Articulation Errors Research Articles

Effects of a naturalistic intervention on the speech outcomes of young children with cleft palate

Purpose: The purpose of this study was to investigate the extent to which a naturalistic communication intervention, Enhanced Milieu Teaching with Phonological Emphasis (EMT + PE) improved the speech outcomes of toddlers with cleft palate with or without cleft lip (CP ± L)Method: This study was a stratified randomised controlled trial.Setting: Treatment was delivered in a university clinic by a trained speech-language pathologist.Thirty children aged between 15 and 36 months (M = 25) with nonsyndromic CP ± CL and typical cognitive development were randomly assigned to a treatment (EMT + PE) or business as usual comparison condition.Participants in the EMT + PE treatment group received 48, 30-min sessions, over a 6-month period. Fidelity of treatment was high across participants.The primary outcome measures were percent consonants correct (PCC), consonant inventory, compensatory articulation errors, and nasal emission.Result: Regression analyses controlling for pre-intervention child characteristics were conducted for PCC and consonant inventory. Intervention was not a significant predictor of post-intervention outcome. Words per minute differentiated the children who benefitted from the intervention from those who did not. Reduction in compensatory errors and nasal emission occurred in both groups but to a greater degree in the EMT + PE group.Conclusion: EMT + PE is a promising early speech intervention for young children with CP ± L, especially for children with higher rates of word use.

The effect of maxillary advancement on articulation of alveolar consonants in cleft patients

IntroductionMaxillary advancement may affect speech in cleft patients. The aim of this study was to evaluate the effect of maxillary advancement on Finnish alveolar consonants /s/, /l/, and /r/ in cleft patients. Materials and methodsFifty-nine Finnish-speaking nonsyndromic cleft patients, who had undergone Le Fort I or bimaxillary osteotomies, were evaluated retrospectively Production of the Finnish alveolar consonants /s/, /l/, and /r/ was assessed from pre- and postoperative standardized video recordings by two experienced speech pathologists. McNemar's test was used in the statistical analyses. Kappa statistics were calculated to assess reliability. ResultsThe patients included 35 females and 24 males with CP (n = 12), UCLP (n = 31), and BCLP (n = 16). There was a significant improvement in /s/ and /l/ sounds after maxillary advancement (p = 0.039 and p = 0.002, respectively). The preoperative mean percentage of /s/ errors was 34%; postoperatively it was 20%. /L/ was misarticulated preoperatively by 34% of the patients and postoperatively by 19%. /R/ was misarticulated preoperatively by 47% of the patients and postoperatively by 42%. The level of mild articulation errors rose from 25% to 31%, while severe articulation errors decreased from 37% to 25%. The reliabilities were good. ConclusionWhen planning orthognathic surgery in cleft patients with maxillary retrusion and articulation errors, advancement of the maxilla might be a means for improving articulation of /s/ and /l/.

PERUBAHAN ARTIKULASI FONEM BAHASA ARAB BAGI PENUTUR BAHASA ASING

The impact of the articulation of the second language phonemes will lead to mistaken meanings. Pronounced mistakes made by second language speakers will confuse the speaker, especially the native speaker. Mistakes of meaning and misinterpretation result in communication not working properly. Research Objectives 1.) to indicate Arabic phonemes that often occur in articulation changes for Arabic IAIN Bengkulu students. 2.) to find out the factors that influence changes in the articulation of Arabic phonemes for students of IAIN Bengkulu Arabic Language Study Program. The research approach used in this study is a qualitative approach with the type of phenomenological research this study aims to reveal the phenomenon of changes in the articulation of Arabic phonemes for students of the Arabic IAIN Bengkulu Study Program and the factors that influence it. This research is a qualitative descriptive study. Based on the data, it is known that the error rate of Arabic phoneme articulation in the fourth semester students of PBA Study Program is known that there are several forms of Arabic phoneme pronunciation errors that are often found, namely: هـ, ف, ذ, ث The factors that cause the articulation errors of Arabic phoneme IV semester students of Study Program PBA Because of the intersection between Arabic and Indonesian (Interference), which is a mistake caused by the carrying out of the habits of spoken language or dialect of the mother into the second language or dialect. Lack of Motivation to master Arabic articulation in accordance with the rules. Lack of mastery in the pronunciation of the Arabic phoneme There are several factors for speech disordersKeywords: articulation, phonemes, foreign speakers

Topological properties of the resting-state functional network in nonsyndromic cleft lip and palate children after speech rehabilitation.

