| 1. |
- Semb, Gunvor, et al.
(författare)
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A Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 1. Planning and management.
- 2017
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - : Taylor & Francis. - 2000-656X .- 2000-6764. ; 51:1, s. 2-13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Longstanding uncertainty surrounds the selection of surgical protocols for the closure of unilateral cleft lip and palate, and randomised trials have only rarely been performed. This paper is an introduction to three randomised trials of primary surgery for children born with complete unilateral cleft lip and palate (UCLP). It presents the protocol developed for the trials in CONSORT format, and describes the management structure that was developed to achieve the long-term engagement and commitment required to complete the project.METHOD: Ten established national or regional cleft centres participated. Lip and soft palate closure at 3-4 months, and hard palate closure at 12 months served as a common method in each trial. Trial 1 compared this with hard palate closure at 36 months. Trial 2 compared it with lip closure at 3-4 months and hard and soft palate closure at 12 months. Trial 3 compared it with lip and hard palate closure at 3-4 months and soft palate closure at 12 months. The primary outcomes were speech and dentofacial development, with a series of perioperative and longer-term secondary outcomes.RESULTS: Recruitment of 448 infants took place over a 9-year period, with 99.8% subsequent retention at 5 years.CONCLUSION: The series of reports that follow this introductory paper include comparisons at age 5 of surgical outcomes, speech outcomes, measures of dentofacial development and appearance, and parental satisfaction. The outcomes recorded and the numbers analysed for each outcome and time point are described in the series.TRIAL REGISTRATION: ISRCTN29932826.
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| 2. |
- Billaud Feragen, Kristin, et al.
(författare)
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Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 10. Parental perceptions of appearance and treatment outcomes in their 5-year-old child
- 2017
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - : TAYLOR & FRANCIS LTD. - 2000-656X .- 2000-6764. ; 51:1, s. 81-87
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: Few studies have explored childrens emotional and behavioural reactions to cleft surgery and treatment-related stress. The objective was to investigate parents evaluations of appearance and treatment outcomes in their 5-year-old child with unilateral cleft lip and palate (UCLP), and their perceptions of how their child was coping with treatment, comparing this information with recorded postsurgical complications.Design: Three parallel group randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK.Methods: Three different surgical procedures for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with a non-syndromic UCLP. A total of 356 parents completed the Scandcleft Parent Questionnaire, and 346 parents completed the Cleft Evaluation Profile.Results: The results indicated that the majority of parents were satisfied with cleft-related features of their childs appearance. Further, most children coped well with treatment according to their parents. Nevertheless, 17.5% of the children showed minor or short-term reactions after treatment experiences, and 2% had major or lasting difficulties. There were no significant relationships between parent perceptions of treatment-related problems and the occurrence of post-surgical medical complications.Conclusions: Most parents reported satisfaction with their childs appearance. However, treatment-related problems were described in some children, urging cleft centres to be aware of potential negative emotional and behavioural reactions to treatment in some young children, with a view to preventing the development of more severe treatment-related anxiety.
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| 3. |
- Brunnegård, Karin, et al.
(författare)
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A cross-sectional study of speech in 10-year-old children with cleft palate: results and issues of rater reliability.
- 2007
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Ingår i: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - : SAGE Publications. - 1055-6656. ; 44:1, s. 33-44
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To describe speech based on perceptual evaluation in a group of 10-year-old children with cleft palate. A secondary aim was to investigate the reliability of speech-language pathologists' perceptual assessment of cleft palate speech. DESIGN: Retrospective cross-sectional study in children with cleft palate. External raters made assessments from randomized speech recordings. SUBJECTS: Thirty-eight children with unilateral cleft lip and palate (UCLP) or cleft palate only (CPO) and 10 children in a comparison group. MAIN OUTCOME MEASURES: Ratings of hypernasality, hyponasality, audible nasal air leakage, weak pressure consonants, and articulation. Exact agreement and weighted kappa values were used for reliability. RESULTS: Hypernasality was found in 25% of children with a cleft of the soft palate (CSP), 33% of children with a cleft of the hard and soft palate (CHSP), and 67% of children with a UCLP. Similar results were found for audible nasal air leakage. Articulation errors were found in 6% of the CHSP group and 25% of the UCLP group, whereas no child in the CSP group had articulation errors. The reliability was moderate to good for different variables, with lowest values for hypernasality. CONCLUSIONS: Speech results in this series seem less satisfactory than those reported in other published international studies, but it is difficult to draw any certain conclusions about speech results because of large methodological differences. Further developments to ensure high reliability of perceptual ratings of speech are called for.
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| 4. |
- Brunnegård, Karin, et al.
(författare)
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Untrained listeners’ ratings of speech disorders in a group with cleft palate : a comparison with speech and language pathologists’ ratings
- 2009
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Ingår i: International journal of language and communication disorders. - : John Wiley & Sons. - 1368-2822 .- 1460-6984. ; 44:5, s. 656-674
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hypernasal resonance, audible nasal air emission and/or nasal turbulence, and articulation errors are typical speech disorders associated with the speech of children with cleft lip and palate. Several studies indicate that hypernasal resonance tends to be perceived negatively by listeners. Most perceptual studies of speech disorders related to cleft palate are carried out with speech and language pathologists as listeners, whereas only a few studies have been conducted to explore how judgements by untrained listeners compare with expert assessments. These types of studies can be used to determine whether children for whom speech and language pathologists recommend intervention have a significant speech deviance that is also detected by untrained listeners.Aims: To compare ratings by untrained listeners with ratings by speech and language pathologists for cleft palate speech.Methods & Procedures: An assessment form for untrained listeners was developed using statements and a five-point scale. The assessment form was tailored to facilitate comparison with expert judgements. Twenty-eight untrained listeners assessed the speech of 26 speakers with cleft palate and ten speakers without cleft in a comparison group. This assessment was compared with the joint assessment of two expert speech and language pathologists.Outcomes & Results: Listener groups generally agreed on which speakers were nasal. The untrained listeners detected hyper- and hyponasality when it was present in speech and considered moderate to severe hypernasality to be serious enough to call for intervention. The expert listeners assessed audible nasal air emission and/or nasal turbulence to be present in twice as many speakers as the untrained listeners who were much less sensitive to audible nasal air emission and/or nasal turbulence.Conclusions & Implications: The results of untrained listeners' ratings in this study in the main confirm the ratings of speech and language pathologists and show that cleft palate speech disorders may have an impact in the everyday life of the speaker.
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| 5. |
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| 6. |
- Flynn, Traci, 1973, et al.
(författare)
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A longitudinal study of hearing and middle ear status of individuals with cleft palate with and without additional malformations/syndromes.
