Rough draft.This research track is under review with Dr. Atit's lab. Content and sequence may still change.
The Baby Mateo Case
Disease domainShared clinical backbone (the cleft team)Lesson 12 of 20Your seat: Speech-language pathologist (cleft team)
How a Repaired Palate Lets Mateo Talk
Discovery question
How does the soft let us make clear speech sounds, and what goes wrong with speech when it cannot seal off the nose?
💡 A poorly sealing causes a specific kind of speech problem ( and weak ), not a random one.
The plan
Prerequisite check
Before this page, you should know
- lip repair () is done at about 3 months (within the first 12 months) mainly to restore the form of the lip and nose.
- repair () is done at about 9 to 12 months (within the first 18 months) mainly to separate the oral and nasal cavities and enable normal speech.
If not, review
Today's new idea is only
A poorly sealing causes a specific kind of speech problem ( and weak ), not a random one.
Learn first
What you will learn
Goal: Students will explain how the soft seals off the nose for speech, why a causes and nasal air escape (), and what the does about it.
Know by the end
- Clear speech needs : the lifts and the throat walls move in, closing the door between the mouth and the nose at the right moments.
- The is the muscle that lifts the soft to make this seal; in a palate it is interrupted and out of position.
- is when that seal does not work, producing and weak (p, b, t, d, k, g), the sounds that need built-up mouth air.
- The listens for , runs speech therapy, and, if the still cannot seal after good therapy, the team may consider a secondary speech surgery later in childhood.
Learn first
Model: Pinch your nose, then two children with two speech patterns
Try this with your team: say 'ahh,' then pinch your nose and say it again. It barely changes, because that sound is supposed to let some air through the nose. Now say 'puppy' and 'baby,' then pinch your nose and say them again. The p and b sounds get hard, because to pop out a clean p or b you must build air pressure in your mouth, and that only works if the nose is sealed off at the back. This is the everyday version of what the soft does automatically: it lifts and seals the back of the mouth off from the nose for certain sounds.
From the speech literature (SYNTHESIS section 4), compare two children. Child A's seals well: resonance is normal, air during p, b, t, d, k, g stays in the mouth and sounds crisp, and the child is easy to understand. Child B's palate does not seal, called VPI: resonance is hypernasal (the voice sounds like it is coming through the nose), air during leaks out the nose and sounds weak or puffy, and some sounds are unclear or substituted. Child B's trouble is specifically with the pressure consonants, the sounds that need built-up mouth air.
Do the work
Explore (work the model before reading on)
- In the nose-pinch demo, which sounds got hard to make: 'ahh,' or 'puppy' and 'baby'?
- In the two-child model, which child has a voice that sounds like it is coming through the nose?
- Pinching the nose blocks air at the nostrils; a soft that lifts and seals blocks air at the back of the mouth. For sounds like p and b, why would a palate that cannot seal cause the same trouble that an open nose would?
- Child B's hardest sounds are exactly the . What do those sounds have in common that explains why a leaky hits them hardest?
- Suppose Mateo's seals well most of the time but leaks a little during fast speech. Predict one thing a listener might notice, and whether 'ahh' or 'puppy' would be affected more.
- In one sentence, what pattern did your team find about the soft and clear speech?
The plan
Guided notes
1
The seal that speech needs
Model start: Clear speech needs the back of the mouth to seal off the nose at the right moments, a job done by the soft .
- Clear speech needs ______ closure: the soft lifts and the throat walls move in to seal the mouth off from the nose.
- The muscle that lifts the soft to make this seal is the ______ veli palatini, which is interrupted in a palate.
2
What happens when the seal fails
- When the seal does not work, we call it , or ______ for short.
- With VPI the voice sounds like too much of it comes through the ______ (), and the p, b, t, d, k, g suffer most.
3
What the SLP does
- The listens for , measures speech development, and runs speech ______.
- If the still cannot seal after good therapy, the team may consider a secondary speech surgery later in childhood.
Explore
Reading the Research
What to read
Read the title and the abstract only, not the whole paper. Vyas T, et al. 2020. Cleft of lip and palate: A review. J Family Med Prim Care. [PMID:32984097]
Why this source matters
This is the published evidence behind today's idea: A poorly sealing causes a specific kind of speech problem ( and weak ), not a random one.
Words to unlock first
velopharyngeal closurevelopharyngeal insufficiency (VPI)hypernasalitypressure consonantsspeech-language pathologist
Reading moves
- Skim the title and abstract first to get the gist.
- Circle the one sentence that states the main claim.
- Box the evidence the authors give for that claim.
- Mark one sentence that confuses you, and move on.
Stop point
You do not need the methods or statistics yet. If a sentence is about lab technique or math you have not learned, mark it and skip it.
