Palatoplasty for cleft palate is usually performed before 2 or 3 years of age when the speech starts developing. As the results, children with cleft palate speech has apparently decreased. Despite this progress in the treatment for cleft palte, not a few adult patients with cleft palate still have speech disorders to the extent that their social adjustment is thereby much disturbed. Speech pathologists or therapists have long been well aware of the fact that the speech disorders in adult patients are much more resistent to speech therapy than those in children.
Our recent concentration speech therapy appears to change this dismal pattern of speech therapy in adults.
Our speech therapy concentrated for 21 months, includes not only articulation training but also help for their social adjustment. Our speech therapy features in the following points.
Emphasis on articulation training. Correct articulation, first of lip, is trained with the aid of tactil and visual sensations. Fricative sounds are induced by sustained fricative production with whispered voice, while difficult sounds requiring tongue adjustments are often induced by modification of other sounds. Puff up one's cheeks proved more useful for velopharyngeal closure training than blowing exercise.
It should also be emphasized that the patients for speech therapy should be strictly selected on the basis of objective evaluations of V-P function; aerodynamic, inspectory, auditory and radiographic examination.
Various methods have been applied to accelerate carrying the corrected sounds at the level of monosyllable or word over that of passage or conversation. They are singing a song, repe-tition of monosyllable, participation in a drama and frequent use of the sounds in their daily life conversation.
Active counselling with the patients was also quite effective in promoting their social activity.
