Longitudinal Study of Vocal Development and Language Environments in Infants With Cleft Palate

2021 ◽  
pp. 105566562110425
Author(s):  
Seunghee Ha ◽  
Kimbrough D. Oller
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Late Onset ◽  
Automated Analysis ◽  
Natural Environments ◽  
Vocal Development ◽  
Environment Analysis ◽  
Audio Recordings ◽  
Before And After ◽  
Language Environment

Objective This study investigated vocalization and language environment longitudinally in infants with cleft palate (CP) based on day-long audio recordings collected in their natural environments. Design Language Environment Analysis (LENA) data from all-day recordings at home were collected at 3-month intervals for infants from 4-6 to 16-18 months of age. The recordings were analyzed using experimentally blinded human coding as well as LENA automated analysis. Participants Ten infants with CP (± cleft lip) and 10 age-matched infants without CP. Main Outcome Measures Several measurements were obtained from the LENA automated analysis software. In addition, human coded measurements of vocalization and language environment, including the true canonical babbling ratio and the infant-directed speech ratio, were analyzed for each time point of data collection for each infant. Statistical analyses were performed to conduct group and age comparisons for each measure of vocalization and language environment. Results No group differences emerged in number of syllables produced. Infants with CP exhibited late onset and fewer productions of canonical syllables compared to infants without CP. Infants with CP did not show significant differences from infants without CP in measures related to language environment across ages. Conclusion This study provides detailed information through naturalistic all-day home recordings about vocal development and early language environments in infants with CP before and after palatal repair. Clinical implications for early intervention are discussed.

Automated Assessment of Child Vocalization Development Using LENA

2017 ◽  
Vol 60 (7) ◽  
pp. 2047-2063 ◽  
Author(s):  
Jeffrey A. Richards ◽  
Dongxin Xu ◽  
Jill Gilkerson ◽  
Umit Yapanel ◽  
Sharmistha Gray ◽  
...  
Keyword(s):  
Expressive Language ◽  
Reliability And Validity ◽  
Automated Analysis ◽  
Linear Regression Models ◽  
Vocal Development ◽  
Environment Analysis ◽  
Audio Recordings ◽  
Language Assessments ◽  
Language Environment ◽  
Full Day

Purpose To produce a novel, efficient measure of children's expressive vocal development on the basis of automatic vocalization assessment (AVA), child vocalizations were automatically identified and extracted from audio recordings using Language Environment Analysis (LENA) System technology. Method Assessment was based on full-day audio recordings collected in a child's unrestricted, natural language environment. AVA estimates were derived using automatic speech recognition modeling techniques to categorize and quantify the sounds in child vocalizations (e.g., protophones and phonemes). These were expressed as phone and biphone frequencies, reduced to principal components, and inputted to age-based multiple linear regression models to predict independently collected criterion-expressive language scores. From these models, we generated vocal development AVA estimates as age-standardized scores and development age estimates. Result AVA estimates demonstrated strong statistical reliability and validity when compared with standard criterion expressive language assessments. Conclusions Automated analysis of child vocalizations extracted from full-day recordings in natural settings offers a novel and efficient means to assess children's expressive vocal development. More research remains to identify specific mechanisms of operation.

scholarly journals Speech in a consecutive series of children born with cleft lip and palate with and without syndromes and/or additional malformations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristina Klintö ◽  
Maria Sporre ◽  
Magnus Becker
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Consecutive Series ◽  
Total Group ◽  
One Stage ◽  
Audio Recordings ◽  
Bilateral Cleft Lip ◽  
Palatal Surgery ◽  
Group Comparisons

Abstract Background When evaluating speech in children with cleft palate with or without cleft lip (CP/L), children with known syndromes and/or additional malformations (CP/L+) are usually excluded. The aim of this study was to present speech outcome of a consecutive series of 5-year-olds born with CP/L, and to compare speech results of children with CP/L + and children with CP/L without known syndromes and/or additional malformations (CP/L-). Methods One hundred 5-year-olds (20 with CP/L+; 80 with CP/L-) participated. All children were treated with primary palatal surgery in one stage with the same procedure for muscle reconstruction. Three independent judges performed phonetic transcriptions and rated perceived velopharyngeal competence from audio recordings. Based on phonetic transcriptions, percent consonants correct (PCC) and percent non-oral errors were investigated. Group comparisons were performed. Results In the total group, mean PCC was 88.2 and mean percent non-oral errors 1.5. The group with bilateral cleft lip and palate (BCLP) had poorer results on both measures compared to groups with other cleft types. The average results of PCC and percent non-oral errors in the CP/L + group indicated somewhat poorer speech, but no significant differences were observed. In the CP/L + group, 25 % were judged as having incompetent velopharyngeal competence, compared to 15 % in the CP/L- group. Conclusions The results indicated relatively good speech compared to speech of children with CP/L in previous studies. Speech was poorer in many children with more extensive clefts. No significant differences in speech outcomes were observed between CP/L + and CP/L- groups.

