Development of obstruent correctness from 3 to 5 years in Danish children with unilateral cleft lip and palate.

Line Dahl Jørgensen, Elisabeth Willadsen

Publikation: Konferencebidrag uden forlag/tidsskriftAbstraktForskningpeer review

Abstract

Background:
Speech sound development in pre-schoolers with cleft palate as a group is delayed/deviant. High pressure consonants, also called obstruents, comprise the most vulnerable sound class. Production of these sounds demands increased intra-oral air pressure which is compromised when the palate is completely or partially unrepaired, or in the presence of velopharyngeal dysfunction (VPD).
Notwithstanding, no study has to our knowledge examined the development of obstruent correctness longitudinally in a large group of pre-school children with unilateral cleft lip and palate (UCLP).

Aim:
The present study aims to investigate the development of obstruent correctness (PCC-obs) from 3 to 5 years of age and the possible influence on outcomes of age, gender, VPD, cleft speech characteristics (CSCs), and developmental speech characteristics (DSCs), in two groups of children with UCLP.

Method:
A total of 126 consecutive Danish children born with UCLP were recruited in the Scandcleft project (Semb et al. 2017). Phonetic transcriptions of audio and video recordings of a naming test from 108 participants (30 girls, 78 boys) were available at both three and five years. All 108 participants had their lip and soft palate closed at four months. Fifty-five participants had early hard palate repair at 12 months (EHPC group), and 53 participants had late hard palate repair at 36 months (LHPC group).
Two speech-language pathologists (SLPs), blinded to the randomisation, transcribed all naming tests. Intra and inter rater agreement was acceptable. At 3 years, disagreement was solved by consensus listening. At 5 years, transcriptions from the SLP with the highest intra-rater agreement were included in the data analyses. Groups were analysed separately because earlier studies showed significant group differences at both 3 and 5 years with the LHPC group demonstrating poorer speech correctness than the EHPC group (Willadsen et al., 2017a; 2017b). Paired t-tests with bias-corrected and accelerated bootstrapping were used to analyse differences between outcomes at 3 and 5 years, and logistic regression analyses were used to investigate predictors of PCC-obs at 5 years.

Results:
In the EHPC group, PCC-obs scores increased significantly from age 3 to 5, but effect sizes were small. PCC-obs also increased per sound, but not for early developing sounds. A significant decrease in DSCs was found, but not CSCs. Logistic regression analyses showed that PCC-obs at 3 years, CSCs, DSCs, and gender were significant predictors of PCC-obs at 5 years.
In the LHPC group, PCC-obs scores increased significantly from age 3 to 5 with large effect sizes. PCC-obs increased per sound, except for the velar stop /k/. A significant decrease in both DSCs and CSCs was found. Logistic regression analyses showed that PCC-obs at 3 years and CSCs were significant predictors of PCC-obs at 5 years whereas DSCs and gender were not.

Conclusion:
Both groups of children with UCLP showed significant progress in obstruent correctness from age 3 to 5. However, groups did not only differ in outcomes at 3 and 5 years; they also showed different developmental trajectories. In addition, predictors of PCC-obs scores at 5 years also differed between groups. These results contribute to our understanding of predictors of obstruent correctness at 5 years and further indicates that we need to look beyond CSCs and acknowledge the importance of more overall measures of speech correctness, including DSCs.
OriginalsprogEngelsk
Publikationsdato2019
StatusUdgivet - 2019
Udgivet eksterntJa
Begivenhed11. European Craniofacial Congress - Utrecht, Holland
Varighed: 12 jun. 201915 jun. 2019
https://ecpca.eu/programme/scientific-programme/

Konference

Konference11. European Craniofacial Congress
LandHolland
ByUtrecht
Periode12/06/1915/06/19
Internetadresse

Citationsformater