- 2014
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; 51:5
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe and compare the middle ear status and hearing sensitivity in adolescence with isolated cleft palate plus additional malformations and/or syndromes with those with only an isolated cleft palate. Design: Retrospective and longitudinal. Two groups of individuals with isolated cleft palate were compared. Participants: A cohort of individuals born over 4 years in the western region of Sweden. The cohort was divided into one group with isolated cleft palate (n = 31; ICP) and one group with isolated cleft palate plus additional malformations and/or syndromes (n = 37; ICP+). Methods: Middle ear status and hearing thresholds were collected from the medical records at 7, 10, 13, and 16 years of age, examined, and compared within and between groups over time. Results: The ICP+ group demonstrated a significantly higher prevalence of abnormal middle ear status and elevated hearing thresholds as compared with the ICP group. As the individuals aged, the prevalence of abnormal middle ear status decreased. The hearing levels in both groups decreased in the low to middle frequencies as individuals aged; however, the hearing in the high frequencies did not. Conclusions: Individuals with cleft palate need to be followed routinely for middle ear status and hearing thresholds to ensure optimal audiological rehabilitation, with particular attention to those with additional malformations and/or syndromes.
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| 7. |
- Flynn, Traci, 1973, et al.
(författare)
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The high prevalence of otitis media with effusion in children with cleft lip and palate as compared to children without clefts
- 2009
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - Amsterdam : Elsevier Biomedical. - 0165-5876 .- 1872-8464. ; 73:10, s. 1441-1446
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Children with cleft lip and palate universally present with otitis media with effusion. This prevalence has not been systematically studied. The purpose of the present study was to examine and compare the prevalence of otitis media with effusion, hearing sensitivity, and audiometry method utilised for assessment in children with and without clefts. METHODS: Two groups of children (children with unilateral cleft lip and palate, N=22, and children without clefts, N=20) were followed prospectively and longitudinally from 1 to 5 years of age. Data were collected at four points (1, 1.5, 3, and 5 years of age). Assessments at each of the four points included: (1) otomicroscopy, (2) tympanometry, and (3) hearing assessment. RESULTS: Overall the children with unilateral cleft lip and palate demonstrated a significantly higher prevalence of otitis media with effusion (121 ears, 74.7%) than children without clefts (31 ears, 19.4%) (p<0.001). This higher prevalence was also significant at 1, 1.5, 3, and 5 years of age (p<0.001). Of those ears with otitis media with effusion, 83.1% of the ears exhibited a hearing loss (PTA >20dB), with this loss more prevalent in the cleft group (89.7% UCLP and 70.0% non-cleft). The hearing loss was significantly more pronounced in the cleft (group 35.71dB HL UCLP and 26.41dB HL non-cleft group). Children with unilateral cleft lip and palate utilised a lower age-appropriate audiometry testing method than age-matched children with no cleft at 1, 1.5, and 3 years of age. CONCLUSIONS: Children with unilateral cleft lip and palate present with a significantly higher prevalence of otitis media with effusion than children without cleft. Also, the hearing loss associated with otitis media with effusion is demonstrated in this study. Furthermore, the method of audiometry has been examined and children with unilateral cleft lip and palate had to be assessed with a lower level of method than children without cleft.
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| 8. |
- Friede, Hans, 1938, et al.
(författare)
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Letter to the Editor.
- 2012
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Ingår i: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - : SAGE Publications. - 1545-1569. ; 49:4, s. 512-513
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
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| 9. |
- Friede, Hans, 1938, et al.
(författare)
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Long-Term, Longitudinal Follow-Up of Individuals with UCLP After the Gothenburg Primary Early Veloplasty and Delayed Hard Palate Closure Protocol: Maxillofacial Growth Outcome.
- 2012
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1545-1569 .- 1055-6656. ; 49:6, s. 649-656
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective: To study long-term maxillofacial development in a sample of patients born with unilateral cleft lip and palate (UCLP). The patients' palatal repair had been performed according to a two-stage protocol with early velar closure and delayed hard palate surgery. Design: Retrospective longitudinal cohort study. Subjects: The sample consisted of 50 consecutive patients with UCLP born from 1980 to 1989. All of them had been operated on at the Sahlgrenska University Hospital in Gothenburg, Sweden. Methods: Certain maxillary casts as well as lateral roentgencephalograms, obtained at 5; 10; 16; and 19 years of age, were analyzed. Results: Our patients' maxillofacial growth was very good even up to the final examination at early adulthood. We ascribe the advantageous midfacial morphology of our patients particularly to limited growth restriction from palatal scars due to the surgical protocol used in our cleft center. Conclusion: The two-stage protocol advocated by us for repair of the palatal cleft resulted in very satisfactory growth outcome. A palatal scar, that might impair maxillary development, was created only by the velar surgery. If this scar was located close to the posterior border of the hard palate, it might result in less maxillary growth restriction than if it was positioned further anteriorly. Key Words: Cephalometrics, cleft lip and palate, delayed hard palate repair, growth, maxilla, surgery.
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| 10. |
- Friede, Hans, 1938, et al.
(författare)
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Maxillary dental arch and occlusion in patients with unilateral cleft lip and palate treated with different delays in closure of the hard palate after early velar repair.
- 2006
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Ingår i: Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi. - : Informa UK Limited. - 0284-4311. ; 40:5, s. 261-6
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Tidskriftsartikel (refereegranskat)abstract
- We wanted to find out if growth of the maxilla in 26 patients with unilateral cleft lip and palate (UCLP) was adversely affected by having the residual cleft of the hard palate repaired earlier than had been done previously in a 2-stage palatal closure protocol. The ages at repair of the hard palate of the present patients ranged from 38 to 89 months. Dental casts from ages about 3 years (before any repair of the hard palate), 5, 7, and 10 years of age were analysed. The results indicated that earlier repair of the cleft in the hard palate did not influence maxillary growth differently from the later repair.
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| 11. |
- Friede, Hans, 1938, et al.
(författare)
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Two-stage palatal surgery with early veloplasty and delayed hard palate repair: A balanced view on speech and midfacial growth outcome
- 2013
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Ingår i: Cleft Lip and Palate; Diagnosis and management; Third edition; (S. Berkowitz editor). - Berlin Heidelberg 2013 : Springer-Verlag. - 9783642307690 ; , s. 413-437
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Today, there is general consensus that, particularly, the protocol for repair of the palate is crucial for normal speech development and adequate long-term midfacial growth in individuals affected with cleft lip and palate (CLP). About 90 years ago, a new two-stage palatal repair method was introduced. It was characterized by early veloplasty and later closure of the hard palate. Recent follow-up studies of this regimen have revealed excellent long-term outcome regarding maxillary growth and also satisfactory speech development, even if the hard palate surgery was delayed to the stage of early mixed dentition. A speech deviation, coined as “retracted oral articulation of anterior pressure consonants,” seemed to be a relatively common speech error, temporarily affecting about one third of our preschool children born with unilateral CLP. The prevalence of other, more severe cleft speech characteristics, such as symptoms of and related to velopharyngeal incompetence and the occurrence of glottal misarticulations in particular, was very low.
