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Chwa ES, Stoehr JR, Gosain AK. Predictors of Adverse Outcomes Following Cleft Palate Repair: An Analysis of Over 2500 Patients Using International Smile Train Data. Cleft Palate Craniofac J 2024; 61:844-853. [PMID: 36594527 DOI: 10.1177/10556656221148901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE The objective of this study was to use data from Smile Train's global partner hospital network to identify patient characteristics that increase odds of fistula and postoperative speech outcomes. DESIGN Multi-institution, retrospective review of Smile Train Express database. SETTING 1110 Smile Train partner hospitals. PATIENTS/PARTICIPANTS 2560 patients. INTERVENTIONS N/A. MAIN OUTCOME MEASURE(S) Fistula occurrence, nasal emission, audible nasal emission with amplification (through a straw or tube) only, nasal rustle/turbulence, consistent nasal emission, consistent nasal emission due to velopharyngeal dysfunction, rating of resonance, rating of intelligibility, recommendation for further velopharyngeal dysfunction assessment, and follow-up velopharyngeal dysfunction surgery. RESULTS The patients were 46.6% female and 27.5% underweight by WHO standards. Average age at palatoplasty was 24.7 ± 0.5 months and at speech assessment was 6.8 ± 0.1 years. Underweight patients had higher incidence of hypernasality and decreased speech intelligibility. Palatoplasty when under 6 months or over 18 months of age had higher rates of affected nasality, intelligibility, and fistula formation. The same findings were seen in Central/South American and African patients, in addition to increased velopharyngeal dysfunction and fistula surgery compared to Asian patients. Palatoplasty technique primarily involved one-stage midline repair. CONCLUSIONS Age and nutrition status were significant predictors of speech outcomes and fistula occurrence following palatoplasty. Outcomes were also significantly impacted by location, demonstrating the need to cultivate longitudinal initiatives to reduce regional disparities. These results underscore the importance of Smile Train's continual expansion of accessible surgical intervention, nutritional support, and speech-language care.
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Affiliation(s)
- Emily S Chwa
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jenna R Stoehr
- Division of Plastic and Reconstructive Surgery, University of South Florida, Tampa, IL, USA
| | - Arun K Gosain
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Pediatric Plastic and Reconstructive Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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Chiang SN, Fotouhi AR, Doering MM, Skolnick GB, Naidoo SD, Strahle JM, McEvoy SD, Patel KB. Cognitive Development in Lambdoid Craniosynostosis: A Systematic Review and Meta-Analysis. Cleft Palate Craniofac J 2024; 61:450-457. [PMID: 36177519 DOI: 10.1177/10556656221129978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Lambdoid craniosynostosis affects approximately 1 in 33 000 live births per year, and surgical correction is often sought in order to achieve normocephaly and allow for adequate brain growth. However, the effects of lambdoid synostosis and its treatment on cognitive development are unknown. DESIGN Systematic review and meta-analysis. PATIENTS, PARTICIPANTS A systematic review of Ovid Medline, Embase, Web of Science, Scopus, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov was conducted in January 2022. Included studies assessed cognitive development of patients with nonsyndromic unilateral lambdoid craniosynostosis. MAIN OUTCOME MEASURES Results of developmental tests were compared to normative data or controls to generate Hedges' g for meta-analysis. RESULTS Nine studies met the inclusion criteria. Meta-analysis of 3 studies describing general cognition showed that cases scored significantly lower than their peers, but within 1 standard deviation (g = 0.37, 95% CI [-0.64, -0.10], P = .01). Meta-analysis of verbal and psychomotor development showed no significant differences in children with lambdoid synostosis. Studies were of fair quality and had moderate-to-high heterogeneity. CONCLUSIONS Patients with lambdoid craniosynostosis may score slightly below average on tests of general cognition in comparison to normal controls, but results in other domains are variable. Analyses were limited by small sample sizes. Multidisciplinary care and involvement of a child psychologist may be helpful in identifying areas of concern and providing adequate scholastic support. Further research recruiting larger cohorts will be necessary to confirm these findings and extend them to other developmental domains such as attention and executive function.
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Affiliation(s)
- Sarah N Chiang
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Annahita R Fotouhi
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Michelle M Doering
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, MO, USA
| | - Gary B Skolnick
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Sybill D Naidoo
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Jennifer M Strahle
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Sean D McEvoy
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Kamlesh B Patel
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO, USA
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Mira AS, Wilkens ME, Washington KN, McKenna VS. Phonemic and pitch variability in bilingual preschoolers: A comparison of Jamaican Creole and English. Int J Speech Lang Pathol 2024:1-16. [PMID: 38375802 DOI: 10.1080/17549507.2023.2287426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
PURPOSE The purpose of this study was to investigate the cross-linguistic influences of Jamaican Creole (JC) and English on phonemic and vocal development in bilingual JC-English-speaking preschoolers. METHOD Sixteen typically developing children (12 females, M = 4 years; 4 months) completed the Diagnostic Evaluation of Articulation in Phonology Word Inconsistency Assessment subtest in JC and in English. Acoustic measures of voice onset time (VOT), VOT variability (VOT SD), mean fundamental frequency (fo), and fo variability (fo SD) were extracted from each target word. Prevoicing was noted. Mixed models and regression models were analysed to understand the patterns of acoustic measures in each language, and the relationship between phonemic and vocal variability, respectively. RESULT Analyses showed a significant effect of language on fo SD, wherein SD was greater in English than JC. JC spoken (percentage) was a significant positive predictor of VOT SD for voiced (short lag) productions. There was no relationship between phonemic and vocal variability measures. CONCLUSION Greater fo SD in English may be due to linguistic fo differences and speaking environment. Variability for voiced VOT is likely due to the continued maturation of vocal and articulatory control when children are developing adult-like productions, though longitudinal studies are needed.
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Affiliation(s)
- Amna Samir Mira
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
- College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mary Elizabeth Wilkens
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Karla Nadine Washington
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
- Department of Speech-Language Pathology, University of Toronto, Toronto, Canada
- Department of Communicative Sciences and Disorders, New York University, New York, NY, USA
| | - Victoria Sue McKenna
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
- Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati, Cincinnati, OH, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
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de Buys Roessingh A, Robert Y, Despars J, Zbinden-Trichet C, Herzog G, Broome M, El Ezzi O. Unilateral Cleft lip and Palate: Long-Term Results of the Malek Technique. Cleft Palate Craniofac J 2024; 61:219-230. [PMID: 36453758 PMCID: PMC10751977 DOI: 10.1177/10556656221139671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
To review at 18 years-old the results of surgery and follow-up of children born in our hospital with unilateral cleft lip and palate (uCLP). They were operated at the time by the same surgeon, following the same primary surgical procedure (Malek). Retrospective cohort study. Tertiary Children's Hospital. All children born with uCLP between 1996 and 2001 and operated in our hospital. Syndromic children were excluded. Results of the primary surgery, ear-nose-throat interventions, maxillo-facial surgery and final phonatory results. Seventy-nine files of children born with a cleft were reviewed: 34 were taken into consideration for uCLP: 15 right and 19 left. They were operated in two stages, following the inverse Malek procedure. Sixty per cent had a fistula. Eighty-eight percent had grommets. Ninety-seven percent had an alveolar graft at a median age of nine (5-10) and 22% underwent a Le Fort osteotomy. Seven percent were operated for a pharyngeal flap, 29% for a secondary lip surgery at a mean age of 12.8 and 29% for a late rhinoplasty at a mean age of 14.8 years. A median of 5.7 multidisciplinary consultations was realized with a median number of general anesthesia of 7.1 (4-13). This retrospective study shows that the Malek procedure for children born with uCLP is related to a high risk of fistula but good long-term phonatory results. Twenty percent of children were operated for a Le Fort procedure and one-third for a secondary lip procedure and rhinoplasty.
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Affiliation(s)
- Anthony de Buys Roessingh
- Department of Pediatric Surgery, University Hospital Center of the Canton of Vaud (CHUV), Lausanne, Switzerland
| | - Yohann Robert
- Multidisciplinary consultations of facial cleft, CHUV, Lausanne, Switzerland
| | - Josée Despars
- Department of Pediatric Surgery, University Hospital Center of the Canton of Vaud (CHUV), Lausanne, Switzerland
| | - Chantal Zbinden-Trichet
- Department of Pediatric Surgery, University Hospital Center of the Canton of Vaud (CHUV), Lausanne, Switzerland
| | - Georges Herzog
- Department of Pediatric Surgery, University Hospital Center of the Canton of Vaud (CHUV), Lausanne, Switzerland
| | - Martin Broome
- Department of Pediatric Surgery, University Hospital Center of the Canton of Vaud (CHUV), Lausanne, Switzerland
| | - Oumama El Ezzi
- Department of Pediatric Surgery, University Hospital Center of the Canton of Vaud (CHUV), Lausanne, Switzerland
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Varagur K, Murphy J, Skolnick GB, Naidoo SD, Grames LM, Dunsky KA, Menezes M, Snyder-Warwick AK, Patel KB. Impact of Neighborhood Deprivation and Social Vulnerability on Outcomes and Interventions in Patients with Cleft Palate. Cleft Palate Craniofac J 2024:10556656231226070. [PMID: 38196266 DOI: 10.1177/10556656231226070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVE To examine whether neighborhood disadvantage impacts length of follow-up, interventions, and outcomes for patients with cleft palate. DESIGN Retrospective cohort. SETTING Cleft Palate Craniofacial Institute Database at St. Louis Children's Hospital. PATIENTS/PARTICIPANTS Patients with cleft palate following in St. Louis Children's Hospital Cleft Palate Multidisciplinary Team Clinic. INTERVENTIONS Primary palatoplasty between 2012-2017. Patients were divided into quartiles across area deprivation index (ADI) and social vulnerability index (SVI), two validated, composite metrics of neighborhood disadvantage, to examine whether living in neighborhoods from different deprivation quartiles impacts outcomes of interest. MAIN OUTCOME MEASURE Follow-up through age 5, surgeries and surgical complications, speech, developmental, and behavioral outcomes. RESULTS 205 patients were included. 39% of patients belonged to the most deprived ADI quartile, while 15% belonged to the most vulnerable SVI quartile. There were no differences between ADI or SVI quartiles in number of operations received (p ≥ 0.40). Patients in the most deprived ADI quartile were significantly more likely to have speech/language concerns (OR 2.32, 95% CI [1.20-4.89], p = 0.01). Being in a more vulnerable SVI quartile was associated with developmental delay (OR 2.29, 95% CI [1.04-5.15], p = 0.04). ADI and SVI quartile did not impact risk of loss to follow-up in the isolated and combined cleft lip and palate subgroups (p ≥ 0.21). CONCLUSIONS Neighborhood disadvantage impacts speech and developmental outcomes in patients with cleft palate despite comparable length of follow-up in multidisciplinary team clinic.
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Affiliation(s)
- Kaamya Varagur
- Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - John Murphy
- Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Gary B Skolnick
- Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Sybill D Naidoo
- Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Lynn M Grames
- The Cleft Palate-Craniofacial Institute, St. Louis Children's Hospital, St. Louis, MO, USA
| | - Katherine A Dunsky
- Department of Otolaryngology, Washington University in St. Louis, St. Louis, MO, USA
| | - Maithilee Menezes
- Department of Otolaryngology, Washington University in St. Louis, St. Louis, MO, USA
| | - Alison K Snyder-Warwick
- Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Kamlesh B Patel
- Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, St. Louis, MO, USA
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Morrison KA, Park J, Rochlin D, Lico M, Flores RL. Anatomical Study of Domain Rescue of Palatal Length in Patients With a Wide Cleft Palate: Buccal Flap Reconstruction in Primary Palatoplasty. Cleft Palate Craniofac J 2024; 61:103-109. [PMID: 35918811 DOI: 10.1177/10556656221117930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This study characterizes the potential loss of velar length in patients with a wide cleft and rescue of this loss of domain by local flap reconstruction, providing anatomic evidence in support of primary lengthening of the soft palate during palatoplasty. METHODS A retrospective review was conducted of all patients with a cleft palate at least 10mm in width, who underwent primary palatoplasty with a buccal flap prior to 18 months of age over a 2-year period. All patients underwent primary palatoplasty with horizontal transection of the nasal mucosa, which was performed after nasal mucosa repair, but prior to muscular reconstruction. The resulting palatal lengthening was measured and the mucosal defect was reconstructed with a buccal flap. RESULTS Of the 22 patients included, 3 (13.6%) had a history of Pierre Robin sequence, and 5 (22.7%) had an associated syndrome. No patients had a Veau I cleft, 7 (31.8%) had a Veau II, 12 (54.5%) had a Veau III, and 3 had (13.6%) a Veau IV cleft. All patients had a right buccal flap during primary palatoplasty. The mean cleft width at the posterior nasal spine was 10.6 ± 2.82mm, and mean lengthening of the velum after horizontal transection of the nasal mucosa closure was 10.5 ± 2.23mm. There were 2 (9.1%) fistulas, 1 (4.5%) wound dehiscence, 1 (4.5%) 30-day readmission, and no bleeding complications. CONCLUSIONS Patients with a wide cleft palate have a potential loss of 1cm velar length. The buccal flap can rescue the loss of domain in palatal length, and potentially improve palatal excursion.
