Lucy,
Re: 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
It sounds like there is a need for more information. What exactly does he do when he speaks? Does he omit, distort, or substitute sounds? What exactly does he do to make you feel that there is a lack of contrast between nasal and other sounds?
Mirla G. Raz, M.Ed, CCC
Www.speechbooks,com
Sent from my iPad
On Jul 25, 2010, at 1:13 AM, "lucy.brookes" <lucy.brookes@yahoo.co.nz> wrote:
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
Prosody
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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