The Influences of Child Intelligibility and Rate on Caregiver Responses to Toddlers With and Without Cleft Palate

2017 ◽  
Vol 55 (2) ◽  
pp. 276-286 ◽  
Author(s):  
Jennifer R. Frey ◽  
Ann P. Kaiser ◽  
Nancy J. Scherer

Objective: The purpose of this study was to investigate the influences of child speech intelligibility and rate on caregivers’ linguistic responses. Design: This study compared the language use of children with cleft palate with or without cleft lip (CP±L) and their caregivers’ responses. Descriptive analyses of children’s language and caregivers’ responses and a multilevel analysis of caregiver responsivity were conducted to determine whether there were differences in children’s productive language and caregivers’ responses to different types of child utterances. Setting: Play-based caregiver-child interactions were video recorded in a clinic setting. Participants: Thirty-eight children (19 toddlers with nonsyndromic repaired CP±L and 19 toddlers with typical language development) between 17 and 37 months old and their primary caregivers participated. Main Outcome Measures: Child and caregiver measures were obtained from transcribed and coded video recordings and included the rate, total number of words, and number of different words spoken by children and their caregivers, intelligibility of child utterances, and form of caregiver responses. Results: Findings from this study suggest caregivers are highly responsive to toddlers’ communication attempts, regardless of the intelligibility of those utterances. However, opportunities to respond were fewer for children with CP±L. Significant differences were observed in children’s intelligibility and productive language and in caregivers’ use of questions in response to unintelligible utterances of children with and without CP±L. Conclusions: This study provides information about differences in children with CP±L’s language use and caregivers’ responses to spoken language of toddlers with and without CP±L.

Author(s):  
Ariela Nachmani ◽  
Muhamed Masalha ◽  
Firas Kassem

Purpose This purpose of this study was to assess the frequency and types of phonological process errors in patients with velopharyngeal dysfunction (VPD) and the different types of palatal anomalies. Method A total of 808 nonsyndromic patients with VPD, who underwent follow-up at the Center for Cleft Palate and Craniofacial Anomalies, from 2000 to 2016 were included. Patients were stratified into four age groups and five subphenotypes of palatal anomalies: cleft lip and palate (CLP), cleft palate (CP), submucous cleft palate (SMCP), occult submucous cleft palate (OSMCP), and non-CP. Phonological processes were compared among groups. Results The 808 patients ranged in age from 3 to 29 years, and 439 (54.3%) were male. Overall, 262/808 patients (32.4%) had phonological process errors; 80 (59.7%) ages 3–4 years, 98 (40, 0%) ages 4.1–6 years, 48 (24.7%) 6.1–9 years, and 36 (15.3%) 9.1–29 years. Devoicing was the most prevalent phonological process error, found in 97 patients (12%), followed by cluster reduction in 82 (10.1%), fronting in 66 (8.2%), stopping in 45 (5.6%), final consonant deletion in 43 (5.3%), backing in 30 (3.7%), and syllable deletion and onset deletion in 13 (1.6%) patients. No differences were found in devoicing errors between palatal anomalies, even with increasing age. Phonological processes were found in 61/138 (44.20%) with CP, 46/118 (38.1%) with SMCP, 61/188 (32.4%) with non-CP, 70/268 (26.1%) with OSMCP, and 25/96 (26.2%) with CLP. Phonological process errors were most frequent with CP and least with OSMCP ( p = .001). Conclusions Phonological process errors in nonsyndromic VPD patients remained relatively high in all age groups up to adulthood, regardless of the type of palatal anomaly. Our findings regarding the phonological skills of patients with palatal anomalies can help clarify the etiology of speech and sound disorders in VPD patients, and contribute to general phonetic and phonological studies.


