ACPA Family Services

Part 7–One From the Team: Speech Therapy and the School-Aged Child

Part 7–One From the Team: Speech Therapy and the School-Aged Child

Special Challenges for School-Aged Children

Special challenges for school-aged children and their speech development are often associated with tonsils and adenoids. Some of these challenges include:

1) In their school-age years, some children may develop issues that are particularly challenging. One common issue involves a short palate which causes speech to become increasingly hypernasal or air escaping the nose when it hadn’t been a problem earlier.

2) The adenoids sit above and behind the soft palate (but we can’t see them by looking in the mouth). Adenoids can be relatively large in younger children but by 9 or 10 years of age (or older) adenoids may get smaller and take up less space. When this happens it may create a shortness of the palate that wasn’t affecting speech before.

3) In their school-age years some children develop large and infected tonsils and adenoids that may require surgical removal. Removing the tonsils and adenoids can have a very positive effect on the child’s general health. Even if the outcome of the adenoidectomy and tonsillectomy includes the need for secondary palatal surgery to correct the speech and resonance issues, it is usually a necessary step. Likewise, if a child has a short palate or a palate that doesn’t move well, they may need the secondary surgeries previously discussed. It may be necessary to remove large tonsil and adenoids before this surgery. The removal of the tonsils and/or adenoids may make the speech temporarily worse (more hypernasal with air escaping in the nose). This is a temporary issue that the scheduled palate surgery is meant to correct.

In general, the whole area of tonsils, adenoids and palate function can become very complicated and it is critical the child’s team is involved in the decision making for any of these surgeries so that outcomes can be anticipated and solutions planned from the start rather than after the fact.

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