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| 12. |
- Hartelius, Lena, 1957, et al.
(författare)
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Talstörningar allmän del
- 2007
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Ingår i: Lärobok i logopedi. Hartelius L, Nettelbladt, U, Hammarberg B (red). - Lund : Studentlitteratur. - 9789144038865 ; , s. 357-75
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 13. |
- Havstam, Christina, 1963, et al.
(författare)
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Communication attitude and speech in 10-year-old children with cleft (lip and) palate: An ICF perspective.
- 2011
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Ingår i: International journal of speech-language pathology. - : Informa UK Limited. - 1754-9515 .- 1754-9507. ; 13:2, s. 156-164
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Tidskriftsartikel (refereegranskat)abstract
- Many children born with cleft palate have impaired speech during their pre-school years, but usually the speech difficulties are transient and resolved by later childhood. This study investigated communication attitude with the Swedish version of the Communication Attitude Test (CAT-S) in 54 10-year-olds with cleft (lip and) palate. In addition, environmental factors were assessed via parent questionnaire. These data were compared to speech assessments by experienced listeners, who rated the children's velopharyngeal function, articulation, intelligibility, and general impression of speech at ages 5, 7, and 10 years. The children with clefts scored significantly higher on the CAT-S compared to reference data, indicating a more negative communication attitude on group level but with large individual variation. All speech variables, except velopharyngeal function at earlier ages, as well as the parent questionnaire scores, correlated significantly with the CAT-S scores. Although there was a relationship between speech and communication attitude, not all children with impaired speech developed negative communication attitudes. The assessment of communication attitude can make an important contribution to our understanding of the communicative situation for children with cleft (lip and) palate and give important indications for intervention.
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| 14. |
- Havstam, Christina, 1963, et al.
(författare)
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Evaluation of VPI-assessment with videofluoroscopy and nasoendoscopy.
- 2005
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Ingår i: British journal of plastic surgery. - : Elsevier BV. - 0007-1226. ; 58:7, s. 922-31
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate how different amounts of visual assessment information influence the recommended treatment for velopharyngeal insufficiency (VPI). Is a patient presented with videofluoroscopy (VF) in lateral projection recommended the same treatment as when frontal projection, nasoendoscopy, or both, are added? Retrospective material with video recorded assessment of VPI was blinded and copied in random order. Each patient was then presented in four separate combinations: VF in lateral projection; VF in lateral and frontal projection; VF in lateral projection and nasoendoscopy; and VF in lateral and frontal projection and nasoendoscopy (all of the available assessment material). The cleft palate team of Göteborg, Sweden, mutually rated velopharyngeal function and recommended action based on the presented material. SUBJECTS: Nineteen consecutive patients (median age 7:5 years, range 4:4-19:7) investigated with VF in lateral and frontal projection and nasoendoscopy during 1997-99 at the cleft palate centre in Göteborg, Sweden. Post operative assessments were excluded. Percent agreement and Kappa calculations were used to compare the different combinations of parts of information to all of the available information. RESULTS: Thirteen of the 19 patients (68%) were recommended the same action regardless of the amount of presented information. Percent agreement (Kappa) between parts and all of the available information: VF in lateral projection 84% (0.75), VF in lateral and frontal projection 79% (0.74), and VF in lateral projection and nasoendoscopy 84% (0.72). CONCLUSIONS: VF in lateral projection is recommended to be the first step in visualising velopharyngeal function, and nasoendoscopy the next when further investigation is required.
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| 15. |
- Havstam, Christina, 1963, et al.
(författare)
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Speech and satisfaction with outcome of treatment in young adults with unilateral or bilateral complete clefts.
- 2008
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Ingår i: Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi. - : Informa UK Limited. - 0284-4311. ; 42:4, s. 182-9
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Tidskriftsartikel (refereegranskat)abstract
- Thirty-five young adults (22-32 years old, mean 25) born with complete unilateral or bilateral clefts participated in a follow-up of speech, appearance, and teeth after treatment. They completed a questionnaire about their satisfaction with their speech, nose, lip, and teeth on visual analogue scales, and indicated on two overall questions how often they thought about their cleft, and how often they were asked questions about their speech, nose, or lip. Their speech was recorded and assessed blindly and independently by two speech and language pathologists. Participants' satisfaction with their speech did not correlate significantly with the speech assessments. Satisfaction with the nose had the highest correlation with the overall questions. No participant indicated more dissatisfaction with speech than the midpoint of the scale, making conclusions about covariance between satisfaction with speech and the overall questions difficult.
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| 16. |
- Havstam, Christina, 1963, et al.
(författare)
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Taking Charge of Communication: Adults' Descriptions of Growing up with a Cleft-Related Speech Impairment.
- 2011
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Ingår i: The Cleft palate-craniofacial journal. - : SAGE Publications. - 1545-1569 .- 1055-6656. ; 48:6, s. 717-726
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To obtain descriptions of the experience of growing up with a cleft-related speech impairment and how it was dealt with. Design: Semistructured interviews were tape-recorded, transcribed verbatim, and analyzed using a qualitative approach inspired by grounded theory methodology. Setting: Interviews took place at participants' homes or workplaces or at the university. Participants: Thirteen young adults (25 to 34 years of age) born with cleft palate with or without cleft lip. Results: The analysis resulted in the core category Taking charge of communication, which comprised three main categories: Forming an idea of one's speech, Learning about one's communication, and Taking responsibility for communication. The first main category was made up of three subcategories and the other two had two. The categories emerged as parallel processes in the understanding and active handling of communicative interaction. Conclusions: The participants described the processes that had enabled them to take charge of their communication. Seeing things from the listener's perspective and being open about the cleft and the speech disorder emerged as important parts of taking active responsibility for communication, as well as accepting their present speech and communication. Communicative participation should be assessed more thoroughly to understand the individual needs of people born with a cleft who have a speech impairment into adolescence.
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| 17. |
- Johannisson, Tove B, et al.
(författare)
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Assessing intelligibility by single words, sentences and spontaneous speech: a methodological study of the speech production of 10-year-olds.
