Articulation Test Research Articles

비주얼파닉스를 활용한 조음중재가 청각장애아동의 말 명료도와 모음공간에 미치는 영향*

The purpose of this study was to investigate the effect of articulatory intervention using visual phonics to improve the speech intelligibility of children with impaired hearing. The subjects of the study were five hearing impaired children. As per the results of the UTAP articulation tests, five phonemes with the most frequent errors were selected for each child and a total of 10 sessions were provided. The methodology involved analyzing vowel space and related measures (vowel space area, vowel articulatory index, formant centralization ratio, and F2i/F2u ratio) before and after the visual phonics intervention. After the articulation intervention, every child

A study on Articulatory intervention program using visual phonics on the percentage of correct consonant in children with hearing impairment

본 연구는 청각장애 아동이 시각적인 단서에 더 많은 영향을 받는다는 가설 아래 시각적 ‘상징기호’와 ‘손단서’로 구성된 비주얼파닉스를 활용한 조음중재가 청각장애 아동의 자음 산출능력에 어떠한 효과를 주는지 알아보고자 하였다. 연구대상은 5명의 초등학교 저학년 청각장애 아동들이었다. 각 아동을 대상으로 조음검사 결과에서 가장 빈번한 오류를 보인 음소 5개를 선정하여 총 10회기로 구성된 개별 중재 프로그램을 제공하였다. 자음 정확도의 측정을 위해 각 회기별 중재효과를 측정하였고, 사전-사후평가에서 U-TAP을 실시하여 자음정확도를 구하였다. 그 결과 모든 아동이 중재효과 측정에서 목표 음소에 대해 향상된 능력을 보였고, 사후 U-TAP평가에서도 향상된 자음정확도를 보였다. 이러한 결과에 따라 시각적으로 상징기호와 손단서를 사용하는 비주얼파닉스의 활용이 청각장애 아동의 조음능력 향상에 효과적이었으며, 이러한 영향을 미친 요인에 대하여 논의하였다.The purpose of this study was to investigate the effects of articulatory intervention using ‘visual phonics’ that using ‘written symbol’ and ‘hand cue’ on the ability of children with auditory disorder to produce consonants under the hypothesis that children with hearing impairment are more affected by visual cues. The subjects of the study were five children with hearing impairment. In the results of the articulation tests, five consonants with the most frequent errors were selected for each child, and a total of 10 sessions were provided. In order to measure the consonant accuracy, the intervention effect was measured for each session, and the consonant accuracy was obtained by performing U-TAP in pre-post evaluation. As a result, the consonant accuracy of all children was improved in both the intervention effect measurement and U-TAP. According to these results, the use of visual phonics using written symbol and hand clue had a positive effect on the articulation ability of the children with hearing impairment, and the influencing factors were discussed.

Normative and validation data of an articulation test for Italian-speaking children

ObjectivesAs a standardized instrument to assess speech sound development in Italian-speaking children is currently lacking, norms used to diagnose speech sound disorders (SSD) are mainly based on studies including English-speaking participants. This application may result in misidentification of SSD due to linguistic differences. The aims of the study were to establish normative data on speech sound development of Italian-speaking children and to evaluate psychometric properties of Rossi's articulation test, the picture-naming test selected to assess speech sound development. MethodsA cross-sectional study including 694 normally-developing Italian-speaking children aged from 3 to 7 years was conducted. Children were administered Rossi's articulation test, and percentages of speech sound correct production were calculated. To evaluate inter-rater reliability of the test, audio-recordings of 50 children were scored by an additional examiner. The same rater scored the audio-recordings of 50 children twice with an interval of at least 1 week. To evaluate test-retest reliability, 144 participants were re-tested after 1-3 weeks by the same assessor. Scores were compared through Intraclass Correlation Coefficient (ICC). To assess construct validity, the developmental progression of total scores across age groups was verified by the estimation of the reference range for the test, using a regression procedure. ResultsAlmost all Italian children in the sample produced vowels and approximants correctly. Singleton consonants were acquired before consonant clusters. Ages of acquisition of each consonant were presented: plosives and nasals were early mastered by Italian children, while dental affricates, alveolar fricatives and the palatal lateral were the latest acquired segments. All ICCs were superior to 0.9 (reliability). A statistically significant improvement in test score with age was found (construct validity). ConclusionsThe paper provides normative data for speech sound development of Italian-speaking children; preliminary psychometric analysis of Rossi's articulation test revealed satisfactory reliability and construct validity. Clinicians are recommended to use Rossi's articulation test to assess speech sound development in Italian children.

