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[phono-tx] Impaired vestibular system?


Am have just assessed a boy 4.3 years.
His speech sound system is WNL with the exception of intermittent hyper and hyponasality.
He has a history of ENT, with adenoids removed and grommets inserted. He has had a history of drooling but is now extremely minimal.
My obs of him eating and a full oromotor examination indicate strength and tone are WNL with the exception of poor lip closure. At this stage I am assuming the nasality and drooling issues are a result of the ENT history and habitual mouth breathing.
He is clear at the single word level but approx 60% intelligible at the sentence level, I think this is due to rapid monotone speech and the lack of contrasts between oral-nasal sounds
I plan to work on 3 areas:
Nasality contrasts – beginning at the basic level of blowing thr his nose
Speed of speech
Interestingly I noticed his speech was much clearer when he come in from playing on the trampoline. My question is, am I missing an underlying link such as an impaired vestibular system? Should input be a big(ger than usual) part of therapy? Many thanks for your thoughts, Lucy

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