Speech therapy has been widely used as an essential therapy for compensatory articulation errors in nonsyndromic cleft lip and palate patients. We sought to identify potential biomarkers of nonsyndromic cleft lip and palate children after speech rehabilitation based on resting-state fMRI and graph theory techniques. We scanned 28 nonsyndromic cleft lip and palate and 28 typically developing children for resting-state fMRI on a 3T MRI scanner. Functional networks were constructed, and their topological properties were obtained for assessing between-group differences (two-sample t-tests). Also, language clear degree scale scores were obtained for correlation analysis with the topological features in nonsyndromic cleft lip and palate patients. Significant between-group differences of local properties were detected in brain regions involved in higher-order language and social cognition. There were no significant correlations between topological feature differences and language clear degree scale scores in nonsyndromic cleft lip and palate patients. Graph theory provided valuable insight into the neurobiological mechanisms of speech rehabilitation in nonsyndromic cleft lip and palate patients. The global network features, small-world index, nodal clustering coefficient, and nodal shortest path length may represent potential imaging biomarkers for the estimation of effective speech rehabilitation.

Early labial compensation for lingual sounds post partial glossectomy

Speech errors are commonly reported in the literature for postsurgical treatment in lingual carcinomas. The degree of errors relate to the extent of resection and reconstruction. Residual organ compensation is reported in partial glossectomy, while adjacent articulator compensation in total glossectomy. This case report describes an early atypical labial compensation for lingual sounds in a young female postpartial glossectomy and free flap reconstruction. Speech articulation errors were specific to distortion of tongue tip stops, laterals, and liquids. Bilabial flicker like movements were noted during the production of alveolar stops which subsequently developed into a bilabial compensatory articulation. This error indicates that compensation for the affected articulator function may begin at a very early postsurgical stage. The compensation needs to be identified and intervened at an early stage where facilitation must be sought as a modality for speech correction in smaller surgeries to achieve new or near normal speech.

"She Sounds Like a Small Child or Perhaps She has Problems"-Peers' Descriptions of Speech in 7-Year-Olds Born With Cleft Palate.

The aim of this study was to explore how 7-year-olds describe speech in children born with cleft palate in their own words and to investigate whether they perceive signs of velopharyngeal incompetence (VPI) and articulation errors, and if so, which terminology they use. Twenty 7-year-olds participated in 6 focus group interviews where they listened to 8 speech samples with different types of cleft speech characteristics and described what they heard. The same speech samples had been assessed by speech-language pathologists and comprised normal speech, different degrees of VPI, oral articulation disorders, and glottal articulation. The interviews were analyzed with qualitative content analysis. The analysis resulted in 4 interlinked categories: descriptions of speech, thoughts on personal traits, consequences for communication, and emotional reactions and associations. Each category contains 4 to 5 subcategories with the children's descriptions and reflections. Glottal articulation and severe signs of VPI caused the most negative emotional reactions and were described as sounding scary and incomprehensible and the children speculated on the risk of social rejection of the speakers. Retracted oral articulation was also noted and described but with a vocabulary similar to the professionals. Minor signs of VPI were not noted. Seven-year-olds are direct and straightforward in their reactions to cleft palate speech characteristics. More pronounced signs of VPI and articulatory difficulties, also minor ones, are noted. Clinically, articulatory impairments may be more important to treat than minor signs of VPI.

Analysis of Articulation Errors in Dysarthric Speech.

Imprecise articulation is the major issue reported in various types of dysarthria. Detection of articulation errors can help in diagnosis. The cues derived from both the burst and the formant transitions contribute to the discrimination of place of articulation of stops. It is believed that any acoustic deviations in stops due to articulation error can be analyzed by deriving features around the burst and the voicing onsets. The derived features can be used to discriminate the normal and dysarthric speech. In this work, a method is proposed to differentiate the voiceless stops produced by the normal speakers from the dysarthric by deriving the spectral moments, two-dimensional discrete cosine transform of linear prediction spectrum and Mel frequency cepstral coefficients features. These features and cosine distance based classifier is used for the classification of normal and dysarthic speech.