Subjective Evaluation of the Speech Intelligibility on the Background of Noise and Reverberation

In this paper, the results of speech intelligibility subjective assessment of Ukrainian speech monosyllabic sound combinations against background noise and reverberation through articulation tests are presented. The evaluation was carried out with the help of specially developed software that allowed automating and thus greatly facilitating and accelerating the procedure of articulation tests. Special text and sound tables of the Ukrainian speech monosyllables of the consonant-vowel-consonant (CVC) type were developed for the tests. The recordings of pure signals were made in the muffled room of the Acoustics and Acoustoelectronics Department of the National Technical University of Ukraine "Igor Sikorsky Kyiv Polytechnic Institute". The recording was performed at a frequency of 22050 Hz and a bit depth of 16 bits. Speech monosyllables were read using a verbal environment. Listening was done for four situations: pure language; speech distorted by noise; speech distorted by reverberation; speech distorted by the combined effect of noise and reverberation. In the first case, speech monosyllables of 3 articulation tables were listened, each of which contained 50 monosyllables. In the second case, speech distorted by the additive noise with the signal-to-noise ratios minus 10 dB, 0 dB and plus 10 dB was listened. In this case, models of white, pink and brown noises were used, the masking property of which is rather well-studied. In the third case, the reverberant speech for reverberation times from 0.3 to 2.7 s was modeled by convolution of pure speech signals with impulse characteristics of various rooms, and in the fourth case the joint action of pink noise and reverberation was considered. It turned out that the masking ability of white noise exceeds one for brown noise for signal-to-noise ratios (SNR) less than minus 5 dB, which is not entirely consistent with previous preliminary predictive estimates. Signals listening had been made by two ways, namely through the headphones and by means of acoustic monitors. The SNR varied in the range ‑10…+10 dB, and the reverberation time varied in the range 0.3…2.7 s. In addition, it turned out that listening to speech distorted by noise through acoustic monitors could lead to a significant increase in the intelligibility of speech, compared to the case of listening through headphones. With a signal-to-noise ratio of minus 10 dB, the values of speech intelligibility scores increased from 0.1-0.3 to 0.85-0.93. Similar results were obtained for the reverberation action: the speech intelligibility increased from 0.65 to 0.94 for the reverberation time of 2.7 s. This speech intelligibility growth can be explained, firstly, by the action of early reflections. Secondly, usage of two loudspeakers as sound sources and also binaural listening can be also considered as reasons of speech intelligibility increase. Nevertheless, these reasons for increasing the intelligibility of speech are hardly the only ones. Therefore, it is necessary to further study the causes of the revealed significant increase in speech intelligibility. Among such reasons can be both features of the developed automated system of articulation tests, and features of the psychophysical state of listeners.Ref. 13, fig. 5.

Correlation Between Articulation Disorders and Oral Motor Mechanism

Function of oral cavity is to produce speech sounds for verbal communication along with performance of its primary functions. Its defects can decrease intelligibility of speech while affecting production of phonemes. Description of this relationship is important for etiologic diagnosis and treatment planning among children without any disability or ignored craniofacial deformities. Studies highlighting this relationship are rare to none in Pakistan. Therefore, this study aims to detect the type and extent of relationship between these two factors. Methods: A descriptive cross sectional study was conducted on a sample of 140, which were 4-8 years old children with speech sound disorders, without any disability, and visiting various speech clinics in Pakistan. Test for Assessment of Articulation and Phonology in Urdu (TAAPU) was applied as it contains both oral motor screen and articulation tests. Results: The study examined the relationship between Oral Motor Mechanism (OMM) and Articulation Disorders. Oral motor screening of 140 children showed that (23%) had OMM defects among these 33% had substitution errors, 60% distortion errors, and 3.03% omission errors whereas no addition errors were found. The correlation of 0.763 positive relationships between two variables was noticed. High percentage of distortion errors among children having OMM defects shows strong connection between the two otherwise substitution is most prevalent error. Conclusion: Conclusively it can be stated that anatomical and physiological defects of oral cavity lead to articulation errors. Children with articulation deficit had distorted speech with multiple oral motor anomalies.