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Affiliation(s)
| | - Jenn Park
- NYU Langone Health, New York, NY, USA
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Meier AM, Guenther FH. Neurocomputational modeling of speech motor development. J Child Lang 2023; 50:1318-1335. [PMID: 37337871 PMCID: PMC10615680 DOI: 10.1017/s0305000923000260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
This review describes a computational approach for modeling the development of speech motor control in infants. We address the development of two levels of control: articulation of individual speech sounds (defined here as phonemes, syllables, or words for which there is an optimized motor program) and production of sound sequences such as phrases or sentences. We describe the DIVA model of speech motor control and its application to the problem of learning individual sounds in the infant's native language. Then we describe the GODIVA model, an extension of DIVA, and how chunking of frequently produced phoneme sequences is implemented within it.
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Affiliation(s)
- Andrew M Meier
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA02215
| | - Frank H Guenther
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA02215
- Department of Biomedical Engineering, Boston University, Boston, MA02215
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De Ryck M, Van Lierde K, Alighieri C, Hens G, Bettens K. A protocol for a randomized-controlled trial to investigate the effect of infant sign training on the speech-language development in young children born with cleft palate. Int J Lang Commun Disord 2023; 58:2212-2221. [PMID: 37376898 DOI: 10.1111/1460-6984.12920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Children born with a cleft palate with or without cleft lip (CP ± L) are known to be at risk for speech-language disorders that impact educational and social-emotional growth. It is hypothesized that speech-language intervention delivered before the age of 3 years could decrease the impact of CP ± L on speech-language development. Infant sign training in combination with verbal input expands the natural communication of young children including multimodal speech-language input (i.e., verbal and manual input) via caregivers who act as co-therapists. AIMS To determine the effectiveness of infant sign training in 1-year-old children with CP ± L by comparing different interventions. METHODS & PROCEDURES This is a two-centre, randomized, parallel-group, longitudinal, controlled trial. Children are randomized to either an infant sign training group (IST group), a verbal training group (VT group) or no intervention control group (C group). Caregivers of children who are assigned to the IST group or VT group will participate in three caregiver training meetings to practise knowledge and skills to stimulate speech-language development. Outcome measures include a combination of questionnaires, language tests and observational analyses of communicative acts. OUTCOMES & RESULTS It is hypothesized that speech-language development of children with CP ± L will benefit more from IST compared with VT and no intervention. Additionally, the number and quality of communicative acts of both children and caregivers are expected to be higher after IST. CONCLUSIONS & IMPLICATIONS This project will contribute to the development of evidence-based clinical practice guidelines regarding early speech-language intervention in children with CP ± L under the age of 3 years. WHAT THIS PAPER ADDS What is already known on the subject Children with CP ± L are known to be at risk for speech-language delays that impact educational and social emotional growth. Given the limited scientific prove of the impact of early speech-language intervention, no standardized clinical practice guidelines are available yet for children with CP ± L under the age of 3 years. Early intervention in this population mostly focuses on improving verbal input via caregivers or professionals without including a multimodal language input. A growing scientific interest has been seen in the use of infant signs to support speech-language development and caregiver-child interaction in typically developing children and children with developmental delays. What this study adds to existing knowledge No evidence is yet available for the effectiveness and feasibility of early intervention based on infant sign training in combination with verbal input to improve speech-language skills in young children with CP ± L. The current project will investigate the effect of infant sign training on the speech-language development in this population. Outcome measures are compared with those of two control groups: verbal training only and no intervention. It is hypothesized that infant signs may support the intelligibility of verbal utterances produced by children with CP ± L. Improving children's intelligibility may increase the opportunities for these children to engage in early, frequent and high-quality interactions with their caregivers resulting in a richer social and linguistic environment. As a result, infant sign training may result in better speech-language skills compared with the control interventions. What are the potential or actual clinical implications of this work? If providing early intervention based on infant sign training is effective, there is the potential for improved speech-language outcomes in early childhood, resulting in increased speech intelligibility, increased well-being of the child and family and less need for speech-language therapy on the long-term. This project will contribute to the development of evidence-based clinical practice guidelines regarding early speech-language intervention in children with CP ± L under the age of 3 years.
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Affiliation(s)
- Mira De Ryck
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium
| | - Cassandra Alighieri
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium
| | - Greet Hens
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
- Multidisciplinary Cleft Lip and Palate Team, University Hospitals Leuven, Leuven, Belgium
| | - Kim Bettens
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium
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Dunworth K, Sharif-Askary B, Grames L, Jones C, Kern J, Nyswonger-Sugg J, Suárez A, Thompson K, Ching J, Golden B, Merrill C, Nguyen P, Patel K, Rogers-Vizena CR, Rottgers SA, Skolnick GB, Allori AC. Using "Real-World Data" to Study Cleft Lip/Palate Care: An Exploration of Speech Outcomes from a Multi-Center US Learning Health Network. Cleft Palate Craniofac J 2023:10556656231207469. [PMID: 37844605 DOI: 10.1177/10556656231207469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE To assess the ability of a cleft-specific multi-site learning health network registry to describe variations in cleft outcomes by cleft phenotypes, ages, and treatment centers. Observed variations were assessed for coherence with prior study findings. DESIGN Cross-sectional analysis of prospectively collected data from 2019-2022. SETTING Six cleft treatment centers collected data systematically during routine clinic appointments according to a standardized protocol. PARTICIPANTS 714 English-speaking children and adolescents with non-syndromic cleft lip/palate. INTERVENTION Routine multidisciplinary care and systematic outcomes measurement by cleft teams. OUTCOME MEASURES Speech outcomes included articulatory accuracy measured by Percent Consonants Correct (PCC), velopharyngeal function measured by Velopharyngeal Competence (VPC) Rating Scale (VPC-R), intelligibility measured by caregiver-reported Intelligibility in Context Scale (ICS), and two CLEFT-Q™ surveys, in which patients rate their own speech function and level of speech distress. RESULTS 12year-olds exhibited high median PCC scores (91-100%), high frequency of velopharyngeal competency (62.50-100%), and high median Speech Function (80-91) relative to younger peers parsed by phenotype. Patients with bilateral cleft lip, alveolus, and palate reported low PCC scores (51-91%) relative to peers at some ages and low frequency of velopharyngeal competency (26.67%) at 5 years. ICS scores ranged from 3.93-5.0 for all ages and phenotypes. Speech Function and Speech Distress were similar across phenotypes. CONCLUSIONS This exploration of speech outcomes demonstrates the current ability of the cleft-specific registry to support cleft research efforts as a source of "real-world" data. Further work is focused on developing robust methodology for hypothesis-driven research and causal inference.
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Affiliation(s)
- Kristina Dunworth
- Department of Surgery, Division of Plastic, Maxillofacial, and Oral Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Banafsheh Sharif-Askary
- Department of Surgery, Division of Plastic, Maxillofacial, and Oral Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Lynn Grames
- Cleft Palate and Craniofacial Institute, St. Louis Children's Hospital, St. Louis, USA
| | - Carlee Jones
- Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, NC, USA
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC, USA
| | - Jennifer Kern
- Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, NC, USA
- Department of Speech Pathology & Audiology, Duke University Hospital, Durham, NC, USA
| | - Jillian Nyswonger-Sugg
- Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, NC, USA
- Department of Speech Pathology & Audiology, Duke University Hospital, Durham, NC, USA
| | - Arthur Suárez
- Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, NC, USA
- Department of Speech Pathology & Audiology, Duke University Hospital, Durham, NC, USA
| | - Karen Thompson
- Cleft Lip and Palate Program/Craniofacial Program, Boston Children's Hospital, Boston, MA, USA
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Jessica Ching
- University of Florida Craniofacial Center, University of Florida, Gainesville, FL, USA
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Florida, Gainesville, FL, USA
| | - Brent Golden
- Pediatric Cleft Lip and Palate Surgery Program, Orlando Health Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Corinne Merrill
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, USA
| | - Phuong Nguyen
- Division of Plastic Surgery, Department of Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Kamlesh Patel
- Cleft Palate and Craniofacial Institute, St. Louis Children's Hospital, St. Louis, USA
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, USA
| | - Carolyn R Rogers-Vizena
- Cleft Lip and Palate Program/Craniofacial Program, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - S Alex Rottgers
- Cleft and Craniofacial Center, Johns Hopkins Children's Center, Baltimore, MD, USA
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Gary B Skolnick
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, USA
| | - Alexander C Allori
- Department of Surgery, Division of Plastic, Maxillofacial, and Oral Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Cleft & Craniofacial Center, Duke Children's Hospital, Durham, NC, USA
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC, USA
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10
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Grabar C, Fligor J, Kanack M, Walsh J, Kim J, Vyas R. A Survey on Enhanced Recovery After Surgery (ERAS) Elements in Cleft Palate Repair. Cleft Palate Craniofac J 2023; 60:1305-1312. [PMID: 35619553 DOI: 10.1177/10556656221103756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aims to characterize current use, knowledge, and attitude toward ERAS protocols by academic craniofacial surgeons. Craniofacial surgeons were provided with electronic surveys. Electronic survey; Institutional tertiary surgeons. 102 cleft palate surgeons surveyed and 31 completed the survey (30.4%). None. Respondents rated their knowledge, use, and willingness to implement perioperative interventions modeled after adult ERAS protocols. Majority (67.7%) rated they were knowledgeable about ERAS. However, 61.3% "never use" a standardized protocol for cleft palate surgery. Only 3 ERAS elements are currently implemented by a majority of cleft surgeons: avoiding prolonged perioperative fasting (67.7%), using hypothermia prevention measures (74.2%), and minimizing use of opioids (62.5%). A large majority of respondents noted they never administer bolus (71.0%) or infusion (80.6%) dosing of tranexamic acid; most of these surgeons also indicated that administering tranexamic acid "would not be a valuable addition" (67.7% and 71.0%, respectively). Short-acting sedatives are used by 12.9% and by 16.1% of surgeons in all patients during extubation and postoperative recovery, respectively. By contrast, 22.6% never use such agents during extubation and 48.4% never use it during postoperative recovery. Overall, 67.7% of respondents replied that they would be willing to implement an ERAS protocol for cleft palate repair. Many respondents report using interventions compatible with an ERAS approach and the majority are willing to implement an ERAS protocol for cleft palate repair.
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Affiliation(s)
- Christina Grabar
- School of Medicine, University of California Irvine, Orange, CA, USA
| | - Jennifer Fligor
- Department of Plastic Surgery, University of California Irvine, Orange, CA, USA
| | - Melissa Kanack
- Department of Plastic Surgery, University of California Irvine, Orange, CA, USA
| | - Juleah Walsh
- Pediatric Plastic Surgery, CHOC Children's, Orange, CA, USA
| | - Joe Kim
- Pediatric Plastic Surgery, CHOC Children's, Orange, CA, USA
| | - Raj Vyas
- Department of Plastic Surgery, University of California Irvine, Orange, CA, USA
- Pediatric Plastic Surgery, CHOC Children's, Orange, CA, USA
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11
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Murakami D, Kimura T, Kono M, Sakai A, Suenaga T, Hiraoka M, Sakatani H, Ohtani M, Suzuki H, Tokuhara D, Hotomi M. Case report: Cochlear implantation was effective for progressive bilateral severe hearing loss associated with Kawasaki disease. Front Pediatr 2023; 11:1199240. [PMID: 37635798 PMCID: PMC10448821 DOI: 10.3389/fped.2023.1199240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/25/2023] [Indexed: 08/29/2023] Open
Abstract
Sensorineural hearing loss associated with Kawasaki disease has been increasingly reported, but its etiology remains unclear. Most reported cases of sensorineural hearing loss associated with Kawasaki disease have been mild and reversible during acute or subacute phases. However, bilateral severe hearing loss as a complication of Kawasaki disease can cause delays in cognitive and speech development. A 4-year-old Japanese boy treated for Kawasaki disease had right-side moderate and left-side profound sensorineural hearing loss on the 141st day after onset of Kawasaki disease. Despite systemic steroid pulse treatment, hearing loss remained in both sides. After the recurrence of Kawasaki disease, hearing on the right side progressively worsened, meaning there was now severe hearing loss on both sides. Left cochlear implantation performed on the 1065th day after the onset of Kawasaki disease improved the patient's hearing and his ability to communicate. Sensorineural hearing loss associated with Kawasaki disease may progress over a long period and cause bilateral severe hearing loss, although past reports showed occurrence during acute or subacute phases. The clinical course of our patient suggests that intense inflammation caused by Kawasaki disease could be related to prolonged hearing loss. Cochlear implantation seems to be effective for sensorineural hearing loss associated with Kawasaki disease.
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Affiliation(s)
- Daichi Murakami
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
| | - Takahito Kimura
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
| | - Masamitsu Kono
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
| | - Akihiro Sakai
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
- Sakai ENT Clinic, Kinokawa, Japan
| | - Tomohiro Suenaga
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Masanobu Hiraoka
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hideki Sakatani
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
| | - Makiko Ohtani
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroyuki Suzuki
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
- Department of Pediatrics, Wakayama Tsukushi Medical and Welfare Center, Iwade, Japan
| | - Daisuke Tokuhara
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Muneki Hotomi
- Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan
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12
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Blum JD, Benítez DB, Caballero FR, Villavisanis DF, Cho DY, Bartlett SP, Taylor JA, Magee L, Sierra NE, Swanson JW. Disability Caused by Cleft Lip and Palate: A Systematic Review and Critical Valuation Appraisal. Cleft Palate Craniofac J 2023:10556656231173478. [PMID: 37403346 DOI: 10.1177/10556656231173478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023] Open
Abstract
OBJECTIVE Measuring disability as a concept of impaired global function enables beneficiaries of treatment, the impact of treatment, and targets of health system investment to be rigorously assessed. Measures of disability are not well established for cleft lip and palate. This study aims to systematically review disability weight (DW) studies pertaining to orofacial clefts (OFCs) and identify methodological strengths and shortcomings of each approach. DESIGN Systematic literature review of studies that met the following criteria: (1) peer-reviewed publication, (2) focus on disability valuation, (3) mention orofacial clefts, and (4) publication January 2001-December 2021. SETTING None. PATIENTS/PARTICIPANTS None. INTERVENTIONS None. MAIN OUTCOME MEASURE(S) Disability weight method of valuation and the value itself. RESULTS The final search strategy yielded 1,067 studies. Seven manuscripts were ultimately included for data extraction. The disability weights used in our studies, including those newly generated or taken from the Global Burden of Disease Studies (GBD), ranged widely for isolated cleft lip (0.0-0.100) and cleft palate with or without cleft lip (0.0-0.269). The GBD studies limited their consideration of cleft sequelae informing disability weights to impact on appearance and speech-related concerns, while other studies accounted for comorbidities such as pain and social stigma. CONCLUSIONS Current measures of cleft disability are sparse, inadequately reflect the comprehensive impact of an OFC on function and socialization, and are limited in detail or supporting evidence. Use of a comprehensive health state description in evaluating disability weights offers a realistic means of accurately representing the diverse sequelae of an OFC.
