Perfil da fala de pacientes submetidos à palatoplastia primária

Menegueti, Katia Ignacio; Mangilli, Laura Davison; Alonso, Nivaldo; Andrade, Cláudia Regina Furquim de

doi:10.1590/2317-1782/20172016146

Cited by 4 publications

(1 citation statement)

References 22 publications

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“…Embora a ideia central estivesse baseada na falta de ferramenta que analisasse o desenvolvimento de fala na FLP, bem como a necessidade da obtenção de informações que favorecessem o encaminhamento precoce nos casos em que a intervenção fosse necessária, observou-se que esta é uma temática pouco explorada (SILVA et al, 2008;ALONSO et al, 2009;MENEGUETI et al, 2017).…”

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Instrumento de rastreio do risco para alterações de fala em crianças com fissura labiopalatina

Mendes¹

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Screening tool to identify children with cleft lip and palate at risk for speech disorders Objectives: To develop and to evaluate screening tool to identify children with cleft lip and palate (CLP) at risk for speech disorder addressing the relationship between clinical factors and aspects of speech production and perception in the first three years of life. Methods: The study involved 3 phases: phase 1 the planning and development of the instrument was done combining a list of clinical factors and a list of speech behaviors. After an initial evaluation of the material, by one Pediatrician and one Speech-Language Pathologist (SLP) experienced with CLP, the lists were combined creating the screening tool to identify children with Cleft Lip and Palate at Risk for Speech Disorder (CLP-RSP). Phase 2 involved the content evaluation of the CLP-RSP by five Pediatricians and three SLPs from the Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), establishing the Content Validity Index (CVI) followed by refinement of the CLP-RSP. Phase 3 included the preliminary assessment of the CLP-RSP effectiveness in corroborating the speech-language pathologist's referrals (follow-up of speech development or speech therapy). Results: The tool developed in this study aims to combine the clinical conditions related to CLP (such as hospitalizations, middle ear conditions, oronasal coupling, for example) with speech behaviors expected during the first three years of life. The content of the material was evaluated by 5 pediatricians and 3 SLPs and, after modifications, the CLP-RSP was created with the purpose of identify what the toddler understands, what the toddler speaks and clinical factors observed during the first three years of life. To better interpret the findings, the items in the CLP-RSP were divided into 6 age groups (0-6months, 7-12months, 13-18months, 19-24months, 25-30months, and 31-36 months) including three behaviors each for speech production and speech perception paired with possible clinical conditions expected at each age group for babies and toddlers with CLP. The content of the CLP-RSP was evaluated positively with a mean Content Validity Index indicating that 87% of the evaluators considered the content of the material very clear while 13% considered it clear. That is, there was no ratings indicating least clear or not clear content. The tool was applied with 18 caregivers establishing its efficacy in corroborating the SLPs referrals for either follow-up of speech development or intervention with speech therapy. Conclusion: In the present study the screening tool to identify children with Cleft Lip and Palate at Risk for Speech Disorder (CLP-RSP) was developed and its content was evaluated by pediatricians and SLPs experts in CLP management, which agreed in its majority, that the proposed material is "very clear". After establishing the tool preliminary efficacy, final refinement was proposed and should be implemented before its use in future studies to validate the screening tool CLP-RSP.

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Section: Discussão 6 Discussãounclassified

Instrumento de rastreio do risco para alterações de fala em crianças com fissura labiopalatina

Mendes¹

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Global and communicative development skills in preschool children with cleft lip and palate

Jurado

Cavalheiro

Corrêa

et al. 2021

Pediatric Investigation

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Importance Cleft lip and palate (CLP) is globally among the most common childhood malformations. This disorder impacts childhood development, including speech and language, and affects children worldwide. Objective To analyze child development skills (adaptive fine motor, gross motor, personal‐social, and language) in preschool children with isolated CLP compared with children without this malformation. Methods The participants included an experimental group of 27 children with isolated CLP and a comparison group of 27 children without CLP aged between 48 and 59 months. The groups were evaluated using two instruments: the Denver Developmental Screening Test II (DDST‐II) and the Avaliação do Desenvolvimento da Linguagem (ADL‐Language Development Assessment). Data were analyzed by descriptive and inductive analyses, using the Student’s t ‐test and the Mann‐Whitney test, at a significance level of P ˂ 0.05. Results All children in the comparison group performed within normal standards for their age range in the DDST‐II and the ADL. The worst performance in the experimental group was observed in language skills, followed, in declining order, by adaptive fine motor, personal‐social, and gross motor as measured by the DDST‐II. Children with isolated CLP also performed poorly in receptive, expressive, and global language in the ADL. No statistically significant differences were observed in the experimental group’s scores for the ADL and the DDST‐II. Interpretation Developmental skill levels were below expectations for children of this age with isolated CLP.

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The Association Between Age at Palatoplasty and Speech and Language Outcomes in Children With Cleft Palate: An Observational Chart Review Study

Shaffer

Ford

Losee

et al. 2019

The Cleft Palate-Craniofacial Journal

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Objective: To determine whether timing of palatoplasty (early, standard, or late) is associated with speech and language outcomes in children with cleft palate. Design: Retrospective case series. Setting: Tertiary care children’s hospital. Participants: Records from 733 children born between 2005 and 2015 and treated at the Cleft Craniofacial Clinic of a tertiary children’s hospital were retrospectively reviewed. Exclusion criteria were cleft repair at an outside hospital, intact secondary palate, absence of postpalatoplasty speech evaluation, syndromes, staged palatoplasty, and introduction to clinic after 12 months of age. Data from 232 children with cleft palate ± cleft lip were analyzed. Interventions: Palatoplasty. Main Outcome Measures: Speech/language delays and disorders at 20 months and 5 years of age based on formal hospital or community-based testing or screening evaluation in the Cleft Craniofacial Clinic; additional speech surgery. Results: Median age at palatoplasty was 12.6 months (range: 8.8-21.9 months). Age at palatoplasty was classified as early (<11 months, n = 28), standard (11-13 months, n = 158), or late (>13 months, n = 46). Late palatoplasty was associated with increased odds of speech/language delays and speech therapy at 20 months, and language delays at 5 years, compared with standard or early palatoplasty ( P < .05 for all comparisons). However, speech sound production disorders, velopharyngeal incompetence, tube replacement, and hearing loss were not significantly associated with age at palatoplasty. Conclusions: Late palatoplasty may be associated with short- and long-term delays in speech/language development. Future studies with standardized surgical technique/timing and outcome measures are required to more definitively describe the impact of age at palatoplasty on speech/language development.

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Perfil da fala de pacientes submetidos à palatoplastia primária

Cited by 4 publications

References 22 publications

Instrumento de rastreio do risco para alterações de fala em crianças com fissura labiopalatina

Instrumento de rastreio do risco para alterações de fala em crianças com fissura labiopalatina

Global and communicative development skills in preschool children with cleft lip and palate

The Association Between Age at Palatoplasty and Speech and Language Outcomes in Children With Cleft Palate: An Observational Chart Review Study

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