This was a note I sent to Barbara Wilson Clay, who thought this
would be of general interest on Lactnet. I'm a Speech Pathologist working
in a public school system so I always find discussion of oral structures
interesting:
Your comments about bubble palates make a lot of sense. I began
seeing a student in December who was moved to my caseload from another
therapist. I reviewed his records including the oral peripheral exam- all
structures appeared normal. I began therapy where the other therapist had
left off, never bothering to look in his mouth. Well, this kid had the
slushiest speech, lateralizing every sibilant. He also had language
issues. He was one of those kids who was not very stimulable, so my goal
was to clean up his speech the best I could and mostly work on language.
We worked and worked and worked on this stuff with minimal progress,
until one of the last days of therapy, the kid comes out with absolutely
perfect sounding sibilants (during structured activities- not in
spontaneous speech). It blew me away. I showed the other speech therapist
who nearly fainted, and then lo and behold, the mom was walking down the
hallway and I showed her, and she began to cry. Now this kid- I wouldn't
call him an FLK- and I don't think he looks "syndromey", but he is really
large for his age and he appears very low tone to me. He is in regular
classes, but he has repeated first grade and is still struggling. He has
been tested with a very low IQ, bordering on MR, but he won't ever
qualify as MR. Anyhow, his mom told me that the dr. said he "almost had a
cleft palate but it wasn't". I immediately asked the child to open his
mouth and sure enough, he had an incredibly high palatal vault-
definitely not what I would consider unremarkable in an oral peripheral.
It made me think that this might be related to the hypotonia. I asked mom
if she bfed or bottle fed him- to my shock she said he bfed with
absolutely no difficulty. She had him naturally with no drugs and he was
not breech. (She is probably the only mother in that whole school who
bfed! It is NOT the cultural norm in Del Valle.) Anyhow, the interesting
thing is that his little brother who is two years younger, has the
identical speech problem, however he does not appear hypotonic and has
not been identified with any problems. It is not at all unusual to see a
younger sibling with similar sound errors- sometimes it is probably a
genetic predisposition, but other times it is clearly imitation. It will
be interesting to see if the little brother has similar palatal
formation.
Sandy
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