Procesos de simplificación fonológica en niños con fisura labiovelopalatina intervenidos quirúrgicamente  <span class="so-article-trans-title" dir="auto"> Translated title: Phonological processes in children with surgery treated cleft lip and palate </span>

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Abstract

OBJETIVO: conocer las características del desempeño fonológico en niños con fisura labiovelopalatina uni y bilateral, entre 3 y 4,11 años. MÉTODO: se evaluaron 39 pacientes con fisura labiovelopalatina tratada quirúrgicamente, los cuales fueron divididos en 4 grupos de estudio, según el tipo de fisura (uni o bilateral) y edad (3-3,11 años y 4-4,11 años). Para la determinación de la cantidad, tipo y frecuencia de procesos de simplificación fonológica en el grupo de estudio, se aplicó el Test de Procesos de simplificación fonológica (Chile). Los puntajes obtenidos fueron comparados con la norma a través del análisis estadístico t test y analizados descriptivamente. RESULTADOS: se observó una cantidad significativamente mayor de procesos fonológicos presentes en niños con fisura respecto a la norma. Para todos los grupos de estudio los procesos fonológicos de simplificación más frecuentes fueron los de sustitución, con excepción del grupo de niños con fisura unilateral de 3-3,11 años, donde los procesos más frecuentes fueron los relativos a la estructura silábica. CONCLUSIONES: los resultados obtenidos sugieren la necesidad de incluir técnicas de evaluación de la presencia de procesos fonológicos en niños fisurados con el fin que las terapias consideren el entrenamiento para la eliminación de estos procesos en etapas adecuadas del desarrollo, con el fin de mejorar el aspecto conversacional del lenguaje.

Translated abstract

PURPOSE: to determine the phonological skills of Chilean children between 3 years and 4 years 11 months old with unilateral and bilateral cleft lip and palate. METHOD: a sample of thirty-nine cleft lip and palate children treated with surgery was divided into four different groups according to the type of cleft lip and palate (unilateral and bilateral) and age (3-3,11 years and 4-4,11 years). We were carried out the TEPROSIF test (Chile), in order to determine the amount, type and frequency of simplification phonological processes in the studied group. The scores obtained were compared with the Chilean standard utilizing the t test statistical package. Descriptive statistics were obtained. RESULTS: more phonologic processes were significantly observed in the cleft group. In all groups the most frequently subtype of simplification phonological processes was the replacement processes' group, except for in the 3-3,11 years of age in unilateral cleft, where the most frequently were the syllabic structure processes. CONCLUSION: results suggest the need to include techniques for assessing the presence of phonological processes in cleft children in order to consider the training for eliminating these processes in their therapies in the appropriate stages of development, aiming at improving the language conversational aspect.

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Reconsidering the impact of preterm birth on language outcome.

Annalisa Guarini, Alessandra Sansavini, Cristina Fabbri … (2009)

Since preterm birth is associated with a constellation of pre-, peri- and post-natal risk factors, we hypothesised that prematurity may continue to impact the development of linguistic abilities even up to the end of the preschool years and beyond, giving rise to an atypical developmental trajectory. The study tested this hypothesis at six years of age, investigating whether language is affected by preterm birth and how different linguistic abilities are interrelated. Seventy monolingual Italian preterms and 34 age-matched controls were recruited. Linguistic abilities (vocabulary, grammar, and phonological awareness) as well as general cognitive developmental levels were measured. No general cognitive delay emerged, but less developed abilities in vocabulary, grammar, and phonological awareness were found in preterms compared to fullterms. Moreover, the relations among the different linguistic competences differed across groups. Our study shows that even without brain damage, preterm birth continues to affect linguistic development up to the end of the preschool years, and probably beyond, highlighting a continuity between pre- and peri-natal life and subsequent development, and pointing to an atypical developmental trajectory in this population compared to fullterms (different rates of development, different strategies employed, and differences in the relationships among linguistic abilities).

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Phonological accuracy and intelligibility in connected speech of boys with fragile X syndrome or Down syndrome.

Joanne Erwick Roberts, S Long, Ellen E. Martin … (2009)

To compare the phonological accuracy and speech intelligibility of boys with fragile X syndrome with autism spectrum disorder (FXS-ASD), fragile X syndrome only (FXS-O), Down syndrome (DS), and typically developing (TD) boys. Participants were 32 boys with FXS-O (3-14 years), 31 with FXS-ASD (5-15 years), 34 with DS (4-16 years), and 45 TD boys of similar nonverbal mental age. We used connected speech samples to compute measures of phonological accuracy, phonological process occurrence, and intelligibility. The boys with FXS, regardless of autism status, did not differ from TD boys on phonological accuracy and phonological process occurrence but produced fewer intelligible words than did TD boys. The boys with DS scored lower on measures of phonological accuracy and occurrence of phonological processes than all other groups and used fewer intelligible words than did TD boys. The boys with FXS and the boys with DS did not differ on measures of intelligibility. Boys with FXS, regardless of autism status, exhibited phonological characteristics similar to those of younger TD children but were less intelligible in connected speech. Boys with DS showed greater delays in all phonological measures than the boys with FXS and the TD boys.

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Communication disorders in individuals with cleft lip and palate: An overview

Roopa Nagarajan, V. H. Savitha, B. Subramaniyan (2009)

The need for an interdisciplinary approach in the comprehensive management of individuals with cleft lip and palate is well recognized. This article provides an introduction to communication disorders in individuals with cleft lip and palate for members of cleft care teams. The speech pathologist is involved in identifying those infants who are at risk for communication disorders and also for initiating early intervention to prevent or mitigate communication disorders caused by the cleft. Even with early cleft repair, some children exhibit ‘cleft palate speech’ characterized by atypical consonant productions, abnormal nasal resonance, abnormal nasal airflow, altered laryngeal voice quality, and nasal or facial grimaces. These manifestations are evaluated to identify those that (a) are developmental, (b) can be corrected through speech therapy alone, and, (c) those that may require both surgery and speech therapy. Speech is evaluated perceptually using several types of stimuli. It is important to identify compensatory and obligatory errors in articulation. When velopharyngeal dysfunction is suspected, the assessment should include at least one direct measure such as nasoendoscopy or videofluoroscopy. This provides information about the adequacy of the velopharyngeal valve for speech production, and is useful for planning further management of velopharyngeal dysfunction. The basic principle of speech therapy in cleft lip and palate is to establish the correct placement of the articulators and appropriate air flow. Appropriate feedback is important during therapy for establishing the correct patterns of speech.