- 2014
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Ingår i: Logopedics, phoniatrics, vocology. - : Informa UK Limited. - 1651-2022 .- 1401-5439. ; 39:4, s. 159-168
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the impact of different assessment methods on intelligibility scores and to examine the validity and reliability of those methods. Four assessment methods were used: multiple-choice and transcription of single words (read out), transcription of sentences (read out), and spontaneous speech. The results showed a statistically significant difference between outcomes for the different assessment methods. Reliability was high for all methods. Validity was low for all three reading-based methods. The method using transcription of spontaneous speech had low validity for the population included. It was concluded that reading is not a suitable elicitation technique for 10-year-olds and that the assessment procedure used for spontaneous speech needs to be further developed and investigated.
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| 18. |
- Johannisson, Tove B, et al.
(författare)
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The Communication Attitude Test (CAT-S): normative values for 220 Swedish children.
- 2009
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Ingår i: International journal of language & communication disorders / Royal College of Speech & Language Therapists. - : Wiley. - 1460-6984 .- 1368-2822. ; 44:6, s. 813-25
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Tidskriftsartikel (refereegranskat)abstract
- Background: The risk of developing a negative attitude to communication as a consequence of having a speech disorder has been in focus for decades in research concerning fluency disorders in relation to both children and adults. The Communication Attitude Test (CAT), which was created to measure children's attitudes towards their own communication, has been widely used. Research has shown that children who stutter have a significantly more negative attitude to their own communication than normal-speaking children and preliminary results show a similar picture in children with other types of speech disorders. However, the setting for obtaining data on normal-speaking children often differs from that on children with speech disorders. In order to make a significant interpretation of results from children with a speech disorder, comparable data on normal-speaking children are needed. Aims: The main purpose of this study was to obtain norm values for the Swedish version of the test (CAT-S) and examine possible differences related to age, sex or small town/big city. A second aim was to investigate some aspects of reliability, such as internal consistency, and validity in terms of item analysis as well as a qualitative analysis of the answers to the different items. In addition, group setting was compared with individual setting for the test procedure. Methods & Procedures: CAT-S was completed in a group setting by 220 normal-speaking children aged 7-15 years and by an additional group of 35 normal-speaking 10-year-old children who completed the test individually. Outcomes & Results: The 220 Swedish children had a mean score of 6.05 (a slightly higher mean score have been found in other countries, i.e. Belgium = 7.05 and USA = 8.24). The 7-year-olds had a significantly higher mean score than children at the other ages, except for the 15-year-olds. No other differences were found related to age, sex or size of community. The aspects of reliability and validity investigated for the CAT-S were satisfactory. Furthermore, there was no significant difference between the groups of 10-year-olds objected to different test procedures. Conclusions & Implications: The norm values of CAT-S could be used for comparison of scores from Swedish children with speech disorders. The CAT-S is easy to administer and could be used either in a group setting for research purpose or individually at the clinic.
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| 19. |
- Klintö, Kristina, et al.
(författare)
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Speech and Phonology in Swedish-Speaking 3-Year-Olds with Unilateral Complete Cleft Lip and Palate Following Different Methods for Primary Palatal Surgery
- 2014
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Ingår i: The Cleft Palate - Craniofacial Journal. - : SAGE Publications. - 1545-1569 .- 1055-6656. ; 51:3, s. 274-282
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe and compare speech and phonology at age 3 years in children born with unilateral complete cleft lip and palate treated with three different methods for primary palatal surgery. Design: Prospective study. Setting: Primary care university hospitals. Participants: Twenty-eight Swedish-speaking children born with nonsyndromic unilateral complete cleft lip and palate. Interventions: Three methods for primary palatal surgery: two-stage closure with soft palate closure between 3.4 and 6.4 months and hard palate closure at mean age 12.3 months (n = 9) or 36.2 months (n = 9) or one-stage closure at mean age 13.6 months (n = 10). Main Outcome Measures: Based on independent judgments performed by two speech-language pathologists from standardized video recordings: percent correct consonants adjusted for age, percent active cleft speech characteristics, total number of phonological processes, number of different phonological processes, hypernasality, and audible nasal air leakage. The hard palate was unrepaired in nine of the children treated with two-stage closure. Results: The group treated with one-stage closure showed significantly better results than the group with an unoperated hard palate regarding percent active cleft speech characteristics and total number of phonological processes. Conclusions: Early primary palatal surgery in one or two stages did not result in any significant differences in speech production at age 3 years. However, children with an unoperated hard palate had significantly poorer speech and phonology than peers who had been treated with one-stage palatal closure at about 13 months of age.
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| 20. |
- Liedman-Boshko, Julia, 0, et al.
(författare)
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Perceptual analysis of speech and the activity in the lateral pharyngeal walls before and after velopharyngeal flap surgery.
- 2005
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Ingår i: Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi. - : Informa UK Limited. - 0284-4311. ; 39:1, s. 22-32
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate the effects of velopharyngeal flap surgery on speech and its relation with the activity in the lateral pharyngeal walls. Videofluoroscopic recordings made before and after operation were used in this retrospective study, which comprised 28 patients who had pharyngeal flap surgery between 5:5 and 14:3 (mean 8:6) years:months of age at the Sahlgrenska University Hospital, Göteborg, Sweden. Twenty-four patients had different types of clefts and four had velopharyngeal impairment (VPI) without a cleft palate. Eleven had additional malformations. Speech and activity in the lateral pharyngeal walls were perceptually preoperatively and postoperatively. The study confirmed that patients with VPI can be helped by a velopharyngeal flap operation. There seemed to be a relation with the activity in the lateral pharyngeal wall and speech. The later the postoperative assessment, the better the speech, but the age at operation did not affect the result. The impact of additional anomalies and syndromes should be investigated further.
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| 21. |
- Lohmander, Anette, 1956, et al.
(författare)
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A longitudinal study of speech production in Swedish children with unilateral cleft lip and palate and two-stage palatal repair.