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Affiliation(s)
- Jessica D Blum
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | - Dillan F Villavisanis
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Daniel Y Cho
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Scott P Bartlett
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jesse A Taylor
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Leanne Magee
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Jordan W Swanson
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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13
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Romski M, Sevcik RA, Barton-Hulsey A, Fisher E, King M, Albert P, Kaldes G, Walters C. Parent-implemented augmented communication intervention and young children with Down syndrome: an exploratory report. Front Psychol 2023; 14:1168599. [PMID: 37384179 PMCID: PMC10299806 DOI: 10.3389/fpsyg.2023.1168599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/22/2023] [Indexed: 06/30/2023] Open
Abstract
Introduction Young children with Down syndrome (DS) present with speech and language impairments very early in childhood. Historically, early language intervention for children with DS included manual signs, though recently there has been an interest in the use of speech-generating devices (SGDs). This paper examines the language and communication performance of young children with DS who participated in parent-implemented communication interventions that included SGDs. Specifically, we compared the functional vocabulary usage and communication interaction skills of children with DS who received augmented communication interventions (AC) that included an SGD with those children with DS who received spoken communication intervention (SC). Methods Twenty-nine children with DS participated in this secondary data analysis. These children were part of one of two longitudinal RCT studies investigating the effectiveness of parent-implemented augmented communication interventions in a larger sample of 109 children with severe communication and language impairments. Results There were significant differences between children with DS in the AC and SC groups in terms of the number and proportion of functional vocabulary targets used and the total vocabulary targets provided during the intervention at sessions 18 (lab)and 24 (home). Discussion Overall, the AC interventions provided the children with a way to communicate via an SGD with visual-graphic symbols and speech output, while the children in the SC intervention were focused on producing spoken words. The AC interventions did not hinder the children's spoken vocabulary development. Augmented communication intervention can facilitate the communication abilities of young children with DS as they are emerging spoken communicators.
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Affiliation(s)
- MaryAnn Romski
- Departments of Communication and Psychology, Georgia State University, Atlanta, GA, United States
| | - Rose A. Sevcik
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Andrea Barton-Hulsey
- Department of Communication Sciences and Disorders, Florida State University, Tallahassee, FL, United States
| | - Evelyn Fisher
- Center for Development and Disability, University of New Mexico, Albuquerque, NM, United States
| | - Marika King
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Phebe Albert
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Gal Kaldes
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Casy Walters
- Department of Psychology, Georgia State University, Atlanta, GA, United States
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14
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Keintzel T, Raffelsberger T, Niederwanger L, Gundacker G, Rasse T. Systematic Literature Review and Early Benefit of Cochlear Implantation in Two Pediatric Auditory Neuropathy Cases. J Pers Med 2023; 13:jpm13050848. [PMID: 37241018 DOI: 10.3390/jpm13050848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
Approximately 1 in 10 children with hearing loss is affected by auditory neuropathy spectrum disorder (ANSD). People who have ANSD usually have great difficulty understanding speech or communicating. However, it is possible for these patients to have audiograms that may indicate profound hearing loss up to normal hearing. This disorder is prognosed with positive, intact or present otoacoustic emissions (OAE) and/or cochlear microphonics (CM) as well as abnormal or absent auditory brainstem responses (ABR). Treatment methods include conventional hearing aids as well as cochlear implants. Cochlear implants (CI) usually promise better speech understanding for ANSD patients. We performed a systematic literature review aiming to show what improvements can effectively be achieved with cochlear implants in children with ANSD and compare this with our experience with two cases of ANSD implanted at our clinic. The retrospective review of two young CI patients diagnosed with ANSD during infancy demonstrated improvements over time in speech development communicated by their parents.
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Affiliation(s)
- Thomas Keintzel
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, 4600 Wels, Austria
| | - Tobias Raffelsberger
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, 4600 Wels, Austria
| | - Lisa Niederwanger
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, 4600 Wels, Austria
| | - Gina Gundacker
- Department Health and Rehabilitation Engineering, University of Applied Sciences Technikum Wien, 1200 Vienna, Austria
| | - Thomas Rasse
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, 4600 Wels, Austria
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15
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Houde JF, Ménard L, Jones JA, Shiller DM, Tian X. Editorial: New perspectives on the role of sensory feedback in speech production. Front Hum Neurosci 2023; 17:1189751. [PMID: 37228854 PMCID: PMC10203948 DOI: 10.3389/fnhum.2023.1189751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 03/31/2023] [Indexed: 05/27/2023] Open
Affiliation(s)
- John F. Houde
- Department of Otolaryngology – Head and Neck Surgery, University of California San Francisco, San Francisco, CA, United States
| | - Lucie Ménard
- Département de Linguistique, Université du Québec à Montréal, Montréal, QC, Canada
| | - Jeffery A. Jones
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Douglas M. Shiller
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montréal, QC, Canada
| | - Xing Tian
- Department of Neural and Cognitive Sciences, NYU Shanghai, Shanghai, China
- NYU-ECNU Institute of Brain and Cognitive Science at NYU Shanghai, Shanghai, China
- Shanghai Key Laboratory of Brain Functional Genomics (Ministry of Education), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
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16
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Bode C, Ghaltakhchyan N, Silva ER, Turvey T, Blakey G, White R, Mielke J, Zajac D, Jacox L. Impacts of Development, Dentofacial Disharmony, and Its Surgical Correction on Speech: A Narrative Review for Dental Professionals. Appl Sci (Basel) 2023; 13:5496. [PMID: 37323873 PMCID: PMC10270670 DOI: 10.3390/app13095496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Speech is a communication method found only in humans that relies on precisely articulated sounds to encode and express thoughts. Anatomical differences in the maxilla, mandible, tooth position, and vocal tract affect tongue placement and broadly influence the patterns of airflow and resonance during speech production. Alterations in these structures can create perceptual distortions in speech known as speech sound disorders (SSDs). As craniofacial development occurs, the vocal tract, jaws, and teeth change in parallel with stages of speech development, from babbling to adult phonation. Alterations from a normal Class 1 dental and skeletal relationship can impact speech. Dentofacial disharmony (DFD) patients have jaw disproportions, with a high prevalence of SSDs, where the severity of malocclusion correlates with the degree of speech distortion. DFD patients often seek orthodontic and orthognathic surgical treatment, but there is limited familiarity among dental providers on the impacts of malocclusion and its correction on speech. We sought to review the interplay between craniofacial and speech development and the impacts of orthodontic and surgical treatment on speech. Shared knowledge can facilitate collaborations between dental specialists and speech pathologists for the proper diagnosis, referral, and treatment of DFD patients with speech pathologies.
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Affiliation(s)
- Christine Bode
- Orthodontics and Oral Surgery Group, Division of
Craniofacial and Surgical Care, Adams School of Dentistry, University of North
Carolina, 201 Brauer Hall, CB#7450, Chapel Hill, NC 27599-7450, USA
| | - Nare Ghaltakhchyan
- Orthodontics and Oral Surgery Group, Division of
Craniofacial and Surgical Care, Adams School of Dentistry, University of North
Carolina, 201 Brauer Hall, CB#7450, Chapel Hill, NC 27599-7450, USA
- Division of Oral and Craniofacial Health Sciences, Adams
School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel
Hill, NC 27599-7450, USA
| | - Erika Rezende Silva
- Biological and Biomedical Sciences Program, School of
Medicine, University of North Carolina, 1116 Bioinformatics Building, Chapel Hill,
NC 25799-7450, USA
- Oral and Craniofacial Biomedicine Program, Adams School of
Dentistry, University of North Carolina, 365 S Columbia St., Chapel Hill, NC
25799-7450, USA
| | - Timothy Turvey
- Orthodontics and Oral Surgery Group, Division of
Craniofacial and Surgical Care, Adams School of Dentistry, University of North
Carolina, 201 Brauer Hall, CB#7450, Chapel Hill, NC 27599-7450, USA
| | - George Blakey
- Orthodontics and Oral Surgery Group, Division of
Craniofacial and Surgical Care, Adams School of Dentistry, University of North
Carolina, 201 Brauer Hall, CB#7450, Chapel Hill, NC 27599-7450, USA
| | - Raymond White
- Orthodontics and Oral Surgery Group, Division of
Craniofacial and Surgical Care, Adams School of Dentistry, University of North
Carolina, 201 Brauer Hall, CB#7450, Chapel Hill, NC 27599-7450, USA
| | - Jeff Mielke
- English Department, North Carolina State University,
Tompkins Hall, Raleigh, NC 27695, USA
| | - David Zajac
- Speech Pathology Group, Division of Craniofacial and
Surgical Care, Adams School of Dentistry, University of North Carolina, 201 Brauer
Hall, CB#7450, Chapel Hill, NC 27599-7450, USA
| | - Laura Jacox
- Orthodontics and Oral Surgery Group, Division of
Craniofacial and Surgical Care, Adams School of Dentistry, University of North
Carolina, 201 Brauer Hall, CB#7450, Chapel Hill, NC 27599-7450, USA
- Division of Oral and Craniofacial Health Sciences, Adams
School of Dentistry, University of North Carolina, 270 Brauer Hall, CB#270, Chapel
Hill, NC 27599-7450, USA
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17
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Guzek A, Iwanicka-Pronicka K. Auditory Discrimination-A Missing Piece of Speech and Language Development: A Study on 6-9-Year-Old Children with Auditory Processing Disorder. Brain Sci 2023; 13:brainsci13040606. [PMID: 37190571 DOI: 10.3390/brainsci13040606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/28/2023] [Accepted: 04/01/2023] [Indexed: 05/17/2023] Open
Abstract
Auditory discrimination, the hearing ability crucial for speech and language development, allowing one to perceive changes in volume, duration and frequency of sounds, was assessed for 366 participants with normal peripheral hearing: 220 participants with auditory processing disorders (APD) and 146 typically developing (TD) children, all aged 6-9 years. Discrimination of speech was tested with nonsense words using the phoneme discrimination test (PDT), while pure tones-with the frequency pattern test (FPT). The obtained results were statistically analyzed and correlated. The median of the FPT results obtained by participants with APD was more than twice lower than those of TD (20% vs. 50%; p < 0.05), similarly in the PDT (21 vs. 24; p < 0.05). The FPT results of 9-year-old APD participants were worse than the results of TD 6-year-olds (30% vs. 40%; p < 0.05), indicating that the significant FPT deficit strongly suggests APD. The process of auditory discrimination development does not complete with the acquisition of phonemes but continues during school age. Physiological phonemes discrimination is not yet equalized among 9-year-olds. Nonsense word tests allow for reliable testing of phoneme discrimination. APD children require testing with PDT and FPT because both test results allow for developing individual therapeutic programs.
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Affiliation(s)
- Anna Guzek
- The Outpatient of Speech Therapy, The Children's Memorial Health Institute, 04-736 Warsaw, Poland
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18
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Holm A, van Reyk O, Crosbie S, De Bono S, Morgan A, Dodd B. Preschool children's consistency of word production. Clin Linguist Phon 2023; 37:223-241. [PMID: 35200086 DOI: 10.1080/02699206.2022.2041099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Consistency of word production contributes to carers' ability to understand children's speech. Reports of the proportion of words produced consistently by typically developing preschool children, however, vary widely from 17% to 87%. This paper examines the quantitative (consistency count) and qualitative (e.g. phonemic analysis) characteristics of word consistency in 96 children aged 36-60 months. Children named 15 pictures twice, in separate trials, in the same assessment session. The mean consistency of the production for the whole group was 82%. Older children were more consistent than younger children. Girls were more consistent than boys. Words produced correctly in one trial and in error in another may indicate resolving error patterns. Words produced in error in two different ways provided useful evidence about the nature of inconsistent word production in typically developing children. The clinical and theoretical implications are discussed.