Audiological Management of Pediatric Oncology Patients

Audiological Management of Pediatric Oncology Patients

Objective assessment of cleft lip and palate speech intelligibility using articulation and hypernasality measures.

Assessment of intelligibility is required to characterize the overall speech production capability and to measure the speech outcome of different interventions for individuals with cleft lip and palate (CLP). Researchers have found that articulation error and hypernasality have a significant effect on the degradation of CLP speech intelligibility. Motivated by this finding, the present work proposes an objective measure of sentence-level intelligibility by combining the information of articulation deficits and hypernasality. These two speech disorders represent different aspects of CLP speech. Hence, it is expected that the composite measure based on them may utilize complementary clinical information. The objective scores of articulation and hypernasality are used as features to train a regression model, and the output of the model is considered as the predicted intelligibility score. The Spearman's correlation coefficient based analysis shows a significant correlation between the predicted and perceptual intelligibility scores (ρ = 0.77, p < 0.001).

초급 중국인 학습자의 한국어 자음 발음 유형 분석 -음절 경계의 자음을 중심으로 -

The goal of this study is to analyze articulatory errors of Korean consonants in the pronunciations of Chinese learners in Korean. In articulating Korean words, to enunciate any consonant sequence of a syllable boundary means to vocalize a final consonant by overlapping it with the subsequent initial consonant. This paper investigates these Korean phonological phenomena through the findings of Chinese students’ Korean pronunciations. There are three basic types of errors in phonetics at the consonantal sequences of syllable boundaries when Chinese students phonate Korean. Firstly, the syllable final deletion which is considered as the most typical error from Chinese learners occurs in various types of consonantal sequences. Although Chinese /n, ŋ/ can be distributed in syllable final positions, the Chinese students tend to delete Korean syllable finals such as ‘ㄴ,ㅇ’ due to their both distributional restrictions and characteristics of deleting convention of their native language. Secondly, the syllable initial alternation occurred in an isolated syllables can happen due to pronunciation errors of Korean obstruents. In this case, any syllable final consonants do not have any specific roles concerned with this progress. Lastly, the syllable final alteration attempted to the consonants has low sonority. The altered syllable final consonants tend to maintain their inherent places of articulations.

The relationship between trained ratings and untrained listeners’ judgments of global coherence in extended monologues

ABSTRACTBackground: Global coherence rating scales have been used by a number of researchers to examine spoken discourse in populations with and without acquired neurogenic communication disorders. The 4-point global coherence (GC) scale in the current study has demonstrated reliability and convergent validity. However, we have not yet established how a global coherence rating corresponds to functional communication.Aims: The current study explores the clinical meaningfulness of the 4-point GC rating scale. Survey questions and ratings were developed to examine discourse quality and functional coherence as perceived by untrained listeners. Ratings by untrained listeners were compared to trained discourse ratings using the established 4-point GC scale.Methods and Procedures: Twelve discourse samples, scored by a trained rater, were selected for the current study from a previously collected set of discourse transcripts. Transcripts were extended monologues in response to one of four possible open-ended questions that were re-recorded by the trained rater to remove any distracting features of the original recordings, such as articulatory errors. Twenty-four untrained listeners rated the discourse samples using a short questionnaire that included questions for each sample about: topic maintenance, inclusion of unnecessary information, and the listener level of interest and attention. Questions for untrained listeners were based on operational definitions of global coherence and discourse quality respectively. These untrained ratings were compared to trained ratings of global coherence. Outcome measures were compared using non-parametric tests and a Spearman Rank Order test was also used to examine relationships among variables.Main Contribution: Untrained listeners’ ratings for topic maintenance and inclusion of unnecessary information were significantly different between trained low, medium, and high global coherence ratings. Topic maintenance and inclusion of unnecessary information were also both significantly correlated with global coherence. Untrained listeners’ ratings of their level of interest and attention for a sample were significantly different between trained medium-high and low-high global coherence ratings. Interest and attention ratings were also significantly correlated with ratings of global coherence.Conclusions: Untrained raters did differentiate between levels of global coherence using ratings of topic maintenance, inclusion of unnecessary information, and their level of attention and interest. Global coherence was also significantly correlated with the untrained ratings. These findings provide preliminary external validity for the global coherence scale and support its clinical utility.

