有唇裂或没有唇裂(CP±L)的left裂儿童出生时倾向于使用较少的口腔压力辅音和更多的声门声音。非常早期腭修复的目的(即,在6个月大之前进行一期pal关闭)是为了在语音习得开始之前使pal起作用,以减少儿童正在发育的语音系统中错误模式的锚定。因此,预计存在较少的补偿性关节误差。目前,在非常早期的pal关闭后,没有详细的纵向语音结果。这项研究旨在为在6个月大之前接受pa关闭的CP±L乌干达儿童提供纵向言语结果。
对10名CP±L儿童进行评估,平均年龄为5岁和10岁。语音可理解性,言语可接受性,共振,两位经验丰富的言语语言病理学家对鼻腔气流和关节进行了感知评估。使用咽喉综合评分(VPC-sum)评估咽喉功能。有关言语治疗的信息,瘘管率,并收集二次(言语)手术。将结果与年龄和性别匹配的对照组的纵向结果进行比较,对照组为10名无CP±L的乌干达儿童。
CP±L组的语音可理解性和可接受性随时间而显着改善(所有p\s≤0.05,所有Z\s>-2.43)。在两个测试日期,与对照组相比,CP±L组的这些变量和与被动言语错误相关的变量的判断显著更差(所有p's≤0.05,所有Z's>2.49).在5岁时存在代偿性衔接错误,但在10岁时不存在,与对照组有统计学意义的差异。表明儿童患有CP±L。
与12个月的一期腭封堵相比,6个月大之前的一期腭封堵是否更有利于言语结局,目前尚不清楚。CP±L儿童的言语随着时间的推移而改善,但在5岁和10岁时与对照组有显著差异。在解释结果时,需要考虑到获得医疗保健设施的机会有限以及营养不良对伤口愈合的可能影响。6个月之前的腭封堵术是否可转移到其他国家,有待进一步研究。包括纵向和前瞻性设计与较大的样品。
Children born with cleft palate with or without cleft lip (CP±L) tend to use less oral pressure consonants and more glottal sounds in their babbling. The purpose of very early palatal repair (i.e., one-stage palatal closure prior to 6 months of age) is to make the palate functional before the onset of speech acquisition to reduce the anchoring of wrong patterns in the child\'s developing phonological system. As a result, less compensatory articulation errors are expected to be present. Currently, no detailed longitudinal speech outcomes after very early palatal closure are available. This study aimed to provide longitudinal speech outcomes in Ugandan children with CP±L who received palatal closure prior to the age of 6 months.
Ten children with CP±L were assessed at a mean age of 5 and 10 years old. Speech understandability, speech acceptability, resonance, nasal airflow and articulation were perceptually rated by two experienced speech-language pathologists. Velopharyngeal function was estimated using the velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary (speech) surgery was collected. The outcomes were compared with the longitudinal outcomes of an age- and gender-matched control group of 10 Ugandan children without CP±L.
Speech understandability and acceptability improved significantly over time in the group with CP±L (all p\'s ≤ 0.05, all Z\'s > -2.43). At both test dates, significantly worse judgments were found for the group with CP±L compared to the control group for these variables and variables related to passive speech errors (all p\'s ≤ 0.05, all Z\'s > 2.49). A statistically significant difference with the control group was found for the presence of compensatory articulation errors at the age of 5 years but not at the age of 10 years, indicating a catch up by the children with CP±L.
Whether a one-stage palatal closure prior to the age of 6 months is more favorable for speech outcomes compared to one-stage palatal closure at 12 months is still not clear. Speech of the children with CP±L improved over time, but significantly differed from the control group at the age of 5 and 10 years old. Limited access to health care facilities and possible influence of malnutrition on wound healing need to be considered when interpreting the results. Whether palatal closure prior to the age of 6 months is transferable to other countries is subject for further research, including both longitudinal and prospective designs with larger samples.