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Affiliation(s)
- Alison Holm
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Olivia van Reyk
- Speech and Language Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Sharon Crosbie
- School of Allied Health, Australian Catholic University, Brisbane, Queensland, Australia
| | - Simone De Bono
- Speech and Language Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Angela Morgan
- Speech and Language Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Audiology & Speech Pathology Department, University of Melbourne, Melbourne, Victoria, Australia
| | - Barbara Dodd
- Speech and Language Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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19
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Aleman RM, Martinez MG. Thematic Analysis of Coping Strategies Used by Parents of Children with Cleft Lip and Palate in El Salvador. Cleft Palate Craniofac J 2023; 60:336-343. [PMID: 34859701 DOI: 10.1177/10556656211062839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The aim of this study was to describe coping strategies used by parents of children with cleft palate with or without a cleft (CP ± L) during the early development of their children in El Salvador. DESIGN Qualitative interviews were completed with 16 parents of children born with CP ± L who were 6 months to 6 years old. Parents were questioned about their emotions and coping during eight time periods: prenatal, birth, social interaction before the first surgery, the beginning of surgeries, social interaction after the first surgery, early childhood education (ECE), speech-language therapy, and formal education. Thematic analysis (TA) was used to identify coping strategies as conceptualized by Lazarus and Folkman (1984). RESULTS Four major themes emerged: (a) experienced emotions related to diagnosis, (b) interpretations related to the birth of a child with a cleft, (c) seeking and experiencing cleft treatment, and (d) social interaction of the children. During prenatal and birth stages, parents used emotion-focused strategies. A few hours to a week after birth, they used problem-focused strategies, which led them in search of treatment. Some parents used avoidance strategies during periods of social interaction before surgery, ECE, and formal education. Socioeconomic challenges impacted access to speech-language therapy. Sociocultural factors, such as discrimination, religion, and folk beliefs, appeared to influence some of the coping strategies used by parents. CONCLUSIONS Problem-focused strategies appear to be helpful in seeking surgical treatments. The emotion-focused strategy of avoidance seemed to have adverse effects in minimizing opportunities for social interaction prior to surgery and early education.
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Affiliation(s)
- Ramon Manuel Aleman
- Evangelical University of El Salvador, Dr Juan Jose Fernandez National Hospital of El Salvador, Chief of Clinica Aleman: Cleft Lip and Palate Center, San Salvador, El Salvador
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20
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Hardin-Jones M, Chapman KL, Heimbaugh L, Dahill AE, Cummings C, Baylis A, Hatch Pollard S. Stop Consonant Production in Children with Cleft Palate After Palatoplasty. Cleft Palate Craniofac J 2023:10556656231159974. [PMID: 36814368 PMCID: PMC10442459 DOI: 10.1177/10556656231159974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
The current study examined stop consonant production in children with cleft lip and/or palate (CP ± L) 2-6 months following palatal surgery. Prospective comparative study. Multisite institutional. Participants included 113 children with repaired CP ± L (mean age = 16 months) who were participating in the multicenter CORNET study. Parents of participants were asked to record approximately two hours of their child's vocalizations/words at home using a Language ENvironmental Analysis (LENATM) recorder. Four ten-minute audio-recorded samples of vocalizations were extracted from the original recording for each participant and analyzed for presence of oral stop consonants. A minimum of 100 vocalizations were required for analysis. Preliminary findings indicate that at least one oral stop was evident in the consonant inventory for 95 of the 113 children (84%) at the time of their post-surgery 16-month recording, and 80 of these children (71%) were producing two or more different stops. Approximately 50% of the children (57/113) produced the three voiced stops, and eight of the children (7%) were producing all six stop consonants. The findings of this study suggest that the majority of children with repaired CP ± L from English-speaking homes are producing oral stops within six months following palatal surgery. Similar to same-age children without CL ± P, voiced stops were more frequently evident in the children's inventories than voiceless stops. In contrast to findings of previous reports suggesting place of articulation differences, a somewhat comparable percentage of children in this study produced voiced bilabial, alveolar, and velar stops.
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21
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Conover L, Bahr RH. Covert contrasts and categorical perception: a comparison of two measurement tools. Clin Linguist Phon 2023; 37:143-156. [PMID: 34982013 DOI: 10.1080/02699206.2021.2022212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
This study considers adults' perception of subtle differences in the error productions of /r/ and /l/ in young children. Given that these two phonemes share a common substitution [w], the potential covert contrast between these three sounds was investigated. The utility of two perceptual rating scales was compared: a linear visual analogue scale (VAS) and a triangular scale that considered the possibility of covert contrast among /r,l,w/. Adult listeners rated speech productions from children with cochlear implants (CIs) and speech age-matched children with normal hearing (NH) as they produced VCV or CV productions with /r,l,w/ in syllable-initial position. Mahalanobis distances of the listener ratings for each stimulus on each rating scale were calculated for analysis. Ultimately, there was no difference between the ratings of the two speaker populations. However, there was a significant difference in the amount of variability captured with each scale. The triangular scale reliably captured more variability in the productions than the linear VAS. The significant effect of scale type on the spread of listeners' responses provides support for the claim that the type of rating system used can capture different aspects of a listener's perceptions, thereby suggesting that the type of rating system used in a study may significantly influence that study's findings.
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Affiliation(s)
- Laura Conover
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida, USA
| | - Ruth Huntley Bahr
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida, USA
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22
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Kim YC, Oh SM, Park BR, Oh TS. Effect of Acellular Dermal Matrix on Long-Term Speech Outcomes in Primary Palatoplasty with Radical Intravelar Veloplasty. Cleft Palate Craniofac J 2023:10556656221149519. [PMID: 36635977 DOI: 10.1177/10556656221149519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE This study investigates whether the use of acellular dermal matrix (ADM) affects the long-term speech outcomes in patients undergoing primary palatoplasty with radical intravelar veloplasty. DESIGN Retrospective cohort study. SETTING Tertiary university-affiliated hospital. PARTICIPANTS A consecutive cohort of 112 patients who underwent primary palatoplasty with radical intravelar veloplasty from August 2014 to March 2018 were included. MAIN OUTCOME MEASURES A 2 × 2 cm-sized ADM was incorporated as an interpositional graft between the oral and nasal lining at the soft-hard palate junction. The perceptual analysis of hypernasality and articulation was performed when the age of the patient reached at least 36 months. Cleft-related characteristics and surgical factors affecting the speech outcomes were investigated. RESULTS The ADM was applied in 57 patients with a mean follow-up of45.76 months (SD, 10.69), while no ADM was used in 55 patients with a mean follow-up of 48.43 months (SD, 14.98). Regarding the hypernasality outcome, 33.3% (19 of 57 patients) of the ADM group and 27.3% (15 of 55 patients) of the control group showed a greater than mild-to-moderate degree. The distribution of hypernasality and articulation grade showed no significant difference between the two groups. After controlling for potential risk factors that may affect the speech outcomes, the use of ADM showed no significant relationship with velopharyngeal insufficiency. CONCLUSION The use of ADM use in primary palatoplasty with radical intravelar veloplasty is not associated with the alteration of speech function in early childhood.
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Affiliation(s)
- Young Chul Kim
- Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, 65526Asan Medical Center, Seoul, Korea
| | - So Min Oh
- Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, 65526Asan Medical Center, Seoul, Korea
| | - Bo Ra Park
- Department of Rehabilitation Medicine, 65526Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Suk Oh
- Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, 65526Asan Medical Center, Seoul, Korea
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23
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Maina G, Pollock D, Lockwood C, Cook L, Ooi E. Managing Chronic otitis media with Effusion in Children with non-Syndromic Cleft Palate: Short-Term Ventilation Tubes Versus Surveillance. Cleft Palate Craniofac J 2023:10556656221148368. [PMID: 36600676 DOI: 10.1177/10556656221148368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To compare the effectiveness of short-term ventilation tubes compared to surveillance on conductive hearing loss in children with non-syndromic orofacial clefting involving the muscular palate. INTRODUCTION Chronic otitis media with effusion is a common finding in children with cleft palate. The accepted convention is insertion of short-term ventilation tubes at the time of palate repair, but some centres are choosing conservative management. Each approach has its advantages but there is currently no consensus on the most appropriate management in children with non-syndromic cleft palate. INCLUSION CRITERIA Children <18 years with cleft lip and palate, or isolated cleft palate, not associated with a genetic syndrome, who have been diagnosed with chronic otitis media with effusion. METHODS A systematic search of MEDLINE, CINAHL, Embase and Scopus databases was conducted. Grey literature searches were conducted through Central Register of Controlled Trials, Clinicaltrials.gov and ProQuest. Two reviewers screened the studies, conducted critical appraisal, assessed the methodological quality, and extracted the data. Where possible, studies were pooled in statistical meta-analysis with heterogeneity being assessed using the standard Chi-squared and I2 tests. RESULTS Four studies met the inclusion criteria but were of low quality with a moderate risk of bias. Only data on hearing thresholds could be pooled for analysis which found no statistically significant difference. Other outcomes were presented in narrative form. Certainty of evidence for all outcomes was deemed low to very low using GRADE criteria. CONCLUSIONS No definitive conclusions can be drawn regarding most effective management at improving conductive hearing loss. Missing data and inconsistent reporting of outcomes limited capacity for pooled analysis.
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Affiliation(s)
- Grace Maina
- JBI, Faculty of Health and Medical Sciences, 1066The University of Adelaide, Adelaide, Australia
- Department of Otolaryngology and Head and Neck Surgery, 14351Flinders Medical Centre, Adelaide, Australia
| | - Danielle Pollock
- JBI, Faculty of Health and Medical Sciences, 1066The University of Adelaide, Adelaide, Australia
| | - Craig Lockwood
- JBI, Faculty of Health and Medical Sciences, 1066The University of Adelaide, Adelaide, Australia
| | - Lachlan Cook
- JBI, Faculty of Health and Medical Sciences, 1066The University of Adelaide, Adelaide, Australia
- Department of Otolaryngology and Head and Neck Surgery, 14351Flinders Medical Centre, Adelaide, Australia
| | - Eng Ooi
- Department of Otolaryngology and Head and Neck Surgery, 14351Flinders Medical Centre, Adelaide, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
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Slana N, Hočevar-Boltežar I, Kornhauser-Cerar L. Risk Factors for Feeding and Swallowing Disorders in Very Low Birth Weight Infants in Their Second Year of Life. Medicina (Kaunas) 2022; 58:1536. [PMID: 36363492 PMCID: PMC9697318 DOI: 10.3390/medicina58111536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/09/2022] [Accepted: 10/24/2022] [Indexed: 10/07/2023]
Abstract
Background and Objectives: This study aimed to identify the prevalence of feeding and swallowing disorders (FSD) in very low birth weight (VLBW, 1500 g or less) infants in the first two years after discharge from the maternity hospital, their possible risk factors, and the consequences of them. Materials and Methods: A total of 117 preterm children with VLBW born between 2013 and 2015 were included. The data concerning possible FSD after discharge from the hospital were obtained through accessible medical documentation for the child and a short parental questionnaire. Results: FSD was reported in 32 (27.4%) infants following discharge from the hospital but in only five children (4.3%) at a mean age of four years. Four variables (birth gestational age less than 28 weeks, birth weight equal to or less than 1000 g, birth length below 33 cm, and start of oral feeding after the 34th gestational week) were identified as risk factors for FSD after discharge. However, only birth length remained a significant predictor after being included in a binary logistic regression model (p = 0.000). Abnormal oral sensitivity and a decrease in weight to under the 10th percentile were significantly more common in the FSD group at follow-up visits at the age of about 2 years. Conclusions: FSD was still present in more than one-quarter of VLBW infants after discharge from the maternity hospital but mostly disappeared within four years. A birth gestational age under 28 weeks, weight up to 1000 g, the late beginning of per oral feeding, and a birth length below 33 cm were determined to be significant predictive factors for FSD. Having a birth length below 33 cm was associated with an almost 6.5-fold increase in the odds of having persistent FSD after discharge from the hospital. FSD in the first years of life may have an impact on the child's further growth and development.
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Affiliation(s)
- Nuša Slana
- Department for (Re)Habilitation of Children, University Rehabilitation Institute Republic of Slovenia Soča, SI-1000 Ljubljana, Slovenia
- Department of Special Education and Rehabilitation, Faculty of Education, University of Ljubljana, SI-1000 Ljubljana, Slovenia
| | - Irena Hočevar-Boltežar
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana, SI-1525 Ljubljana, Slovenia
- Department of Otorhinolaryngology and Cervicofacial Surgery, Faculty of Medicine, University of Ljubljana, SI-1000 Ljubljana, Slovenia
| | - Lilijana Kornhauser-Cerar
- Neonatal Intensive Care Unit, Department for Obstetrics and Gynaecology, Division for Perinatology, University Medical Center Ljubljana, SI-1525 Ljubljana, Slovenia
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25
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Michon M, Zamorano-Abramson J, Aboitiz F. Faces and Voices Processing in Human and Primate Brains: Rhythmic and Multimodal Mechanisms Underlying the Evolution and Development of Speech. Front Psychol 2022; 13:829083. [PMID: 35432052 PMCID: PMC9007199 DOI: 10.3389/fpsyg.2022.829083] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Abstract
While influential works since the 1970s have widely assumed that imitation is an innate skill in both human and non-human primate neonates, recent empirical studies and meta-analyses have challenged this view, indicating other forms of reward-based learning as relevant factors in the development of social behavior. The visual input translation into matching motor output that underlies imitation abilities instead seems to develop along with social interactions and sensorimotor experience during infancy and childhood. Recently, a new visual stream has been identified in both human and non-human primate brains, updating the dual visual stream model. This third pathway is thought to be specialized for dynamics aspects of social perceptions such as eye-gaze, facial expression and crucially for audio-visual integration of speech. Here, we review empirical studies addressing an understudied but crucial aspect of speech and communication, namely the processing of visual orofacial cues (i.e., the perception of a speaker's lips and tongue movements) and its integration with vocal auditory cues. Along this review, we offer new insights from our understanding of speech as the product of evolution and development of a rhythmic and multimodal organization of sensorimotor brain networks, supporting volitional motor control of the upper vocal tract and audio-visual voices-faces integration.
