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| 2. |
- Larsson, AnnaKarin, 1975, et al.
(author)
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Early Speech in Children with Unilateral Cleft Lip and Palate – a Comparative Study of Internationally Adopted and Swedish-Born Children
- 2015
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In: Oral presentation, 10th European Craniofacial Congress, Göteborg 24-27 June 2015.
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Conference paper (other academic/artistic)abstract
- Introduction: In the last decade, a large number of internationally adopted children with cleft lip and palate has arrived in Sweden. A majority of the children were born in China, usually arriving with an unoperated palate. There is a lack of knowledge regarding the speech/articulation development in this group of patients, who also have to deal with a late first language switch. The main purpose of the present study was to compare the articulation at the age of 3 in a group of internationally adopted children with a control group, consisting of a gender and age matched group of children born in Sweden. Methods: A total number of 43 children born in 2006-2009 with a unilateral cleft lip and palate joined the study, twentytwo adopted children from China (mean age of arrival to Sweden 21 months, SD 6,4) and 21 children born in Sweden. Both groups were treated by the same cleft palate team. The audio recordings of the protocol based 3 year old-visits at the cleft palate team, were perceptually analyzed by blinded listeners. Percent consonants correct (PCC), percent correct places (PCP), percent correct manners (PCM) and the frequencies of glottal articulation and nasal air leakage were compared. Results: Preliminary results show significant differences (p<.05) between groups on the variables PCC, PCP and PCM. No other differences were found. Conclusion: At this early age the adopted children had a lower prevalence of correct articulation. This needs to be followed up carefully longitudinally.
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- Larsson, AnnaKarin, 1975, et al.
(author)
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Internationally Adopted Children With Unilateral Cleft Lip and Palate-Consonant Proficiency and Perceived Velopharyngeal Competence at the Age of 5.
- 2020
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In: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - : SAGE Publications. - 1545-1569. ; 57:7, s. 849-859
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Journal article (peer-reviewed)abstract
- To compare consonant proficiency, consonant errors, and the perceived velopharyngeal (VP) competence in internationally adopted (IA) children with unilateral cleft lip and palate (UCLP) and nonadopted (NA) children with the same cleft-palate type at age 5.Case-control study based on phonetic transcriptions of standardized speech recordings of 5-year-olds at a tertiary hospital.Twenty-five IA children were compared to 20 NA children. All consecutive patients at a cleft lip and palate center participated.Consonant proficiency was measured using percentage consonants correct, percentage consonants correct-adjusted for age, percentage correct place, percentage correct manner, and consonant inventory. Cleft speech characteristics (CSCs), developmental speech characteristics (DSCs), and the perceived VP competence were also measured.The IA children had significantly lower values for all consonant proficiency variables (p < .05) and a smaller consonant inventory (p = .001) compared to the NA children. The IA children had a higher frequency of CSCs (IA = 84%, NA = 50%, p < .05) and DSCs (IA = 92%, NA = 65%, p = .057), and twice as many IA children as NA children had perceived VP incompetence (IA = 52%, NA = 25%, p = .17).Severe speech disorder was more common in IA children than in NA children at age 5. Most importantly, the speech disorders seem to be not only cleft-related. More detailed speech assessments with a broader focus are needed for IA children with UCLP. Longitudinal studies are recommended to further investigate the impact of speech difficulties in IA children's daily lives.
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| 4. |
- Larsson, AnnaKarin, 1975, et al.
(author)
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Speech production in 3-year-old internationally adopted children with unilateral cleft lip and palate.
