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Speech Characteristics After Articulation Therapy in Children With Cleft Palate and Velopharyngeal Dysfunction - a Single Case Experimental Design Publisher Pubmed



Derakhshandeh F1, 2 ; Nikmaram M3 ; Hosseinabad HH4 ; Memarzadeh M5 ; Taheri M6 ; Omrani M7 ; Jalaie S8 ; Bijankhan M9 ; Sell D10
Authors
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Authors Affiliations
  1. 1. Department of Speech Therapy, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Craniofacial Anomalies and Cleft Palate Research Center, Isfahan university of Medical Sciences, Isfahan, Iran
  3. 3. Department of Physiology, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Communication Sciences and Disorders, College of Allied Health Sciences, University of Cincinnati, Cincinnati, United States
  5. 5. Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  6. 6. Social Security Organization, Isfahan, Iran
  7. 7. IBCFPRS, Department of Otorhinolaryngolog, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  8. 8. Department of physiotherapy, Biostatistics, School of rehabilitation, Tehran University of Medical sciences, Tehran, Iran
  9. 9. Laboratory of Linguistics Department, University of Tehran, Tehran, Iran
  10. 10. North Thames Regional Cleft Centre, Speech and Language Therapy Department, Great Ormond Street Hospital Trust for Children, London, United Kingdom

Source: International Journal of Pediatric Otorhinolaryngology Published:2016


Abstract

Objective: The aim of this study was to investigate the impact of an intensive 10-week course of articulation therapy on articulation errors in cleft lip and palate patients who have Velopharyngeal Insufficiency (VPI), non-oral and passive cleft speech characteristics. Methods: Five children with cleft palate (+/-cleft lip) with VPI and non-oral and passive cleft speech characteristics underwent 40 intensive articulation therapies over 10 weeks in a single case experimental design. The percentage of non-oral CSCs (NCSCs), passive CSCs (PCSCs), stimulable consonants (SC), correct consonants in word imitation (CCI), and correct consonants in picture naming (CCN) were captured at baseline, during intervention and in follow up phases. Visual analysis and two effect size indexes of Percentage of Nonoverlapping Data and Percentage of Improvement Rate Difference were analyzed. Results: Articulation therapy resulted in visible decrease in NCSCs for all 5 participants across the intervention phases. Intervention was effective in changing percentage of passive CSCs in two different ways; it reduced the PCSCs in three cases and resulted in an increase in PCSCs in the other two cases. This was interpreted as intervention having changed the non-oral CSCs to consonants produced within the oral cavity but with passive characteristics affecting manner of production including weakness, nasalized plosives and nasal realizations of plosives and fricatives. Percent SC increased throughout the intervention period in all five patients. All participants demonstrated an increase in percentage of CCI and CCN suggesting an increase in the consonant inventory. Follow-up data showed that all the subjects were able to maintain their ability to articulate learned phonemes correctly even after a 4-week break from intervention. Conclusion: This single case experimental study supports the hypothesis that speech intervention in patients with VPI can result in an improvement in oral placements and passive CSCs. © 2016 Elsevier Ireland Ltd.
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