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Affiliation(s)
- Maëva Michon
- Laboratory for Cognitive and Evolutionary Neuroscience, Department of Psychiatry, Faculty of Medicine, Interdisciplinary Center for Neuroscience, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Estudios en Neurociencia Humana y Neuropsicología, Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - José Zamorano-Abramson
- Centro de Investigación en Complejidad Social, Facultad de Gobierno, Universidad del Desarrollo, Santiago, Chile
| | - Francisco Aboitiz
- Laboratory for Cognitive and Evolutionary Neuroscience, Department of Psychiatry, Faculty of Medicine, Interdisciplinary Center for Neuroscience, Pontificia Universidad Católica de Chile, Santiago, Chile
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王 影, 耿 曼, 张 慧, 平 凯. [Effects of cytomegalovirus infection on infants' hearing and speech development]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 36:163-166. [PMID: 35193334 PMCID: PMC10128301 DOI: 10.13201/j.issn.2096-7993.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Indexed: 06/14/2023]
Abstract
Objective:To investigate the effects of cytomegalovirus(CMV) infection on infants' hearing and speech development. Methods:A total of 192 infants with cytomegalovirus infection were selected as research objects(CMV group). Among 320 normal infants who received physical examinations in the Second Affiliated Hospital of Zhengzhou University during the same period were selected as the control group. Using transiently evoked otoacoustic emission to conduct initial hearing screening. Jointing automatic auditory brainstem response screening method to follow up for infants infected with cytomegalovirus. Those who failed to pass the screening were diagnosed with auditory brainstem response and acoustic immittance examination. The two groups of infants were evaluated for follow-up at the age of 12, 24, 36 months using the Gesell Development scale. Results:Hearing screening(initial hearing screening and 42 d hearing re-screening): CMV group retrospectively failed rates 28.65%(55/192), 31.77%(61/192), normal control group retrospectively failed rates 9.06%(29/320), 4.06%(13/320), the results of the two groups' hearing screening showed statistically significant differences(P<0.05). 48 cases of diagnostic ABR were abnormal in CMV group in 3 month's hearing diagnosis, including 11 cases of secretory otitis media, 37 cases of sensorineural hearing loss. Follow-up for 36 months, 192 infants with CMV infection were confirmed congenital SNHL 37 cases(19.27%), 21 cases of delayed SNHL(10.94%), a total of diagnosis with SNHL 58 cases(30.21%). The development quotient(DQ) of CMV group were respectively 92.05±4.68, 86.53±4.46, 85.92±4.82 in 12, 24, 36 months, and the DQ value of the normal control group were respectively 93.10±4.56, 94.35±4.52, 95.03±4.16. At the age of 24, 36 months, the DQ value of two groups' differences were statistically significant(P<0.05). Conclusion:CMV infection is hearing loss' risk factors. It had the characteristics of volatility, delay and progressive decline. Follow-up should be strengthened for hearing and speech development.
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Affiliation(s)
- 影 王
- 郑州大学第二附属医院耳鼻咽喉头颈外科(郑州,450014)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450014, China
| | - 曼英 耿
- 郑州大学第二附属医院耳鼻咽喉头颈外科(郑州,450014)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450014, China
| | - 慧 张
- 郑州大学第二附属医院耳鼻咽喉头颈外科(郑州,450014)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450014, China
| | - 凯歌 平
- 新乡市中心医院重症监护室ICU, Xinxiang Central Hospital
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Ceron MI, Simoni SND, Keske-Soares M. Phonological acquisition of Brazilian Portuguese: Ages of customary production, acquisition and mastery. Int J Lang Commun Disord 2022; 57:274-287. [PMID: 34957652 DOI: 10.1111/1460-6984.12689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 10/15/2021] [Accepted: 10/21/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND AIMS: To describe typical phonological development of Brazilian Portuguese (BP)-speaking children, considering the following parameters: age of customary production, acquisition and mastery. METHODS & PROCEDURES Data were collected from 857 children aged between 3 years and 8 years 11 months with typical language and speech development. The sample was grouped into 6-month age bands. The data were analysed using one-way analysis of variance (ANOVA) followed by Games-Howell post-hoc tests. OUTCOMES & RESULTS Stops (/p, b, t, d, k, g/), nasals (/m, n, ɲ/) and some fricatives (/f, v, s, z/) were mastered before the age of 3 years (age of mastery). The age of acquisition for phonemes /ʃ, ʒ/ was 3;6, though both were only mastered at 4;0 years. The liquid /l/ was acquired at 3;0 and mastered at age 3;6, while /x/ was acquired and mastered at age 3;6. The phoneme /ʎ/ was acquired at 7;0 and mastered at age 8;6. The tap /ɾ/ was acquired between the ages of 4;0 and 4;6, and mastered at 4;6. In coda position, /n, l/ were acquired at 3;0, while /s/ was mastered at 4;6 and /ɾ/ between 4;6 and 5;0 years. Clusters involving /ɾ/ were acquired at 6;0, while those with /l/ were acquired between the ages of 6;6 and 7;0. CONCLUSIONS & IMPLICATIONS This study presented acquisition for consonants in BP and can be used as a reference for the assessment of developmental speech disorders. In this study, stops and nasals were acquired first, followed by fricatives and, lastly, liquids. This finding is corroborated by previous studies in BP and other languages. WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work?
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Affiliation(s)
- Marizete Ilha Ceron
- Human Communication Disorders, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
- Family Health Support Center of Santa Cruz do Sul, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Simone Nicolini De Simoni
- Human COMMUNICATION Disorders, UFSM, Santa Maria, Rio Grande do Sul, Brazil
- Health House Hospital, Santa Maria, Rio Grande do Sul, Brazil
| | - Márcia Keske-Soares
- Applied Linguistics, Catholica Pontifical University of Rio Grande do Sul
- Speech-Language Hearing Department, UFSM, Santa Maria, Rio Grande do Sul, Brazil
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Alolama FM, Mohammad HM, Alhmid IH, Alhammadi HM. Designing and validating the Dubai Tool for Developmental Screening (DTDS). Front Pediatr 2022; 10:924017. [PMID: 36071880 PMCID: PMC9441853 DOI: 10.3389/fped.2022.924017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Early detection of developmental problems is vital for facilitating early access to targeted intervention and augmenting its beneficial outcomes. Standardized developmental screening tools are known to enhance detection rates of developmental problems compared to clinical judgment alone and are widely recommended to be used in infants and young children. Most of the available developmental screening tools have been developed in Western countries. Many of their items may not be suitable for other cultures while others are expensive. Currently, none of the developmental screening tools have been validated in the United Arab Emirates (UAE), with only a few available in the Arabic language. OBJECTIVE To create and validate a developmental screening tool, in both English and Arabic, that is simple, quick to use, and culturally relevant to the United Arab Emirates (UAE) child population aged 9-48 months. METHODS The available literature was used to create a list of developmental milestones in five domains for children aged 9-48 months, divided into seven age groups. The selected milestones were used to create questionnaires in both English and Arabic, which were pilot tested twice. Each time, the results were analyzed and used to select, modify, and rephrase questions. Validation of the Dubai Tool for Developmental Screening (DTDS) was done against Parents' Evaluation of Developmental Status (PEDS) as a gold standard instrument. The DTDS and PEDS were administered cross-sectionally to parents of 1,400 children in seven age groups. Sensitivity, specificity, and kappa agreement of the DTDS compared with PEDS were calculated. RESULTS The DTDS had a sensitivity of 100% in four age groups and 75-78% in the other three age groups. Specificity ranged from 96 to 99% across all age groups. The kappa measure showed substantial agreement in five age groups, a moderate agreement in one age group, and a fair agreement in one age group. CONCLUSIONS The DTDS is a valid screening tool for early identification of developmental delays and disabilities in early childhood.
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Affiliation(s)
- Fatma Mohammad Alolama
- Child Health Section, Specialized Programs Services Department, Primary Health Care Sector, Dubai Health Authority, Dubai, United Arab Emirates
| | - Haitham Mahmoud Mohammad
- Child Health Section, Specialized Programs Services Department, Primary Health Care Sector, Dubai Health Authority, Dubai, United Arab Emirates
| | - Idris Helal Alhmid
- Child Health Section, Specialized Programs Services Department, Primary Health Care Sector, Dubai Health Authority, Dubai, United Arab Emirates
| | - Hanan Mohammed Alhammadi
- Medical Affairs Department, Primary Health Care Sector, Dubai Health Authority, Dubai, United Arab Emirates
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29
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Asikainen M, Kylliäinen A, Mäkelä TE, Saarenpää‐Heikkilä O, Paavonen EJ. Exposure to electronic media was negatively associated with speech and language development at 18 and 24 months. Acta Paediatr 2021; 110:3046-3053. [PMID: 34227158 DOI: 10.1111/apa.16021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/04/2021] [Accepted: 07/05/2021] [Indexed: 11/28/2022]
Abstract
AIM This study evaluated early speech and language development at 18 and 24 months, and associated factors, based on parental reports. METHOD We followed up the CHILD-SLEEP birth cohort of 1667 Finnish-speaking families, who were randomly recruited in 2011-2013 during routine visits to maternity clinics in the Pirkanmaa Hospital District of Finland. The women were approximately 32 weeks' pregnant at enrolment. Parents reported the size of their child's expressive vocabulary, word combinations, intelligibility, finger-pointing and adherence to instructions. A subsample was studied using the Expressive Language subscale of the Bayley Scales of Infant and Toddler Development, Third Edition. RESULTS The children's vocabulary was smaller than previously reported. At 18 months of age, 68.8% of the 997 children had a vocabulary of 20 words or less and 35.7% used about five words at most. At 24 months, 32.4% of the 822 children had a vocabulary of 50 words or less and 18.4% used about 20 words at most. Longer child and parental exposure to electronic media was negatively associated with the size of the child's expressive vocabulary. CONCLUSION Vocabulary size at 18 and 24 months was smaller than previously reported and negatively associated with exposure to electronic media.
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Affiliation(s)
- Marja Asikainen
- Department of Phoniatrics Tampere University Hospital Tampere Finland
| | - Anneli Kylliäinen
- Psychology, Faculty of Social Sciences Tampere University Tampere Finland
| | - Tiina E. Mäkelä
- Psychology, Faculty of Social Sciences Tampere University Tampere Finland
| | - Outi Saarenpää‐Heikkilä
- Faculty of Medicine and Life Sciences Tampere University Tampere Finland
- Department of Pediatrics Tampere University Hospital Tampere Finland
| | - E. Juulia Paavonen
- Public Health and Welfare Finnish Institute for Health and Welfare Helsinki Finland
- Pediatric Research Center Child Psychiatry University of Helsinki and Helsinki University Hospital Helsinki Finland
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Morrison MM, Mason NT, Forde BL, Stone PR, Fowler PV, Thompson JMD. Speech Outcomes of a National Cohort of Children with Orofacial Cleft at 5 and 10 Years of age. Cleft Palate Craniofac J 2021; 59:1400-1412. [PMID: 34672811 DOI: 10.1177/10556656211044939] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess speech outcomes at five and ten years of age in a nationwide study of children with orofacial cleft. DESIGN Prospective study. PARTICIPANTS Children born with orofacial cleft and having primary surgery in New Zealand. Speech samples were available for 151 five-year-old, and 163 ten-year-old children. MAIN OUTCOME MEASURES Intelligibility, Acceptability, Velopharyngeal function, Hypernasality, Hyponasality, severity of airflow evaluated by perceptual speech assessment (using the standardised Rhinocleft assessment), and overall assessment of requirement for clinical intervention. RESULTS A large proportion of five-year-old children had speech that was considered to be not completely intelligible, was not acceptable, and had inadequate velopharyngeal function. The noted deficiencies led to a clinical judgement that further speech and/or surgical intervention was required in 85% with cleft lip and palate, 65% with cleft palate and 26% with cleft lip. The proportion of children with poor speech outcomes in the ten-year-old children was lower, though of clinical importance, further intervention required for 25% with CLP, 15% with CP and 3% with CL. The number of sound production errors in both age groups followed the same pattern with fewest in those with CL and most in those with CLP. CONCLUSIONS A significant proportion of children with orofacial cleft were found to have poor speech outcomes requiring further treatment. The outcomes are poor compared to centres reported in the UK and Scandinavia. New Zealand requires a review of the current services for individuals born with cleft to improve speech outcomes and interdisciplinary care.
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Affiliation(s)
- Maeve M Morrison
- Department of Allied Health, 1400Middlemore Hospital, Counties Manukau District Health Board.,Department of Plastics, 1400Middlemore Hospital, Counties Manukau District Health Board
| | - Nicola T Mason
- Speech Language Therapy, 67587Christchurch Hospital, Canterbury District Health Board
| | - Bryony L Forde
- Speech Language Therapy, 161292Hutt Valley Hospital, Hutt Valley District Health Board
| | - Peter R Stone
- Department of Obstetrics and Gynaecology, 1415University of Auckland, Auckland, New Zealand
| | | | - John M D Thompson
- Department of Obstetrics and Gynaecology, 1415University of Auckland, Auckland, New Zealand.,Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
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van Haaften L, Diepeveen S, Terband H, De Swart B, Van Den Engel-Hoek L, Maassen B. Maximum repetition rate in a large cross-sectional sample of typically developing Dutch-speaking children. Int J Speech Lang Pathol 2021; 23:508-518. [PMID: 33605173 DOI: 10.1080/17549507.2020.1865458] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose: The current study aims to provide normative data for the maximum repetition rate (MRR) development of Dutch-speaking children based on a large cross-sectional study using a standardised protocol.Method: A group of 1014 typically developing children aged 3;0 to 6;11 years performed the MRR task of the Computer Articulation Instrument (CAI). The number of syllables per second was calculated for mono-, bi-, and trisyllabic sequences (MRR-pa, MRR-ta, MRR-ka, MRR-pata, MRR-taka, MRR-pataka). A two-way mixed ANOVA was conducted to compare the effects of age and gender on MRR scores in different MRR sequences.Result: The data analysis showed that overall MRR scores were affected by age group, gender and MRR sequence. For all MRR sequences the MRR increased significantly with age. MRR-pa was the fastest sequence, followed by respectively MRR-ta, MRR-pata, MRR-taka, MRR-ka and MRR-pataka. Overall MRR scores were higher for boys than for girls, for all MRR sequences.Conclusion: This study presents normative data of MRR of Dutch-speaking children aged 3;0 to 6;11 years. These norms might be useful in clinical practice to differentiate children with speech sound disorders from typically developing children. More research on this topic is necessary. It is also suggested to collect normative data for other individual languages, using the same protocol.