2019 ◽  
Vol 6 ◽  
pp. 2333794X1985141 ◽  
Author(s):  
Raúl Herreras Mercado ◽  
Kenneth Simpson ◽  
Kristen H. Bellom-Rohrbacher

Objective. This investigation researched the effectiveness of the PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) method to address compensatory articulation errors in children with cleft palate. Design. Single-subject AB multiple baselines across participants and behaviors. Setting. Pediatric outpatient rehabilitation department in a local hospital in a metropolitan city. Participants. The investigation consisted of 3 participants (ages = 4:4 to 12:8) born with bilateral complete cleft lip and palate. All participants underwent several reconstructive surgeries to repair their lips and palates. Interventions. The PROMPT treatment was provided for 45 minutes 3 times a week for 4 weeks (3 weeks for Participant 2). Main Outcome Measure. Therapy sessions addressed anterior lingual speech motor phonemes across 3 tiers (syllables, words, and phrases). Results. Direct visual observation of data obtained throughout this investigation indicate potential positive effects and significant correlation between improvements in sound production at 3 tiers and the implementation of the PROMPT technique. Speech intelligibility was judged by 3 blinded listeners who were unfamiliar with children with speech disorders or with cleft palate speech. All listeners identified and judged improvement in overall speech intelligibility over the course of this investigation. Listeners examined speech samples selected from sessions 3, 6, 9, and 12. Conclusion. The findings in this investigation provide a potential relationship on the effectiveness of the PROMPT method and attainment of accurate speech productions in children with cleft palate producing compensatory articulation errors, resulting in improvement in overall speech intelligibility.


2017 ◽  
Vol 54 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Alice Lee ◽  
Fiona E. Gibbon ◽  
Kimberley Spivey

Objective The objective of this study was to investigate whether reduced speech intelligibility in children with cleft palate affects social and personal attribute judgments made by typically developing children of different ages. Design The study (1) measured the correlation between intelligibility scores of speech samples from children with cleft palate and social and personal attribute judgments made by typically developing children based on these samples and (2) compared the attitude judgments made by children of different ages. Participants A total of 90 typically developing children, 30 in each of three age groups (7 to 8 years, 9 to 10 years, and 11 to 12 years). Outcome Measures Speech intelligibility scores and typically developing children s attitudes were measured using eight social and personal attributes on a three-point rating scale. Results There was a significant correlation between the speech intelligibility scores and attitude judgments for a number of traits: “sick-healthy” as rated by the children aged 7 to 8 years, “no friends-friends” by the children aged 9 to 10 years, and “ugly-good looking” and “no friends-friends” by the children aged 11 to 12 years. Children aged 7 to 8 years gave significantly lower ratings for “mean-kind” but higher ratings for “shy-outgoing” when compared with the other two groups. Conclusions Typically developing children tended to make negative social and personal attribute judgments about children with cleft palate based solely on the intelligibility of their speech. Society, educators, and health professionals should work together to ensure that children with cleft palate are not stigmatized by their peers.


2008 ◽  
Vol 45 (2) ◽  
pp. 131-140 ◽  
Author(s):  
Soung Min Kim ◽  
Young Joon Lee ◽  
Sang Shin Lee ◽  
Yeon Sook Kim ◽  
Suk Keun Lee ◽  
...  

Objective: To elucidate abnormal growth patterns of human fetal maxillae with cleft lip and palate (CLP). Subject: A total of 71 fetal maxillae with CLP were obtained from aborted human fetuses. Method: Dimensions of the maxillary trapezoid (MT), formed by the maxillary primary growth centers (MxPGC), were taken from radiographic images. The CLP dimensions were compared with maxillary trapezoid dimensions of normal fetuses from a previous study (Lee et al., 1992). Main Outcome Measures: Cleft lip subjects without a cleft palate, unilateral cleft lip-alveolar cleft or cleft palate (UCL+A/UCLP), and bilateral cleft lip-alveolar cleft or cleft palate (BCL+A/BCLP) displayed abnormal MT patterns. MT abnormalities were most marked in the BCL+A/BCLP cohort. Results: The MT growth of prenatal CLP maxillae was severely arrested, resulting in abnormal MT shape on palatal radiograms. BCL+A/BCLP subjects had a more protruded nasal septum than subjects with other types of CLPs, while UCL+A/UCLP subjects showed severe deviation of the protruded nasal septum toward the noncleft side. Cleft lip-only subjects also exhibited abnormal MT growth. Conclusion: MT is primarily involved in CLPs, so that the MT shape could be utilized as a sensitive indicator for the analysis of maxillary malformation in different types of CLPs.