Speech Production Skills in Children With Cleft Palate Who Were Internationally Adopted.

The objective of this study was to investigate the impact of international adoption (IA), age at palatoplasty (PR age), and velopharyngeal sufficiency (VPS) on articulation outcomes. This was a cross-sectional, prospective, observational study. Outpatient hospital clinic. Fifty-one IA and 65 not-adopted (NA) children between the ages of 3 and 9 with nonsyndromic cleft palate with or without cleft lip. The Goldman-Fristoe Test of Articulation-2nd Edition (GFTA-2) standard score and cleft-related articulation errors (CREs). Articulation impairment was observed for 40% to 76% of NA children and 71% to 92% IA children, depending on age. PR age mean IA = 2.07 (0.86) years; NA = 1.23 (0.71) years. Children who were IA had poorer performance on the GFTA-2 ( B = -13.82, P = .015). Children who were IA were not significantly more likely to make CRE; rather, age at the time of assessment ( B = -.10, P = .002) and VPS ( B = .24, P = .021) were associated with CRE. Children who were IA demonstrated poorer articulation skills. Although primary palatoplasty was accomplished later among children who were IA, age at assessment and VP status (not PR age) were significantly correlated with articulation outcomes. Implications for timing of surgical intervention are discussed.

Tribological evaluation of biomedical polycarbonate urethanes against articular cartilage.

This research investigated the in-vitro wear and friction performance of polycarbonate urethane (PCU) 80A as they interact with articular cartilage, using a customised multidirectional pin-on-plate tester. Condyles were articulated against PCU 80A discs (Bionate® I and Bionate® II) (configuration 1) and the results arising from these tests were compared to those recorded during the sliding of PCU pins against cartilage plates (configuration 2). Configuration 1 produced steadily increasing coefficient of friction (COF) (up to 0.64 ± 0.05) and had the same trend as the cartilage-on-stainless steel articulation (positive control). When synovial fluid rather than bovine calf serum was used as lubricant, average COF significantly decreased from 0.50 ± 0.02-0.38 ± 0.06 for condyle-on-Bionate® I (80AI) and from 0.41 ± 0.02-0.24 ± 0.04 for condyle-on-Bionate® II (80AII) test configurations (p < 0.05). After 15 h testing, the cartilage-on-cartilage articulation (negative control) tests showed no cartilage degeneration. However, different levels of cartilage volume loss were found on the condyles from the positive control (12.5 ± 4.2 mm3) and the PCUs (20.1 ± 3.6 mm3 for 80 AI and 19.0 ± 2.3 mm3 for 80AII) (p > 0.05). A good correlation (R2 =0.84) was found between the levels of average COF and the volume of cartilage lost during testing; increasing wear was found at higher levels of COF. Configuration 2 showed low and constant COF values (0.04 ± 0.01), which were closer to the negative control (0.03 ± 0.01) and significantly lower than configuration 1 (p < 0.05). The investigation showed that PCU is a good candidate for use in hemiarthroplasty components, where only one of the two articulating surfaces is replaced, as long as the synthetic material is implanted in a region where migrating cartilage contact is achieved. Bionate® II showed better tribological performance, which suggests it is more favourable for use in hemiarthroplasty design.

The treatment efficacy of multiple opposition phonological approach via telepractice for two children with severe phonological disorders in rural areas of West Texas in the USA

The goals of the present study were to (1) examine the effects of the multiple opposition phonological approach on improving phoneme production accuracy in children with severe phonological disorders and (2) explore whether the multiple opposition approach is feasible for the telepractice service delivery model. A multiple-baseline, single-participant design replicated across two children, was implemented. Two male children who resided in rural areas of West Texas in the USA participated. One child was 4 years and 10 months old and the other child was 6 years old. Both of the children were diagnosed with phonological disorders without any sensory, motoric, or intellectual disabilities. The children’s articulation was tested using Goldman–Fristoe Articulation Test-2 and probes were administered across the period of the study. The children received a 30-minute phonological intervention via telepractice twice a week for 12 or 16 weeks. An increasing trend for production accuracy for target sounds was observed during intervention for both children. Maintenance also was observed at 2-week and 2-month follow-ups. Standard scores from a standardized articulation test increased during posttest compared to pretest. The multiple opposition phonological approach can lead to improved speech production accuracy in children with severe phonological disorders. Telepractice may be an effective context for a phonological intervention approach as has been found for other domains of speech and language intervention and a useful service delivery model to underserved children with speech disorders who are unable to access a speech pathologist due to various circumstances.

