Training Voluntary Pharyngeal Wall Movements in Children with Normal and Inadequate Velopharyngeal Closure

Abstract

The older clinical speech literature recommended use of therapeutic exercises for improvement of palatopharyngeal closure (1, 7, 9, 16'). How— ever, little research was done to test the efiicacy of the exercises and their use declined. Recently, Yules and Chase (1'7) reported successful develop— ment of pharyngeal wall movements and reduction of hypernasality in persons with minimal velopharyngeal incompetency. Their procedure involved electrical stimulation and training; however, they mentioned that other sources of stimulation might work equally well. In an unpublished pilot study one of the authors developed procedures for training pharyngeal wall movements during phonation of /a/. Stimulation with a cotton swab was used to elicit pharyngeal wall movements, and then training was directed toward voluntary production of the movements. Visual observations indicated that three of four young normal female adults learned to produce voluntary mesial movement of the lateral pharyngeal walls and anterior movement of the posterior pharyngeal wall during phonation of /a/. Two of the subjects learned the task in less than 30 minutes. One subject learned in ten days. The fourth subject was given three weeks of training and was able to produce voluntary mesial movement of the lateral walls with phonation but not anterior movement of the posterior pharyngeal wall with phonation. Tape recordings and color motion pictures were made of the subjects 1) phonating without voluntary pharyngeal wall movements, 2) phonating