- 2008
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Ingår i: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - : SAGE Publications. - 1055-6656. ; 45:1, s. 32-41
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe speech production longitudinally in a group of children with unilateral cleft lip and palate (UCLP). PARTICIPANTS: Twenty consecutive children with UCLP and nine age-matched children without clefts in a comparison group. INTERVENTION: A two-stage palatal repair procedure with soft palate closure at 6 months and hard palate repair at 3 to 4 years. MAIN OUTCOME MEASURES: Percent correct consonants (PCC), percent correct places (PCP), and percent correct manners (PCM) at 3, 5, and 7 years of age. Cleft speech errors at the same ages. Previously collected data on number of consonant tokens, consonant types, frequency of occurrence of places and manners of articulation at 18 months. RESULTS: PCC and PCP were significantly lower in the UCLP group than in the comparison group at all ages. Number of consonant types and frequency of occurrence of dental plosives at 18 months correlated significantly with PCC at age 3. A high frequency of velar plosives at 18 months correlated significantly with a high prevalence of retracted oral articulation (dental/alveolar to palatal or velar) at both 3 and 5 years of age. CONCLUSIONS: The UCLP group performed worse than the comparison group at all ages. A high occurrence of dental plosives as well as a high number of consonant types in babbling and first words seem to be good indicators for better consonant production in later speech. The same prevalence of retracted oral articulation as in previous studies is attributed to the surgical technique.
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| 22. |
- Lohmander, Anette, 1956, et al.
(författare)
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Early Consonant Production in Swedish Infants with and without Unilateral Cleft Lip and Palate and Two-stage Palatal Repair.
- 2010
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Ingår i: The Cleft palate-craniofacial journal. - : SAGE Publications. - 1545-1569 .- 1055-6656. ; 48:3, s. 271-285
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Tidskriftsartikel (refereegranskat)abstract
- Abstract OBJECTIVE: to investigate the consonant production at 12 and 18 months of age following early soft palate repair in infants with unilateral cleft lip and palate (UCLP), and compared with typically developing children without clefts. DESIGN: randomized study with comparison group. PARTICIPANTS: 20 Swedish infants born with UCLP included in a randomized trial of palatal surgery (Scandcleft project) and 21 without clefts (COMP). Soft palate closure was completed at age 5 months, hard palate closure in 11 of the infants with UCLP at 1 year of age (HPC) and left open in nine (HPO). METHOD: Audio recordings at 12 months (UCLP=9, COMP=21) and 18 months (UCLP=18, COMP=21) were phonetically transcribed. Consonant inventory, frequency of manner and place of articulation, true canonical babbling (TCB), and impact of hearing status were analyzed. RESULTS: At 12 months of age all children had reached the stage of TCB. Mild hearing impairment was significantly correlated with fewer consonant types. A lower frequency of dentals and oral stops was found in the UCLP group than in the COMP group. However, the number of oral stops was high compared to what has been previously reported. CONCLUSIONS: Early soft palate closure seems to give a relatively high number of oral stops even with the hard palate unrepaired, although with significantly fewer dentals/alveolars than peers without clefts. Differences in consonant inventory were correlated to hearing function. KEY WORDS: babbling, consonants, unilateral cleft lip and palate, two-stage palatal repair, early velar closure, hearing impairment.
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| 23. |
- Lohmander, Anette, 1956, et al.
(författare)
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Electropalatography in home training of retracted articulation in a Swedish child with cleft palate: Effect on articulation pattern and speech.
- 2010
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Ingår i: International journal of speech-language pathology. - : Informa UK Limited. - 1754-9515 .- 1754-9507. ; 12:6, s. 483-496
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to evaluate the effectiveness of electropalatography (EPG) in home training of persistent articulation errors in an 11-year-old Swedish girl born with isolated cleft palate. The /t/ and /s/ sounds were trained in a single subject design across behaviours during an eight month period using a portable training unit (PTU). Both EPG analysis and perceptual analysis showed an improvement in the production of /t/ and /s/ in words and sentences after therapy. Analysis of tongue-contact patterns showed that the participant had more normal articulatory patterns of /t/ and /s/ after just 2 months (after approximately 8 hours of training) respectively. No statistically significant transfer by means of intelligibility in connected speech was found. The present results show that EPG home training can be a sufficient method for treating persistent speech disorders associated with cleft palate. Methods for transfer from function (articulation) to activity (intelligibility) need to be explored.
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| 24. |
- Lohmander, Anette, 1956, et al.
(författare)
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Long-term, longitudinal follow-up of individuals with UCLP after the Gothenburg primary early veloplasty and delayed hard palate closure: Speech outcome.
- 2012
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Ingår i: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - : SAGE Publications. - 1545-1569. ; 49:6, s. 657-671
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Abstract Objective: To investigate long-term, longitudinal speech outcome in patients born with unilateral cleft lip and palate (UCLP) treated according to a two-stage primary palatal protocol with early veloplasty and delayed hard palate closure. Design: Retrospective, longitudinal cohort study. Setting: A University Hospital in Western Sweden. Subjects: A consecutive series of 55 patients from the total cohort of 65 were included. All patients had surgical procedures at Sahlgrenska University Hospital, Gothenburg, Sweden. Methods: Standardized audio recordings were blindly analyzed at 5, 7, 16, and 19 years of age, and after at a clinical visit at 10 years of age. Typical cleft speech variables were independently rated on ordinal scales. Intelligibility and perceived velopharyngeal function were also assessed. Prevalences of speech characteristics were determined, and inter- and intra agreement were calculated. Results: Prominent hypernasality, nasal air leakage, and retracted oral articulation at 5 years were markedly reduced throughout the years with low prevalences at age 16 and 19 years. Perceived velopharyngeal competence (VPC) was noted in 82 % at age 16 and 87 % at age 19 years along with normal intelligibility. Pharyngeal flap surgery was performed in six of the 55 patients (11 %). Conclusions: Long-term speech outcome in patients with two-stage palatoplasty with early soft palate repair was considered good and improved even before hard palate repair. The typical retracted oral articulation was quite frequent during the early ages, whereas non-oral misarticulations were almost non-existing implying good VPC. Keywords: Speech outcome, unilateral cleft lip and palate, longitudinal, long-term, two-stage repair.
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| 25. |
- Lohmander, Anette, 1956, et al.
(författare)
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Methodology for perceptual assessment of speech in patients with cleft palate: a critical review of the literature.
- 2004
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Ingår i: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - 1055-6656. ; 41:1, s. 64-70
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE AND DESIGN: This review of 88 articles in three international journals was undertaken for the purpose of investigating the methodology for perceptual speech assessment in patients with cleft palate. The articles were published between 1980 and 2000 in the Cleft Palate-Craniofacial Journal, the International Journal of Language and Communication Disorders, and Folia Phoniatrica et Logopaedica. RESULTS AND CONCLUSIONS: The majority of articles (76) were published in the Cleft Palate-Craniofacial Journal, with an increase in articles during the 1990s and 2000. Information about measures or variables was clearly given in all articles. However, the review raises several major concerns regarding method for collection and documentation of data and method for measurement. The most distressing findings were the use of a cross-sectional design in studies of few patients with large age ranges and different types of clefts, the use of highly variable speech samples, and the lack of information about listeners and on reliability. It is hoped that ongoing national and international collaborative efforts to standardize procedures for collection and analysis of perceptual data will help to eliminate such concerns and thus make comparison of published results possible in the future.