2007 ◽  
Vol 44 (6) ◽  
pp. 635-641 ◽  
Author(s):  
João Henrique Nogueira Pinto ◽  
Giseleda Silva Dalben ◽  
Maria Inês Pegoraro-Krook

Objective: To evaluate the speech intelligibility of patients with clefts before and after placement of a speech prosthesis. Design: Cross-sectional. Setting: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Bauru, Brazil. Patients: Twenty-seven patients with unoperated cleft palate or operated cleft palate presenting with velopharyngeal insufficiency (VPI) after primary palatoplasty, treated with speech prosthesis, aged 8 to 63 years. Interventions: Patients were fitted with palatopharyngeal obturators or pharyngeal bulbs, suitable to their dental needs. Five speech-language pathologists blindly evaluated speech samples of the patients with and without the prosthesis. Main Outcome Measures: Classification of speech samples according to a scoring system developed for speech intelligibility problems: 1 (normal), 2 (mild), 3 (mild to moderate), 4 (moderate), 5 (moderate to severe), and 6 (severe). Results were evaluated by the calculation of means of all judges for each patient in both situations. Results: The judges presented significant agreement (W = .789, p < .01). Speech intelligibility was significantly better after placement of the prosthesis for both unoperated patients (Z = 1.93, p = .02) and operated patients with VPI after primary palatoplasty (Z = 1.78, p = .03). Conclusions: Speech intelligibility may be improved by rehabilitation of patients with cleft palate using a speech prosthesis. Speech therapy is needed to eliminate any compensatory articulation productions developed prior to prosthetic management.


2001 ◽  
Vol 38 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Tom Millard ◽  
Lynn C. Richman

Objective The purpose of this investigation was to study the adjustment and learning characteristics of children with different types of clefts. The hypotheses were that there may be different relationships among cleft variables (speech and appearance) according to the cleft types. Design The study compared three cleft groups on behavior rating, anxiety scales, depression scales, and self-perception (analyses of variance) and examined the influence of facial and speech ratings on self-perception (multiple regression analyses). Setting All patients were treated at a university hospital cleft palate clinic. Patients Sixty-five children aged 8 years to 17 years were selected based on nonsyndromic cleft (unilateral cleft lip and palate [ULP], bilateral cleft lip and palate [BLP], and cleft palate only [CPO]) and no significant neurological condition or hearing loss. Results The findings indicated children with CPO showed greater problems with parent- and teacher-reported depression, anxiety, and learning related to speech than children with ULP or BLP. The later two groups showed fewer problems and a greater relationship of problem to facial appearance. The children with ULP self-reported lower levels of depression than the other two groups. Conclusions Children with cleft show relatively good overall adjustment, but some problems appear related to speech and facial appearance. Subgroups may need to be studied separately.


2014 ◽  
Vol 03 (04) ◽  
pp. 203-208
Author(s):  
Alpana Barman ◽  
B C Dutta ◽  
J K Sarkar

Abstract Background : Cleft lip and palate are some of the most common congenital deformities. They frequently occur as isolated deformities, but can be associated with other medical conditions and anomalies. Aim of the study: To study the distribution of different types of cleft lip and palate and associated anomalies. Materials and methods: Forty patients of cleft lip and palate were studied. Relevant history was taken, clinical examination done and recorded with photography with consent. The cases were classified as per Nagpur Classification. Results: In our study 24 cases (60%) were cleft lip and palate (type III) and 10 cases (25%) of cleft palate alone (type II) and 6 cases (15%) of cleft lip alone (type I). Males were found to predominate in type I and III. Females predominated in type II. Among the cleft lip, left side is found to be involved in most of the cases. In our study, out of 40 cases, 8 cases (20%) had other associated anomalies. Most of these were associated with cleft lip and palate (type III) and isolated cleft palate (type II). Conclusion: The typical universal distribution of cleft types and associated anomalies tallies with our results.


