Risk Factors for Subtypes of Children with Speech Sound Disorders Classified by Linguistic Symptoms

Objectives: The purpose of this study is to investigate 22 risk factors for speech sound disorders (SSDs) and to find out whether there are differences in risk factors for each subtype of SSDs of Dodd’s model.Methods: Sixty-two children with SSDs aged 3-9 years participated in the study, and 22 risk factors reported in literature were investigated through parental interviews and a nonverbal intelligibility test. Children with SSDs were divided into children with articulation disorders, phonological delays, and consistent/inconsistent phonological disorders.Results: As a result of the principal component analysis, 22 risk factors were classified into 1) language and gross motor development, 2) gender and early development, 3) otitis media with effusion, 4) socioeconomic status, and 5) family history. Among all risk factors, only general developmental delay around 2 years of age showed a significantly different frequency among subtypes of SSDs.Conclusion: This study directly investigated the risk factors of children with SSDs and classified a number of risk factors into five categories. This study suggests that if children show early general developmental delays, they should be closely monitored and early evaluation and interventions should be planned.

INTERVENÇÕES FONOLÓGICAS EM CRIANÇAS COM DESVIO FONOLÓGICO: UMA REVISÃO SISTEMÁTICA

Introdução: Dentre os distúrbios dos sons da fala, tem-se o desvio fonológico, sendo este caracterizado por erros na produção de fala. A partir dos achados da avaliação fonológica, o terapeuta deverá selecionar a proposta de intervenção mais adequada para cada caso dentre os diversos modelos elaborados a partir de teorias linguísticas que buscam alcançar a reorganização fonológica. Objetivo: Avaliar a intervenção fonológica para os casos de desvios fonológicos no Português Brasileiro Método: a revisão sistemática foi conduzida conforme as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A busca por artigos científicos foi conduzida por dois pesquisadores independentes nas bases de dados Medline (Pubmed), LILACS, SciELO, Cochrane Library e Scopus. A pesquisa foi realizada com os descritores [(Phonological disorders) or (Phonological impairment) or (Speech sound disorders) or (Articulation Disorders) or (Language and Hearing Sciences) and (Speech Therapy) or (Speech Intervention) or (Phonological treatment) or (Phonological Intervention)] e compreendeu o período de janeiro de 2015 a maio de 2020. Resultados: Todas as crianças apresentaram evolução e ampliação no sistemas fonológicos, independente da intervenção fonológica escolhida para o caso. Entretanto, os estudos que aliaram a terapia tradicional com outros recursos alternativos (exemplo, softwares) obtiveram resultados promissores. Conclusão: Apesar dos resultados terem sido eficazes nos estudos analisados, não foi possível sistematizar a escolha da intervenção com o quadro clínico dos sujeitos em decorrência da falta de uniformização dos sujeitos e ao delineamento metodológico. Não é possível realizar conclusões sistemáticas com relação à intervenção fonológica de crianças brasileiras.

Speech disorders in preschool children in Republic of North Macedonia – cross sectional study