Your output
Write one claim-evidence sentence: what this source claims, and the one piece of evidence that backs it up.
Where this fits
Tested on (Ohio WebXam)
Genetics of Disease · 072130
PLTW lesson
MI · Disease domain · Medical Interventions (MI), speech outcomes and therapy
WebXam domain
Bio-Molecular Technology
Evidence to produce
As Mateo's SLP at his 2-year visit, answer the parents' question 'Why does he sound like he is talking through his nose, and what will you do?' in three short sentences: (1) what the soft palate is supposed to do during speech, (2) what VPI means in plain words, and (3) one thing you will do about it. Use the words 'seal,' 'nose,' and 'pressure consonants.'
Lab / skill
Clinical backbone (cleft team) · Clinical backbone (cleft team)
Words
Vocabulary (the same words your classes use)
Explore
Vetted readings for this lesson
- Vyas T, et al. 2020. Cleft of lip and palate: A review. J Family Med Prim Care. [PMID:32984097]
- Dean KM, Leeper LK. 2020. Management of submucous cleft palate. Curr Opin Otolaryngol Head Neck Surg. [PMID:33105231]
- Camargo Y, et al. 2023. Pharyngeal flap versus sphincter pharyngoplasty for VPI in 22q11.2 deletion syndrome. J Craniofac Surg. [PMID:37431935]
The plan
Track your progress today
Check these off as you work through the lesson, then submit. This tells Mr. Mendoza how you're doing so he can help the class. It does not replace turning in your producible.
Use the code Mr. Mendoza gave you, not your name. Saved on this device.
Check off as you finish
- Read the Model and answered the Explore questions.
- Filled in the guided notes in my own words.
- Defined the new vocabulary with an example.
- Built the producible: As Mateo's SLP at his 2-year visit, answer the parents' question 'Why does he sound like he is talking through his nose, and what will you do?' in three short sentences: (1) what the soft palate is supposed to do during speech, (2) what VPI means in plain words, and (3) one thing you will do about it. Use the words 'seal,' 'nose,' and 'pressure consonants.'
- Wrote my Claim, Evidence, and Reasoning exit ticket.
Pick your period and code first.
Check yourself
Exit ticket (Claim, Evidence, Reasoning)
- Claim: A poorly sealing causes a ____ (specific / random) kind of speech problem.
- Evidence: The speech feature most affected is ____ and the sound group most affected is the ____ consonants (p, b, t, d, k, g).
- Reasoning: Those sounds, and not a sound like 'ahh,' suffer because ____.
How this is graded (rubric)
For: As Mateo's SLP at his 2-year visit, answer the parents' question 'Why does he sound like he is talking through his nose, and what will you do?' in three short sentences: (1) what the soft palate is supposed to do during speech, (2) what VPI means in plain words, and (3) one thing you will do about it. Use the words 'seal,' 'nose,' and 'pressure consonants.'
| Criterion | Proficient | Developing | Beginning |
|---|---|---|---|
| Complete | Every required part of the artifact is present and filled in. | Most parts are present, but one is missing or left blank. | Several parts are missing. |
| Accurate | The science and data are correct and match the evidence. | Mostly correct, with a small factual slip. | Key science or data is wrong. |
| Scientific reasoning (CER) | States a claim, backs it with specific evidence, and explains the reasoning. | Has a claim and evidence, but the reasoning is thin or missing. | Gives an answer with no evidence or reasoning. |
| Professional communication | Clear, organized, and labeled the way a clinician or scientist would write it. | Readable but disorganized or missing labels. | Hard to follow. |
| Submitted | Turned in the right way (Schoology for routine work) and confirmed. | Turned in, but in the wrong place or unconfirmed. | Not turned in. |
How the model answer scores against this rubric
- CompleteProficient: Nothing is left blank: the model fills every part of "As Mateo's SLP at his 2-year visit, answer the parents' question 'Why does he sound like he is talking through his nose, and what will you do?' in three short sentences: (1) what the soft palate is supposed to do during speech, (2) what VPI means in plain words, and (3) one thing you will do about it. Use the words 'seal,' 'nose,' and 'pressure consonants.'".
- AccurateProficient: Every number and claim matches the case evidence.
- Scientific reasoning (CER)Proficient: It names a claim, cites the specific evidence, and explains the reasoning, not just the answer.
- Professional communicationProficient: It is organized and labeled like a real chart note.
- SubmittedProficient: It would be turned in on Schoology and confirmed.
Explore
Where this leads: careers
Speech-language pathologist Craniofacial speech specialist Early-intervention therapist
What's next: We answered how the lets Mateo make clear speech and what VPI is. But the same little muscles near the palate do another job: they help drain the . Mateo keeps getting ear infections and does not always turn to soft sounds. How do we protect his hearing?