Perception of Tamil Mono-Syllabic and Bi-Syllabic Words in Multi-Talker Speech Babble by Young Adults with Normal Hearing.

Background and ObjectivesThis study compared the perception of mono-syllabic and bisyllabic words in Tamil by young normal hearing adults in the presence of multi-talker speech babble at two signal-to-noise ratios (SNRs). Further for this comparison, a speech perception in noise test was constructed using existing mono-syllabic and bi-syllabic word lists in Tamil.Subjects and MethodsA total of 30 participants with normal hearing in the age range of 18 to 25 years participated in the study. Speech-in-noise test in Tamil (SPIN-T) constructed using mono-syllabic and bi-syllabic words in Tamil was used as stimuli. The stimuli were presented in the background of multi-talker speech babble at two SNRs (0 dB and +10 dB SNR). ResultsThe effect of noise on SPIN-T varied with SNR. All the participants performed better at +10 dB SNR, the higher of the two SNRs considered. Additionally, at +10 dB SNR performance did not vary significantly for neither mono-syllabic or bi-syllabic words. However, a significant difference existed at 0 dB SNR.ConclusionsThe current study indicated that higher SNR leads to better performance. In addition, bi-syllabic words were identified with minimal errors compared to mono-syllabic words. Spectral cues were the most affected in the presence of noise leading to more of place of articulation errors for both mono-syllabic and bi-syllabic words.

Development of Articulation Screening Tool to Assess the Articulation Errors in Urdu Speaking School Going Children

Urdu is the national language of Pakistan and more than 100 million people speak Urdu worldwide. Urdu has 43 phonemes, however, there are some distinct phonemes in English and Urdu languages that affect the accuracy of test results. Ultimately, it leads to difficulty in assessment, diagnosis and intervention planning. This study is aimed to develop a criterion based articulation screening tool to identify articulation errors in Urdu speaking school going children. For this purpose, 500 Urdu words were selected after literature review for eliciting spontaneous single word responses at initial, medial and final positions. 10 professionals were requested to review and rate each word on a scale ranging from 1 – 5 (1=strongly disagree, 2= disagree, 3= neutral, 4=agree, 5= strongly agree). Pilot study was conducted on 25 Urdu speaking school going children to check content validity. The mean score of all the responses was calculated and the top three responses were selected for further application. In the second application, 200 school going children including 100 boys and 100 girls were included. Their responses comprising sound utterances at initial, medial and final positions were converted to mean scores. Mean scores of expert opinion, pilot study and final application of UAST were calculated using Excel spreadsheets. The minimum mean score of selected words was 3, whereas the maximum mean score was 5. Final application proves the validity of UAST. The minimum mean score of selected words was 4.5, whereas the maximum mean score was 5. The study proved that UAST is a valid screening tool to screen articulation errors in Urdu speaking school going children.

Tongue-palate contact patterns for Japanese speakers with and without cleft lip and palate

Purpose: Visual feedback therapy, using electropalatography (EPG), has been used to remedy residual articulation errors associated with cleft palate. The tongue-palate contact patterns of typical speakers without cleft palate are usually used as a model. However, it is questionable whether these model patterns are adequate for clients with repaired cleft palate, as their dento-palatal morphology is different from non-cleft speakers. The objective of this study was to investigate the differences in tongue-palate contact patterns between typical speakers with and without cleft palate.Method: EPG data were recorded for alveolar consonants in 15 participants with repaired unilateral cleft lip and palate (UCLP) whose speech was perceptually assessed as typical Japanese. The cumulative templates for each consonant were generated from the maximum contact frame; quantitative analyses (centre of gravity [CoG], variability index) were performed. Fifteen typical Japanese speakers without cleft served as a control group.Result: EPG patterns for each consonant were generally similar between groups. The CoG value of the UCLP group was significantly lower only for /s/. The average variability index was higher for every consonant but the comparisons did not reach significance.Conclusion: The typical tongue-palate contact patterns can be used as a model of visual feedback therapy.

