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  • Author: Benjamas Prathanee x
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Benjamas Prathanee, Cholada Seepuaham and Tawitree Pumnum

Abstract

Background: Compensatory articulation disorders (CAD) are the most common speech defects in patients with a cleft. Early prevention programs are needed to avoid CAD.

Objectives: To examine articulation disorders, patterns, and related speech outcomes in children with a cleft palate with or without lip defects.

Methods: Articulation test record forms and clinical records of 42 children were accessed retrospectively to provide the data of speech outcomes related to cleft palate. Double data entries and incorrect completion type errors were corrected.

Results: Prevalence of articulatory defects was 88% (functional articulation disorders, 12%; compensatory articulation disorders, 10%; functional articulation disorders and CAD, 67%), resonance disorder was 50%, and voice abnormalities was 19%. Abnormal backing of oral consonants, particularly glottal substitution was the most common pattern of CAD (40%), follow by velar substitution (36%), and nasal consonant for oral pressure consonant (21%). There was high incidence of functional articulation disorder in patients with a cleft (76%). Younger children (≤7 years old) had more articulation defects than older children (>7 years old) (mean difference = 3.308, P = 0.002, 95% confident interval 1.683-6.971). Levene’s test for equal variance found that resonance disorder seems unaffected by the number of articulation errors (mean difference = 0.253, P = 0.897, 95% confident interval -3.736-4.241).

Conclusion: CAD, particularly abnormal backing of oral consonants and hypernasality were the most common speech defects in children with cleft. Refinement and revision of timing for referring for early speech intervention should be reconsidered.

Open access

Benjamas Prathanee, Preeya Lorwatanapongsa, Kalyanee Makarabhirom, Ratchanee Suphawatjariyakul, Worawan Wattanawongsawang, Sirinakorn Prohmtong and Panida Thanaviratananit

Abstract

Background: There is a critical need for speech therapy services for people born with cleft lip and/or palate in developing countries.

Objective: Assess the effectiveness of a speech camp and follow-up session for children with cleft lip and/or palate.

Methods: A Community-Based Model for Speech therapy was implemented at Suwanaphum Hospital District, Roiet, Thailand. Thirteen children with cleft lip and/or palate (3; 6-13 years) attended a four-day speech camp and a one-day follow-up session (six months later) for remediation of their articulation disorders. Paraprofessional training was also provided. Pre- and post-tests were administered to the participants, caregivers, and paraprofessionals to determine the effectiveness of the program. A pre- and post-articulation test, as well as an audiological evaluation were administered. Five speech and language pathologists provided speech therapy, both individual and group, for a total of 18 hours during the four-day speech camp and six hours in the one-day follow-up session. The median difference of the number of articulation errors was determined by results of the Wilcoxon Signed-Rank Test.

Results: There was a significant decrease in articulation errors following both the main speech camp and the follow-up session (z = 3.11, p < 0.01; z = 2.87, p<0.01, respectively). Caregivers’ and health care providers’ satisfaction ratings for participation in the speech camps ranged from good to excellent.

Conclusion: A Community-Based Model of both a speech camp and follow-up session provided an effective speech therapy treatment for children with cleft lip and/or palate.