Harper has contented that the widespread weakness of facial and palatal muscles together with the associated secondary bony deformations of facio-maximllary structures may cause this problem. Wright reported that 10 of 42 patients with CMD has recurrent Ear Infections. Male child is 5 years old diagnosised with CMyD at less than 2 weeks of age. Milestones of sitting alone was 11 months and walking was 16 months. First words were at 3 years.
Immunizations are up to date.
There are some simplifications in conversational speech with some glottal stops but with good oral air pressure. Pitch is high and this is future aggravated when he becomes upset. I do hear some posterior nasal friction suggesting touch Velopharyngeal closure. The fundamental frequency for this was 286 Hz. This is normal.