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Nancy J. Scherer scherern@etsu East Tennessee State University, USA Zuzana Oravkinova

Longitudinal comparison of early speech and language milestones in children with cleft palate: A comparison of American and Slovak children Presented at the International Clinical Phonetics and Linguistics Conference Cork, Ireland June 28, 2012. Nancy J. Scherer scherern@etsu.edu

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Nancy J. Scherer scherern@etsu East Tennessee State University, USA Zuzana Oravkinova

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  1. Longitudinal comparison of early speech and language milestones in children with cleft palate: A comparison of American and Slovak children Presented at the International Clinical Phonetics and Linguistics ConferenceCork, IrelandJune 28, 2012 Nancy J. Scherer scherern@etsu.edu East Tennessee State University, USA ZuzanaOravkinova Clinic of Plastic and Reconstructive Surgery, University Hospital Ruzinov, Bratislava, Slovakia

  2. Characteristics of Early Speech Development in Children with CLP • Early delays in acquisition of consonants even after repair of the palate • Delayed onset and acquisition of vocabulary • Lexical selectivity • Produce more words beginning with nasals, vowels, approximates & fewer beginning with obstruents (high pressure) • Preference for labial, velar, and glottal place of articulation • 30-50% of children require intervention

  3. Background • There are few cross linguistic studies of early speech and language development in children with cleft lip and/or palate (CLP).

  4. English and Slovak sound systems

  5. Purpose • Examine early speech and language milestones in the first two years of life for children with clefts in the US and Slovakia and two control groups of noncleft children

  6. Methods • Participants (32 children 6-24 months of age) • 16 children with nonsyndromic CLP • 8 from Slovakia • 8 from US • 16 noncleft children • 8 from Slovakia • 8 from US • Cleft type • 4 children with CLP and 4 with CP from Slovakia and US

  7. Methods • Inclusion criteria • Nonsyndromic cleft lip and/or palate • Palate repair by 12 months of age • Absence of sensorineural hearing loss • Pass hearing screen • Children with CLP recruited from single cleft palate team • East Tennessee, USA • Bratislava, SK • Noncleft children recruited from community daycare

  8. Sample characteristics

  9. Procedures • Assessment measures at 4 time points between 6-24 months • Language sample • 20-30 minutes language sample during play with parent • Standard set of toys representing place/manner characteristics of early words • Video/audio recorded in child’s home or daycare setting • Hearing screening • Analysis • Transcription of language sample • Phonetic transcription of child speech • Reliability of transcription calculated on 20-25% of sample

  10. Measures • Mean Babbling Level (MBL) at 6 and 12 months (Stoel-Gammon, 1989, 1998) • Level 1: vowels, voiced syllabic consonants or CV syllables with glottal stop or glide • Level 2:VC or CVC syllables with single consonant type. Canonical babbling that includes repeated consonants and vowels • Level 3: syllables with 2 or more different consonant types. Variegated babbling in which consonants and vowels are varied. • Consonant Inventory at 6, 12, 18, 24 months • Used at least twice • Number of different words at 12, 18, 24 months • Mean length of utterance at 12, 18, 24 months

  11. Analysis • A repeated measures model was fitted to the 4 outcome measures • For measures with 3 or 4 time points, a multi level growth model was used

  12. Results

  13. Mean Babbling Level • No significant differences between US and Slovak groups • Noncleft Slovak children did have greater rate of change than noncleft US children • Significant differences between cleft and noncleft children (both US & SK)

  14. Consonant Inventory • Significant difference in rate of growth in CI for cleft and noncleft children • No difference between US and SK children

  15. Pressure Consonants

  16. Place of Articulation

  17. Place of Articulation

  18. Place of Articulation

  19. Language Measures

  20. Vocabulary Diversity • No significant difference between between US and SK groups • Significant difference in growth in the number of different words between cleft and noncleft groups

  21. MLU • No significant difference between US and SK groups • Significant main effect for rate of growth in MLU between cleft and noncleft groups

  22. Conclusions • Slovak and US samples showed similar performance on the measures used in this study • Children with CLP showed slower acquisition of all place and manner features • Significant deficits in acquisition of • high pressure consonants • Alveolar place of articulation

  23. Conclusions • What are the factors contributing to these early delays in speech development in children with CLP? • Velopharyngeal status • Impact of early structural deficits • Sensory deficits in the palate • Early speech delays impact language development • Fewer sounds limits vocabulary diversity and word combinations • Early intervention needs to address both speech and language simultaneously

  24. Thank You The US portion of this study was funded by the National Institute of Deafness and other Communicative Disorders (DC002301)

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