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Honor Chan

Craniofacial Anomalies Impede Feeding & Speech Development

Craniofacial Anomalies Impede Feeding & Speech Development

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Craniofacial anomalies represent a varied cluster of defects in the development of both the facial bones and the head. An anomaly means ‘not normal’ or ‘irregularity.’  These anomalies are usually present even at birth (congenital) and feature several variations while others are quite severe and may need surgery.

For a better understanding on how these anomalies affect speech development and feeding, it is essential to establish a proper understanding on specific details about the craniofacial anomalies to establish how they affect such aspects of human body functioning.

Causes of Craniofacial Anomalies

A majority of medical professionals unanimously agree that no single factor can be credited for causing these abnormalities. Alternatively, there are numerous factors which may contribute to them developing among them:

  • Gene combination: A child may get a particular gene(s) combination from either or both parents, as well as a slight alteration in the genes may occur during conception that may result in craniofacial anomalies.
  • Environmental: Exposure to environmental factors may play a vital role in the development of craniofacial anomalies particularly combined with genetic anomalies.
  • Folic acid Deficiency: Folic Acid is a vitamin B component found in enriched grain products, leafy, green vegetables, orange juice, as well as breakfast cereals (fortified). Research outlines women who do not consume adequate or any folic acid amounts during pregnancy are more prone to their babies having particular craniofacial anomalies including cleft palate or cleft lip.

Types of Craniofacial Anomalies

  1. Cleft Palate

It is a condition where the mouth’s roof is unable to close completely, leaving an opening which can broaden into the nose cavity. This cleft can occur on both sides of a palate. Also, it can stretch from the hard (mouth front) to soft palate. It may also include the lip.

  1. Cleft lip

This is an abnormality where the lip is unable to form completely. The extent of this defect can greatly vary, from mild (lip notching) to relatively severe (big opening from a lip up to the nose).

  1. Craniosynostosis

This is a condition where the soft spots (sutures) in an infant’s skull close early on resulting in issues with ordinary skull and brain development. This (premature) sutures closure can also prompt increased pressure within the head resulting in a alteration from normal (symmetrical) appearance of skull or facial bones.

  1. Hemifacial microsomia:

This is a condition where tissues are underdeveloped on a given side of the face therefore primarily affecting the mouth, jaw, and ear (aural) regions. At times, both face sides can be affected and can usually include the skull together with the face.

  1. Vascular malformation:

This is congenital growth or birthmark which comprises blood vessels and can result in aesthetic or functional problems. This defect may involve numerous body systems. It features multiple malformations all labeled in accordance to the blood vessels type affected.  This condition is also called vascular gigantism, arteriovenous malformations and lymphangiomas.

  1. Hemangioma:

This is an unusually developing blood vessel which can either appear as a red (faint) mark, or show in the initial months after being born. It is also called strawberry hemangioma, among other names.

  1. Deformational plagiocephaly:

It is a condition where the head’s shape has a deformed shape because of repeated pressure to a particular region.

Craniofacial Anomalies and Their Effects of Feeding and Speech Development

Children having craniofacial anomalies have some difficulties with their swallowing, feeding, oral motor movements, and speech development. This is a result of the lack of physical structure (since they have a hole between their mouth and nose). The infants have delays when it comes to phonation, articulation, resonance, and respiration primarily because their soft palates are not fully functional.

Infants with incomplete or minimal clefts of the lip can usually show some difficulty with achieving full lip seal on a nipple. An infant with complete or incomplete clefts of the soft palate demonstrates variant challenges in feeding, typified by nasal regurgitation due to inadequate velopharyngeal closure while swallowing or inability to proper negative intraoral pressure during sucking.

This nasopharyngeal regurgitation can usually be reduced or eradicated with positional alterations (upright) as well as by using specialized feeding systems by placing the nipple away from the infant’s cleft while feeding.

Additionally, infants featuring broader clefts of the soft and hard palate show difficulty with extracting liquids since their open palate offer a little surface area to compress the nipple. The ability of the infant to produce adequate compression (positive pressure) and suction (negative pressure) for proper sucking is impaired.

Infants with a cleft lip will perhaps breastfeed or feed using a standard bottle. However, infants having a cleft palate may exhibit difficulties in breastfeeding. As such, they may need special nipples or feeding bottles for feeding.

Children with a medical history of having cleft palate are prone to delays in acquiring speech skills and might even be at risk of delayed early language development – not just because of orofacial incongruity but also because of neurological disorders as well as cognitive problems commonly associated with the craniofacial syndrome. This is usually because their open palate renders them slower in developing phonemes.

This particular delay endures until the open palate has been repaired and in most cases for periods, postoperatively. The articulation problems are usually due to velopharyngeal incompetence/insufficiency (VPI). The abnormal function or structure of the human velopharyngeal valve may result in impaired speech often resulting in compensatory and obligatory errors.

Children with VPI (velopharyngeal insufficiency) cannot touch their soft palates at the back of their throat. This can be either due to the soft palate being unable to move correctly or is too short. This allows sound and air to escape through the nose during communication. Our soft palate needs to move to touch the throat’s back. This subsequently shuts the space between our nose and mouth and is essential for sounds to be produced from the mouth. Some sounds such as ‘n’ and ‘m’ come off our noses. For such sounds to come out, it is essential for soft palates to stay closed.

