Speech Evaluation and Treatment for Patients With Cleft Palate

Kuehn, David P.; Henne, Lisa J.

doi:10.1044/1058-0360(2003/056)

Cited by 35 publications

(14 citation statements)

References 9 publications

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“…Most of them (76%) had CAD (10% had functional articulation disorders and 67% had functional articulation and CAD). This confirmed that children with CP ± L had typical characteristics of cleft speech types and supports previous studies [26,27]. When data from the first assessment ( Table 2) were compared with the formal articulation test in the second or later visits (Table 3), the results showed the number of children with CP ± L who had normal articulation decreased from 5 (12%) to 3 children (7%).…”

Section: Discussionsupporting

confidence: 88%

Original article. Articulation disorders and patterns in children with a cleft

2014

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Background: Compensatory articulation disorders (CAD) are the most common speech defects in patients with a cleft. Early prevention programs are needed to avoid CAD. Objectives: To examine articulation disorders, patterns, and related speech outcomes in children with a cleft palate with or without lip defects. Methods: Articulation test record forms and clinical records of 42 children were accessed retrospectively to provide the data of speech outcomes related to cleft palate. Double data entries and incorrect completion type errors were corrected. Results: Prevalence of articulatory defects was 88% (functional articulation disorders, 12%; compensatory articulation disorders, 10%; functional articulation disorders and CAD, 67%), resonance disorder was 50%, and voice abnormalities was 19%. Abnormal backing of oral consonants, particularly glottal substitution was the most common pattern of CAD (40%), follow by velar substitution (36%), and nasal consonant for oral pressure consonant (21%). There was high incidence of functional articulation disorder in patients with a cleft (76%). Younger children (≤7 years old) had more articulation defects than older children (>7 years old) (mean difference = 3.308, P = 0.002, 95% confident interval 1.683−6.971). Levene's test for equal variance found that resonance disorder seems unaffected by the number of articulation errors (mean difference = 0.253, P = 0.897, 95% confident interval -3.736−4.241). Conclusion: CAD, particularly abnormal backing of oral consonants and hypernasality were the most common speech defects in children with cleft. Refinement and revision of timing for referring for early speech intervention should be reconsidered.

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Section: Discussionsupporting

confidence: 88%

Original article. Articulation disorders and patterns in children with a cleft

2014

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“…Motor-oriented speech therapy should be applied in the majority of the patients in order to modify the atypical production of disordered speech sounds by teaching the correct place and manner of articulation for a single phoneme at a time [51]. Early initiation of the therapy is preferred, as it is easier to eliminate compensatory articulations initially than to treat them subsequently [52]. Correction of the vulnerable plosive /d/ and fricatives /s, z, v/ would be recommended in many patients of the current study.…”

Section: Discussionmentioning

confidence: 99%

Impact of Early Synchronous Lip and Palatal Repair on Speech

Luyten

Bettens

D’haeseleer

et al. 2013

Folia Phoniatr Logop

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Aims: The purpose of this study was to describe articulation and resonance characteristics of Ugandan English-speaking children with cleft lip and palate (CLP) after synchronous lip and palatal closure (Sommerlad technique) prior to the age of 6 months in comparison with an age- and gender-matched control group. Methods: Eleven Ugandan patients with CLP (mean age 4;9 years), repaired during a synchronous lip and (soft and hard) palatal closure at a mean age of 3.4 months, were included as well as a control group (n = 22) consisting of 2 Ugandan age- and gender-matched noncleft children for each patient (mean age 4;10 years). Objective and perceptual speech assessment techniques were applied. Results: Consonant inventories were significantly smaller in the CLP group. Moreover, phonetic disorders and phonological processes occurred in 91 and 100% of the CLP group, respectively. Perceptual consensus evaluation revealed absence of hyponasality and cul-de-sac resonance in all patients. Hypernasality and nasal emission/turbulence occurred in 18 and 27% of the patients, respectively. No significant group differences were observed regarding the mean nasalance values of oral speech samples. Conclusion: Various deviations from normal speech development seem to occur in patients with CLP following synchronous lip and palatal closure before 6 months of age.

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“…However, velopharyngeal dysfunction persists in 7 to 30% of the patients, despite anatomical repositioning of the muscles during surgery, [5], [6], [10]–[12]. This results in speech abnormalities [13]. Various factors such as age at the time of the surgery, skills and experience of the surgeon, type and extension of the cleft, and damage of the motor and proprioceptive nerves have been attributed to suboptimal repair [5], [14]–[16].…”

Section: Introductionmentioning

confidence: 99%

A Rat Model for Muscle Regeneration in the Soft Palate

et al. 2013

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BackgroundChildren with a cleft in the soft palate have difficulties with speech, swallowing, and sucking. Despite successful surgical repositioning of the muscles, optimal function is often not achieved. Scar formation and defective regeneration may hamper the functional recovery of the muscles after cleft palate repair. Therefore, the aim of this study is to investigate the anatomy and histology of the soft palate in rats, and to establish an in vivo model for muscle regeneration after surgical injury.MethodsFourteen adult male Sprague Dawley rats were divided into four groups. Groups 1 (n = 4) and 2 (n = 2) were used to investigate the anatomy and histology of the soft palate, respectively. Group 3 (n = 6) was used for surgical wounding of the soft palate, and group 4 (n = 2) was used as unwounded control group. The wounds (1 mm) were evaluated by (immuno)histochemistry (AZAN staining, Pax7, MyoD, MyoG, MyHC, and ASMA) after 7 days.ResultsThe present study shows that the anatomy and histology of the soft palate muscles of the rat is largely comparable with that in humans. All wounds showed clinical evidence of healing after 7 days. AZAN staining demonstrated extensive collagen deposition in the wound area, and initial regeneration of muscle fibers and salivary glands. Proliferating and differentiating satellite cells were identified in the wound area by antibody staining.ConclusionsThis model is the first, suitable for studying muscle regeneration in the rat soft palate, and allows the development of novel adjuvant strategies to promote muscle regeneration after cleft palate surgery.

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Speech Evaluation and Treatment for Patients With Cleft Palate

Cited by 35 publications

References 9 publications

Original article. Articulation disorders and patterns in children with a cleft

Original article. Articulation disorders and patterns in children with a cleft

Impact of Early Synchronous Lip and Palatal Repair on Speech

A Rat Model for Muscle Regeneration in the Soft Palate

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