Speech evaluation in children with missing anterior teeth and after prosthetic rehabilitation with fixed functional space maintainer

Speech and language development in children is a dynamic process. Development of vocal sound into meaningful speech was one of the major discoveries which have made the human beings to reach the pinnacle of the animal kingdom. The ability to speak is determined by the flow of air into the mouth which affects pronunciation of various words and phrases. This study aimed to evaluate speech changes before and after prosthetic rehabilitation with fixed functional space maintainer in children with missing maxillary anterior teeth. The study sample comprised of 25 children in the age range of 3-6 years having at least two maxillary anterior teeth indicated for extraction or had already got extracted. Speech therapist evaluated articulation of [v], [ph], [n], [d], [dh], [th], [t], [s.],[s], and [l] speech sounds of patients preoperatively (T0), postoperatively after the appliance insertion (T1), and postoperatively after 7 days (T2) using Weiss Comprehensive Articulation Test. The data obtained were analyzed using Chi-square and Mcnemar's test. There was statistically significant (P < 0.05) correction in [v], [ph], [d], [dh], [th], [t], [s.], and [s] speech sounds immediately after prosthetic rehabilitation (T1). While, the assessment of speech sounds after 7 days of appliance insertion (T2) showed statistically nonsignificant differences. The results suggested that treatment of a patient with missing anterior teeth should not be restricted to esthetic and functional oral rehabilitation, but also comprehend with the speech, as premature loss of the primary maxillary incisor appears to have long-term effect on the speech development.

Use of metacognitive strategies in the speech and language intervention of Marathi speaking individuals with cleft of lip and/or palate

Introduction: Compensatory Articulation Disorder (CAD) is frequently seen in individuals with Cleft of lip and Palate (CLP). Speech intervention with metacognitive strategies in these individuals requires a long period of time. Objective: To study the use of metacognitive strategies in therapeutic intervention of individuals with Cleft of Lip and Palate. Methodology: 14 Marathi speaking Children with CLP between 4 to 6 years of age were evaluated for language and articulation. 7 Speech Language Pathologists devised Percentage Correct Consonants on the Photo Articulation Test for Articulation pre and post intervention. Language measures were compared pre and post therapy on the Receptive Expressive Emergent Language Scale. Results: There was a significant difference between articulation and language measures pre and post intervention respectively which is attributed to the use of metacognition strategies. Conclusion: Severity of CAD and effectiveness of strategies used for correcting articulation errors are linked to one another. Assessment of CAD and therapy scaffolding metacognition strategies can be used in Speech treatment of individuals with CLP.

A novel technique for superior-based pharyngeal flaps: 10-year results with formal speech outcomes assessment

PurposeDescribe a novel technique for superior-based pharyngeal flaps allowing restoration of bulk to the soft palate and intraoperative fine-tuning of lateral port size, while avoiding midline palate-splitting. Validated speech assessment tools are employed for quantitative analysis. MethodsRetrospective review of all patients who underwent superior-based pharyngeal flap in a 10-year period by a single surgeon. Pittsburgh Weighted Values for Speech Symptoms Associated with VPI and the Goldman-Fristoe Test of Articulation were used for formal speech assessment. Results78 patients met inclusion criteria with clinical data up to 10years postoperatively. 31 patients had congenital velopharyngeal insufficiency (VPI), and the remainder acquired VPI after cleft palate repair or adenoidectomy. 37 patients had a recognized syndrome. All patients noted subjective improvement in nasality, and evaluation with the validated speech assessment tools demonstrated statistically significant improvement in speech. Only one flap takedown was required in a patient with severe midface hypoplasia who developed sleep apnea several years postoperatively. ConclusionsThis technique is successful in congenital and acquired VPI, and in patients with complex craniofacial syndromes. Customization of lateral ports based on preoperative nasopharyngoscopy, and avoidance of a midline palate splitting incision, make this an attractive option for superior-based flap surgery.