These children may require surgery to correct the VPI problem or an exclusive device in their mouths to help keep their soft palate closed. Additionally, therapy may be necessary to help them cope with the condition and lead a healthy life.

 

 

 

 

 

How Infant Hearing Loss Impacts Speech Development

How Infant Hearing Loss Impacts Speech Development

By | Language Development, Speech Therapy | No Comments

Hearing loss is one of the most dominant birth defects in the USA. Statistics indicate that 3 in every 1,000 infants suffer from hearing loss. It is crucial to note that whereas some children might not be born with hearing loss they might subsequently develop it. The severity of the hearing loss varies from one child to the other. Whereas there are some who will only experience partial hearing loss, others are born with complete hearing loss. Despite the levels of severity involved, the unfortunate truth is that hearing loss will affect their ability to develop speech or language. This is because hearing is integral to speech development.

However, there is hope that with early intervention, as early as six months, children who are facing challenges with hearing can be helped. Before looking into how hearing loss might negatively impact a child’s ability to communicate, it is essential to understand the factors that cause hearing loss and the symptoms that parents need to look out for.

What are the causes of infant or childhood hearing loss?

Research has pointed out that there are many factors that can lead to hearing loss. These factors can be categorized into those which are present at birth, known as congenital, or those that are acquired after birth.

To begin with, congenital causes include both genetic and non-genetic factors. However, a higher number of children develop hearing loss due to genetic factors such as autosomal recessive hearing loss or common genetic syndromes such as Treacher Collins or Down Syndrome.

Congenital causes include things such as;

• Factors relating to the mother

Certain diseases during pregnancy might result in hearing loss if the infant also gets affected either during the pregnancy or at birth. This includes viral infections such as herpes, syphilis, German measles, toxoplasmosis among others. It is, therefore, recommended that both the mother and doctors in such cases should keenly observe if the child is showing any symptoms.

Secondly, infants who are born to mothers who used drugs and alcohol during their pregnancy are more likely to develop hearing loss. To add on that, it has been discovered that pregnant women or children who use ototoxic medication might develop hearing problems. Therefore, it is important for pregnant women to keep off from using such medication.

• Premature Birth

This is yet another factor that is likely to cause hearing challenges. Most of the healthy babies have a weight of 3 pounds or more at birth. However, prematurely born babies might not have developed enough to get to such a weight. As such they might have to be given some drugs to boost their respiration. Others might end up being on a ventilator for a prolonged time. These two factors might subsequently cause hearing loss.

• Children who are born with brain disorders are also more susceptible to hearing loss.

Non-congenital factors include;

• Subsequent ear infections. If left untreated for a long time, these infections might lead to a buildup of fluids in the ear which might ultimately cause hearing loss.

• If a child develops infections such as meningitis or whooping cough, there is a possibility that it might cause partial or absolute hearing loss.

• A perforated eardrum might also result in this challenge.

Symptoms of hearing loss

The above are some of the common factors that cause childhood hearing loss. Other than knowing these factors, it is of essence that parents or caretakers should be able to identify the symptoms that point it to the possibility of hearing loss in children. For instance, a newborn who does not respond to loud noises such as a bang of the door might have a hearing problem. Once a child gets older, they should be able to recognize voices or the direction where they are coming from. If your child is unable to do that by the fourth month, you should take him or her to be screened by a professional.

How does hearing loss affect speech development?

Hearing loss affects the development of the essential parts of the brain that aid communication. This is because such children are unable to hear what people around them are saying. These children find difficulty in being able to not only talk but also understand because their brain was unable to learn.

Children who have hearing loss often have a delayed development in their expressive and receptive communication. Given that it impacts the child’s auditory processing, which is crucial for language and speech, they experience challenges building their vocabulary and pronouncing.

Due to the delay in speech development, these children often have difficulty in building language. The other children who do not have hearing challenges are more advanced in vocabulary. Children with hearing loss find it hard to pronounce words that have the /sh/ or /f/ sound. Consequently, most of them leave out such letters. This can make it difficult to make meaning out of what they are trying to communicate because it affects their ability to speak.

As a result of delayed vocabulary, these children also find it hard to understand words that have more than one meaning. In addition, they struggle with words which end in ‘-s’ and ‘-ed’. This factor further affects the development of their speech as such children have difficulty in not only understanding but also pronouncing words that are in past tense or in plural form.

Hearing loss also impacts on the ability to differentiate certain words based on their sound frequencies. Most words have one part that has a high frequency while the other part has a low frequency. For instance, for a word such as jump, the first part /ju/ has a higher frequency compared to the second part. Children who have hearing loss, therefore, experience difficulty in figuring out the remaining part of the word that has a low sound frequency. This further delays their ability to improve their speech.

Lastly, when you consider sentence structures, most of these children have a challenge with compound sentences or passive sentences. They find them hard to comprehend. Due to this factor, children in this category mostly use short and direct sentences.

As stated earlier, early detection of hearing loss is crucial because there are various treatment options that might be of help. For instance, when deemed necessary, they might give such a child a hearing aid or other assistive listening devices. Cochlear implants are also provided as an alternative to hearing aids. These options together with speech therapy can be crucial towards improving speech development.

To sum it up, there are various causes of infant hearing loss such as genetics, viral infections, and premature birth among others. Given that it hinders speech development, it is imperative that such children should receive immediate medical attention so as to find an effective treatment option.