Despite advances in surgical management and the advantages offered by team care, the majority of preschoolers with cleft palate continue to demonstrate delays in speech sound development that require direct speech therapy. An optimal treatment regimen for these children is one that includes primary palatal surgery no later than 13 months of age.
The findings suggested that children who were less lexically advanced and younger at the time of palatal surgery exhibited better articulation and resonance outcomes at 3 years of age.
This study compared the prelinguistic vocal development of 9-month-old babies with unrepaired cleft palate (n = 30) and age-matched peers (n = 15). Samples of the babies' spontaneous vocalizations were obtained while they interacted with their primary caregiver during play. The groups were compared on a number of variables including (a) canonical babbling ratios, (b) percentage of babies who reached the canonical babbling stage by 9 months, (c) syllable and segmental aspects of babbling, and (d) vocal frequency. Results indicated that the babies with cleft palate had smaller canonical babbling ratios than their age-matched peers, with just 57% of the babies with cleft palate reaching the canonical babbling stage by 9 months compared to 93% of the noncleft babies. Although syllable types and length were similar for the two groups, differences were noted for consonant characteristics. The babies with cleft palate had smaller consonant inventories, with fewer stops, glides, and velars noted. Glottals occurred more frequently in the vocalizations of the babies with cleft palate. Finally, no statistically significant difference was noted in the number of vocalizations produced by the two groups. Some possible explanations for why babies with cleft palate are delayed in babbling are explored.
This study examined the relationship between speech measures at presurgery/9 months and postsurgery/13 months and speech and language performance at 21 months for children with cleft lip and palate and their noncleft peers. Comparisons were also made between the speech and lexical development of children with cleft lip and palate and noncleft children at 21 months of age. The participants included 30 children; 15 with cleft lip and palate and 15 noncleft children. Results revealed differences between the groups for several measures of speech and lexical development at 21 months. For the children with cleft palate, correlational analyses suggested that true stop production, both immediately before and after palatal surgery, was positively correlated with a majority of the speech production measures at 21 months. At postsurgery/13 months, true stop production was related to later vocabulary development, and size of true consonant inventory was related to all measure of speech production and one measure of lexical development at 21 months. For the noncleft group, true canonical babbling ratio at 13 months was the only measure that was significantly correlated with any of the speech and/or language measures at 21 months. The impact of clefting on prelinguistic and later speech and language skills is discussed.
Forty children with mild to severe hearing losses were administered a battery of speech and language tasks. The children’s speech was characterized by misarticulation of affricates and fricatives, mild-moderate hoarseness, mild resonance problems, and good intelligibility. Their language samples included syntactic errors, primarily involving the use of bound morphemes and complex sentence structures. The children’s pragmatic errors consisted primarily of providing inadequate or ambiguous information to the listener. These results indicate a consistent pattern of oral communication behavior that reflects the reduction of acoustic input that they experience.
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