- 2017
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In: International journal of language & communication disorders. - : Wiley. - 1460-6984 .- 1368-2822. ; 52:5, s. 626-636
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Journal article (peer-reviewed)abstract
- In the last decade, a large number of children with cleft lip and palate have been adopted to Sweden. A majority of the children were born in China and they usually arrive in Sweden with an unoperated palate. There is currently a lack of knowledge regarding speech and articulation development in this group of children, who also have to deal with a late first language switch.To study consonant proficiency in 3-year-old internationally adopted children with unilateral cleft lip and palate (UCLP) compared with peers with UCLP born in Sweden. Also to study the type and frequency of consonant errors and to perceptually compare velopharyngeal competence between the groups.Thirty-two children born between 2006 and 2010 with UCLP participated in the study-14 adopted from China and 18 children born in Sweden. Both groups were treated by the same cleft palate team. Audio recordings at 3 years of age were perceptually analysed by blinded listeners. Consonant proficiency was measured via per cent consonants correct adjusted for age (PCC-A), per cent correct manners (PCM) and per cent correct places (PCP). The prevalence of audible nasal air leakage and velopharyngeal competence were judged and compared between groups. The type and frequencies of consonant errors related to place and manner of articulation were also analysed.The internationally adopted children had significantly fewer correct consonants compared with the Swedish-born children. This was true for PCC-A, PCP and PCM. This group also had significantly higher prevalence of glottal stops/fricatives and deleted target consonants more often. Also the internationally adopted children had a higher prevalence of incompetent velopharyngeal function. The only outcome variable with similar results in the groups was audible nasal air leakage.The present study indicated that there were significant differences regarding consonant proficiency and velopharyngeal competence between internationally adopted children with a UCLP and their Swedish-born peers with UCLP at the age of 3 years. Internationally adopted children with UCLP should be considered an at risk group for a higher prevalence of speech difficulties than non-adoptees. Thus, it is particularly important to follow this group of children over time. Longitudinal studies of speech and language development in internationally adopted children with UCLP are needed.
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| 6. |
- Larsson, AnnaKarin, 1975, et al.
(author)
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Speech Production in Internationally Adopted Children With Unilateral Cleft Lip & Palate at Age Three
- 2016
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In: American Speech-Language-Hearing Assocation (ASHA) Convention, Philadelphia 17-19 November 2016.
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Conference paper (other academic/artistic)abstract
- Summary: A large number of internationally adopted children with cleft lip and palate has arrived in Sweden during the last decade. Most of the children were born in China and they most often arrived in Sweden with an unoperated palate. There is currently a lack of knowledge regarding the speech development in this group of children, who also have to deal with a late first language switch. Method: The main purpose of the present study was to study speech production in three-year-old internationally adopted children with a unilateral cleft lip and palate (UCLP) and to compare with same-age children born in Sweden with the same type of cleft. A total number of 32 children with UCLP joined the study, 14 adopted children from and 18 children born in Sweden. Both groups were treated by the same cleft palate team. The audio recordings of the protocol based 3 year old-visits at the cleft palate team, were perceptually analyzed by blinded listeners and based on word naming of 59 target words from the SVANTE (Swedish Articulation and Nasality Test). Speech production was measured with 1) percent consonants correct adjusted for age (PCC-A), 2) percent correct places (PCP), 3) percent correct manners (PCM), 4) nasal air leakage and 5) velopharyngeal competence. A speech error analysis was performed and comparisons between groups were made. Clinical implications: Internationally adopted children with UCLP showed more speech difficulties than non-adopted peers at age 3. However, the present study is limited, mainly due to the small sample sizes. Though, the results must be interpreted with caution. However, internationally adopted children may be at great risk of developing more severe speech difficulties than their non-adopted peers and should be thoroughly assessed and followed over time.
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- Sahlsten Schölin, Johnna, 1970, et al.
(author)
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A national registry-based study of surgery and demography comparing internationally adopted and children born in Sweden with cleft lip and/or palate.
