6 Times an SLP refers to an ENT

Have you ever wondered when to refer to an ENT or a craniofacial team?

SLPs may refer to an ENT specialist when they suspect that the patient’s speech or language is caused by a structural problem or medical condition in the ear, nose, or throat. For example, if a child has persistent difficulty with speech sounds despite speech therapy.

It’s important that our patient’s receive the most appropriate and effective treatment for their speech or language and we don’t continue with speech therapy if there is a structural component.

When to Refer to an ENT

1. Hypernasality – When there is too much nasal resonance and airflow though the nose, especially on vowels and voiced consonants. Hypernasality does not affect voiceless consonants, and it is most associated with velopharyngeal dysfunction.

2. Hyponasality – When there is too little nasal resonance and airflow through the nose, primarily on nasal consonants (m, n, ng.) This can be due to allergies, enlarged adenoids, upper respiratory infections or sinus infections.

3. Chronic ear infections.

4. Chronic mouth breathing.

5. Snoring or irregular breathing during sleep.

6. Enlarged tonsils or suspected large adenoids.

Note: Speech therapy CANNOT FIX hypernasility, hyponasailty, or nasal air emission from velopharyngeal dysfunction. This is when the velopharyngeal port does not have proper closure. Air leaks into the nasal passage during speech due to inadequate speed or range of function of the soft palate. Speech therapy is effective when teaching abnormal speech sounds placement caused by velopharyngeal dysfunction.

Who is an ENT?

ENT stands for Ear, Nose, and Throat. An ENT specialist, also known as an Otolaryngologist, is a medical doctor who specializes in the diagnosis, management, and treatment of disorders and conditions related to the ear, nose, and throat, as well as the head and neck. Some common conditions that an ENT may diagnose and treat include ear infections, hearing loss, voice and swallowing disorders, tinnitus, allergies, and tonsillitis. ENT specialists may also perform surgical procedures, such as tonsillectomies, adenoidectomies, sinus surgeries, and reconstructive surgeries of the head and neck.

How do I find a craniofacial team?

If you want to find a craniofacial team in your area, use the American Cleft Palate Craniofacial Association website. https://acpacares.org/find-a-care-team/

Odds are a child has a craniofacial team if they have a history of cleft lip, palate, and/or submucous cleft. The child’s guardian should be able to get in contact with their craniofacial coordinator to schedule an appointment.

A craniofacial team is a group of specialists who work together to coordinate a child’s care over the long term. The doctors and specialists on the team work with a child and his or her parents to design a personal treatment plan.

Interested in a comprehensive resource for cleft speech?

The Cleft Palate Speech Guidebook is a comprehensive manual for evaluating and treating cleft speech, along with parent handouts. This unique cleft speech book has concise, easy-to-understand information for SLPs and SLPAs to assess and treat cleft-affected children. It contains over 100 pages of accessible information to feel confident in treating cleft speech!