Active versus passive cleft‐type speech characteristics: implications for surgery and therapy

Abstract

ABSTRACT Cleft palate speech is generally characterised by hypernasality and compensatory articulations. A longitudinal study of children at different stages of surgical treatment revealed a distinction between passive and active cleft‐type speech characteristics as described by Hutters and Brondsted (1987). Passive characteristics are the product, not of disordered articulatory patterns, but of structural abnormality or dysfunction. Active characteristics are alternative articulatory gestures which function in place of intended consonants. Passive and active patterns of articulation will be described and defined in the context of three longitudinal studies: five bilateral left lip and palate (BCLP) subjects aged, 1;6‐4;6; 12 mixed unilateral cleft lip and palate (UCLP) and BCLP subjects aged 4;6–7;6 and nine mixed UCLP and BCLP subjects aged 9;0–11;0. The effects of surgery on the speech of seven subjects will be discussed using the active/passive distinction. Active cleft‐type characteristics did not change as a direct result of surgery, whereas passive characteristics were largely eliminated following surgery. This distinction between active and passive patterns of articulation can serve to identify those cleft‐type speech error patterns most likely to respond to surgical intervention. Indications from this study are that active cleft‐type characteristics require destabilisation in a course of speech and language therapy before the potential benefits of surgery can be properly assessed.