Influence of valproate on language functions in children with epilepsy

The aim of the current study was to assess the influences of valproate (VPA) on the language functions in newly diagnosed pediatric patients with epilepsy. We reviewed medical records of 53 newly diagnosed patients with epilepsy, who were being treated with VPA monotherapy (n=53; 22 male patients and 31 female patients). The subjects underwent standardized language tests, at least twice, before and after the initiation of VPA. The standardized language tests used were The Test of Language Problem Solving Abilities, a Korean version of The Expressive/Receptive Language Function Test, and the Urimal Test of Articulation and Phonology. Since all the patients analyzed spoke Korean as their first language, we used Korean language tests to reduce the bias within the data. All the language parameters of the Test of Language Problem Solving Abilities slightly improved after the initiation of VPA in the 53 pediatric patients with epilepsy (mean age: 11.6±3.2years), but only “prediction” was statistically significant (determining cause, 14.9±5.1 to 15.5±4.3; making inference, 16.1±5.8 to 16.9±5.6; prediction, 11.1±4.9 to 11.9±4.2; total score of TOPS, 42.0±14.4 to 44.2±12.5). The patients treated with VPA also exhibited a small extension in mean length of utterance in words (MLU-w) when responding, but this was not statistically significant (determining cause, 5.4±2.0 to 5.7±1.6; making inference, 5.8±2.2 to 6.0±1.8; prediction, 5.9±2.5 to 5.9±2.1; total, 5.7±2.1 to 5.9±1.7). The administration of VPA led to a slight, but not statistically significant, improvement in the receptive language function (range: 144.7±41.1 to 148.2±39.7). Finally, there were no statistically significant changes in the percentage of articulation performance after taking VPA. Therefore, our data suggested that VPA did not have negative impact on the language function, but rather slightly improved problem-solving abilities.

Auralization generated by modeling HRIRs with artificial neural networks and its validation using articulation tests

The usual method to generate an auralization is to simulate the acoustic field with a computer code and to convolve each wavefront that arrives to the receiver with the corresponding measured head-related impulse response (HRIR) direction, to obtain the binaural room impulse responses (BRIRs) for selected positions. In this work, this technique is replaced by a procedure where the HRIRs are modeled by a set of artificial neural networks, with significant computational gain. The type of network and its architecture is briefly described and a comparison between measured and modeled responses — both in time and frequency domains — are presented for several directions covering the sphere around the head. Furthermore, since graphs do not tell all when auralizations are the concern, a virtual auralization assessment is performed. In this work, computer modeling auralizations are validated through articulation tests. Three articulation scores are computed. The first one is obtained in the actual room itself. The second one is obtained from measuring the BRIRs and convolving them with anechoic speech signals. The third one result from the room’s numerical simulation, generating as output the virtual BRIRs. These are then convolved with the same anechoic speech signals. The three articulation scores are then compared, and this is done in four different conditions. To investigate the influence of background noise level in the error among the compared articulation scores, pink noise with two distinct levels is introduced in one of the rooms, both in the actual and virtual tests. Finally, one strongly reverberant room is considered in other to evaluate if, in this condition of low intelligibility, the auralization is still trustworthy. In all cases, the results show that differences lower than 3.5% among actual and virtual articulation scores were found. The main conclusions are that the virtual auralizations obtained with the room simulator using artificial neural networks to model the head-related impulse responses are successful and that articulation scores are a reliable metric to validate auralizations.