- 2023
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In: Journal of plastic surgery and hand surgery. - 2000-656X .- 2000-6764. ; 57:1-6, s. 354-359
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Journal article (peer-reviewed)abstract
- This national registry-based study compares surgical procedures, demography, and concurrent medical conditions, in internationally adopted and Swedish-born children with cleft lip and/or palate until the age of five years. Data on the cleft type and gender for 331 internationally adopted children and 2064 Swedish-born children born from 2007 to 2018, were extracted from the registry and analyzed. Data on surgical procedures performed in Sweden and concurrent medical conditions and were collected for internationally adopted children and Swedish-born children with unilateral or bilateral cleft, born 2007-2013. A higher prevalence of unilateral and bilateral clefts (p<0.0001), as well as a predominance of male patients with unilateral clefts (p=0.0025), were identified among the internationally adopted children compared with children born in Sweden. Differences in the concurrence of other medical conditions in internationally adopted children versus Swedish-born infants were non-significant. Primary palatal surgeries performed in Sweden were significantly delayed for the adopted group. More secondary palatal surgeries such as speech improving surgery and palatal re-repair were needed for internationally adopted children (p<0.0001) until age five.Conclusions: The Swedish CLP Registry provided national coverage of the CL/P cohort. Internationally adopted children exhibited a predominance of more severe cleft types, a predominance of males, delayed primary palatal surgery and increased need for secondary surgeries before age five.
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| 9. |
- Schölin, Johnna, 1970, et al.
(author)
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Bowel obstruction after laparoscopic and open colon resection for cancer : results of 5 years of follow-up in a randomized trial
- 2011
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In: Surgical Endoscopy. - : Springer Science and Business Media LLC. - 0930-2794 .- 1432-2218. ; 25:12, s. 3755-3760
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Journal article (peer-reviewed)abstract
- BACKGROUND: Postoperative bowel obstruction caused by intra-abdominal adhesions occurs after all types of abdominal surgery. It has been suggested that the laparoscopic technique should reduce the risk for adhesion formation and thus for postoperative bowel obstruction. This study was designed to compare the incidence of bowel obstruction in a randomized trial where laparoscopic and open resection for colon cancer was compared. METHODS: A retrospective analysis was performed, collecting data of episodes of bowel obstruction with or without surgery. Only episodes treated in the hospital where the index surgery took place were included. Data for 786 patients were collected for the 5-year period after cancer surgery. RESULTS: Baseline characteristics for the evaluated laparoscopic (n = 383) and open (n = 403) groups were comparable. The cumulative obstruction percentages at 5 years for the open and laparoscopic groups were 6.5 and 5.1% respectively and did not significantly differ from each other. Tumor stage seemed to influence the risk for bowel obstruction: 2.8% in stage I, 6.6% in stage II, and 7% in stage III, but the differences were not significant. CONCLUSIONS: This analysis does not support the hypothesis that laparoscopy leads to fewer episodes of bowel obstruction compared with open surgery.
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| 10. |
- Schölin, Johnna, 1970, et al.
(author)
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Surgical, speech, and hearing outcomes at five years of age in internationally adopted children and Swedish-born children with cleft lip and/or palate
- 2020
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In: Journal of Plastic Surgery and Hand Surgery. - : Medical Journals Sweden AB. - 2000-656X .- 2000-6764. ; 54:1, s. 6-13
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Journal article (peer-reviewed)abstract
- Internationally adopted children (IAC) with a cleft lip and/or palate (CL/P) tend to arrive with un-operated palates at an age at which their Swedish-born peers have completed their primary palate surgery. Our aim of the present study was to analyze surgical, speech and hearing outcomes of IAC at age 5 and compare with those of a matched group of Swedish-born children. Fifty children with CL/P born in 1994-2005 participated in the study. Twenty-five IAC were matched according to age, sex and cleft type with 25 Swedish-born children. Audio recordings were perceptually analyzed by two experienced, blinded speech-language pathologists. Hearing and speech statuses were evaluated on the same day for all children. Surgical timing and complications as in fistulas and requirement for secondary velopharyngeal (VP) surgery, speech evaluation results, and present hearing status were analyzed for all children of age 5 years. Results showed that primary palatal surgery was delayed by a mean of 21 months in IAC. IAC had a higher prevalence of velopharyngeal impairment that was statistically significant, a higher fistula rate, and experienced more secondary surgery than Swedish-born peers. Hearing loss due to middle ear disease was slightly more common among IAC, whereas the rate of treatment with tympanostomy tubes was similar between the two groups. In conclusion, IAC with CL/P represent a challenge for CL/P teams because of the heterogeneous nature of the patient group and difficulties associated with delayed treatment, and the results show the importance of close follow-up over time.
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