Speech in 5-Year-Olds With Cleft Palate With or Without Cleft Lip Treated With Primary Palatal Surgery With Muscle Reconstruction According to Sommerlad

2018 ◽  
Vol 55 (10) ◽  
pp. 1399-1408 ◽  
Author(s):  
Kristina Klintö ◽  
Evelina Falk ◽  
Sara Wilhelmsson ◽  
Björn Schönmeyr ◽  
Magnus Becker
Keyword(s):  
Cleft Palate ◽  
Normative Data ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
University Hospital ◽  
Air Leakage ◽  
Fistula Surgery ◽  
Audio Recordings ◽  
Velopharyngeal Function ◽  
Palatal Surgery

Objective: To evaluate speech in 5-year-olds with cleft palate with or without cleft lip (CP±L) treated with primary palatal surgery in 1 stage with muscle reconstruction according to Sommerlad at about 12 months of age. Design: Retrospective study. Setting: Primary care university hospital. Participants: Eight 5-year-olds with cleft soft palate (SP), 22 with cleft soft/hard palate (SHP), 33 with unilateral cleft lip and palate, and 17 with bilateral CLP (BCLP). Main Outcome Measures: Percent oral consonants correct (POCC), percent consonants correct adjusted for age (PCC-A), percent oral errors, percent nonoral errors, and variables related to velopharyngeal function were analyzed from assessments of audio recordings by 3 independent speech-language pathologists. Results: The median POCC was 75.4% (range: 22.7%-98.9%), median PCC-A 96.9% (range: 36.9%-100%), median percent oral errors 3.4% (range: 0%-40.7%), and median percent nonoral errors 0% (range: 0%-20%), with significantly poorer results in children with more extensive clefts. The SP group had significantly less occurrence of audible nasal air leakage than the SHP and the BCLP groups. Before age 5 years, 1.3% of the children underwent fistula surgery and 6.3% secondary speech improving surgery. At age 5 years, 15% of the total group was perceived as having incompetent velopharyngeal function. Conclusions: Speech was poorer in many children with more extensive clefts. Children with CP±L had poorer speech compared to normative data of peers without CP±L, but the results indicated relatively good speech compared to speech of children with CP±L in previous studies.

Surgical Closure of the Cleft Palate Has a Transient Obstructive Effect on the Upper Airway in Children

2017 ◽  
Vol 55 (1) ◽  
pp. 112-118
Author(s):  
Priscila Capelato Prado ◽  
Marilyse de Bragança Lopes Fernandes ◽  
Armando dos Santos Trettene ◽  
Alícia Graziela Noronha Silva Salgueiro ◽  
Ivy Kiemle Trindade-Suedam ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Cleft Palate ◽  
Respiratory Symptoms ◽  
Cleft Lip ◽  
Upper Airway ◽  
Surgical Closure ◽  
Obstructive Sleep ◽  
High Prevalence ◽  
Before And After ◽  
Palate Repair

Objective: To prospectively investigate the occurrence of respiratory symptoms related to obstructive sleep apnea (OSA) following primary palatoplasty in children with cleft palate (CP). Method: Fifty-six nonsyndromic children presenting CP with a previously repaired cleft lip (CL) or without CL were assessed before and after palate repair. Twenty nonsyndromic children with isolated CL were analyzed as controls before and after lip repair. Respiratory symptoms were investigated preoperatively, and at early and late postoperative periods. Based on the parent reports of “difficulty of breathing (D), apnea events (A) and/or snoring (S) during sleep, a validated OSA index (1.42D + 1.41A + 0.71S – 3.83) was used to predict absence of OSA, possible OSA, and presence of OSA, at the 3 periods analyzed. Results: Screening for OSA showed that the CP group exhibited an increased mean index at the early postoperative assessment, suggesting “possible OSA,” and a higher frequency of snoring at the early and late postoperative assessments, as compared to the CL group ( P < .05). Sleep apnea events were not reported. Conclusions: Surgical closure of the palate has an obstructive effect on the upper airway in the short term, causing OSA-related respiratory symptoms, mostly transient. However, the high prevalence of snoring still observed in the long term indicate that children with a palatal cleft who undergo surgical repair are at risk for OSA. The results support the conclusion that OSA is underappreciated in this population.