Not all /r/s and /l/s are the same: Classification of errors in children with cochlear implants versus normal hearing

Purpose: As children acquire speech sounds, they progress from clear substitutions, to “intermediate forms” (covert contrasts), to adult-like productions. However, there is evidence that this progression may be different in CI users as compared to NH children. Identification of intermediate forms is dependent upon rating scales that are sensitive to fine phonetic detail, such as visual analogue scales (VAS). This study uses both traditional VAS and a new 3-dimensional rating scale to explore differences in the /r,l/ productions of young children with and without hearing loss. Methods: Correct and error productions of /r,l/ were extracted from a standardized articulation test for nine congenitally deafened children who received cochlear implants (CIs) prior to age 3 and their speech age-matched controls. Stimuli were shortened to nonsense syllables to prevent real-word bias. Listeners rated these productions on both a VAS and a triangular scale, which allowed listeners to rate phone quality as a multi-dimensional function of /r/, /l/, and /w/. Results &amp; Conclusions: Both rating scales were sensitive to subtle acoustic differences in speech sounds. Listener responses suggested more variability in sound production within the group of CI users. Listeners preferred the triangular scale because it provided greater response sensitivity.

Speech sound disorders or differences: Insights from bilingual children speaking two Chinese languages

The study investigated how Putonghua-Cantonese bilingual children differ from monolinguals in their acquisition of speech sound and phonological patterns. Fifty-four typically developing Putonghua-Cantonese bilingual children aged 3;6–6;0 were recruited from nurseries in the North District of Hong Kong. The Hong Kong Cantonese Articulation Test (Cheung et al., 2006) and a Putonghua picture-naming task (Zhu & Dodd, 2000) were used to elicit single-word samples of both languages. Acquisition of speech sound and phonological patterns exhibited by ≥20% of the children in an age group were compared to the normative data on children who were Cantonese native or Putonghua monolingual speakers. The bilingual children demonstrated smaller sound inventory in both languages and more delayed and atypical phonological processes. The atypical patterns could be explained by phonological interference between Putonghua and Cantonese. The findings serve as a preliminary reference for clinicians in differentiating language difference from true speech sound disorders in Putonghua-Cantonese bilingual children in Hong Kong.

ARTICULATION OF CHILDREN IN PRESCHOOL PREPARATORY PROGRAM

The development of speech and language culture of pre-school children is one of important (if not the most important) tasks of preschool education. The paper contains the results of research on pronunciation of preschool children realized on a sample of 119 children of pre-school preparatory program. We have presented a standardized test of articulation. Research has highlighted the particular importance of early treatment of disorders in sound pronunciation of preschool children. Early identification of difficulties in pronunciation of children provides more adequate help and support from teachers, which help children with difficulties in articulating to get better achievements, not only in pre-school, but also later in school. This emphasizes the need for training teachers to determine the speech-language status of children, to use the articulation exercises of critical sounds in Serbian language sound system, and thus to correct the articulation disorders which do not belong to the etiology of speech pathology. For this purpose it is specially emphasized that children's literature is the basis for the realization of activities in the area of discrimination and articulation of sounds and speech in general, and in the later stages of the formation of children's vocabulary, logically connected and cultivated speech, expressive speech and a number of other targeted activities. Accordingly, in this paper we analyzed the role of the so-called "nonsense", "playful" children’s literature and practically presented papers that can be used in order to develop the speech of preschool children.

Three-dimensional analysis of liquid sounds produced by first graders

The liquids /r/ and /l/ in American English are complex sounds whose productions are highly variable among adult speakers, but there is currently little knowledge about how children articulate these sounds, which are typically acquired late in development. In this study, the Goldman-Fristoe Test of Articulation (GFTA-3) was administered to typically developing first graders (6 and 7 years old) while a 4D ultrasound system imaged the tongue with synchronous audio and webcam video recordings. The GFTA-3 contains words in which /r/ and /l/ occur in a variety of syllable positions and phonetic contexts. Among 14 first grade participants in this study, the so-called “bunched /r/” is overwhelmingly preferred over the so-called “retroflexed /r/.” In contrast, three-dimensional tongue shapes in the production of syllable initial /l/ are substantially more variable with two basic configurations (“coronal” and “dorsal”), while syllable final /l/ productions are more consistently “dorsal.” Examples of 3D tongue shapes will be presented, along with results from a Principal Components Analysis.

