Electrical Stimulation of the Soft Palate

Abstract

, Illz'nois 60680 Recent years have seen a resurgence of interest in what Shelton (22) has termed " physical therapy techniques " in the treatment of velopharyn— geal incompetency (12, 25, 32). Yules and Chase (32) and Tash et al. (25) investigated training programs for the development of voluntary pharyn-geal wall movements. The development of such programs was preceded by numerous reports of changes in pharyngeal wall movements following obturator insertion (1, 6, 20, 28). Tash et al. (25) used tactile stimulation to elicit movement of the pharyn— geal walls as the first step in a program designed to teach subjects to produce these movements voluntarily. The results indicated that children with adequate closure were able to produce the criterion voluntary wall movements on phonation of /c/; however, subjects with closure deficits were not able to learn the task as well and showed no improvement in closure at the end of the training program. Yules and Chase (32) applied electrical stimulation first to the palate and then to the posterior and lateral pharyngeal walls in patients with velopharyngeal incompetency in the first phase of an extensive training program which was devised to (1) obtain " voluntary pharyngeal contrac— tions, " and (2) automate these contractions into spontaneous speech. Subsequent phases of the training program involved home practice with Q—tips and a mirror and the use of an operant conditioning device to in— corporate the movements into speech. The first published report (32) was optimistic but did not allow objective evaluation of the nature and degree of change in the behavior of velopharyngeal musculature. Furthermore, a follow—up report (30) indicated that only one of the seven subjects available for re—evaluation a year after the training program " demonstrated a sig— nificant reduction in nasality in his speech. " Yules and Chase (32) pointed out that ". .. any object for touching the pharyngeal wall might prove effective " in eliciting movement. In discussing the results of their own study, Tash et al. (25) suggested that another Dr. Peterson is affiliated With