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Affiliation(s)
- Leenke van Haaften
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Department of Rehabilitation, Nijmegen, The Netherlands
| | - Sanne Diepeveen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Department of Rehabilitation, Nijmegen, The Netherlands
- HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Hayo Terband
- Utrecht Institute of Linguistics-OTS, Utrecht University, Utrecht, The Netherlands, and
| | - Bert De Swart
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Department of Rehabilitation, Nijmegen, The Netherlands
- HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Lenie Van Den Engel-Hoek
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Department of Rehabilitation, Nijmegen, The Netherlands
| | - Ben Maassen
- Centre for Language and Cognition, Groningen University, Groningen, The Netherlands
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Strutt C, Khattab G, Willoughby J. Does the duration and frequency of dummy (pacifier) use affect the development of speech? Int J Lang Commun Disord 2021; 56:512-527. [PMID: 33939239 DOI: 10.1111/1460-6984.12605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/19/2020] [Accepted: 12/31/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The current literature suggests a link between dummy (or pacifier) use and a number of both positive and detrimental consequences. Positive consequences include soothing effect and protection from sudden infant death syndrome (SIDS), while negative ones include increased risk of otitis media and dental malformation. However, there is little research surrounding the impact of dummy use on the development of speech sounds. AIMS To investigate whether duration (in number of months) and frequency per day of dummy use have an individual or combined effect on the development of a child's speech, and if so, in what way. METHODS & PROCEDURES A total of 100 British-English children aged 24-61 months and growing up in the UK were recruited through nurseries, playgroups and by word of mouth. Their parents were asked to complete a questionnaire about the duration and frequency of dummy use and factors known to influence the development of speech. Following this, the children's speech was assessed using the phonology section of the Diagnostic Evaluation of Articulation and Phonology (DEAP). Analysis of the DEAP was conducted to determine the percentage of consonants correct, number of age-appropriate, delayed and atypical errors. Dummy use and speech outcome measures were then analysed qualitatively and quantitatively using mean and median group comparisons alongside multivariate generalized least squares and generalized negative binomial modelling approaches to test for significant associations. OUTCOMES & RESULTS The results showed that the majority of speech outcomes are not significantly associated with dummy use, however measured, in bivariate or multivariate analyses. However, there is a significant association between increased atypical errors and greater frequency of daytime dummy use. This association is strengthened by restricted sampling within the younger members of the sample, with this association not observable within children older than 38 months, the median sample age. CONCLUSIONS & IMPLICATIONS The evidence base for any effects of dummy use on speech is very small. Dummy use may increase the number of atypical speech errors a young child makes. However, only the frequency of daytime use seems relevant, not the duration or night-time use, and these errors may resolve over time. What this paper adds What is already known on this subject The use of a dummy with infants in Western countries is comparatively high (between 36-85%). A number of positive and detrimental consequences of dummy use have been documented in the literature; however, research on the effect of dummy use on speech development is significantly lacking. Past studies have included small sample sizes or used single measures of speech outcomes, which may not be specific enough to reveal how speech may be affected. Many speech and language therapists speculate that the use of a dummy could be contributing to many of the conditions they treat, yet this claim remains largely unsubstantiated. Clinical implications of this study The study suggests that only prolonged use of a dummy over several hours and during the day may start to show any impact on speech; even then, professionals need to be aware that the evidence base for any speech effects is very small. Clinicians and other professionals who parents consult on dummy use should make sure to provide both the pros and cons of dummy use, in order to enable parents to make an informed decision.
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Affiliation(s)
- Charlie Strutt
- Speech and Language Sciences Section, School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ghada Khattab
- Speech and Language Sciences Section, School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Joe Willoughby
- Speech and Language Sciences Section, School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
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Menn L, Peters AM, Rose Y. The Menn Phonetic Mini-Corpus: Articulatory Gestures as Precursors to the Emergence of Segments. Front Psychol 2021; 12:646090. [PMID: 33995202 PMCID: PMC8113676 DOI: 10.3389/fpsyg.2021.646090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 02/25/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Lise Menn
- Institute for Cognitive Science and Linguistics Department, University of Colorado, Boulder, CO, United States
| | - Ann M. Peters
- Linguistics Department, University of Hawaii, Manoa, HI, United States
| | - Yvan Rose
- Department of Linguistics, Memorial University of Newfoundland, St. John's, NL, Canada
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Abstract
Much research in child speech development suggests that young children coarticulate more than adults. There are multiple, not mutually-exclusive, explanations for this pattern. For example, children may coarticulate more because they are limited by immature motor control. Or they may coarticulate more if they initially represent phonological segments in larger, more holistic units such as syllables or feet. We tested the importance of several different explanations for coarticulation in child speech by evaluating how four-year-olds' language experience, speech practice, and speech planning predicted their coarticulation between adjacent segments in real words and paired nonwords. Children with larger vocabularies coarticulated less, especially in real words, though there were no reliable coarticulatory differences between real words and nonwords after controlling for word duration. Children who vocalized more throughout a daylong audio recording also coarticulated less. Quantity of child vocalizations was more predictive of the degree of children's coarticulation than a measure of receptive language experience, adult word count. Overall, these results suggest strong roles for children's phonological representations and speech practice, as well as their immature fine motor control, for coarticulatory development.
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Affiliation(s)
- Margaret Cychosz
- Department of Hearing and Speech Sciences, University of Maryland, College Park
- Center for Comparative and Evolutionary Biology of Hearing, University of Maryland, College Park
| | - Benjamin Munson
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Twin Cities
| | - Jan R. Edwards
- Department of Hearing and Speech Sciences, University of Maryland, College Park
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Meyer MK, Munson B. Clinical experience and categorical perception of children's speech. Int J Lang Commun Disord 2021; 56:374-388. [PMID: 33599080 DOI: 10.1111/1460-6984.12610] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Accurate and detailed records of children's speech are a critical component of competent service delivery in speech-language pathology/speech and language therapy (SLP/SLT). Previous research has shown that during speech-sound acquisition, children gradually learn to produce sounds in adult-like manners. Continuous rating scales are a way to track this gradual learning. AIMS To examine whether clinical experience affects the ability and willingness to rate children's speech production using continuous rating scales. METHODS & PROCEDURES An online survey was administered to 81 US-based SLPs/SLTs, binned into more- and less-experienced groups, and 20 non-SLPs/SLTs. The survey included a speech-sound rating task in which participants rated the production of place of articulation in children's productions of word-initial /θ/, /s/, /ʃ/, /d/, /ɡ/, /t/ and /k/ on a nine-point equally appearing interval scale. We examined the extent to which these were accurate (i.e., the extent to which they matched laboratory measures of production characteristics) and the extent to which the ratings were gradual (i.e., they used the entire rating scales, rather than just the endpoints). MAIN CONTRIBUTION There were no consistent differences between non-SLPs/SLTs, less-experienced SLPs/SLTs and more-experienced SLPs/SLTs in a measure of the accuracy of responses. More consistent differences were found in the extent to which listeners used the endpoints of the scale: greater experience was associated with greater use of the endpoint values. CONCLUSIONS & IMPLICATIONS More-experienced SLPs/SLTs are less likely to use the entire range of continuous rating scales to rate children's speech accuracy than less-experienced SLPs/SLTs or clinically untrained listeners. Implications for service delivery are discussed. What this paper adds What is already known on the subject Children's productions of individual sounds, like /k/, become gradually more adult-like over the course of development. For a child who has a [t] for /k/ error, this gradual development means that children's productions become progressively less like /t/ and more like /k/ over development. Phonetic transcription does not capture this gradual development. In contrast, studies have shown that continuous ratings of children's speech (such as rating productions on a scale anchored by the text "the 't' sound" at one end and "the 'k' sound" at the other end) can capture this gradual development. What this paper adds to existing knowledge To determine continuous ratings are clinically feasible, we must first determine whether clinical experience affects people's use of continuous rating scales to rate children's speech. We conducted an on-line speech perception experiment in which 81 speech-language pathologists/speech and language therapists (SLPs/SLTs) and 20 non-SLPs/SLTs rated 60 productions by children on continuous rating scales. The 60 stimuli included many sounds that had been independently verified to be intermediate productions (i.e., a target /k/ that was neither completely /k/-like nor completely /t/-like). Non-SLPs/SLTs and less-experienced SLPs/SLTs rated those intermediate sounds with intermediate ratings (i.e., somewhere on the midpoint of a continuous scale). In contrast, more-experienced SLPs/SLTs were more likely to rate those sounds as instances of endpoints (i.e., as either /k/ or /t/). What are the potential or actual clinical implications of this work? This finding suggests that clinical experience is paradoxically associated with a reduced tendency to use the entire range of responses on continuous rating scales. This finding suggests that we must better understand the cause of this reduced tendency, so that clinicians at all levels can use continuous rating scales equally effectively.
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Affiliation(s)
- Marie K Meyer
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Twin Cities, MN, USA
| | - Benjamin Munson
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Twin Cities, MN, USA
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Aragón N, Díaz C, Contreras A. Dental, Occlusal, and Craniofacial Features of Children With Microcephaly Due to Congenital Zika Infection: 3 Cases Report From Valle del Cauca, Cali-Colombia-2020. Cleft Palate Craniofac J 2021; 58:1318-1325. [PMID: 33563005 DOI: 10.1177/1055665621990978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Describes dental, occlusal, and craniofacial characteristics of 3 children aged 3 to 4 years with microcephaly due to congenital Zika infection in Cali Valle del Cauca, 2020. DESIGN Three children case report with congenital Zika virus microcephaly. SETTING Institutional. PATIENTS Three children with maternal viral infection confirmed by polymerase chain reaction during first trimester of pregnancy were included and were born from 2016 to 2017. INTERVENTIONS Oral and mouth functional examination was performed including soft tissue examination; lingual and labial frenulum; evaluation of swallowing and chewing; craniofacial analysis; dimension of dental arch; intercanine and intermolar distance, palate form; relationship and growth of maxilla, mandible, and facial dental midline using plaster models; and complementary image analysis. MAIN OUTCOME MEASURES Child and mother sociodemographic features, craniofacial measurements; dental and oral features; maxillary and mandibular measures; and speech, swallowing, and chewing disorders. RESULTS Small head circumference at birth and at the time of clinical evaluation was compared to normal children of approximately their age. Upper third of the face was short, and presence of hypertonic masticatory muscles with hypotonic swallowing muscles, dysphagia, dyslalia, bruxism, lip incompetence, tongue interposition, and hypersalivation and epilepsy were the main medical problem. They have complete primary dentition with normal dental morphology, tooth eruption altered, dental caries, and dental malocclusion was identified. CONCLUSION There are no changes in the dental formula and dental morphology in the deciduous dentition. They present severe chewing and speaking limitation, facial disproportion, and occlusal problems that warrant dental and medical attention.
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Affiliation(s)
- Natalia Aragón
- Dentistry School, Universidad del Valle, Cali, Colombia.,Group Periodontal Medicine, Universidad del Valle, Cali, Colombia
| | - Catalina Díaz
- Dentistry School, Universidad del Valle, Cali, Colombia
| | - Adolfo Contreras
- Dentistry School, Universidad del Valle, Cali, Colombia.,Group Periodontal Medicine, Universidad del Valle, Cali, Colombia
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Meara JG, Hughes CD, Sanchez K, Catallozzi L, Clark R, Kummer AW. Optimal Outcomes Reporting (OOR): A New Value-Based Metric for Outcome Reporting Following Cleft Palate Repair. Cleft Palate Craniofac J 2021; 58:19-24. [PMID: 32551851 PMCID: PMC7739115 DOI: 10.1177/1055665620931708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Palatoplasty outcome measurements vary widely among institutions. A standardized outcome metric would help provide quality benchmarks. DESIGN Retrospective review of primary palatoplasty patients from 2007 to 2013. SETTING Tertiary care children's hospital. MAIN OUTCOME MEASURES We created a novel conceptual quality metric called "OOR" (Optimal Outcome Reporting). Optimal Outcome Reporting is designed to reflect the percentage of patients with cleft palate who experience the best outcomes: one operation, velar competence by age 5 years, and no unintended palatal fistula. RESULTS Optimal Outcome Reporting was 72.3% (68/94). Eight patients had "suboptimal" outcomes for having undergone more than one operation. Eighteen patients failed for velar incompetence. No additional patients fell out of the algorithm for fistula. A significantly higher proportion of nonsyndromic patients demonstrated an "optimal" result compared to syndromic patients (61/80, 76.3% vs 7/14, 50.0%; P = .04). Patients who required more than one procedure had significantly more clinic visits (32.6 vs 14.9; P < .01) and accrued higher costs compared to "optimal" patients (US$34 019.88 vs US$15 357.25; P < .01). CONCLUSIONS Optimal Outcome Reporting represents a novel quality metric that can provide meaningful information for patients with cleft palate. Optimal Outcome Reporting utilization can help cleft centers adopt changes that matter to patients and their families. By allowing for cross-institutional comparisons in a clear and objective manner, OOR can promote competition, innovation, and value in cleft palate care.
