews
The DIRFloortime® framework can be used not only with children with autism, but with a wide variety of ages and diagnoses. This 4-hour master class describes DIRFloortime principles and concepts such as Functional Emotional Developmental Capacities (FEDCs) and relationship-based intervention. Case studies provide examples of goals and therapy activities, including virtual experiences, for various populations.

Assessment of Childhood Apraxia of Speech
Presented by Jenya Iuzzini-Seigel, PhD, CCC-SLP
Video

Presenter

Jenya Iuzzini-Seigel, PhD, CCC-SLP
Course: #9705Level: Intermediate1.5 Hours
  'great examples'   Read Reviews
This is Part 1 of a two-part series on childhood apraxia of speech (CAS). Differential diagnosis of CAS and other speech sound disorders (SSDs) can be challenging. This course demonstrates the steps of the differential diagnosis process, including rating perceptual features of CAS and interpreting test results. Case studies are included for additional practice.

Motor Planning: The Impact on Communication and Beyond
Presented by Joleen R. Fernald, PhD, CCC-SLP, BCS-CL, Lyn Bennett, OTR/L
Video

Presenters

Joleen R. Fernald, PhD, CCC-SLP, BCS-CLLyn Bennett, OTR/L
Course: #10222Level: Intermediate4 Hours
  'Great use of videos and follow up questions'   Read Reviews
Master skills to implement in your practice immediately with continued Master Class. This four-hour course describes the components of motor planning and the areas of impact. Assessment, strategies for supporting clients with motor planning challenges, and tips for discussing praxis with caregivers are also addressed.

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.