Nature of errors in percentage syllable articulation as an effect of reverberation time on Bangla

This paper identifies the nature of errors in the Percentage Syllable Articulation (PSA) test for Bangla, as a continuation and extension of a study conducted and published by the authors to determine the effects of Reverberation Time (RT) on Bangla. Errors due to RT 2.0 s are enumerated to derive Percent Error (PE) at initial, medial and final positions of phonemes in syllables, for both vowels and consonants. It is found that consonants are more vulnerable to errors than vowels, as their mean PEs are 37.8% and 27.6% respectively. Relative positions of phonemes in syllables have significant effect on PE. For vowels, mean PE increases from 12.1% to 56.7% for their medial and medial plus final positions respectively. For consonants, mean PE rises from 17.1% to 67.8% for their initial and final positions. Variations in PE within same groups of vowels and consonants, exemplify unique inherent characteristics of each phoneme.Bangladesh J. Sci. Ind. Res. 52(1), 21-30, 2017

Investigation of the speech results of posterior pharyngeal wall augmentation with fat grafting for treatment of velopharyngeal insufficiency

PurposeThe purpose of this study was to evaluate the speech results of posterior pharyngeal wall augmentation (PPWA) with fat grafting both in the early and late postoperative period, and to clarify the impact of the procedure concomitant with speech therapy. Materials and methodsThis is a prospective case-control study. The study involved 87 cleft palate ± cleft lip patients with velopharyngeal insufficiency (VPI) who has been treated with PPWA. Patients were separated into two groups according to age; the first group consisted of 49 pediatric participants between 6 and 12 years of age and the second group consisted of 38 adolescent participants between 13 and 18 years of age. Preoperative velopharyngeal function and articulation were compared postoperatively at the following time points: the 3rd month, 12th month, 18th month and 24th month. The velopharyngeal function was evaluated with regards to the velopharyngeal closure type and velopharyngeal closure amount, by using the pediatric flexible nasoendoscopy and the nasometer methods. In the nasometer evaluation, nasalance sores were measured by using nonsense syllables and meaningful sentences. The Ankara Articulation Test (AAT) (Ege et al., 2004) was used to detect compensatory articulation products secondary to VPI. Consonant production error types and frequencies were determined according the guidelines stated in the study of Hardin-Jones et al. (2009). These were Pharyngeal Fricatives – Posterior Nasal Fricatives/Stop Production, Glottal Stop Production, Middorsum Palatal Stop Production, Nasal Frictional Production, Posterior Nasal Frictional Production/Phoneme Specific Nasal Emission, use of Nasal Consonants for Oral Consonants, and Replacement of Trills. All the participants received concurrent speech therapy four times, twice in the post-operative period between 1 and 3 months and twice between 3 and 6 months. ResultsPPWA improved the speech performance from the 18th month to 24th month of the postoperative period. AAT assessment of the first group after 24 months comparing the post-PPWA with the preoperative data showed a highly significant decrease with regard to compensatory production errors and hypernasality; however, in the second group, the same comparison revealed a highly significant decrease in regard to the degree of hypernasality and a significant difference in terms of glottal articulation and pharyngealization of fricatives. A circular closure pattern was observed in 17 individuals with cleft palate at a rate of 70.6%. ConclusionPPWA with concurrent speech therapy is an acceptable surgical method to correct VPI and to improve speech performance.

Research on the relationship between articulation levels and social skills of Turkish children between the ages of 4 and 5 years

AbstractObjective:This study aims to investigate whether there is a relationship between articulation levels and social skills of normally developing children at the ages of 4 and 5 years and to determine whether articulation levels and social skills are differentiated with regard to variable factors.Methods:A relational screening model was used in this study. Eighty-seven boys and 73 girls (160 children in total) who were educated at four preschools were selected according to simple random sampling in Kütahya province, Turkey. The mean age of the children was 4.6 years. The Ankara Articulation Test (AAT) was used to specify the articulation levels of children and the Preschool Social Skills Rating Scale [PSSRS, Okul Öncesi Sosyal Beceri Değerlendirme Ölçeği (OSBED)] was used to evaluate the social skills of the children.Findings:The results of the study revealed that the articulation mistakes decrease and social skills increase as the age of children rises. It was found that girls had better results in both social skills and articulation levels than boys. Analysis of the socio-economic statuses of the children showed no significant differences between articulation levels and social skills. Correlation analysis showed that children with articulation disorders have lower social skills rankings than children without articulation disorders, and speech is one of the factors that affect social skills ranking.Results:This study is important because of its observations about speech, communication, and social skills in children, as well as for raising awareness among parents and teachers of preschool children.