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| 26. |
- Lohmander, Anette, 1956, et al.
(författare)
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Methodology for speech assessment in the scandcleft project-an international randomized clinical trial on palatal surgery: experiences from a pilot study.
- 2009
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Ingår i: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - : SAGE Publications. - 1055-6656. ; 46:4, s. 347-62
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To present the methodology for speech assessment in the Scandcleft project and discuss issues from a pilot study. Design: Description of methodology and blinded test for speech assessment. Speech samples and instructions for data collection and analysis for comparisons of speech outcomes across five included languages were developed and tested. Participants and Materials: Randomly selected video recordings of 10 5-year-old children from each language (n = 50) were included in the project. Speech material consisted of test consonants in single words, connected speech, and syllable chains with nasal consonants. Five experienced speech and language pathologists participated as observers. Main Outcome Measures: Narrow phonetic transcription of test consonants translated into cleft speech characteristics, ordinal scale rating of resonance, and perceived velopharyngeal closure (VPC). A velopharyngeal composite score (VPC-sum) was extrapolated from raw data. Intra-agreement comparisons were performed. Results: Range for intra-agreement for consonant analysis was 53% to 89%, for hypernasality on high vowels in single words the range was 20% to 80%, and the agreement between the VPC-sum and the overall rating of VPC was 78%. Conclusions: Pooling data of speakers of different languages in the same trial and comparing speech outcome across trials seems possible if the assessment of speech concerns consonants and is confined to speech units that are phonetically similar across languages. Agreed conventions and rules are important. A composite variable for perceptual assessment of velopharyngeal function during speech seems usable; whereas, the method for hypernasality evaluation requires further testing.
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| 27. |
- Lohmander, Anette, et al.
(författare)
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Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 4. Speech outcomes in 5-year-olds - velopharyngeal competency and hypernasality
- 2017
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - : TAYLOR & FRANCIS LTD. - 2000-656X .- 2000-6764. ; 51:1, s. 27-37
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: Adequate velopharyngeal function and speech are main goals in the treatment of cleft palate. The objective was to investigate if there were differences in velopharyngeal competency (VPC) and hypernasality at age 5 years in children with unilateral cleft lip and palate (UCLP) operated on with different surgical methods for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. Design: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. Methods: Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with a non-syndromic UCLP. Speech audio and video recordings of 391 children (136 girls, 255 boys) were available and perceptually analysed. The main outcome measures were VPC and hypernasality from blinded assessments. Results: There were no statistically significant differences between the prevalences in the arms in any of the trials. VPC: Trial 1, A: 58%, B: 61%; Trial 2, A: 57%, C: 54%; Trial 3, A: 35%, D: 51%. No hypernasality: Trial 1, A: 54%, B: 44%; Trial 2, A: 47%, C: 51%; Trial 3, A: 34%, D: 49%. Conclusions: No differences were found regarding VPC and hypernasality at age 5 years after different methods for primary palatal repair. The burden of care in terms of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed.
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| 28. |
- Lohmander, Anette, 1956, et al.
(författare)
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Speech development in patients with unilateral cleft lip and palate treated with different delays in closure of the hard palate after early velar repair: a longitudinal perspective.
- 2006
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Ingår i: Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi. - : Informa UK Limited. - 0284-4311. ; 40:5, s. 267-74
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Tidskriftsartikel (refereegranskat)abstract
- We wanted to find out if different timing of delayed repair of the hard palate in a two-stage procedure had an impact on the speech of 26 patients with unilateral cleft lip and palate (UCLP). The soft palate was closed at the age of 7 months and the hard palate between 38 and 89 months of age. Speech audio recordings at the age of 3 years (baseline, before any repair of the hard palate) and at the ages of 5, 7, and 10 years (the latter obtained at least one year after closure) were analysed. We used standardised speech assessments at routine follow-up and assessment by one external listener. The prevalence of speech errors caused by the cleft was similar to those described in previous reports from our centre in which hard palate repair was delayed. Unexpectedly, the results showed no difference in speech production related to timing of hard palate repair, except for nasal air leakage at the age of 7 years.
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| 29. |
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| 30. |
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| 31. |
- Lohmander, Anette, 1956, et al.
(författare)
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The impact of early infant jaw-orthopaedics on early speech production in toddlers with unilateral cleft lip and palate.
- 2004
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Ingår i: Clinical linguistics & phonetics. - : Informa UK Limited. - 0269-9206 .- 1464-5076. ; 18:4-5, s. 259-84
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of study was to investigate the impact of pre-surgical Infant Orthopaedics (IO) on consonant production at 18 months of age in children with Unilateral Cleft Lip and Palate (UCLP) and to compare the consonant production to that of age-matched children without clefts. The first ten children in a consecutive series of 20 with UCLP received IO and the following ten did not. Both groups had soft palate repair at 6.3 months of age. The cleft in the hard palate was unrepaired. Ten normally developing children without clefts served as controls. Nine children in each group accomplished the study. Phonetic transcriptions of consonants were made from audiotape recordings obtained during a 45-60 minute interactive session. No significant differences in the number of consonant tokens or of consonant types were found between the UCLP children with and without IO but both groups had significantly lower numbers than the control group. There was no significant difference in frequency of different manners or places of articulation of plosives between the UCLP groups. The frequency of occurrence of bilabial and dental consonant placements of plosives were significantly higher in the control group than in both UCLP groups.
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| 32. |
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| 33. |
- Miniscalco, Carmela, 1963, et al.
(författare)
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Language skills at age 6 years in Swedish children screened for language delay at 2(1/2) years of age.
- 2005
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 94:12, s. 1798-806
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Tidskriftsartikel (refereegranskat)abstract
- This study concerns language outcome in 6-y-old children who participated in a longitudinal community-based study of 105 children screened for language delay (LD) at 2(1/2) y of age. The purpose was to investigate (1) whether results from the 2(1/2)-y screening were persistent at 6 y of age, and (2) what language domains at age 6 were difficult for (a) children with LD at age 2(1/2) y and (b) children with normal language (LN) at the same age. Significant differences between LD and LN at age 2(1/2) y were persistent at age 6. The vulnerability that was identified at 2(1/2) y of age, such as problems with going from single-word utterances to multi-word utterances, seems to persist as delayed development at different language levels and across language domains. CONCLUSION: This study has shown that children who failed the 2(1/2)-y screening are at high risk of having persistent language problems at age 6 y.
