Dr. PerryDr. Jamie Perry is a licensed speech language pathologist and speech scientist. She is an associate professor at East Carolina University where she conducts research using magnetic resonance imaging and 3D computer technology to study the anatomy, speech, and surgical approaches used to treat cleft palate. Her research is funded through the National Institute of Health. Her current collaborative work aims to examine the variations in presurgical anatomy effect postsurgical speech outcomes in children born with cleft palate. Dr. Perry serves on the cleft palate craniofacial team at New Hanover Regional Medical Center in Wilmington, NC. She is the director of the Speech Imaging and Visualization Laboratory at East Carolina University. Dr. Perry serves as the coordinator for the resonance disorders clinic where she provides speech evaluations and therapy to individuals with errors related to cleft palate and resonance disorders. Dr. Perry also provides support and training through surgical mission trips to third world countries.


 

How did you specifically become interested in the treatment of cleft palate?

When I was a graduate student I observed a cleft palate craniofacial team and observed cleft palate surgeries during the summers. I enjoyed the multidisciplinary team approach and I loved the medical aspects related to the patient care. Observing cleft surgeries allowed me to see firsthand how changes in the anatomy produced changes in a child’s speech. Also, while I was in graduate school, my nephew was born with a cleft palate, making this area of clinical practice more personal than ever before. Combined, these experiences sparked my interest in cleft palate care.

 

What are some of the main speech difficulties that can arise for those with cleft palate after surgery? What are the unique obstacles to correcting these difficulties?

There are specific errors called compensatory misarticulations, which are common among children with cleft palate. These are treated only with speech therapy using a high intensity, high frequency articulation motor-based therapy approach. Blowing, sucking, and whistling (and all non-speech oral motor exercises) have been proven to be ineffective treatment methods and should not be used. The obstacle in treating these errors is that some kids may have errors that are termed “obligatory” meaning they are due to structural/functional/neurological issues and are not considered learned behaviors. As a SLP, our role is to perform a careful differential diagnosis to tweeze out which errors are learned (needing speech therapy) and which are obligatory (typically needing surgery to correct). It is well documented in the literature that SLPs often feel uncomfortable and poorly prepared on how to treat children with cleft palate. SLPs who are treating children with a cleft palate should work very closely alongside the cleft palate craniofacial team SLP and seek guidance and support through the process to ensure successful outcomes.

 

How have 3D computer reconstructions added to our ability to understand cleft palate and how to treat it? Tell us about some of the improvements that have come from having this technology.

The use of 3D computer reconstructions and finite element models (with my collaborator at University of Virginia, Silvia Blemker) are powerful tools that can help us ask questions that are physically not possible in the real world. For example, we can use MRI to image a child and then we can use a computational model to apply variations to the anatomy to simulate surgery. Using these models, we can understand how variable alterations to the anatomy change the function of the velopharynx for speech production. Our simulations have demonstrated that certain surgical techniques, such as levator veli palatini muscle overlapping at the velar midline, produce favorable outcomes compared to an end-to-end approximation of the muscle.

 

You travel to third world countries on surgical mission trips, how has what you have seen influenced the direction your research takes?

Traveling to third world countries on mission trips has helped me see how great the need is for improvements in surgical techniques using imaging and computational modeling. It estimated 20-35% of children with cleft palate will need a secondary surgery to correct hypernasal speech. This statistic is worse in third world countries where surgeries are often performed later in life. Unfortunately, children do not always get an opportunity for a secondary surgery for hypernasality because of the limited access to care in these countries. This further underscores the importance of optimizing the primary surgery. Our research using MRI and computational modeling (through our collaborators) aims to improve our understanding of the impact of surgery techniques on speech outcomes.

 

What drew you to becoming a professor?

I enjoyed my research lab experiences as an undergraduate student and this sparked a passion for cleft palate research. I had many excellent mentors along the way who helped me learn the skill of being a researcher. Ultimately, what led me to my interest in becoming a professor was a desire to make an impact in the direction of healthcare. I wanted to make a difference in my field by providing clinicians and medical professionals guidance through evidence-based research that would improve the outcomes for children born with cleft palate.

 

What is your best advice for speech-language pathology graduate students?

My suggestions are: 1) don’t dismiss your curiosity, 2) ask questions, and 3) just go for it! If you think you have ANY interest at all in getting your PhD and being in academia for your profession, reach out to a research faculty at your institution and get more information. Browse university websites that you know students are getting their PhD from and learn about the labs. If you find one that piques your interest, contact the professor of the lab and start asking questions early. Often, it is easier to go straight from your master’s degree into the PhD. I find students who say they will “think about it” after a few years of practice find their lives are now too complicated to go back to school, yet so many of them wish they would have just continued on. Getting a PhD will be one of the most exciting times of your life and will stretch you further than you could ever imagine. Research and academia is such a rewarding profession and an additional perk is that it is a very family-friendly career.

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Note: You should consult with your doctor or speech pathologist for recommendations on treatment. The views and opinions expressed in this article are those of Dr. Perry and do not necessarily reflect the official policy or position of SpeechPathologyMastersPrograms.com