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Affiliation(s)
- John G. Meara
- Department of Plastic and Oral Surgery, Boston Children’s Hospital, Boston, MA, USA
| | | | - Karl Sanchez
- Department of Plastic and Oral Surgery, Boston Children’s Hospital, Boston, MA, USA
| | - Liza Catallozzi
- Department of Otolaryngology and Communication Enhancement, Boston Children’s Hospital, Boston, MA, USA
| | - Roseanne Clark
- Department of Otolaryngology and Communication Enhancement, Boston Children’s Hospital, Boston, MA, USA
| | - Ann W. Kummer
- Division of Speech-Language Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Lohmander A, Westberg LR, Olsson S, Tengroth BI, Flynn T. Canonical Babbling and Early Consonant Development Related to Hearing in Children With Otitis Media With Effusion With or Without Cleft Palate. Cleft Palate Craniofac J 2020; 58:894-905. [PMID: 33084358 DOI: 10.1177/1055665620966198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate and compare babbling, early consonant production and proficiency from 10 to 36 months of age and its relationship with hearing in children with otitis media with effusion (OME) with or without cleft palate. DESIGN Prospective, longitudinal group comparison study. SETTING University hospital. PARTICIPANTS Fifteen children born with nonsyndromic cleft palate with or without cleft lip (CP±L) and 15 age-matched children with hearing loss (HL) associated with OME but without cleft palate (noncleft group). MAIN OUTCOME MEASURES Canonical babbling (CB) and early consonant variables (presence of oral stops, anterior stops, dental/alveolar stops, number of different true consonants) at 10 and 18 months, and percentage of consonants correct proficiency (PCC) at 36 months. RESULTS A total of 54% of the CP±L group and 77% of the noncleft group had CB. The noncleft group had a significantly higher prevalence of all consonant variables. Percentage of consonants correct was 61.9% in the CP±L group and 81.6% in the noncleft group. All early consonant variables except CB were significantly related to PCC. Hearing sensitivity at 18 and 30 months correlated with PCC and explained 40% of the variation. CONCLUSIONS Mild HL impacted presence of CB at 10 months and was related to consonant proficiency at 36 months in children with HL associated with OME and children with cleft palate. The noncleft group showed results at 36 months similar to children with normal hearing; however, the CP±L group did not. Although the cleft palate may have a bigger impact on the speech development, management of hearing sensitivity would also be beneficial.
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Affiliation(s)
- Anette Lohmander
- Division, Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, 59562Karolinska Institutet, Stockholm, Sweden.,Medical Unit of Speech and Language Pathology and Stockholm Craniofacial Team, 59562Karolinska University Hospital, Stockholm, Sweden
| | - Liisi Raud Westberg
- Medical Unit of Speech and Language Pathology and Stockholm Craniofacial Team, 59562Karolinska University Hospital, Stockholm, Sweden
| | - Sofia Olsson
- Division of Speech and Language Pathology, 72250Södertälje Hospital, Södertälje, Sweden
| | | | - Traci Flynn
- School of Humanities and Social Sciences, Faculty of Education and Arts, 5982University of Newcastle, Newcastle, Australia
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Torrecillas V, Pollard SH, McCrary H, Taylor HM, Palmer A, Meier J, Muntz H, Skirko JR. Management of Velopharyngeal Insufficiency in Cleft Patients With and Without Multidisciplinary Team Care. Cleft Palate Craniofac J 2020; 58:479-488. [PMID: 33016110 DOI: 10.1177/1055665620954063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To evaluate the effect of an American Cleft Palate-Craniofacial Association (ACPA)-approved multidisciplinary team on velopharyngeal insufficiency (VPI) diagnosis and treatment. DESIGN Retrospective cohort setting; tertiary children's hospital patients; children with cleft palate repair identified through procedure codes. MAIN OUTCOME MEASURES Velopharyngeal insufficiency diagnosis was assigned based on surgeon or team assessment. Age at diagnosis and surgery was recorded. Difference in age and rate of VPI diagnosis and surgery was analyzed with t test. Multivariate linear and logistic regression adjusted for confounding variables. RESULTS Nine hundred forty patients were included with 71.5% cared for by an ACPA-approved multidisciplinary team. More (38.8% ) team care patients were found to have a diagnosis of VPI in comparison to 10% in independent care (P < .001). Team care was associated with an almost 6-fold increase in VPI diagnosis (P < .001). Team care was associated with a higher proportion of speech surgery (21% vs 10%, P < .001). Among children receiving team care, each visit was associated with 25% increased odds of being diagnosed with VPI (P < .001) and 20% increased odds of receiving speech surgery (P < .001). Age at VPI diagnosis and speech surgery were similar between groups (P = .55 and .29). DISCUSSION Team care was associated with more accurate detection of VPI, resulting in more VPI speech therapy visits and surgical management. A higher number of team visits were similarly associated. CONCLUSION Further studies of the clinical implication of timely and accurate VPI diagnosis, including quality of life assessments, are recommended to provide stronger guidance on team visit and evaluation planning.
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Affiliation(s)
- Vanessa Torrecillas
- Division of Otolaryngology, University of Utah, 7060The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Sarah Hatch Pollard
- Division of Otolaryngology, University of Utah, 7060The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Hilary McCrary
- Division of Otolaryngology, University of Utah, 7060The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Helene M Taylor
- Intermountain Primary Children's Hospital, 7060The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Alexandra Palmer
- Division of Otolaryngology, University of Utah, 7060The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Jeremy Meier
- Division of Otolaryngology, University of Utah, 7060The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Harlan Muntz
- Division of Otolaryngology, University of Utah, 7060The University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Jonathan R Skirko
- Division of Otolaryngology, University of Utah, 7060The University of Utah School of Medicine, Salt Lake City, UT, USA
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Scherer NJ, Kaiser AP, Frey JR, Lancaster HS, Lien K, Roberts MY. Effects of a naturalistic intervention on the speech outcomes of young children with cleft palate. Int J Speech Lang Pathol 2020; 22:549-558. [PMID: 32164442 PMCID: PMC10712350 DOI: 10.1080/17549507.2019.1702719] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose: The purpose of this study was to investigate the extent to which a naturalistic communication intervention, Enhanced Milieu Teaching with Phonological Emphasis (EMT + PE) improved the speech outcomes of toddlers with cleft palate with or without cleft lip (CP ± L)Method: This study was a stratified randomised controlled trial.Setting: Treatment was delivered in a university clinic by a trained speech-language pathologist.Thirty children aged between 15 and 36 months (M = 25) with nonsyndromic CP ± CL and typical cognitive development were randomly assigned to a treatment (EMT + PE) or business as usual comparison condition.Participants in the EMT + PE treatment group received 48, 30-min sessions, over a 6-month period. Fidelity of treatment was high across participants.The primary outcome measures were percent consonants correct (PCC), consonant inventory, compensatory articulation errors, and nasal emission.Result: Regression analyses controlling for pre-intervention child characteristics were conducted for PCC and consonant inventory. Intervention was not a significant predictor of post-intervention outcome. Words per minute differentiated the children who benefitted from the intervention from those who did not. Reduction in compensatory errors and nasal emission occurred in both groups but to a greater degree in the EMT + PE group.Conclusion: EMT + PE is a promising early speech intervention for young children with CP ± L, especially for children with higher rates of word use.
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Affiliation(s)
- Nancy J Scherer
- Department of Speech and Hearing Science, College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Ann P Kaiser
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - Jennifer R Frey
- Department of Special Education and Disability Studies, The George Washington University, Washington, DC, USA, and
| | - Hope Sparks Lancaster
- Department of Speech and Hearing Science, College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Kari Lien
- Department of Speech and Hearing Science, College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Megan Y Roberts
- School of Communication, Northwestern University, Evanston, IL, USA
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Williams C, Harding S, Wren Y. An Exploratory Study of Speech and Language Therapy Intervention for Children Born With Cleft Palate ± Lip. Cleft Palate Craniofac J 2020; 58:455-469. [PMID: 32945191 DOI: 10.1177/1055665620954734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Children born with a cleft palate ± lip are at risk of developing speech and language difficulties, which may require intervention from a speech and language therapist (SLT). To date, there is no strong evidence to support one approach to intervention over another, neither is it clear which approaches or methods of provision are commonly used. OBJECTIVES To describe the range of speech and language therapy interventions being used with children born with cleft palate in the United Kingdom up to 5 years of age. To explore the different ways, interventions are being delivered. DESIGN A prospective study to conduct 9 semi-structured focus groups. Iterative content analysis was completed. SETTING Regional Cleft Lip and Palate Centers in the United Kingdom. PARTICIPANTS Sixty-two speech and language therapy professionals from specialist cleft teams and community services. RESULTS Four main codes were identified: "intervention approaches," "service delivery models," "decision-making and rationale," and "patient-centered care." Participants frequently discussed how they adopt an eclectic style when delivering intervention, the importance of an individualized approach for each child and service delivery constraints, such as a lack of resources. CONCLUSION Insight into the multitude of intervention approaches used by SLTs, aspects which influence their decision-making and the variability of service delivery models were gained. Uncertainty regarding which intervention approaches and methods for delivery are most effective provides rationale for future research, to improve the effectiveness of speech and language intervention for children with cleft palate ± lip.
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Affiliation(s)
- Caroline Williams
- Bristol Speech and Language Therapy Research Unit, 1982North Bristol NHS Trust and University of Bristol, England, UK
| | - Sam Harding
- Bristol Speech and Language Therapy Research Unit, 1982North Bristol NHS Trust and University of Bristol, England, UK
| | - Yvonne Wren
- Bristol Speech and Language Therapy Research Unit, 1982North Bristol NHS Trust and University of Bristol, England, UK
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Paulsgrove K, Miller E, Seidel K, Kinter S, Tse R. Crowdsourcing to Assess Speech Quality Associated With Velopharyngeal Dysfunction. Cleft Palate Craniofac J 2020; 58:25-34. [PMID: 32806948 DOI: 10.1177/1055665620948770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To assess crowdsourced responses in the evaluation of speech outcomes in children with velopharyngeal dysfunction (VPD). DESIGN Fifty deidentified speech samples were compiled. Multiple pairwise comparisons obtained by crowdsourcing were used to produce a rank order of speech quality. Ratings of overall and specific speech characteristics were also collected. Twelve speech-language pathologists (SLPs) who specialize in VPD were asked to complete the same tasks. Crowds and experts completed each task on 2 separate occasions at least 1 week apart. SETTING On-line crowdsourcing platform. PARTICIPANTS Crowdsource raters were anonymous and at least 18 years of age, North American English speakers with self-reported normal hearing. Speech-language pathologists were recruited from multiple cleft/craniofacial teams. INTERVENTIONS None. MAIN OUTCOME MEASURE(S) Correlation of repeated assessments and comparison of crowd and SLP assessments. RESULTS We obtained 6331 lay person assessments that met inclusion criteria via crowdsourcing within 8 hours. The crowds provided reproducible Elo rankings of speech quality, ρ(48) = .89; P <.0001, and consistent ratings of intelligibility and acceptability (intraclass correlation coefficient [ICC] = .87 and .92) on repeated assessments. There was a significant correlation of those crowd rankings, ρ(10) = .86; P = .0003, and ratings (ICC = .75 and .79) with those of SLPs. The correlation of more specific speech characteristics by the crowds and SLPs was moderate to weak (ICC < 0.65). CONCLUSIONS Crowdsourcing shows promise as a rapid way to obtain large numbers of speech assessments. Reliability of repeated assessments was acceptable. Large groups of naive raters yield comparable evaluations of overall speech acceptability, intelligibility, and quality, but are not consistent with expert raters for specific speech characteristics such as resonance and nasal air emission.
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Affiliation(s)
- Kaylee Paulsgrove
- Speech & Language Services, 7274Seattle Children's Hospital, Seattle, WA, USA
| | - Erin Miller
- Division of Plastic Surgery, Department of Surgery, 21617University of Washington, Seattle, WA, USA
| | - Kristy Seidel
- CSATS Inc, A Division of Johnson & Johnson, Seattle, WA, USA
| | - Sara Kinter
- Speech & Language Services, 7274Seattle Children's Hospital, Seattle, WA, USA
| | - Raymond Tse
- Division of Plastic Surgery, Department of Surgery, 21617University of Washington, Seattle, WA, USA.,Division of Craniofacial and Plastic Surgery, Department of Surgery, 7274Seattle Children's Hospital, Seattle, WA, USA
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Brown MN, Grames LM, Skolnick GB. Augmentative and Alternative Communication (AAC) Use Among Patients Followed by a Multidisciplinary Cleft and Craniofacial Team. Cleft Palate Craniofac J 2020; 58:324-331. [PMID: 32783478 DOI: 10.1177/1055665620947606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To establish preliminary data describing the number of patients who visit a multidisciplinary cleft and craniofacial team who use augmentative and alternative communication (AAC) supports. DESIGN This retrospective study consisted of chart reviews for all patients who visited a single site's multidisciplinary cleft and craniofacial team for 1 calendar year. SETTING A single multidisciplinary craniofacial team at a tertiary teaching hospital. PARTICIPANTS Four hundred sixty-four patients met the inclusion criteria for this study. Of these, 59.9% (n = 278) were male and 40.1% (n = 186) were female. RESULTS Of the sample population, 6.9% (n = 32) were AAC users as they received AAC intervention in a therapeutic context, while 93.1% (n = 432) were not. The AAC group had a mean age of 5.1 years (standard deviation [SD]: 4.2) and was 68.8% (n = 22) male. The non-AAC group had a mean age of 6.3 (SD: 4.9) and was 59.3% (n = 256) male. Within the AAC group, 40.6% (n = 13) were found to have an identified syndromic diagnosis in comparison to 17.6% (n = 76) of the non-AAC group (P = .003). CONCLUSIONS This is the first study to report the prevalence of AAC use among patients in the care of multidisciplinary cleft and craniofacial teams. Our findings suggest that a subset of craniofacial team patients may have complex communication disorders that require AAC supports. Craniofacial teams should be aware of resources available for these patients so that the patients' communication needs are met in the hospital, in school, and in the community.