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| 34. |
- Miniscalco, Carmela, 1963-, et al.
(författare)
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Language skills at age 6 years in Swedish children screened for language delay at 2½ years of age
- 2005
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 94:12, s. 1798-1806
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Tidskriftsartikel (refereegranskat)abstract
- This study concerns language outcome in 6-y-old children who participated in a longitudinal community-based study of 105 children screened for language delay (LD) at 2(1/2) y of age. The purpose was to investigate (1) whether results from the 2(1/2)-y screening were persistent at 6 y of age, and (2) what language domains at age 6 were difficult for (a) children with LD at age 2(1/2) y and (b) children with normal language (LN) at the same age. Significant differences between LD and LN at age 2(1/2) y were persistent at age 6. The vulnerability that was identified at 2(1/2) y of age, such as problems with going from single-word utterances to multi-word utterances, seems to persist as delayed development at different language levels and across language domains. CONCLUSION: This study has shown that children who failed the 2(1/2)-y screening are at high risk of having persistent language problems at age 6 y.
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| 35. |
- Nordberg, Ann, et al.
(författare)
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Consonant production and overall speech characteristics in school-aged children with cerebral palsy and speech impairment.
- 2014
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Ingår i: International journal of speech-language pathology. - : Informa UK Limited. - 1754-9515 .- 1754-9507. ; 16:4, s. 386-95
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Tidskriftsartikel (refereegranskat)abstract
- Abstract The aim of the present study was to investigate the speech characteristics of school-aged children with cerebral palsy (CP) and speech impairment at various cognitive levels. Nineteen children with a mean age of 11;2 years (9;2-12;9 years) with spastic, dyskinetic, and ataxic CP and speech impairment participated. Phonetic transcription of oral consonants, ratings of hypernasality, and severity of overall dysarthria, together with free field descriptions of respiration, voice quality, and prosody, were performed independently by two speech-language pathologists. The non-verbal cognitive level was also studied. More than half of the children had large problems with the articulation of consonants, and the children with ataxic CP were most affected. The majority was rated as having dysarthria, mostly mild, but hypernasality was rare. Gross motor problems were not significantly associated with the articulation of consonants or the severity of dysarthria, whereas non-verbal cognitive level was. This underlines the importance of taking non-verbal cognitive level into account, when designing individual speech treatment programs for this group of children. Finally, a careful examination of the articulation of consonants is recommended in order to study speech production thoroughly in children with CP.
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| 36. |
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| 37. |
- Nordberg, Ann, et al.
(författare)
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Speech problems affect more than one in two children with cerebral palsy: Swedish population-based study.
- 2013
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 102:2, s. 161-166
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe speech ability in a population-based study of children with cerebral palsy (CP), in relation to CP subtype, motor function, cognitive level and neuroimaging findings. METHODS: A retrospective chart review of 129 children (66 girls, 63 boys) with CP, born in 1999-2002, was carried out. Speech ability and background information, such as type of CP, motor function, cognitive level and neuroimaging data, were collected and analysed. RESULTS: Speech disorders were found in 21% of the children and were present in all types of CP. Forty-one per cent of the children with speech disorders also had mental retardation, and 42% were able to walk independently. A further 32% of the children were nonverbal, and maldevelopment and basal ganglia lesions were most common in this group. The remaining 47% had no speech disorders, and this group was most likely to display white matter lesions of immaturity. CONCLUSION: More than half of the children in this CP cohort had a speech disorder (21%) or were nonverbal (32%). Speech ability was related to the type of CP, gross motor function, the presence of mental retardation and the localization of brain maldevelopment and lesions. Neuroimaging results differed between the three speech ability groups.
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| 38. |
- Persson, Christina, 1959, et al.
(författare)
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A prospective cross-sectional study of speech in patients with the 22q11 deletion syndrome.
- 2003
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Ingår i: Journal of communication disorders. - 0021-9924. ; 36:1, s. 13-47
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate a consecutive series of 65 participants between 3 and 33 years of age (median age of 9 years and 4 months) with a confirmed 22q11.2 deletion, in order to ascertain the frequency and severity of articulation difficulties, velopharyngeal impairment (VPI), and the level of intelligibility. The majority had velopharyngeal impairment; over half of them to such a degree that surgery had been performed or was considered necessary. A high level of correct place and manner of consonants was only found in children with the 22q11 deletion syndrome from age 6. The most misarticulated consonants were stops and fricatives. Glottal articulation assessed in words and sentences was less frequent than expected according to earlier studies. A high prevalence of reduced intelligibility at different ages indicates an obvious communication limitation in younger children, and for some individuals even as teenagers and adults. EDUCATIONAL OBJECTIVES: As a result of this activity, the participant will have knowledge about the frequency and severity of: (1) articulation difficulties; (2) velopharyngeal impairment; and (3) the level of intelligibility in patients with a 22q11.2 deletion.
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| 39. |
- Persson, Christina, 1959, et al.
(författare)
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Speech in children with an isolated cleft palate: A longitudinal perspective.
- 2006
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Ingår i: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - 1055-6656. ; 43:3, s. 295-309
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe articulation and speech symptoms related to velopharyngeal impairment in children born with an isolated cleft palate. DESIGN: Blind assessment of speech at 3, 5, 7, and 10 years of age was performed. Two subgroups were formed based on the results at age 5 years, the no-VPI group and the VPI group, and they were compared with controls. SETTING: A university hospital. PATIENTS: Twenty-six children born with isolated cleft palate. Seventeen children served as controls. Interventions: Soft palate closure at 7 months and hard palate closure at a mean age of 3 years and 11 months if the cleft extended into the hard palate. MAIN OUTCOME MEASURES: Perceptual assessments of four variables related to velopharyngeal function and of articulation errors were performed at all ages. Phonetic transcriptions of target speech sounds were obtained at 5, 7, and 10 years and nasalance scores were obtained at age 10 years. RESULTS: The no-VPI group continued to have no or minor difficulties. The VPI group improved but continued to have moderate velopharyngeal impairment. Both groups differed significantly from the controls at age 10 years. Persistent velopharyngeal impairment, as well as glottal misarticulation, were mostly found in children with the cleft as a part of a syndrome or together with multiple malformations. CONCLUSION: Small changes in velopharyngeal impairment were found across ages. Improvement seemed to be related to surgical intervention, and persistent problems seemed to be related to the presence of additional multiple malformations or syndromes.
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| 40. |
- Persson, Christina, 1959, et al.
(författare)
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Speech outcomes in isolated cleft palate: impact of cleft extent and additional malformations.