scholarly journals Mapping the Early Language Environment Using All-Day Recordings and Automated Analysis

2017 ◽  
Vol 26 (2) ◽  
pp. 248-265 ◽  
Author(s):  
Jill Gilkerson ◽  
Jeffrey A. Richards ◽  
Steven F. Warren ◽  
Judith K. Montgomery ◽  
Charles R. Greenwood ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Adult Child ◽  
Automated Analysis ◽  
Early Language ◽  
Data Set ◽  
Environment Analysis ◽  
Assessment Scores ◽  
Research Reporting ◽  
Language Assessments ◽  
Language Environment

Purpose This research provided a first-generation standardization of automated language environment estimates, validated these estimates against standard language assessments, and extended on previous research reporting language behavior differences across socioeconomic groups. Method Typically developing children between 2 to 48 months of age completed monthly, daylong recordings in their natural language environments over a span of approximately 6–38 months. The resulting data set contained 3,213 12-hr recordings automatically analyzed by using the Language Environment Analysis (LENA) System to generate estimates of (a) the number of adult words in the child's environment, (b) the amount of caregiver–child interaction, and (c) the frequency of child vocal output. Results Child vocalization frequency and turn-taking increased with age, whereas adult word counts were age independent after early infancy. Child vocalization and conversational turn estimates predicted 7%–16% of the variance observed in child language assessment scores. Lower socioeconomic status (SES) children produced fewer vocalizations, engaged in fewer adult–child interactions, and were exposed to fewer daily adult words compared with their higher socioeconomic status peers, but within-group variability was high. Conclusions The results offer new insight into the landscape of the early language environment, with clinical implications for identification of children at-risk for impoverished language environments.

scholarly journals Remote Microphone System Use at Home: Impact on Child-Directed Speech

2019 ◽  
Vol 62 (6) ◽  
pp. 2002-2008 ◽  
Author(s):  
Carlos R. Benítez-Barrera ◽  
Emily C. Thompson ◽  
Gina P. Angley ◽  
Tiffany Woynaroski ◽  
Anne Marie Tharpe
Keyword(s):  
Hearing Loss ◽  
Home Environment ◽  
Primary Caregivers ◽  
Environment Analysis ◽  
Auditory Speech ◽  
Audio Recordings ◽  
System Use ◽  
Children With Hearing Loss ◽  
Language Environment ◽  
The Impact

Purpose The impact of home use of a remote microphone system (RMS) on the caregiver production of, and child access to, child-directed speech (CDS) in families with a young child with hearing loss was investigated. Method We drew upon extant data that were collected via Language ENvironment Analysis (LENA) recorders used with 9 families during 2 consecutive weekends (RMS weekend and no-RMS weekend). Audio recordings of primary caregivers and their children with hearing loss obtained while wearing and not wearing an RMS were manually coded to estimate the amount of CDS produced. The proportion of CDS that was likely accessible to children with hearing loss under both conditions was determined. Results Caregivers produced the same amount of CDS when using and when not using the RMS. However, it was concluded that children with hearing loss, on average, could potentially access 12% more CDS if caregivers used an RMS because of their distance from their children when talking to them. Conclusion Given our understanding of typical child language development, findings from this investigation suggest that children with hearing loss could receive auditory, speech, and language benefits from the use of an RMS in the home environment.

Incidence of Cleft Pathology in Greater New Orleans before and after Hurricane Katrina

2011 ◽  
Vol 48 (6) ◽  
pp. 757-761 ◽  
Author(s):  
Haig A. Goenjian ◽  
Ernest S. Chiu ◽  
Mary Ellen Alexander ◽  
Hugo St. Hilaire ◽  
Michael Moses
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
Cleft Palate ◽  
Hurricane Katrina ◽  
New Orleans ◽  
Environmental Risk ◽  
Cleft Lip ◽  
Environmental Risk Factors ◽  
Stress Reactions ◽  
Before And After

