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By Jane Passy

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Speech may be characterised by glottal stops, substituting stops, especially velars (an error of place) with fricatives and affricates (an error of place and manner). Pharyngeal fricatives may be used as substitutes for fricatives and affricates (error of place). Vowels may be hypernasal (error of manner) as may be consonantal sounds. Nasal emission of air (especially during production of fricatives and affricates) is also a common phenomenon. In addition to these difficulties directly related to the anatomical deviation, these children are at risk for developmental articulatory problems, as are all children.

The cues here were very helpful. ’s articulation was still slow and difficult. ’s imitation by cueing her while she orally produced the sounds. The exact information included in the cues facilitated control. Sounds were imitated in the correct sequence with the correct combination of features. Eventually, we moved on to monosyllabic words, combining meaning with our sound strings. ’s repertoire. Only those sounds which S. had already demonstrated ability to produce in nonsense syllables were cued.

At the age of five years and nine months, ES was referred by his special education kindergarten speech therapist for consultation. Assessment showed that ES exhibited immature phonological processes not necessarily related to the cleft. These included initial consonant deletion, final consonant deletion, syllable reduplification, co-articulatory assimilation and cluster reduction. Processes more likely to be related to the cleft included nasal frication and nasal assimilation. Therapy was initiated using CA, with the primary initial goal being the achievement of plosion.

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