- 2002
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Ingår i: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - 1055-6656. ; 39:4, s. 397-408
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The purpose of the study was to study the speech outcome in a series of 5-year-old children born with an isolated cleft palate and compare the speech with that of noncleft children and to study the impact of cleft extent and additional malformation on the speech outcome. DESIGN: A cross-sectional retrospective study. SETTING: A university hospital serving a population of 1.5 million inhabitants. SUBJECTS: Fifty-one patients with an isolated cleft palate; 22 of these had additional malformations. Thirteen noncleft children served as a reference group. INTERVENTIONS: A primary soft palate repair at a mean of 8 months of age and a hard palate closure at a mean age of 4 years and 2 months if the cleft extended into the hard palate. MAIN OUTCOME MEASURES: Perceptual judgment of seven speech variables assessed on a five-point scale by three experienced speech pathologists. RESULTS: The cleft palate group had significantly higher frequency of speech symptoms related to velopharyngeal function than the reference group. There were, however, no significant differences in speech outcome between the subgroup with a nonsyndromic cleft and the reference group. Cleft extent had a significant impact on the variable retracted oral articulation while the presence of additional malformations had a significant impact on several variables related to velopharyngeal function and articulation errors. CONCLUSION: Children with a cleft in the soft palate only, with no additional malformations, had satisfactory speech, while children with a cleft palate accompanied by additional malformations or as a part of a syndrome should be considered to be at risk for speech problems.
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| 41. |
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| 42. |
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| 43. |
- Sjögreen, Lotta, 1954, et al.
(författare)
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Oralmotorisk utveckling och joller
- 2008
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Ingår i: Logopediboken. Hartelius L, Netterbladt U, redaktörer. - Lund : Studentlitteratur. - 9789144038865 ; , s. 95-103
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 44. |
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| 45. |
- Sjögreen, Lotta, 1954, et al.
(författare)
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Orofacial dysfunction in children and adolescents with myotonic dystrophy.
- 2007
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Ingår i: Developmental medicine and child neurology. - 0012-1622. ; 49:1, s. 18-22
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Tidskriftsartikel (refereegranskat)abstract
- Myotonic dystrophy (DM) is a neuromuscular disorder caused by an expansion of a CTG repeat sequence on chromosome 19q13. The aim of the present study was to describe the characteristics and prevalence of oral motor dysfunction in a cohort of children and adolescents with DM and to correlate different aspects of oral motor function with the type of DM and sex. Fifty-six individuals with DM (30 males, 26 females; median age 13y 2mo; range 2y 6mo-21y 5mo) were compared with healthy controls. They were divided into four subgroups: severe congenital DM (n=18); mild congenital DM (n=18); childhood DM (n=18); and classical DM (n=2). A speech-language pathologist assessed different variables of oral motor function, intelligibility, and lip force. The families used a questionnaire to report on eating difficulties and drooling. All individuals with DM had impaired facial expression. Intelligibility was moderately or severely reduced in 30 patients (60%), excluding six patients without speech. Most had a moderate or severe impairment of lip motility (76.0%), tongue motility (52.2%), and lip force (69.2%), causing deviant production of bilabial and dental consonants. The families reported problems with eating (51.9%) and drooling (37.0%). Oral motor dysfunction was most prominent in congenital DM, and males were more affected than females.
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| 46. |
- Sjögreen, Lotta, 1954, et al.
(författare)
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The effect of lip strengthening exercises in children and adolescents with myotonic dystrophy type 1.
- 2010
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Ingår i: International journal of pediatric otorhinolaryngology. - : Elsevier BV. - 1872-8464 .- 0165-5876. ; 74:10, s. 1126-34
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Myotonic dystrophy type 1 (DM1) is a slowly progressive neuromuscular disease. Most children and adolescents with DM1 have weak lips and impaired lip function. The primary aim of the present study was to investigate if regular training with an oral screen could strengthen the lip muscles in children and adolescents with DM1. If lip strength improved, a secondary aim would be to see if this could have an immediate effect on lip functions such as lip mobility, eating and drinking ability, saliva control, and lip articulation. METHODS: Eight school aged children and adolescents (7-19 years) with DM1 were enrolled in an intervention study with a single group counterbalanced design. After three baseline measurements four children (Subgroup A) were randomly chosen to start 16 weeks therapy while the others (Subgroup B) acted as controls without therapy. After 16 weeks the subgroups changed roles. During treatment the participants exercised lip strength with an oral screen for 16 min, 5 days/week. Lip force, grip force (control variable), and lip articulation were followed-up every fourth week. At baseline, after treatment, and after maintenance, the assessment protocol was completed with measurements of lip mobility using 3D motion analysis and parental reports concerning eating ability and saliva control. RESULTS: Seven of eight participants improved maximal lip strength and endurance but only four showed significant change. Increased lip strength did not automatically lead to improved function. There was a wide intra-individual variation concerning speech and eating ability within and between assessments. The treatment programme could be carried out without major problems but the frequency and the effect of training were affected by recurrent infections in some. CONCLUSIONS: Maximal lip force and lip force endurance can improve in school aged children and adolescents with DM1. Improved lip strength alone cannot be expected to have an effect on lip articulation, saliva control, or eating and drinking ability in this population. Lip strengthening exercises can be a complement but not a replacement for speech therapy and dysphagia treatment. A prefabricated oral screen is an easy to use tool suitable for strengthening lip exercises.
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| 47. |
- Öller Darelid, Marja, 1958, et al.
(författare)
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Generalised EPG treatment effect in a cochlear implant user maintained after two years
- 2016
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Ingår i: International Journal of Speech-Language Pathology. - : Informa UK Limited. - 1754-9507 .- 1754-9515. ; 18:1, s. 65-76
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to evaluate speech therapy using electropalatography (EPG) in home training of persistent articulation errors in a cochlear implant user with hearing impairment. There was a particular focus on aspects of maintenance of training effects and possible transfer to connected speech. Method: The participant was a young woman, deaf from early childhood and a cochlear implant user from pre-school age. Treatment effects were evaluated using a single-subject design with multiple measures. Result: Instrumental and perceptual outcome measures showed a clear improvement in the production of the treatment target /ɡ/ in single words and sentences after 4 months of therapy (17 hours). The results were maintained at 3, 6 and 24 months after intervention. Also, /ɡ/ in connected speech, consisting of text reading and spontaneous speech, showed a significant difference between before and after treatment and at long-term follow-up. Conclusion: The results show that EPG used in home training can be an efficient method for treating persistent speech disorders associated with hearing impairment and that the treatment effect appears to maintain. Keywords: Electropalatography (EPG), articulation disorder, cochlear implant, intervention
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