The impact of palatal repair before and after 6 months of age on speech characteristics

Anke Luyten; Kim Bettens; Evelien D'haeseleer; Sophia De Ley; Andrew Hodges; George Galiwango; Katrien Bonte; Hubert Vermeersch; Kristiane Van Lierde

doi:10.1016/j.ijporl.2014.02.012

The impact of palatal repair before and after 6 months of age on speech characteristics

Int J Pediatr Otorhinolaryngol. 2014 May;78(5):787-98. doi: 10.1016/j.ijporl.2014.02.012. Epub 2014 Feb 15.

Authors

Anke Luyten¹, Kim Bettens², Evelien D'haeseleer³, Sophia De Ley⁴, Andrew Hodges⁵, George Galiwango⁶, Katrien Bonte⁷, Hubert Vermeersch⁸, Kristiane Van Lierde⁹

Affiliations

¹ Ghent University, Department of Speech, Language and Hearing Sciences, De Pintelaan 185, 2P1, 9000 Gent, Belgium. Electronic address: [email protected].
² Ghent University, Department of Speech, Language and Hearing Sciences, De Pintelaan 185, 2P1, 9000 Gent, Belgium. Electronic address: [email protected].
³ Ghent University, Department of Speech, Language and Hearing Sciences, De Pintelaan 185, 2P1, 9000 Gent, Belgium. Electronic address: [email protected].
⁴ Ghent University, Department of Speech, Language and Hearing Sciences, De Pintelaan 185, 2P1, 9000 Gent, Belgium. Electronic address: [email protected].
⁵ Comprehensive Rehabilitation Services in Uganda (CoRSU), PO Box 46, Kisubi, Uganda. Electronic address: [email protected].
⁶ Comprehensive Rehabilitation Services in Uganda (CoRSU), PO Box 46, Kisubi, Uganda. Electronic address: [email protected].
⁷ Ghent University, Department of Head and Neck Surgery, De Pintelaan 185, 2P2, 9000 Gent, Belgium. Electronic address: [email protected].
⁸ Ghent University, Department of Head and Neck Surgery, De Pintelaan 185, 2P2, 9000 Gent, Belgium. Electronic address: [email protected].
⁹ Ghent University, Department of Speech, Language and Hearing Sciences, De Pintelaan 185, 2P1, 9000 Gent, Belgium. Electronic address: [email protected].

PMID: 24630984
DOI: 10.1016/j.ijporl.2014.02.012

Abstract

Objective: Optimal timing of palatal repair is still subject of discussion. Although literature provides some evidence that palatal closure prior to 6 months positively influence speech outcome in children with clefts, only few studies verified this hypothesis. The purpose of this study was to describe and compare articulation and resonance characteristics following early (≤6 months) and later (>6 months) palatal repair, performed using the Sommerlad technique.

Methods: Comparison was made between 12 Ugandan children with isolated cleft (lip and) palate following early palatal repair (mean age: 3.3 m) and 12 Belgian patients with later palatal repair (mean age: 11.1 m), matched for cleft type, age and gender. A Ugandan and Belgian age- and gender-matched control group without clefts was included to control for language, culture and other environmental factors. Articulation assessments consisted of consonant inventories and phonetic and phonological analyses that were based on consensus transcriptions. In addition, resonance was evaluated by perceptual consensus ratings and objective mean nasalance values.

Results: The Belgian and Ugandan control groups were comparable for the majority of the variables. Comparison of cleft palate groups revealed no clinically relevant significant group differences for consonant inventory or phonological processes. Phonetic analysis showed significantly more distortions in the Belgian cleft palate group due to higher occurrence frequencies for (inter)dental productions of apico-alveolar consonants. Neither perceptual consensus ratings of hypernasality, hyponasality, cul-de-sac resonance and nasal emission/turbulence, nor objective mean nasalance values for oral speech samples revealed significant group differences (p>0.05).

Conclusion: Articulation and resonance characteristics of young children following palatal repair before and after 6 months of age seem to be at least comparable.

Keywords: Articulation; Cleft; Resonance; Sommerlad technique; Speech; Timing of palatoplasty.

Publication types

Comparative Study
Evaluation Study

MeSH terms

Age Factors
Articulation Disorders / etiology
Articulation Disorders / physiopathology*
Articulation Disorders / therapy*
Belgium
Case-Control Studies
Child
Child, Preschool
Cleft Palate / diagnosis
Cleft Palate / surgery*
Cohort Studies
Developing Countries
Female
Follow-Up Studies
Humans
Infant
Male
Phonetics
Plastic Surgery Procedures / adverse effects
Plastic Surgery Procedures / methods*
Risk Assessment
Speech Intelligibility*
Speech Production Measurement
Speech Therapy / methods
Treatment Outcome
Uganda