Speech Development of Children with Cleft Palate before and after Palatal Surgery

2003 ◽  
Vol 40 (1) ◽  
pp. 19-31 ◽  
Author(s):  
Courtney E. Jones ◽  
Kathy L. Chapman ◽  
Mary A. Hardin-Jones
Keyword(s):  
Cleft Palate ◽  
Speech Production ◽  
Educational Level ◽  
Speech Development ◽  
Group Differences ◽  
Significant Group ◽  
Before And After ◽  
Palate Repair ◽  
Palatal Surgery ◽  
Over Time

Objective This study examined the speech production abilities of children with cleft palate before and after palate repair. Participants Twenty-eight children participated in the study, 14 with cleft palate and 14 without clefts matched for age, gender, and mothers’ educational level. Main Outcome Measures Comparisons were made between the children with cleft palate before and after surgery for canonical babbling ratios, size of consonant inventories, place and manner characteristics, and early developing sounds [p, b, t, d, k, g, m, n, η]. Also, comparisons were made between the children with cleft palate and their peers without clefts at postsurgery/17 months for the measures described above. Results Paired ttests revealed differences in pre- and postsurgery performance of the children with cleft palate for production of canonical syllables and size of consonant inventories. Although no significant differences were noted for place and manner features, production of oral stops doubled from the time before surgery to that after surgery. Specifically, production of the bilabial stop [b] showed significant change over time. Results of independent t tests indicated no difference between groups for production of canonical syllables and size of consonant inventories at 17 months. However, significant group differences were noted for production of stops, oral stops, nasals, glides, and alveolars. The children without clefts produced more stops, oral stops, and alveolars. In contrast, more nasals and glides were seen in the vocalizations of the children with cleft palate. Conclusions Children with cleft palate made gains in production of canonical syllables and size of consonant inventories postsurgery; however, they continued to show deficits in production of stops and alveolar place features.

Timing of Palatal Surgery and Speech Outcome

2008 ◽  
Vol 45 (3) ◽  
pp. 297-308 ◽  
Author(s):  
Kathy L. Chapman ◽  
Mary A. Hardin-Jones ◽  
Jeffrey A. Goldstein ◽  
Kelli Ann Halter ◽  
Robert J. Havlik ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Speech Production ◽  
Group Differences ◽  
Significant Group ◽  
Lexical Status ◽  
Group 2 ◽  
Manner Of Articulation ◽  
The Impact ◽  
Palatal Surgery ◽  
Group 1

Objective: To examine the impact of age and lexical status at the time of primary palatal surgery on speech outcome of preschoolers with cleft palate. Participants: Forty children (33 to 42 months) with nonsyndromic cleft palate participated in the study. Twenty children (Group 1) were less lexically advanced and younger (mean age  =  11 months) and 20 children (Group 2) were more lexically advanced and older (mean age  =  15 months) when palatal surgery was performed. Main Outcome Measures: Samples of the children's spontaneous speech were compared on 11 speech production measures (e.g., size of consonant inventory, total consonants correct, % correct for manner of articulation categories, compensatory articulation usage, etc.). Next, listeners rated a 30-second sample of each child's connected speech for articulation proficiency and hypernasality, separately, using direct magnitude estimation (DME). Results: Group differences were noted for 4 of the 11 speech production measures. Children in Group 1 exhibited larger consonant inventories (and true consonant inventories) and more accurate production of nasals and liquids compared to children in Group 2. On the DME task, significant group differences were found for ratings of articulation proficiency and hypernasality. Children in Group 1 exhibited better articulation and less hypernasality than children in Group 2. Conclusions: The findings suggested that children who were less lexically advanced and younger at the time of palatal surgery exhibited better articulation and resonance outcomes at 3 years of age.

Phonetic, Phonological, and Language Skills of Children with a Cleft Palate

2003 ◽  
Vol 40 (5) ◽  
pp. 460-470 ◽  
Author(s):  
Helen Morris ◽  
Anne Ozanne
Keyword(s):  
Language Development ◽  
Cleft Palate ◽  
Language Proficiency ◽  
Language Skills ◽  
Expressive Language ◽  
Speech Development ◽  
Group Differences ◽  
Language Abilities ◽  
Significant Group ◽  
Language Measures