1997 ◽  
Vol 6 (4) ◽  
pp. 48-54 ◽  
Author(s):  
Nancy J. Scherer ◽  
Linda D'Antonio

The relationship between play gesture performance and language milestones was examined for 6 children with cleft lip and/or palate at 20, 24, and 30 months of age. Standardized measures of language development, language samples, and a play gesture protocol were administered and analyzed at each assessment. Results showed language delays for several of the children with cleft palate and displayed a complex relationship between play and language development. The results show parallels between single object use and vocabulary development as well as sequential play gestures and structural aspects of language use. Data from this study demonstrated slow play gesture and language development for children with cleft palate only.


2005 ◽  
Vol 42 (2) ◽  
pp. 185-191 ◽  
Author(s):  
Diego F. Wyszynski ◽  
Claudia Perandones ◽  
Patricia Yannibelli ◽  
Ricardo D. Bennun

Objective The purpose of this investigation was to study the social environment of families of children with different types of nonsyndromic oral clefts (OC) and to compare these groups with a control population of families of children without clefts. Design The study compared three nonsyndromic oral cleft groups and the control group using the Moos Family Environment Scale, which examines cohesion, expressiveness, conflict, independence, achievement-orientation, intellectual-cultural orientation, active-recreational orientation, moral-religious emphasis, organization, and control. Setting All parents of children with nonsyndromic oral clefts from a large craniofacial clinic in Buenos Aires, Argentina, were identified and were enrolled in this study between June 2000 and August 2001. Control families were ascertained from the pediatrics service of a hospital located in the vicinity of the craniofacial clinic. Participants One hundred and sixty-five parents were selected, based on having a child with nonsyndromic unilateral cleft lip with or without cleft palate (UCL/P), bilateral cleft lip with or without cleft palate (BCL/P), or isolated cleft palate (ICP). One hundred and eighty control parents with no family history of congenital anomalies were selected, as well. Results There was no major difference in the social environment of families of children with different types of nonsyndromic oral clefts. When compared with families in the control group, families of children with nonsyndromic oral clefts scored better in all three subdimensions of family relationship, revealed a high level of independence, and showed better structure and organization than control families did; however, families of children with nonsyndromic oral clefts reported participating in fewer recreational activities. Conclusions Overall, families of children with nonsyndromic oral clefts displayed a good social environment. Efforts should be focused to involve them in recreational activities.


Development ◽  
1977 ◽  
Vol 39 (1) ◽  
pp. 203-220
Author(s):  
Ravindra M. Shah

A single intraperitoneal injection of 1–2·5 g/kg body weight of hadacidin was teratogenic when administered to pregnant hamsters between days 8 and 11 of gestation. Both the frequency of malformation and resorption were related to the dose and time of hadacidin administration. The drug produced both gross and microscopic malformation in the fetus and impaired its general growth. The malformation involved craniofacial structures, central nervous system, respiratory, digestive and urinary systems, limbs and tail. Morphologically different types of cleft lip and cleft palate were related to the dose and time of hadacidin treatment. An association was observed between cleft lip, cleft palate and micrognathia on one hand, and between cleft palate and micrognathia on the other. Significance of association between the lip, the palate and the mandibular malformation was discussed and the hypothesis that human cases of Pierre Robin syndrome may result from an environmental assault was supported. It was suggested that the fetal weight and the microscopic analysis should be included in the criteria for the teratological drug safety evaluation procedures.


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