Pacifier Use and Speech Sound Development Tamara Nagoda, M.S. 1 & Peter Flipsen Jr., Ph.D. 2

1. Pacifier Use and Speech Sound Development Tamara Nagoda, M.S.1 & Peter Flipsen Jr., Ph.D.2 1Idaho State University, Meridian, ID 2Pacific University, Forest Grove, OR ASHA Convention, 2013 Chicago, IL • INTRODUCTION • Anywhere from 55-80% of infants may use pacifiers for various periods. • Pacifiers may reduce the risk of SIDS; they may also improve feeding skills in premature infants. • However, pacifiers may also increase the incidence of both middle ear disease and oral myofunctional disorders such as tongue thrust. • Studies of pacifier use and speech development have been mixed to date (Barbosa et al., 2009; Fox, Dodd, & Howard, 2002; McNally, 1997; Schotts, McDaniel, & Neeley, 2008). • Why Might Pacifiers Affect Speech? • 1. May influence tooth eruption, position, and/or alignment? • 2. May alter tongue resting posture? • 3. May be a link through increased middle ear disease? • 4. Parents and others may be less likely to initiate communication when something is in the child’s mouth (fewer speech models)? • 5.Pacifier in mouth may reduce child’s time to practice speech and/or receive specific feedback about their speech? • METHOD • Test Protocol • Speech skills assessed with GFTA-2. • Language skills assessed with PPVT-4. • Oral facial exam. • Bilateral hearing screening at 25 dB HL. • Participants • 20 children (11 males; 9 females) age 41-64 months. Referred by parents or local SLPs. • No other known concerns. All passed oral facial exam and hearing screening. All scored at least 85 on PPVT-4. • TD Group: n = 15 (7 males; 8 females); achieved standard scores of 93+ on the GFTA-2. • SD Group: n = 5 (4 males; 1 female); achieved standard scores of <82 on GFTA-2. • Parent Survey • Did child use a pacifier or suck thumb or fingers? • If pacifiers were used, at what age did they start and stop? • Were pacifiers used at naptime/bedtime only or also during the day (i.e., when awake)? • If daytime use, approximately how many hours per day of use on average? • RESULTS • Overall, use of pacifiers was reported for 13/20 (65%) participants. This is consistent with published reports. • Pacifier use was reported for 2/5 in the SD Group and 11/15 in the TD Group. No significant difference (Chi-square p = .1760). • Months of pacifier use was 6-8 months for the SD Group and 5-48 months for the TD Group. No significant difference (MW p = .1671). • Daytime (awake) use was reported for 1/2 in the SD Group and 7/11 in the TD Group. No significant difference (Fisher Exact p = 1.000). • Data on average hours of pacifier use were available for the 7 daytime users in the TD group but not for the one SD participant who used a pacifier. • Total dose of pacifier use (hours/day X months of use) are plotted against GFTA-2 scores for the 7 TD participants in Figure 1. • DISCUSSION • Small sample size likely precluded finding any group effects. • Trend in Figure 1 suggests dose effect for TD children. Longer use of pacifiers may result in lower speech skill scores. • Note: outlier in lower left of Figure 1 was the only child where thumb sucking was reported. Stopped using pacifier early on but may have substituted thumb. Barbosa et al. (2009) suggested thumb sucking may also affect speech. • Additional study with larger samples clearly indicated. • References • Barbosa, C., Vasquez, S., Parada, M. A., Gonzalez, J. C. V., Jackson, C., Yanez, N. D., Gelaye, B., & Fitzpatrick, A. L. (2009). The relationship of bottle feeding and other sucking behaviors with speech disorder in Patagonian preschoolers. BMC Pediatrics, 9, 66. • Fox, A.V., Dodd, B., & Howard, D. (2002). Risk factors for speech disorders in children. International Journal of Language & Communication Disorders, 37(2), 117-131. • McNally, J. (1997) Speech development and dummy sucking and other comfort habits. Health Visitor, 70(5), 191-193. • Shotts, L. L., McDaniel, D. M., & Neeley, R. A. (2008). The impact of prolonged pacifier use on speech articulation: A preliminary investigation. Contemporary Issues in Communication Science and Disorders, 35, 72-75. Acknowledgments Many thanks to Jeanne Johnson, Diane Ogiela, and Judith Crews for their assistance with the project. Thanks especially to the children who participated and their parents.