Pacifiers, Thumb Sucking, Breastfeeding, and Bottle Use: Oral Sucking Habits of Children with and without Phonological Impairment

Abstract

Aims: The aim of this study was to describe the nutritive and non-nutritive oral sucking habits (breastfeeding, bottle use, pacifier/dummy/soother use, thumb/finger sucking) of preschoolers with and without phonological impairment, and to determine whether oral sucking habits are associated with the presence and severity of phonological impairment. Methods: We conducted a cross-sectional study of 199 Australian English-speaking preschoolers with and without phonological impairment. Preschoolers’ speech was directly assessed, and parents/caregivers completed a questionnaire. Chi-square (χ²) tests were used to examine relationships between oral sucking habits and the presence and severity of phonological impairment. Results: Based on caregiver reports, 79.9% of participants had been breastfed (33.3% for >12 months), 58.3% had used a pacifier (74.2% for ≥12 months), 83.9% had used a bottle (73.4% for > 12 months), and 15.1% sucked their thumb/fingers. There was no association between a history of oral sucking and the presence and severity of phonological impairment. Conclusion: The majority of preschoolers had been breastfed and bottle-fed, and more than half had used a pacifier. The findings support an understanding that phonological impairment is not associated with a history of nutritive and non-nutritive sucking habits. Research is needed to examine the association between oral sucking habits and other types of speech sound disorders.

The Relationship between Feeding and Non-Nutritive Sucking Behaviours and Speech Sound Development: A Systematic Review

“…In contrast, Vieira et al [38] consistently reported associated ORs with 95% CIs alongside their p values. Baker et al [34] and Pereira et al [37] only reported p values.…”

“…Information is not provided on the interviewer or recording of these data. Barbosa et al [39] and Baker et al [34] distributed self-administered parent questionnaires. While all studies collected data on the presence and duration of feeding and NNS behaviours, only Barbosa et al [39] collected data on the frequency of bottle-feeding and pacifier use.…”

“…Details of the population samples for each study are provided in Table 3. Only 2 of the 4 papers [34, 38] reported any use of exclusion criteria in their sample definitions, and only one of these, hearing loss, was common to both studies (Table 4). Baker et al [34] reported the most comprehensive exclusion criteria, including genetic, medical and developmental factors known to have some association with SSD.…”

“…Specific reference to distinct types of SSD was not made; however, through their use of the Brazilian speech sound assessment TEPROSIF [40] to “determine the type and number of errors in the child-age related phonological processes” [39, p. 3], the implication was to focus on phonological impairment (PI). Baker et al [34] were more explicit in stating their specific focus on children with diagnosed PI and defined the group as presenting with “one or more age-inappropriate common phonological error patterns […] with no evidence of motor speech involvement” [34, p. 7]. As Baker et al [34] themselves acknowledged, “PI is presumed to be a cognitive-linguistic difficulty involving a difficulty abstracting rules about the phonological system, and the abstract phonological representation of speech rather than an articulation difficulty.…”

“…Table 2 summarises the total quality scores awarded to each paper. Baker et al [34] scored highest in the quality appraisal with almost 75% of the maximum score, while Pereira et al [37] and Vieira et al [38] obtained the lowest scores with just over 50% of the maximum.…”