Background Speech communication is a complex process based on the function of the central nervous system, and also on speech mechanisms conditioned and controlled by auditory perception, verbal memory, intellectual activity and peripheral speech apparatus. The aim of this study was to determine the prevalence of the most common phonological articulation disorders in preschool children, from 4-6 years old. Methods A cross-sectional study was conducted during 2018 year on a representative sample of 550 preschool children aged 4 - 6 years, who attend preschool institutions-kindergartens in the city of Skopje. The study used standardized articulation tests: the Global Articulation Test (GAT) and the Triple Test (vocals, plasia, africative, fricative, nasal, and lateral), and a questionnaire filled out by a social worker at the kindergarten for socioeconomic status and the child's health condition. Results Using GAT, we found that 260 (47.3%) children didn't have a phonological articulation disorders, and 290 (52.7%) had disorders. The analysis of gender-based data showed a higher percentage of speech disorders in 57% of boys and 46.9% of girls. The highest percentage of speech disorder is sigmatism with 24.5% in boys and 20.4% in girls, rhotachism was found in 17.8% in boys and 16.5% in girls. Lambdacism with 8.3% was found in boys and 4.2% in girls. A mixed form (sigmatism, rotacism, and lambdacism) was also found in 2.4% of boys and 3.5% of girls. Conclusions The prevalence of phonological articulation disorders in preschool children is 52.7%, 57.9% in boys and 46.9% in girls, or every second child in kindergarden at age 4-6 years has speech disorder. These findings indicate that the treatment of speech disorders should be started in appropriate services as soon as possible, because early detection and treatment of speech disorders enable to child normal intellectual development. Key messages Speech disorders are important public health issue because these children will require in some cases emotional and behavioral support, not only speech-related intervention. The treatment of speech disorders should be started in appropriate services because early detection and treatment of speech disorders gives the child more confidence to build his intellect.

Oral Myofunctional and Articulation Disorders in Children with Malocclusions: A Systematic Review

<b><i>Background:</i></b> Relationships between malocclusion and orofacial myofunctional disorders (OMD), as well as malocclusions and articulation disorders (AD) have been described, though the exact relationships remain unclear. Given the high prevalence of these disorders in children, more clarity is needed. <b><i>Summary:</i></b> The purpose of this study was to determine the association between OMD (specifically, bruxism, deviate swallowing, caudal resting tongue posture, and biting habits), AD, and malocclusions in children and adolescents aged between 3 and 18 years. To conduct a systematic review, 4 databases were searched (MEDLINE, Embase, Web of Science, and Scopus). The identified articles were screened for the eligibility criteria. Data were extracted from the selected articles and quality assessment was performed using the tool of Munn et al. [Int J Health Policy Manag. 2014;3:123–81] in consensus. Using the search strategy, the authors identified 2,652 articles after the removal of duplicates. After reviewing the eligibility criteria, 17 articles were included in this study. One of the included articles was deemed to have an unclear risk of bias, whereas all other articles were considered to have a low risk of bias. The articles showed a relationship between anterior open bite and apico-alveolar articulatory distortions, as well as between anterior open bite and deviate swallowing. For the biting habits, bruxism, and low tongue position no clear conclusions could be drawn. <b><i>Key Messages:</i></b> The current review suggests a link between specific types of malocclusion and OMD and AD. However, more high-quality evidence (level 1 and level 2, Oxford Levels of Evidence) is needed to clarify the cooccurrence of other OMD, AD, and malocclusions.

The Effect of Frenotomy on the Tongue Length, Motion, and Speech According to Age

Background and Objectives Ankyloglossia often results in articulation disorders, which depends on age, articulation ability, and mobility of the tongue. A primary treatment strategy includes surgery and/or speech therapy. This study aimed to evaluate the changes of the tongue length, tongue mobility, and percentage of consonants correct (PCC) after frenotomy. We investigated the optimal surgery timing for ankyloglossia.Subjects and Method A total of 136 patients underwent frenotomy for the tongue tie between January 2016 and December 2019. There were 90 males and 46 females, with the mean age of 5.23, which ranged from 2 to 10 years. The length of the tongue was measured for all patients during the operation preoperatively and postoperatively. The mobility of the tongue and PCC were performed preoperatively and 1 month after surgery by two speech therapists. Patients were divided according to age into three groups: 2-3 years, 4-5 years, and over 6 years old.Results The mean tongue length of all age groups was significantly elongated after surgery (<i>p</i><0.05). After frenotomy, the mobility of tongue, including horizontal protrusion, protrusion with upward pointing, circumlocution, and lateral movement, was improved. Also, PCCs of all age groups were significantly improved after surgery (<i>p</i><0.05).Conclusion Frenotomy can be an effective procedure for children with ankyloglossia in all age groups. After frenotomy, length of the tongue, mobility of the tongue and PCC were significantly improved.