Techniques and timings for cleft palate surgery: a randomised controlled trial

Background: There is a lack of reliable information on outcomes following cleft surgery. Options for timing and choice of primary cleft surgery have not been compared in randomised trials. Methods: Non-syndromic infants, aged six months, with isolated cleft of the secondary palate without associated lip deformity, were included in this prospective randomised trial to one of four options: Veau-Wardill-Kilner palatoplasty at six months of age (VWK06) or 12 months of age (VWK12), or two-flap palatoplasty with intra-velar veloplasty at six months of age (2F-IVV06) or 12 months of age (2F-IVV12). Outcome measures are early and late postoperative complications, velopharyngeal inadequacy symptoms, nasality, articulation and presence of otitis media at three years of age. Results: Of the 76 infants included in the trial, 90.8 per cent received surgery: VWK06 (n = 18), VWK12 (n = 16), 2F-IVV06 (n = 18) and 2F-IVV12 (n = 17). Early postoperative complications occurred in two VWK infants (6.1%) and three 2F-IVV infants (8.8%)—a difference of -2.8 per cent. With surgery planned at six months of age (T06) and 12 months of age (T12) respectively, there were three VWK infants (8.6%) and two 2F-IVV infants (6.3%)—a difference of +2.3 per cent. At age three, speech assessments were conducted for 62 (84%) children. Velopharyngeal inadequacy symptoms were detected in 4/30 VWK children (13.3%) and 3/30 2F-IVV children (10.0%)—a difference of 3.3. With T06 and T12, there were three VWK infants (9.4%) and four 2F-IVV infants (14.3%)—a difference -4.9%. Otitis media was documented in 40/61 of children (65.6%), hyper- and/or hyponasality in 27/61 of children (44%) and articulation errors in 53/60 of children (88%). Conclusion: Post-surgical complication rates appear low, and differ little, between VWK and 2F-IVV. At three years, there were no demonstrable differences in velopharyngeal inadequacy symptoms, nasality, articulation and otitis media between the two surgical techniques at two different times.

Techniques and timings for cleft palate surgery: a randomised controlled trial

Background: There is a lack of reliable information on outcomes following cleft surgery. Options for timing and choice of primary cleft surgery had not been compared in randomised trials. Methods: Non-syndromic infants, aged six months, with isolated cleft of the secondary palate without associated lip deformity, were included in this prospective randomised controlled trial to one of four options: Veau-Wardill-Kilner palatoplasty at six (VWK06) or 12 months of age (VWK12), or two-flap palatoplasty with intra-velar veloplasty at six (2F-IVV06) or 12 months of age (2F-IVV12). Results: Of the 76 infants included in the trial, 90.8 per cent received surgery: VWK06 (n=18), VWK12 (n=16), 2F-IVV06 (n=18) and 2F-IVV12 (n=17). Early postoperative complications occurred in two VWK infants (6.1%) and three 2F-IVV infants (8.8%). With surgery planned at six (T06) and 12 months of age (T12) respectively, there were three VWK infants (8.6%) and two 2F-IVV infants (6.3%). At age three, speech assessments were conducted for 62 (84%) children. Velopharyngeal inadequacy symptoms were detected in 4/30 VWK children (13.3%) and 3/30 2F-IVV children (10.0%). With T06 and T12, there were three VWK infants (9.4%) and four 2F-IVV infants (14.3%). Otitis media was documented in 40/61 of children (65.6%) hyper- and/or hyponasality in 27/61 of children (44%) and articulation errors in 53/60 of children (88%). Conclusion: Postsurgical complication rates differ little between VWK and 2F-IVV. At three years, there were no demonstrable differences in velopharyngeal inadequacy symptoms, nasality, articulation and otitis media between the two surgical techniques at two different times.

