Terminology / definitions

Active speech errors (also compensatory or optional or learned errors)

These errors are the result of early phonological mis-learning, and persist despite the physical ability for adequate velopharyngeal closure.

Peterson-Falzone, S., Trost-Cardamone, J.E., Karnell, M. & Hardin-Jones, M. (2005). The Clinician’s Guide to Treating Cleft Palate Speech. NY: Mosby.

Harding, A, & Grunwell, P. (1998). Active versus passive cleft-type speech characteristics. Int. J. Language & Communication Disorders, 33(3), 329-352.

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance (2nd ed). NY: Thomson Delmar Learning. Describes compensatory articulation productions

Alveolus

The anterior segment of the maxilla. The top front eight teeth are housed within the alveolus.  The alveolar ridge is the place of articulation for alveolar sounds.

Compensatory articulation productions

See Active speech errors.

High pressure consonants (HPCs)

Plosives, fricatives and affricates. These sounds require a build up of oral air pressure. In normal articulation, there is seal at the velopharyngeal port to enable the required oral pressure.

Peterson-Falzone, S., Trost-Cardamone, J.E., Karnell, M. & Hardin-Jones, M. (2005). The Clinician’s Guide to Treating Cleft Palate Speech. NY: Mosby.

Hypernasality

Excessive nasal resonance for oral sounds.

Peterson-Falzone, S., Trost-Cardamone, J.E., Karnell, M. & Hardin-Jones, M. (2005). The Clinician’s Guide to Treating Cleft Palate Speech. NY: Mosby.

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance (2nd ed). NY: Thomson Delmar Learning, pp 180-182.

Henningsson, G., Kuehn, D.P., Sell, D., Sweeney, T., Trost-Cardamone, J. E., Whitehill, T. L., & Speech Parameters Group. (2008). Universal Parameters for Reporting Speech Outcomes in Individuals with Cleft Palate. Cleft Palate-Craniofacial Journal, 45(1), 1-17.

Hyponasality

Insufficient nasal resonance for nasal sounds.

Peterson-Falzone, S., Trost-Cardamone, J.E., Karnell, M. & Hardin-Jones, M. (2005). The Clinician’s Guide to Treating Cleft Palate Speech. NY: Mosby.

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance (2nd ed). NY: Thomson Delmar Learning, pp 180-182.

Learned speech errors

See Active speech errors.

Nasal air emission

Escape of air through the nose during speech production of high pressure sounds due to a leak in the system such as fistula or reduced velopharyngeal closure. May be audible or inaudible.

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance (2nd ed). NY: Thomson Delmar Learning, p 183

Henningsson, G., Kuehn, D.P., Sell, D., Sweeney, T., Trost-Cardamone, J. E., Whitehill, T. L. & Speech Parameters Group. (2008). Universal Parameters for Reporting Speech Outcomes in Individuals with Cleft Palate. Cleft Palate-Craniofacial Journal, 45(1), 1-17.

Nasal turbulence

Audible nasal air emission that is accompanied by a snorting sound.

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance (2nd ed). NY: Thomson Delmar Learning, p 183.

Henningsson, G., Kuehn, D.P., Sell, D., Sweeney, T., Trost-Cardamone, J. E., Whitehill, T. L. & Speech Parameters Group. (2008). Universal Parameters for Reporting Speech Outcomes in Individuals with Cleft Palate. Cleft Palate-Craniofacial Journal, 45(1), 1-17.

Nasalence

Nasalence is a measure of the proportion of the acoustic energy produced in the oral and nasal cavities during speech. It is measured by a computerised instrument called a nasometer. 

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance (2nd ed). NY: Thomson Delmar Learning, Chapter 14.

Nasality

The term nasality is used by some authors to refer to Resonance.

Obligatory speech errors

See Passive speech errors.

Optional speech errors

See Active speech errors.

Passive speech errors (also obligatory)

These errors are caused by a physical problem with the articulatory or velopharyngeal mechanism, eg a fistula or velopharyngeal insufficiency.

Peterson-Falzone, S., Trost-Cardamone, J.E., Karnell, M. & Hardin-Jones, M. (2005). The Clinician’s Guide to Treating Cleft Palate Speech. NY: Mosby.

Harding, A, & Grunwell, P. (1998). Active versus passive cleft-type speech characteristics. Int. J. Language & Communication Disorders, 33(3), 329-352.

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance (2nd ed). NY: Thomson Delmar Learning. Describes obligatory articulation productions

Pharyngoplasty

A surgical technique that reduces the size of the velopharyngeal port, making velopharyngeal closure achievable with less movement from the velopharyngeal structures.

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance (2nd ed). NY: Thomson Delmar Learning. Pp 526-9.

Premaxilla

Part of the bony structure of the hard palate. It is a triangular shaped segment of bone that encompasses the central and lateral incisors. It is bordered by the incisive suture lines and the incisive foramen.

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance (2nd ed). NY: Thomson Delmar Learning. P. 9, Fig 1-6.

PSNE phoneme specific nasal emission (also active / learned nasal emission)

PSNE occurs on only specific phonemes, in the presence of normal velopharyngeal closure for other sounds.

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance (2nd ed). NY: Thomson Delmar Learning. p 183

Resonance

“Resonance, as it relates to voiced speech, is the modification of the sound that is generated by the larynx through selective enhancement of certain frequencies. This is determined by the size and shape of the cavities of the vocal tract (pharynx, oral cavity, and nasal cavity) and the function of the velopharyngeal valve.”

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance (2nd ed). NY: Thomson Delmar Learning. P. 177.

Sleep apnoea – central sleep apnoea

During sleep, the breathing signals from the brainstem are not consistent. This tends to improve with maturity. Evidence is emerging that children with a cleft palate have a higher than normal incidence of central sleep apnoea.

Sleep apnoea – obstructive sleep apnoea

Children who have a cleft palate have a very open airway because of the communication between the oral cavity and the nasal cavity. When the palate is surgically repaired, the space for breathing becomes considerably smaller. When children are asleep, the tongue and other oropharyngeal structures tend to relax, making the space for breathing smaller. This is called obstructive sleep apnoea.

Sleep study

An assessment performed by respiratory physicians which involves measuring breathing signals during sleep. A sleep study is used to determine whether obstructive or central sleep apnoea is present.

Velopharyngeal dysfunction / velopharyngeal inadequacy

Note some authors use terms interchangeably, whereas some use specific terms to indicate aetiology. Velopharyngeal dysfunction / velopharyngeal inadequacy tend to be used as umbrella terms – see below for more specific terminology which denotes aetiology.

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance (2nd ed). NY: Thomson Delmar Learning.

Trost-Cardamone, J.E. (1989). Coming to terms with VPI: A response to Loney and Bloem. Cleft Palate Journal, 26(1), 68-70.

Loney, R.W., & Bloem, T.J. (1987). Velopharyngeal dysfunction: Recommendations for use of nomenclature. Cleft Palate Journal, 24(4), 334-335.

Peterson-Falzone, S., Trost-Cardamone, J.E., Karnell, M. & Hardin-Jones, M. (2005). The Clinician’s Guide to Treating Cleft Palate Speech. NY: Mosby.

Velopharyngeal insufficiency (VPI)

Inadequate velopharyngeal closure related to anatomical or structural defect.

Velopharyngeal incompetence (VPI)

Inadequate velopharyngeal movement secondary to neuromotor or physiological problem.

Velopharyngeal mislearning

Abnormal development of articulation patterns, although anatomy and physiology are adequate for velopharyngeal closure.