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Speech in children with an isolated cleft palate: A longitudinal perspective.

Journal article
Authors Christina Persson
Anette Lohmander
Anna Elander
Published in The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
Volume 43
Issue 3
Pages 295-309
ISSN 1055-6656
Publication year 2006
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Institute of Clinical Sciences
Pages 295-309
Language en
Links dx.doi.org/10.1597/04-071R1.1
Keywords Articulation Disorders, diagnosis, etiology, Case-Control Studies, Child, Child, Preschool, Cleft Palate, complications, surgery, Female, Hearing Loss, complications, Humans, Longitudinal Studies, Male, Nasal Obstruction, complications, diagnosis, Observer Variation, Oral Surgical Procedures, Phonetics, Rhinomanometry, Speech Articulation Tests, Statistics, Nonparametric, Velopharyngeal Insufficiency, complications, etiology, physiopathology, Voice Disorders, diagnosis, etiology
Subject categories Plastic surgery, Logopedics and phoniatrics

Abstract

OBJECTIVE: To describe articulation and speech symptoms related to velopharyngeal impairment in children born with an isolated cleft palate. DESIGN: Blind assessment of speech at 3, 5, 7, and 10 years of age was performed. Two subgroups were formed based on the results at age 5 years, the no-VPI group and the VPI group, and they were compared with controls. SETTING: A university hospital. PATIENTS: Twenty-six children born with isolated cleft palate. Seventeen children served as controls. Interventions: Soft palate closure at 7 months and hard palate closure at a mean age of 3 years and 11 months if the cleft extended into the hard palate. MAIN OUTCOME MEASURES: Perceptual assessments of four variables related to velopharyngeal function and of articulation errors were performed at all ages. Phonetic transcriptions of target speech sounds were obtained at 5, 7, and 10 years and nasalance scores were obtained at age 10 years. RESULTS: The no-VPI group continued to have no or minor difficulties. The VPI group improved but continued to have moderate velopharyngeal impairment. Both groups differed significantly from the controls at age 10 years. Persistent velopharyngeal impairment, as well as glottal misarticulation, were mostly found in children with the cleft as a part of a syndrome or together with multiple malformations. CONCLUSION: Small changes in velopharyngeal impairment were found across ages. Improvement seemed to be related to surgical intervention, and persistent problems seemed to be related to the presence of additional multiple malformations or syndromes.

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