Search

The purpose of the current research was to compare the lexical–grammatical skills of two-year-old children with and without repaired cleft palate (CP), accounting for the effect of variables such as vocabulary size at 18 months of age, maternal education level, and gender. Participants included 52 children with CP and 25 typically developing (TD) children. The CDI-WS was employed to measure vocabulary and grammatical skills. Significant differences were observed between the CP and TD groups with respect to the number of words, word forms (irregular nouns and verbs), word endings (overuse of plural (-s) and past tense (-ed) markers), the mean number of morphemes in their three longest utterances (M3L), and sentence complexity. In addition, compared to TD children, significantly smaller proportions of children with CP were observed to use words to talk about past and future events or use words to talk about an absent object. The difference between the CP and TD groups in terms of the size of vocabulary at 24 months of age remained statistically significant in the multivariable model. Among all predictors, the size of vocabulary at 18 months of age was identified as the most robust precursor of lexical and grammatical skills at 24 months of age. Gender was identified as a predictor of the M3L measure as an index for syntactic ability. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this preliminary study was to determine if cleft type and/or history of otitis media with effusion (OM) contribute to backing of /t/ and/or /s/ in young children with and without repaired cleft palate (CP). Method: Participants were 39 children (Mage = 36 months, range: 34-41). Ten children had repaired unilateral cleft lip and palate (CLP), nine had repaired CP only, 12 had no clefts but histories of OM, and eight were typically developing (TD) without clefts or OM history. All children were video- and audio-recorded during administration of the Goldman-Fristoe Test of Articulation--Third Edition (GFTA-3). Standard scores of articulation, frequency of alveolar backing, and first spectral moments of the /t/--/k/ and /s/--/ʃ/ phonetic contrasts were obtained. Results: Children with CLP had lower GFTA-3 scores than both TD (p = .012) and OM (p = .001) groups. Fisher's exact test showed that significantly more children with CLP backed alveolar targets, mostly /s/, than children with CP (p = .020). Children with CLP also had (a) reduced /t/--/k/ spectral difference compared to TD children (p = .016) and (b) reduced /s/--/ʃ/ spectral difference compared to both children with CP (p = .010) and children with OM (p = .018). Children with OM had reduced /t/--/k/ spectral difference compared to TD children (p = .009). Conclusions: Cleft type contributes to alveolar backing and reduced spectral contrast of /s/--/ʃ/ in 3-year-old children with repaired CP. History of OM affects spectral contrast of /t/--/k/ in noncleft children. Etiology and clinical implications of alveolar backing are discussed. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated vocabulary growth from 18 to 24 months of age in young children with repaired cleft palate (CP), children with otitis media, and typically developing (TD) children. In addition, the contributions of factors such as hearing level, middle ear status, size of consonant inventory, maternal education level, and gender to the development of expressive vocabulary were explored. Method: Vocabulary size of 40 children with repaired CP, 29 children with otitis media, and 25 TD children was measured using the parent report on MacArthur-Bates Communicative Development Inventories: Words and Sentences (Fenson et al., 2007) at 18 and 24 months of age. All participants underwent sound field audiometry at 12 months of age and tympanometry at 18 months of age. A multiple linear regression with and without covariates was used to model vocabulary growth from 18 to 24 months of age across the 3 groups. Results: Children with CP produced a significantly smaller number of words at 24 months of age and showed significantly slower rate of vocabulary growth from 18 to 24 months of age when compared to TD children (p < .05). Although middle ear status was found to predict vocabulary growth from 18 to 24 months of age across the 3 groups (p < .05), the confidence interval was large, suggesting the effect should be interpreted with caution. Conclusions: Children with CP showed slower expressive vocabulary growth relative to their age-matched TD peers. Middle ear status may be associated with development of vocabulary skills for some children. [ABSTRACT FROM AUTHOR]

Purpose: The main objective was to examine temporal parameters of stop-plosives in Persian-speaking children with repaired cleft lip and palate (CLP). Method: Eleven children with repaired bilateral CLP and 20 typically-developing children participated in the study. Stop-gap duration (SGD) and voice-onset time (VOT) were measured based on digital waveform and spectrographic displays. Result: Separate linear mixed model analyses showed significantly longer SGDs for children with CLP for all plosives in word-mid and final positions. Furthermore, children with CLP tend to produce longer VOTs for all voiceless plosives. Conclusion: Persian-speaking children with repaired CLP prolong stop-gap segments, similar to findings reported for English-speaking children with CLP. Prolonged segments may be due to an active strategy to increase oral air pressure and/or improve perceptual accuracy of speech segments. [ABSTRACT FROM PUBLISHER]

