Data suggested that families who had children with OFCs displayed poor socioeconomic status and low educational level which may impede the delivery of health education by health practitioners. Increased risk of comorbid communication disorders and malformations in OFC patients must be emphasized and disseminated to health professionals involved in the management of patients with OFC.

This study examined the intelligibility of speech produced by 17 children (aged 4-11 years) with cochlear implants. Stimulus items included sentences from the Beginners' Intelligibility Test (BIT) and words from the Children Speech Intelligibility Measure (CSIM). Naïve listeners responded by writing sentences heard or with two types of responses to the word recordings; open transcription (CSIM-T) and closed set multiple choice (CSIM-MC). Percentage of items understood, averaged across three naïve judges, were compared across the three measures. Additionally, scores were examined for any relationships with chronological age, age of implantation, and amount of implant experience. Strong positive correlations were observed among all three intelligibility tasks. Scores on all three tasks were found to be significantly different from each other. A significant correlation was obtained between intelligibility and amount of implant experience, but not with chronological age or age of implantation. Results suggest that judging the intelligibility of speech produced by children with cochlear implants using both single word and sentence levels would provide a better overall estimate of their intelligibility. The results also emphasize the vital role of auditory input in the development of intelligible speech.

The study provides normative nasometric data for Arabic speaking Jordanian adults to serve as references for the assessment of velopharyngeal dysfunction in craniofacial clinics. Arabic speakers demonstrated different nasalance scores than speakers of other languages. Gender differences can be attributed to variations in anatomical structure and velopharyngeal function between men and women.

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Results showed the validity of the Spring Passage and the Home Passage in measuring nasalance scores as proved by their high sensitivity and strong correlation with perceptual rating of hypernasality.

Speech production of children with cochlear implants (CIs) is generally characterized by low intelligibility and reduced phoneme accuracy. However, limited research investigated their speech production using acoustic measures. The current study examined voice onset time (VOT) for pharyngealized plosives [t,d], and spectral moments and noise duration for pharyngealized fricatives [s,ð] produced by Arabic speaking children with CIs. Productions from children with CIs were compared with both chronological age-matched and hearing experience-matched normal hearing children. Results showed that children with CIs exhibited difficulty producing distinct VOTs between plosives and produced different spectral patterns of both fricatives relative to both comparison groups; however, they were able to produce an acoustic distinction between both fricatives. Children with CIs produced the fricatives with lower spectral mean and higher skewness and kurtosis. The sources for inter-group differences in the acoustic measures appeared to be due in part to limitations in the quality of auditory input provided by CIs as well as reduced motor experience in speech production. Results suggest that VOT and spectral moments are sensitive to changes in perceived sound quality. Spectral moments analysis appears to give details on subtle aspects of fricative production at the phonetic level beyond that available using perceptual judgments.

DEDICATIONTo my parents, Ahmad and Tamam Khwaileh, my husband, Ali Al-Nadi, and my two sons, Jawad and Abraham.iv ACKNOWLEDGEMENTS