Overview
When the soft palate does not move enough because of a cleft palate or for unknown reasons, this can lead to a speech difference called velopharyngeal insufficiency. The purpose of this research study is to test if soft palate exercises using a hand help breathing device will help improve the ability of the soft palate to close the area between the throat and nose and help improve speech.
Description
The objective of this study is to examine the feasibility and efficacy of expiratory muscle strength training to improve velopharyngeal closure in patients with velopharyngeal dysfunction and nasal air emissions. A randomized, controlled trial will be conducted at a cleft craniofacial center at a tertiary children's hospital. Patients will be block randomized based on Pittsburgh Weighted Speech Scale (PWSS) score (5-6 or 7+) to Expiratory Muscle Strength Training for 6 to 8 weeks or no exercises. Patients with reductions in nasal resonance during this time will be further randomized to EMST maintenance training for 6 months or no exercises.
Eligibility
Inclusion Criteria:
- Pittsburgh weighted speech scores of 5 or greater
- Ages 5-17 years
Exclusion Criteria:
- CAPS-A-AM hypernasality score <2
- Previous speech surgery (e.g. palatoplasty or pharyngeal flap)
- Speech surgery scheduled within the next 56 days
- Unable or unwilling to perform the tests and exercises outlined in the study