Speech and language in children with Klinefelter syndrome

BackgroundSpeech and language deficits are frequent in males with Klinefelter syndrome (KS), yet the research base is slim and specific strengths and deficits in communication have not been well characterised. Nor have studies examined communication abilities across a wide age-range from infancy to adolescence. ObjectiveTo characterise communication in children and adolescents with KS. MethodTwenty-six males, aged 1;1–17;4 years, took part in the study. Oromotor, speech, language, literacy and pragmatic abilities were assessed. ResultsCommunication impairment was seen in 92% of cases (24/26), with salient findings being impairments in social-pragmatic language (15/18; 83%), language-memory (12/15; 80%) and literacy (13/17; 76%). Mild to severe receptive and expressive language deficits were common (16/23; 70%), although performance was varied across linguistic domains of semantics, syntax, and morphology. Oromotor impairment (21/21; 100%) and speech impairments were evident from preschool through to adolescence. Whilst speech was highly intelligible (22/26; 85%), articulation errors (12/26; 46%), phonological delay (12/26; 46%), phonological disorder (5/26; 19%) and dysarthria (2/23 8.7%) were observed. Other atypical, yet mild, speech features were noted such as hyponasality (16/23; 70%). ConclusionsLanguage, literacy and social-pragmatic deficits are common in KS. Data suggested a trend for more notable deficits with age and increasing academic and social demands. We added novel data on the nature of speech production deficits, including persistent phonological errors in a number of cases. Earlier detection and intervention of phonological errors may reduce the risk for later language and literacy challenges and optimise academic, and ultimately social and behavioural difficulties later in life.

Prosthetics and speech therapy in patients with a high-Arched palate

The prosthodontic rehabilitation of patients postcleft palate repair is an important part of the multidisciplinary approach to solving the many problems related to total health. One such problem is speech difficulties and articulation errors. High-arched palate associated with cleft palate repair affects phonation and articulation by affecting the approximation of its surface with the tongue. This results in unintelligible and hypernasal sound production. Palatogram is a fairly simple, yet highly efficacious clinical technique for the assessment of palatal contours, to improve the existent speech deficiencies of affected sounds. This case report demonstrates a multidisciplinary treatment approach to successfully improve the intelligibility of speech by fabrication of a speech appliance by making a palatogram and customizing the palatal contours.

Effect of Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT) on Compensatory Articulation in Children With Cleft Palate/Lip.

Objective. This investigation researched the effectiveness of the PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) method to address compensatory articulation errors in children with cleft palate. Design. Single-subject AB multiple baselines across participants and behaviors. Setting. Pediatric outpatient rehabilitation department in a local hospital in a metropolitan city. Participants. The investigation consisted of 3 participants (ages = 4:4 to 12:8) born with bilateral complete cleft lip and palate. All participants underwent several reconstructive surgeries to repair their lips and palates. Interventions. The PROMPT treatment was provided for 45 minutes 3 times a week for 4 weeks (3 weeks for Participant 2). Main Outcome Measure. Therapy sessions addressed anterior lingual speech motor phonemes across 3 tiers (syllables, words, and phrases). Results. Direct visual observation of data obtained throughout this investigation indicate potential positive effects and significant correlation between improvements in sound production at 3 tiers and the implementation of the PROMPT technique. Speech intelligibility was judged by 3 blinded listeners who were unfamiliar with children with speech disorders or with cleft palate speech. All listeners identified and judged improvement in overall speech intelligibility over the course of this investigation. Listeners examined speech samples selected from sessions 3, 6, 9, and 12. Conclusion. The findings in this investigation provide a potential relationship on the effectiveness of the PROMPT method and attainment of accurate speech productions in children with cleft palate producing compensatory articulation errors, resulting in improvement in overall speech intelligibility.

Phonological Abilities in Persian Speaking Preschool Children with Stuttering and Fluent Peers.

Speech sound production is poorer in stutterers than normally fluent peers. This study was performed to compare speech sound production abilities in Persian speaking children with developmental stuttering. Overall, 34 children with stuttering and 60 children without stuttering aged from 3 to 6 yr old were enrolled from Ahvaz City, Khuzestan Province, southern Iran in 2016. The phonetic information test was used to assess speech sound production in this study and 30-minute mother-child conversations were utilized for calculation of Percentage Consonant Correct. Phonological abilities of these two groups were compared against each other and a correlation between stuttering severity and speech sound articulation was calculated. There was significant difference between children with stuttering and normal peers for articulation error total percentage but not significant difference was found for percentage consonant correct (P=0.16). Moreover, no significant correlation between stuttering severity and speech sound production in this population was found. No association seems to exist between stuttering severity and speech sound production abilities in this population. This study may lead to the notion that there was significant difference between the two groups in speech sound production assessment.