Enlarged Mouth Opening: A Case Study

Enlarged Mouth Opening Often children with cleft palate will attempt to regulate nasal emissions by reducing the opening of the mouth and thus decreasing oral strength, pressure and volume. This contributes to deficient velopharyngeal closure. Enlarging the opening of the mouth intensifies these components of speech and may increase audible nasal emissions; however, it allows the child to discriminate proper air flow and eventually lends itself to remediation of hypernasal speech. Roth & Worthington (2015) utilize a matching game to encourage increased mouth opening for young children that capitalizes on maximum productions of phonemes requiring an open mouth posture. Two pictures of frogs are hung where the child can easily see them. One of the frogs has an exaggerated open-mouth posture. The other frog's mouth is barely open. The child throws a beanbag at one of the frogs. The clinician models a vowel with the degree of mouth opening indicated by the frog that was hit with the beanbag. In order to earn another turn throwing the beanbag, the child must accurately mimic the clinician's model five times. In the initial phase of the game, appropriate targets include /a/, /æ/, /o/, and /e/.
Reduction of Hypernasality A hypernasal voice quality results from inadequate closure of the

However, it is imperative to recognize that the success of treatment relies heavily on inclusion of the client's family. Planning goals that involve the parents and other family members encourage the family to take an active role in the child's speech therapy and reinforce goals being worked on in therapy at home. When the parents are aware of goals and treatment plans, they are more likely to hold the therapist accountable and ensure that their child is compliant with home assignments and making the most of the treatment being offered (Knutsen,