A 9-year-old child one year post tonsillectomy shows moderate hypernasality. What is the next appropriate step for the SLP?

Surgical management is often considered when dealing with persistent or moderate hypernasality following a tonsillectomy, especially in a child who is already a year post-surgery. In this situation, hypernasality indicates that there may be an issue with the velopharyngeal mechanism, which is crucial for normal speech production. If a structural or functional problem is suspected, consulting a craniofacial team can provide a comprehensive assessment of the child’s velopharyngeal function and associated structures.

The craniofacial team can evaluate potential surgical options that may help improve the child’s resonance by addressing any anatomical or functional abnormalities. Appropriate intervention may depend on this collaborative assessment, and it can lead to better outcomes for the child if a surgical solution is indicated.

Other strategies such as monitoring the child’s speech or initiating therapy might be reasonable in some cases, but given the moderate level of hypernasality persisting for a year post-surgery, involving surgical specialists is a more direct approach to addressing the problem. This teamwork can result in more tailored and effective management of the child's speech issues.