Purpose: The objective was to determine velopharyngeal (VP) status of stop consonants and vowels produced by young children with repaired cleft palate (CP) and typically developing (TD) children from 12 to 18 months of age. Method: Nasal ram pressure (NRP) was monitored in 9 children (5 boys, 4 girls) with repaired CP with or without cleft lip and 9 TD children (5 boys, 4 girls) at 12, 14, and 18 months of age. VP status was categorized as open or closed for oral stops and vowels in three contexts—consonant–vowel syllables, vowel–consonant–vowel syllables, and isolated vowels—on the basis of the presence or absence of positive nasal ram pressure. Results: At 12 months of age, TD children produced 98% of stops and vowels in syllables with VP closure throughout the entire segment compared with 81% of stops and vowels for children with CP (p < .0001). There were no significant group differences at 14 or 18 months of age. Conclusions: TD children exhibit consistent VP closure for stop consonants and vowels at 12 months of age. Some children with repaired CP do not achieve consistent closure until 14 months of age, approximately 3 to 4 months following palate repair. [ABSTRACT FROM AUTHOR]

Objective: To compare nasal ram pressure (NRP) data with perceptual speech assessments in young children following palatoplasty. Design and Setting: NRP monitoring, a noninvasive technique using a two-pronged nasal cannula that detects nasal airflow during speech, was performed on patients 12 months following palatoplasty in our Craniofacial Center. Patients: Eighteen English-speaking nonsyndromic patients, aged 21 to 28 months, without hearing or language deficits, underwent NRP testing. Main Outcome Measured: During NRP measurement, the number of oral stop consonants produced spontaneously or following prompts was recorded. Stops were considered produced with velopharyngeal closure if NRP demonstrated no nasal airflow. The percentage of closed stops as measured by NRP was compared to the clinical assessment by craniofacial team speech-language pathologists. Results: Eight patients achieved 100% stop closure. Four patients obtained 90% to 96% sto closure. Three patients had stop closure of 85%, 78%, and 50%. Three patients had 0% sto closure; two of these patients subsequently underwent secondary palatal surgery. No significant clinical speech deficits were noted in patients with >90% closure. No association with defect size or cleft type was identified. Conclusions: NRP monitoring is well-tolerated in young children following palatoplasty. Achieving velopharyngeal (VP) closure for >90% of stops is associated with a clinical assessment of adequate speech and VP function. Postoperative NRP testing may serve as a useful adjunct to clinical speech evaluation for early identification of children who require more ntensive speech therapy or secondary palatal surgery. [ABSTRACT FROM AUTHOR]

Purpose: To determine if children with repaired cleft palate and normal velopharyngeal (VP) closure as determined by aerodynamic testing exhibit greater acoustic nasalance than control children without cleft palate. Method: Pressure-flow procedures were used to identify 2 groups of children based on VP closure during the production of /p/ in the word hamper: (a) children with repaired cleft palate and normal VP closure (n = 23) and (b) controls without cleft palate and with normal VP closure (n = 16). Acoustic nasalance scores were obtained for all children during the production of syllables with high-pressure consonants and sentences with low-pressure consonants (i.e., low-pressure sentences). Results: Nasalance scores were generally higher for children with repaired cleft palate and normal VP function as compared to controls; however, a significant difference occurred only for low-pressure sentences ( p = .005). Conclusion: Results partially support a pressure-sensitive theory of VP function in that some children with repaired cleft palate may achieve VP closure during the production of high-pressure consonants but fail to do so during the production of vowels and low-pressure consonants. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

Spectral moment analysis (SMA) was used to describe voiceless alveolar and velar stop-plosive production in Persian-speaking children with repaired cleft lip and palate (CLP). Participants included 11 children with bilateral CLP who were undergoing maxillary expansion and 20 children without any type of orofacial clefts. Four of the children with CLP also exhibited backed (palatal) placement for alveolar stops. All children produced consonant-vowel-consonant nonsense words that targeted the plosives /t/ and /k/. SMA revealed that children with CLP had significantly reduced first spectral moment of /t/ and /t/-/k/ difference. Children with CLP who produced palatal stops for alveolar targets also had lower but non-significant first spectral moments for /t/ as compared with children with CLP who did not produce palatal stops. The results are consistent with previously reported findings for English-speaking children with repaired CLP and further suggest that maxillary arch constriction may be a contributing factor for (a) reduced spectral distinction of alveolar targets and/or (b) palatal substitutions for alveolar targets. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was twofold: (a) to determine maxillary arch dimensions of children with repaired cleft lip and palate (CLP) who produced middorsum palatal stops and (b) to describe some spectral characteristics of middorsum palatal stops. Method: Maxillary arch width, length, and height dimensions and first spectral moments of /t/-/k/ contrast words were determined for three groups of children ages 7-11 years: (a) with CLP who were clinically judged to produce middorsum palatal stops (n = 5), (b) with CLP but without middorsum palatal stops (n = 6), and (c) typically developing controls (n = 8). Validity of clinical judgments of middorsum palatal stops was assessed by adult listeners via forced-choice identification of /t/-/k/ contrast words. Results: Listeners confirmed production of middorsum palatal stops for 4 of 5 children with CLP. These children had (a) the narrowest anterior maxillary arch width relative to posterior arch width (p = .011) and (b) the lowest first spectral moment for /t/ targets (p = .001) and the lowest /t/-/k/ difference (p = .010). Conclusion: Middorsum palatal stops may occur in children with repaired CLP in response to limited anterior oral cavity space due to restricted (or collapsed) maxillary arches. First spectral moment characteristics of middorsum palatal stops are consistent with backed lingual placement during stop release. [ABSTRACT FROM AUTHOR]