Intensive treatment of speech disorders in robin sequence: a case report

Abstract

Purpose: To describe the speech of a patient with Pierre Robin Sequence (PRS) and severe speech disorders before and after participating in an Intensive Speech Therapy Program (ISTP). Methods: The ISTP consistedof two daily sessions of therapy over a 36-week period, resulting in a total of 360 therapy sessions. The sessionsincluded the phases of establishment, generalization, and maintenance. A combination of strategies, such asmodified contrast therapy and speech sound perception training, were used to elicit adequate place of articulation.The ISTP addressed correction of place of production of oral consonants and maximization of movement ofthe pharyngeal walls with a speech bulb reduction program. Therapy targets were addressed at the phoneticlevel with a gradual increase in the complexity of the productions hierarchically (e.g., syllables, words, phrases,conversation) while simultaneously addressing the velopharyngeal hypodynamism with speech bulb reductions.Results: Re-evaluation after the ISTP revealed normal speech resonance and articulation with the speech bulb.Nasoendoscopic assessment indicated consistent velopharyngeal closure for all oral sounds with the speechbulb in place. Conclusion: Intensive speech therapy, combined with the use of the speech bulb, yielded positiveoutcomes in the rehabilitation of a clinical case with severe speech disorders associated with velopharyngealdysfunction in Pierre Robin Sequence