Phonological Approaches to Speech Difficulties Associated with Cleft Palate

Harding-Bell, Anne; Howard, Sara

doi:10.1002/9781118785065.ch15

Cited by 11 publications

(5 citation statements)

References 44 publications

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“…Authors have previously suggested that it can take 3-6 months for some children to begin producing stops following palatal surgery. 12,30,31 We found that only 21% of the children in this study were producing oral stops three months following surgery, 70% were producing stops 6 months out, and 95% were producing stops nine months following surgery. Similar findings were reported by Zajac and his associates 7 with approximately 80% of their cohort achieving stop emergence 7-8 months following surgery.…”

Section: Discussionmentioning

confidence: 54%

Stop Consonant Production in Children with Cleft Palate After Palatoplasty

Hardin-Jones

Chapman

Heimbaugh

et al. 2023

The Cleft Palate Craniofacial Journal

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The current study examined stop consonant production in children with cleft lip and/or palate (CP ± L) 2-6 months following palatal surgery. Prospective comparative study. Multisite institutional. Participants included 113 children with repaired CP ± L (mean age = 16 months) who were participating in the multicenter CORNET study. Procedures: Parents of participants were asked to record approximately two hours of their child's vocalizations/words at home using a Language ENvironmental Analysis (LENATM) recorder. Four ten-minute audio-recorded samples of vocalizations were extracted from the original recording for each participant and analyzed for presence of oral stop consonants. A minimum of 100 vocalizations were required for analysis. Preliminary findings indicate that at least one oral stop was evident in the consonant inventory for 95 of the 113 children (84%) at the time of their post-surgery 16-month recording, and 80 of these children (71%) were producing two or more different stops. Approximately 50% of the children (57/113) produced the three voiced stops, and eight of the children (7%) were producing all six stop consonants. The findings of this study suggest that the majority of children with repaired CP ± L from English-speaking homes are producing oral stops within six months following palatal surgery. Similar to same-age children without CL ± P, voiced stops were more frequently evident in the children's inventories than voiceless stops. In contrast to findings of previous reports suggesting place of articulation differences, a somewhat comparable percentage of children in this study produced voiced bilabial, alveolar, and velar stops.

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Section: Discussionmentioning

confidence: 54%

Stop Consonant Production in Children with Cleft Palate After Palatoplasty

Hardin-Jones

Chapman

Heimbaugh

et al. 2023

The Cleft Palate Craniofacial Journal

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“…Early intervention and education to whānau on how to model early, anterior pressure consonants can have a positive impact in reducing the extent of speech therapy later on. 23 In addition to reporting VPI and CSCs, SLTs also rate speech outcomes in the functional parameters of intelligibility and acceptability. Having speech that is clear, easy to understand and sounds the same as one's peers is a key factor in socialemotional wellbeing, communicative confidence and educational achievement.…”

Section: Measuring Speech Outcomesmentioning

confidence: 99%

Auckland Regional Cleft Palate Service: service accessibility and speech outcomes

Street,

Miles

2024

NZMJ

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aim: This study explored speech outcomes for five-year-olds born with cleft palate residing in the Auckland Regional Cleft Palate Service catchment, with a focus on ethnicity and geographical influences on service accessibility and speech outcomes. method: A retrospective audit of children born with cleft palate between 2013–2016 was conducted (n=89), including secondary surgeries, ethnicity, distances travelled, services offered and attended. Speech outcomes at five years were compared to international benchmarking. results: Seventy-nine children were included; 10 were lost to follow-up before their 5 years review. At 5 years, 30% children presented with moderate to severe velopharyngeal incompetence; 30% had residual cleft speech characteristics which warranted speech therapy intervention. There was no significant difference in speech outcomes for Māori vs non-Māori. Attendance at clinic was not significantly associated with distance from centre. However, Māori had significantly lower attendance at clinic appointments and were significantly more likely to be referred to community services. conclusion: Auckland Regional speech outcomes are better than the national average, yet still do not compare favourably with international benchmarking. While speech outcomes were not associated with ethnicity, attendance at specialist clinic appointments was lower in Māori. Community services were offered, but attendance at, and satisfaction with, these appointments is unknown. Further work is needed to reach all children regionally in a timely manner to ensure Aotearoa New Zealand speech outcomes meet international standards.

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“…However, there is the potential for developmental errors in children with orofacial cleft, as there is for all children (Sell et al, 1999). SLTs often use the term ‘cleft palate speech’ to cover speech patterns that are associated with a history of cleft palate and/or VPI (McWilliams et al, 1990; Sell et al, 1999; Peterson-Falzone et al, 2016; Harding-Bell, 2019). These speech patterns are characterised by hypernasality, abnormal nasal airflow (nasal emission and nasal turbulence), and articulation disorders mostly affecting consonants requiring intraoral pressure (Sell and Harding-Bell, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Such speech is characterised by nasal air emission, weakened and/or nasalised pressure consonants and/or nasal substitutions. Active CSCs occur when the child’s articulatory gestures appear to compensate for the structural deficit [Harding and Grunwell, 1998; John et al, 2006; Harding-Bell, 2019; Howard et al, 2019]. When there is a lack of intraoral pressure due to VPI, the child may substitute non oral productions such as glottal stops for plosives and pharyngeal or glottal fricatives for fricatives.…”

Section: Introductionmentioning

confidence: 99%

Speech Outcomes of a National Cohort of Children with Orofacial Cleft at 5 and 10 Years of age

Morrison

Mason²,

Forde

et al. 2021

The Cleft Palate-Craniofacial Journal

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Objective To assess speech outcomes at five and ten years of age in a nationwide study of children with orofacial cleft. Design Prospective study. Participants Children born with orofacial cleft and having primary surgery in New Zealand. Speech samples were available for 151 five-year-old, and 163 ten-year-old children. Main outcome measures Intelligibility, Acceptability, Velopharyngeal function, Hypernasality, Hyponasality, severity of airflow evaluated by perceptual speech assessment (using the standardised Rhinocleft assessment), and overall assessment of requirement for clinical intervention. Results A large proportion of five-year-old children had speech that was considered to be not completely intelligible, was not acceptable, and had inadequate velopharyngeal function. The noted deficiencies led to a clinical judgement that further speech and/or surgical intervention was required in 85% with cleft lip and palate, 65% with cleft palate and 26% with cleft lip. The proportion of children with poor speech outcomes in the ten-year-old children was lower, though of clinical importance, further intervention required for 25% with CLP, 15% with CP and 3% with CL. The number of sound production errors in both age groups followed the same pattern with fewest in those with CL and most in those with CLP. Conclusions A significant proportion of children with orofacial cleft were found to have poor speech outcomes requiring further treatment. The outcomes are poor compared to centres reported in the UK and Scandinavia. New Zealand requires a review of the current services for individuals born with cleft to improve speech outcomes and interdisciplinary care.

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Phonological Approaches to Speech Difficulties Associated with Cleft Palate

Cited by 11 publications

References 44 publications

Stop Consonant Production in Children with Cleft Palate After Palatoplasty

Stop Consonant Production in Children with Cleft Palate After Palatoplasty

Auckland Regional Cleft Palate Service: service accessibility and speech outcomes

Speech Outcomes of a National Cohort of Children with Orofacial Cleft at 5 and 10 Years of age

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