Objective To evaluate the language, phonetic, and phonological skills at age 3 years of two groups of young children with a cleft palate, with different expressive language proficiency at 2 years of age. Design Two groups of children with a cleft palate with differing abilities in early expressive language skills were identified at age 2 years. Comparisons across groups were made over a range of speech and language measures at age 3 years. Participants Twenty children with cleft palate were allocated to two groups dependent on expressive language abilities at age 2 years. One group had normal language development, and the second group had been identified as having significantly delayed (8 to 12 months’ delay) expressive language development. Main Outcome Measures The children were assessed at 3 years of age using standardized assessments and spontaneous speech samples. Comparisons between the two groups were made on a range of language measures including comprehension, expressive language, and speech. Results Group differences were found on both language and speech abilities at age 3 years. Significant group differences were found in expressive language, percentage of consonants correct, phonetic inventory, and phonological process usage. The group with delayed early expressive language abilities at 2 years continued to have expressive language difficulties at 3 years of age and had more disordered speech development, compared with the nondelayed group. Conclusions A subgroup of children with a cleft palate was identified who exhibited delays in early expressive language and continued to have delayed language and disordered phonological patterns at a later age. Support for three possible etiologies including a structural/anatomical deficit, cognitive/linguistic delay, or language/phonological disorder are discussed.

Speech Development of Children With Cleft Palate Before and After Palatal Surgery

2003 ◽  
Vol 40 (1) ◽  
pp. 19-31 ◽  
Author(s):  
Courtney E. Jones ◽  
Kathy L. Chapman ◽  
Mary A. Hardin-Jones
Keyword(s):  
Cleft Palate ◽  
Speech Development ◽  
Before And After ◽  
Palatal Surgery

scholarly journals Factors Affecting Articulation Skills in Children with Velocardiofacial Syndrome and Children with Cleft Palate or Velopharyngeal Dysfunction: A Preliminary Report

2008 ◽  
Vol 45 (2) ◽  
pp. 193-207 ◽  
Author(s):  
Adriane L. Baylis ◽  
Benjamin Munson ◽  
Karlind T. Moller
Keyword(s):  
Speech Perception ◽  
Cleft Palate ◽  
Velocardiofacial Syndrome ◽  
Group Differences ◽  
Future Research ◽  
Nonverbal Intelligence ◽  
Cross Sectional ◽  
Significant Group ◽  
Phonological Representations ◽  
Factors Affecting

Objective: To examine the influence of speech perception, cognition, and implicit phonological learning on articulation skills of children with velocardiofacial syndrome (VCFS) and children with cleft palate or velopharyngeal dysfunction (VPD). Design: Cross-sectional group experimental design. Participants: Eight children with VCFS and five children with nonsyndromic cleft palate or VPD. Methods and Measures: All children participated in a phonetic inventory task, speech perception task, implicit priming nonword repetition task, conversational sample, nonverbal intelligence test, and hearing screening. Speech tasks were scored for percentage of phonemes correctly produced. Group differences and relations among measures were examined using nonparametric statistics. Results: Children in the VCFS group demonstrated significantly poorer articulation skills and lower standard scores of nonverbal intelligence compared with the children with cleft palate or VPD. There were no significant group differences in speech perception skills. For the implicit priming task, both groups of children were more accurate in producing primed nonwords than unprimed nonwords. Nonverbal intelligence and severity of velopharyngeal inadequacy for speech were correlated with articulation skills. Conclusions: In this study, children with VCFS had poorer articulation skills compared with children with cleft palate or VPD. Articulation difficulties seen in the children with VCFS did not appear to be associated with speech perception skills or the ability to learn new phonological representations. Future research should continue to examine relationships between articulation, cognition, and velopharyngeal dysfunction in a larger sample of children with cleft palate and VCFS.

Cleft Palate

2018 ◽  
Author(s):  
Oksana A Jackson ◽  
Alison E Kaye ◽  
David W Low
Keyword(s):  
Cleft Palate ◽  
Normal Function ◽  
Speech Development ◽  
Velopharyngeal Insufficiency ◽  
Surgical Interventions ◽  
Feeding Difficulties ◽  
Oronasal Fistula ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Impaired Speech

A cleft of the palate represents one of the most common congenital anomalies of the craniofacial region. Palatal clefting can occur in combination with a cleft of the lip and alveolus or as an isolated finding and can vary significantly in severity. The intact palate is a structure that separates the oral and nasal cavities, and the function of the palate is to close off the nasal cavity during deglutition and to regulate the flow of air between the nose and mouth during speech production. An unrepaired cleft palate can thus result in nasal regurgitation of food and liquid, early feeding difficulties, and impaired speech development. The goals of surgical repair are to restore palatal integrity by closing the cleft defect and repairing the musculature to allow for normal function during speech. The secondary goal of cleft palate repair is to minimize deleterious effects on growth of the palate and face, which can be impacted by standard surgical interventions. This review describes two of the most commonly performed cleft palate repair techniques in use today, as well as highlighting special anatomic considerations, summarizing perioperative care, and reviewing postoperative complications and their management. This review contains 11 figures, 2 videos, 3 tables and 63 references Key words: cleft, cleft team, Furlow, orofacial, oronasal fistula, palatoplasty, speech, submucous cleft, velopharyngeal insufficiency

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.