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Affiliation(s)
| | | | - Gary B Skolnick
- 12275Washington University School of Medicine, St Louis, MO, USA.,Division of Plastic and Reconstructive Surgery, Department of Surgery, 7548Washington University in St Louis School of Medicine, The Cleft Palate-Craniofacial Institute, St Louis Children's Hospital, MO, USA
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Yu YH, Tessel C, Han X, Campanelli L, Vidal N, Gerometta J, Garrido-Nag K, Datta H, Shafer VL. Neural Indices of Vowel Discrimination in Monolingual and Bilingual Infants and Children. Ear Hear 2020; 40:1376-1390. [PMID: 31033699 PMCID: PMC6814506 DOI: 10.1097/aud.0000000000000726] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine maturation of neural discriminative responses to an English vowel contrast from infancy to 4 years of age and to determine how biological factors (age and sex) and an experiential factor (amount of Spanish versus English input) modulate neural discrimination of speech. DESIGN Event-related potential (ERP) mismatch responses (MMRs) were used as indices of discrimination of the American English vowels [ε] versus [I] in infants and children between 3 months and 47 months of age. A total of 168 longitudinal and cross-sectional data sets were collected from 98 children (Bilingual Spanish-English: 47 male and 31 female sessions; Monolingual English: 48 male and 42 female sessions). Language exposure and other language measures were collected. ERP responses were examined in an early time window (160 to 360 msec, early MMR [eMMR]) and late time window (400 to 600 msec, late MMR). RESULTS The eMMR became more negative with increasing age. Language experience and sex also influenced the amplitude of the eMMR. Specifically, bilingual children, especially bilingual females, showed more negative eMMR compared with monolingual children and with males. However, the subset of bilingual children with more exposure to English than Spanish compared with those with more exposure to Spanish than English (as reported by caretakers) showed similar amplitude of the eMMR to their monolingual peers. Age was the only factor that influenced the amplitude of the late MMR. More negative late MMR was observed in older children with no difference found between bilingual and monolingual groups. CONCLUSIONS Consistent with previous studies, our findings revealed that biological factors (age and sex) and language experience modulated the amplitude of the eMMR in young children. The early negative MMR is likely to be the mismatch negativity found in older children and adults. In contrast, the late MMR amplitude was influenced only by age and may be equivalent to the Nc in infants and to the late negativity observed in some auditory passive oddball designs.
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Affiliation(s)
- Yan H. Yu
- Department of Communication Sciences and Disorders, St.
John’s University, Queens, NY, USA
| | - Carol Tessel
- Department of Communication Sciences and Disorders, Florida
Atlantic University, Boca Raton, FL, USA
| | - Xiaoxu Han
- Department of Computer and Information Science, Fordham
University, New York, NY, USA
| | - Luca Campanelli
- Ph.D. Program in Speech-Language-Hearing Sciences, The
Graduate Center, City University of New York, New York, NY, USA
| | - Nancy Vidal
- Speech Communication Studies, Iona College, New Rochelle,
NY, USA
| | | | - Karen Garrido-Nag
- Hearing, Speech, Language Sciences, Gallaudet University,
Washington DC, USA
| | - Hia Datta
- Speech-Language Pathology, Molloy College, Rockville
Centre, NY, USA
| | - Valerie L. Shafer
- Ph.D. Program in Speech-Language-Hearing Sciences, The
Graduate Center, City University of New York, New York, NY, USA
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45
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Pesnot Lerousseau J, Hidalgo C, Schön D. Musical Training for Auditory Rehabilitation in Hearing Loss. J Clin Med 2020; 9:jcm9041058. [PMID: 32276390 PMCID: PMC7230165 DOI: 10.3390/jcm9041058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/02/2020] [Accepted: 04/06/2020] [Indexed: 01/17/2023] Open
Abstract
Despite the overall success of cochlear implantation, language outcomes remain suboptimal and subject to large inter-individual variability. Early auditory rehabilitation techniques have mostly focused on low-level sensory abilities. However, a new body of literature suggests that cognitive operations are critical for auditory perception remediation. We argue in this paper that musical training is a particularly appealing candidate for such therapies, as it involves highly relevant cognitive abilities, such as temporal predictions, hierarchical processing, and auditory-motor interactions. We review recent studies demonstrating that music can enhance both language perception and production at multiple levels, from syllable processing to turn-taking in natural conversation.
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46
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Abstract
Sufficient hearing is the cornerstone of the development of children's complex sensory perception, sound recognition, speech development and optimal communication skills. Hearing screening of newborns is necessary to detect congenital hearing disorders. Compulsory objective hearing screening in Hungary is a significant improvement in early diagnosis. The Audiological Department of Otorhinolaryngology, Head and Neck Surgery Clinic at Semmelweis University serves as a verification center for children identified via the compulsory objective newborn hearing screening and necessitates more detailed assessment. The goal of this study was to summarize the verification results of the year 2018. Case history, ENT examination, electric response measurement, impedance tests, otoacoustic emission measurement, surdopedagogical examination, and genetic examination are the basics of the diagnosis and the therapy as well. Altogether 261 newborns were examined in 2018 and 164 were subjected to audiological tests during the analyzed seven-month period. Normal hearing was detected in both ears in 77% of the cases, while hearing loss has been verified in 37 patients (23% of cases). Permanent hearing loss has been diagnosed in 19 cases, 4 unilateral and 15 bilateral. Hearing loss of sensorineural origin was confirmed in 17, conductive in 2 children. Temporary hearing loss caused by otitis media with effusion was found in further 18 children which healed spontaneously in most cases. Organized neonatal objective hearing examination has been established in Hungary in 2015. As a result, we can diagnose and provide care for children with hearing loss at the earliest stage. The National Newborn Hearing Screening Registry ensures a well-coordinated and smooth process. Orv Hetil. 2019; 160(47): 1850-1855.
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Affiliation(s)
- Anita Gáborján
- Fül-, Orr-, Gégészeti és Fej-, Nyaksebészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szigony u. 36., 1083
| | - Judit Götze
- I. Gyermekgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest
| | - Marianna Küstel
- Fül-, Orr-, Gégészeti és Fej-, Nyaksebészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szigony u. 36., 1083
| | - Nóra Kecskeméti
- Fül-, Orr-, Gégészeti és Fej-, Nyaksebészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szigony u. 36., 1083
| | - Ildikó Baranyi
- Fül-, Orr-, Gégészeti és Fej-, Nyaksebészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szigony u. 36., 1083
| | - Fatime Csontos
- Fül-, Orr-, Gégészeti és Fej-, Nyaksebészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szigony u. 36., 1083
| | - László Tamás
- Fül-, Orr-, Gégészeti és Fej-, Nyaksebészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szigony u. 36., 1083
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47
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Li Y, Kong Y, Xu T, Dong R, Lv J, Qi B, Wang S, Yan F, Li Y, Long M, Chen X. Speech development after cochlear implantation in infants with isolated large vestibular aqueduct syndrome. Acta Otolaryngol 2019; 139:990-997. [PMID: 31550964 DOI: 10.1080/00016489.2019.1630755] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Few studies on speech performance of children after cochlear implantation (CI) described isolated large vestibular aqueduct syndrome (LVAS). Objective: To investigate speech developmental trajectories of infants with LVAS after CI, and to compare with those who have structurally normal inner ears. Materials and methods: 1112 infants with congenital severe to profound hearing loss participated in this study. 150 infants in group A were diagnosed with LVAS, 962 infants in group B with structurally normal inner ear. The speech performance was assessed via the Meaningful Use of Speech Scale (MUSS). The evaluations were performed pre-implant, 1, 3, 6, 9, 12, 24, 36, 48 and 60 months after CI. Results: The mean scores of the MUSS improved over a 5-year period after implantation in both groups A and B. The LVAS group presented similar speech developmental trajectory to the non-LVAS group at each assessment interval, except pre-operation. There were significant differences in mean scores between vocalizing behavior and oral communication skills, clarification skills of infants in both two groups. Conclusions and significance: Speech performance of infants with LVAS developed rapidly after CI and was similar to infants with structurally normal inner ear. For infants with isolated LVAS, CI had a significant effect and should be recommended as a therapeutic option.
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Affiliation(s)
- Yang Li
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, and Beijing Institute of Otolaryngology, Beijing, China
| | - Ying Kong
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, and Beijing Institute of Otolaryngology, Beijing, China
| | - Tianqiu Xu
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, and Beijing Institute of Otolaryngology, Beijing, China
| | - Ruijuan Dong
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, and Beijing Institute of Otolaryngology, Beijing, China
| | - Jing Lv
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, and Beijing Institute of Otolaryngology, Beijing, China
| | - Beier Qi
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, and Beijing Institute of Otolaryngology, Beijing, China
| | - Shuo Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, and Beijing Institute of Otolaryngology, Beijing, China
| | - Fei Yan
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yongxin Li
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, and Beijing Institute of Otolaryngology, Beijing, China
| | - Mo Long
- China Rehabilitation Research Center for Hearing and Speech Impairment, Beijing, China
| | - Xueqing Chen
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, and Beijing Institute of Otolaryngology, Beijing, China
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Adkins J, Gildersleeve-Neumann C, Redford M. INVESTIGATING METRICAL CONTEXT EFFECTS ON ANTICIPATORY COARTICULATION IN CONNECTED SPEECH DEVELOPMENT. Proc Int Congr Phon Sci 2019; 2019:845-849. [PMID: 31663084 PMCID: PMC6818739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
If rhythm acquisition is influenced by the development of articulatory timing, then metrical structure might be expected to condition this timing. This study tested this hypothesis by investigating anticipatory effects of an upcoming noun on the production of a preceding determiner, under the assumption that anticipatory coarticulation indexes chunking. Simple S-V-O sentences were elicited from 5-year-olds, 8-year-olds, and adults. The V was either monosyllabic packed or disyllabic patted. The O was a determiner phrase where nouns varied either in onset place-of-articulation (POA; tack vs. cat) or in their rhymes (tack vs. toot). Acoustic analyses of determiner schwa F1 and F2 showed no effect of verb on schwa coarticulation. Given other results, including an interaction between age group and POA, the findings suggest that the acquisition of articulatory timing is independent of metrical structure, even if this timing is related to speech rhythm acquisition.
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49
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Zajac DJ. Obligatory Nasal Turbulence as a Trigger for the Development of Posterior Nasal Fricatives in a Child With Repaired Cleft Palate. Cleft Palate Craniofac J 2018; 56:690-696. [PMID: 30304959 DOI: 10.1177/1055665618805889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Posterior nasal fricatives (PNFs) are unusual articulations that occur in some children with and without cleft palate. The etiology of PNFs is unclear. A young girl with repaired cleft palate is described who exhibited inconsistent obligatory nasal turbulence during production of stops at 2 years of age. At 3 years of age, she exhibited various phonological processes and used PNFs to replace sibilants and affricates. Pressure-flow testing showed a relatively small velopharyngeal area during production of stops. These observations are consistent with obligatory nasal turbulence triggering the development of PNFs as an unusual phonological process, perhaps facilitated by reduced hearing.
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Affiliation(s)
- David J Zajac
- 1 Department of Dental Ecology, Director, Speech-Language Pathology, Craniofacial Center, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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50
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Abstract
We tested the effect of Auditory-Motor Mapping Training (AMMT), a novel, intonation-based treatment for spoken language originally developed for minimally verbal (MV) children with autism, on a more-verbal child with autism. We compared this child’s performance after 25 therapy sessions with that of: (1) a child matched on age, autism severity, and expressive language level who received 25 sessions of a non-intonation-based control treatment Speech Repetition Therapy (SRT); and (2) a matched pair of MV children (one of whom received AMMT; the other, SRT). We found a significant Time × Treatment effect in favor of AMMT for number of Syllables Correct and Consonants Correct per stimulus for both pairs of children, as well as a significant Time × Treatment effect in favor of AMMT for number of Vowels Correct per stimulus for the more-verbal pair. Magnitudes of the difference in post-treatment performance between AMMT and SRT, adjusted for Baseline differences, were: (a) larger for the more-verbal pair than for the MV pair; and (b) associated with very large effect sizes (Cohen’s d > 1.3) in the more-verbal pair. Results hold promise for the efficacy of AMMT for improving spoken language production in more-verbal children with autism as well as their MV peers and suggest hypotheses about brain function that are testable in both correlational and causal behavioral-imaging studies.
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Affiliation(s)
- Karen V Chenausky
- Music, Neuroimaging, and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical CenterBoston, MA, United States.,Department of Neurology, Harvard Medical SchoolBoston, MA, United States
| | - Andrea C Norton
- Music, Neuroimaging, and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical CenterBoston, MA, United States
| | - Gottfried Schlaug
- Music, Neuroimaging, and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical CenterBoston, MA, United States.,Department of Neurology, Harvard Medical SchoolBoston, MA, United States
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