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A 5 year old girl with a repaired cleft palate and moderate velopharyngeal insufficiency, as documented by nasoendoscopy, exhibits the following speech characteristics: mild breathiness; moderate to severe hypernasality; moderate nasal emission; inconsistent substitution of nasalized alveolar stops for velar stops; and omission of many fricatives and affricates or substitution of /h/ for them. Dentition and occlusion are normal. Cognitive and language skills are age-appropriate, and the client has had no previous speech therapy. Pharyngeal flap surgery is scheduled, but because of pending cardiac surgery will not take place for 12 to 15 months. Which of the following management strategies and rationales is most appropriate and desirable for the child at this time?A. deferring speech therapy until after the pharyngeal flap surgery, because the surgery could improve the speech problemB. Instituting therapy focused
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