The responsibility of the speech correctionist in the treatment of the cleft palate patient who has received surgical or prosthetic treatment

Abstract

U NIVERSAL experience convincingly attests to the primacy of speech in the totality of human behavior. A fact less commonly appreciated is that the integrity of the speech function figures importantly as a determinant of psychosocial health of the individual. It is in the light of these two factsthat of the primacy of speech, and that of the integrity of the speech function-that the full urgency of the cleft palate patient’s needs become manifest. Since the capaciiy for speech is the most distinguishing human attribute, it follows that what affects speech favorably or unfavorably affects the most human part of us. A somatic derangement as extensive as cleft palate will obviously be advertised in a profound functional disturbance. Functional evidences of aberrant organic states assume significance in terms of the level upon which they operate. Some variations of structure have only limited importance because they affect adversely functions that are singularly personal and individualistic. An illustration is the absence of an eye or a leg. Here, locomotion or sensory perception are interfered with. These functions are of primary importance to the person, but their social significance is secondary. Spk-ech, on the other hand, is indisputably a social function. Hence, any disturbance in its integrity resulting from atypic structure assumes additional significance because of its adverse effect upon social adjustment. Its personal importance, though not incidental, is clearly subordinate. It is evident then why the speech c1inicia.n conceives himself to be engaged by the core of the problem of rehabilitating the cleft palate patient. He reasons that the full personal and social impact of the disorder is registered through the patient’s inadequate speech. Rightly or wrongly, he argues that. the success of any and all remedial procedures must be measured in terms of improved speech. He is supported in this observation by the patient’s own testimony, for it is unusual indeed to find a patient who does not give first place to his hope for a recovery of speech. Implicit in the adoption of this view is the acceptance of serious clinical responsibilities. Despite the general recognition of the centrality of the speech needs of the cleft palate patient, a number of practical factors militate against their easy, rapid, and certain satisfaction. First, it is apparent that the patient’s speech improvement is, in a large measure, predetermined by the success of