Background Reports after the 2005 Hurricane Katrina have documented an increase in stress reactions and environmental teratogens (arsenic, mold, alcohol). Objective To assess the incidence of cleft pathology before and after the hurricane, and the distribution of cleft cases by gender and race. Methods Retrospective chart review of cleft lip with or without cleft palate (CUP) and cleft palate (CP) cases registered with the Cleft and Craniofacial Team at Children's Hospital of New Orleans, the surgical center that treated cleft cases in Greater New Orleans between 2004 and 2007. Live birth data were obtained from the Louisiana State Center for Health Statistics. Results The incidence of cleft cases, beginning 9 months after the hurricane (i.e., June 1, 2006) was significantly higher compared with the period before the hurricane (0.80 versus 1.42; p = .008). Within racial group comparisons showed a higher incidence among African Americans versus whites (0.42 versus 1.22; p = .01). The distribution of CUP and CP cases by gender was significant ( p = .05). Conclusion The increase in the incidence of cleft cases after the hurricane may be attributable to increased stress and teratogenic factors associated with the hurricane. The increase among African Americans may have been due to comparatively higher exposure to environmental risk factors. These findings warrant further investigation to replicate the results elsewhere in the Gulf to determine whether there is a causal relationship between environmental risk factors and increased cleft pathology.

Speech Intelligibility of Patients with Cleft Lip and Palate after Placement of Speech Prosthesis

2007 ◽  
Vol 44 (6) ◽  
pp. 635-641 ◽  
Author(s):  
João Henrique Nogueira Pinto ◽  
Giseleda Silva Dalben ◽  
Maria Inês Pegoraro-Krook
Keyword(s):  
Cleft Palate ◽  
Speech Intelligibility ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Velopharyngeal Insufficiency ◽  
Cross Sectional ◽  
Before And After ◽  
Dental Needs

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.

Analysis of Real-World Language Use in a Person With Wernicke's Aphasia

2021 ◽  
pp. 1-13
Author(s):  
Louisa B. Suting ◽  
Jennifer Mozeiko
Keyword(s):  
Home Environment ◽  
Language Use ◽  
Recording Device ◽  
Environment Analysis ◽  
Wernicke's Aphasia ◽  
Before And After ◽  
Communication Environments ◽  
Language Data ◽  
Aphasia Treatment ◽  
Language Environment

Purpose In this study, we evaluate the use of a technology called the Language ENvironment Analysis (LENA) Pro System to quantify the language of a participant with severe Wernicke's aphasia in their home environment. We aimed to characterize language use at home, particularly as it changed in response to an intensive aphasia treatment. Method The participant was trained to use a wearable recording device pre and post 30 hr of intensive aphasia treatment. LENA software was used to process the language data and to determine word counts and conversational turns and compared to manual analysis. Various communication variables were coded for all conversation samples. Results The participant operated the device independently and provided 30 hr of recordings for analysis. Posttreatment, the participant demonstrated a 78.4% increase in adult word count, a 27.5% increase in conversational turn count, an increase in the number of communication partners, and in the diversity of communication environments. There was a 26% decrease in the amount of time spent on electronics and a 140% increase in the number of instances conversing in a social setting. Manual and automated measures showed poor agreement for this particular participant. Conclusions In this study, we establish the feasibility of using LENA to collect language samples in a participant with severe Wernicke's aphasia in their home environment. Using this method, we were able to characterize and quantify language samples in multiple dimensions before and after language treatment.

The Impact of Cleft Type on Early Vocal Development in Babies with Cleft Palate

2003 ◽  
Vol 40 (5) ◽  
pp. 453-459 ◽  
Author(s):  
Mary Hardin-Jones ◽  
Kathy L. Chapman ◽  
Julie Schulte
Keyword(s):  
Cleft Palate ◽  
Outcome Measures ◽  
Significant Role ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Stop Consonants ◽  
Vocal Development ◽  
Student’S T ◽  
The Impact ◽  
Canonical Babbling

Objective The purpose of the present investigation was to examine the impact of cleft type on early sound development in children with cleft palate (with or without cleft lip). Participants The participants included 53 babies with unrepaired cleft palate aged 8 to 10 months. Thirty-five babies had cleft lip and palate (CLP) and 18 had cleft palate only (CPO). Main Outcome Measures Spontaneous vocalizations of the CLP and CPO groups were compared to determine whether differences were evident in canonical babbling, size of consonant inventory as well as place and manner of consonant production, and frequency of vocalization. Results Student's t tests revealed no significant differences between the groups in canonical babbling, size of consonant inventory, place and manner of consonant production, or frequency of vocalization. However, there was a trend for babies in the CPO group to produce fewer compensatory stop consonants and more anterior place features. In addition, a larger percentage of children in the CPO group had entered the canonical babbling stage at the time of this study. Conclusions In general, the findings of this study suggested that cleft type does not appear to play a significant role in early consonant development for babies with cleft palate. Additional study using a larger CPO group is recommended to further investigate the trend toward better performance noted in this group.

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