Trait and State Anxiety in People Who Stutter and People Who Do Not Stutter

2009 ◽  
Vol 19 (3) ◽  
pp. 99-105 ◽  
Author(s):  
Scott Palasik ◽  
Farzan Irani ◽  
Alexander M. Goberman
Keyword(s):  
Trait Anxiety ◽  
State Anxiety ◽  
Group Differences ◽  
Significant Group ◽  
General Anxiety ◽  
Recording Session ◽  
Situational Anxiety ◽  
Trait And State Anxiety ◽  
State And Trait Anxiety ◽  
Over Time

Abstract Previous research suggests that people who stutter (PWS) tend to have heightened general anxiety (i.e., trait anxiety) and situational anxiety (i.e., state anxiety) compared to people who do not stutter (PWDS). Most research with anxiety and stuttering utilizes self-perception scales; however, few studies have looked at anxiety over time. The current study examined self-reported state and trait anxiety in PWS and PWDS over six weeks, along with an investigation of the effects of audio-recording on anxiety. Results indicated no significant group differences in trait (general) anxiety over six weeks; however trends indicated that PWS may have increased trait anxiety compared to PWDS. Furthermore, for both groups, state (situational) anxiety was lower after a recording session compared to before.

Cleft Palate

2018 ◽  
Author(s):  
Oksana A Jackson ◽  
Alison E Kaye ◽  
David W Low
Keyword(s):  
Cleft Palate ◽  
Normal Function ◽  
Speech Development ◽  
Velopharyngeal Insufficiency ◽  
Surgical Interventions ◽  
Feeding Difficulties ◽  
Oronasal Fistula ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Impaired Speech

A cleft of the palate represents one of the most common congenital anomalies of the craniofacial region. Palatal clefting can occur in combination with a cleft of the lip and alveolus or as an isolated finding and can vary significantly in severity. The intact palate is a structure that separates the oral and nasal cavities, and the function of the palate is to close off the nasal cavity during deglutition and to regulate the flow of air between the nose and mouth during speech production. An unrepaired cleft palate can thus result in nasal regurgitation of food and liquid, early feeding difficulties, and impaired speech development. The goals of surgical repair are to restore palatal integrity by closing the cleft defect and repairing the musculature to allow for normal function during speech. The secondary goal of cleft palate repair is to minimize deleterious effects on growth of the palate and face, which can be impacted by standard surgical interventions. This review describes two of the most commonly performed cleft palate repair techniques in use today, as well as highlighting special anatomic considerations, summarizing perioperative care, and reviewing postoperative complications and their management. This review contains 11 figures, 2 videos, 3 tables and 63 references Key words: cleft, cleft team, Furlow, orofacial, oronasal fistula, palatoplasty, speech, submucous cleft, velopharyngeal insufficiency

Magnetic Resonance Imaging of the Levator Veli Palatini Muscle before and after Primary Palatoplasty

2004 ◽  
Vol 41 (6) ◽  
pp. 584-592 ◽  
Author(s):  
David P. Kuehn ◽  
Sandra L. Ettema ◽  
Michael S. Goldwasser ◽  
Joseph C. Barkmeier
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cleft Palate ◽  
Imaging Modality ◽  
Magnetic Resonance Images ◽  
Normal Infant ◽  
Resonance Imaging ◽  
Levator Veli Palatini ◽  
Before And After ◽  
Palatal Surgery

Objective To explore the application of magnetic resonance imaging (MRI) in the evaluation of patients with cleft palate before and after primary palatoplasty with particular attention focused on the levator veli palatini muscle. Design Prospective study using MRIs of subjects before and after primary cleft palate surgery. Setting Hospital and university based. Patients One female infant with normal anatomy. Three male and four female infants with cleft palate of varying severity. Intervention Furlow double-opposing Z-plasty and V-Y palatoplasty. Main Outcome Measures Magnetic resonance images. Results It was found that the levator veli palatini muscle can be imaged before and after palatal surgery in infants using MRI. The muscle may have sufficient volume, proportionate to a normal infant or adult, in infants born with cleft palate. If retrodisplaced properly, the muscle is likely to be steeper (more vertical) from its origin at the base of the skull to its insertion into the velum following palatoplasty, thus providing a more favorable angle for elevating the velum. Following palatal surgery, the levator muscle mass may not be as cohesive across the velar midline, compared with normal musculature. Conclusion MRI is a viable imaging modality for the evaluation of the anatomy of the levator veli palatini muscle before and after primary palatoplasty in infants born with cleft palate.

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