A longitudinal group study of speech development in Danish children born with and without cleft lip and palate.

The present study focuses on contoid vocalization by Danish 1-year-old unrepaired toddlers born with cleft lip and palate, and how they differ from their non-cleft peers. Furthermore, we focus on how the same children master Danish consonants at 3 years of age compared with their non-cleft peers in terms of their ability to produce consonants in accordance with adult target. Also, with the 3 year olds, we look at cleft speech characteristics as well as developmental speech characteristics found in both groups of children. Based on phonetic transcription, it was found that Danish unoperated cleft palate children at 1 year of age produced few types of contoids and preferably contoids that did not require closure of the velopharyngeal port in their prespeech. In addition, the data suggest that consonants produced by cleft children who are treated with one-stage surgery after speech onset, at 3 years of age differ from speech produced by non-cleft children, not only as regards cleft speech characteristics, but also as regards developmental speech characteristics.

A six-centre international study of the outcome of treatment in patients with clefts of the lip and palate: the results of a cross-linguistic investigation of cleft palate speech.

Speech samples of 131 subjects with complete unilateral clefts of the lip and palate from six European cleft palate centres were analysed and assessed using a specifically designed phonetic framework. This framework focused on consonants that are "vulnerable" in speech associated with cleft palate and common to the five languages of the project. The methodology used and the results of the reliability study are reported. Consonant articulation, resonance, and voice quality are also evaluated. The results show good outcomes with regard to consonant articulation across the whole study group with common areas of minor difficulty across languages. The results for resonance were less good, with slight hypernasality in 20% of subjects. There were, however, few indications of seriously disordered speech. The detectable differences between centres match the findings of the Eurocleft Orthodontic Group particularly in regard to the ranking of the centres.

A simple nasal anemometer for clinical purposes.

There is a need for clinical methods which give more direct information about the behaviour of the velopharyngeal mechanism in natural speech than do the examination methods normally applied to patients suffering from velopharyngeal insufficiency. One possibility is the recording of nasal airflow in order to detect nasal emission of air. The purpose of the present study is to examine the qualities and the characteristics of a simple and cheap nasal anemometer. As this type of flowmeter is considered less reliable than most other flowmeters, its limitations must be clearly understood and accounted for in drawing conclusions. Therefore, nasal airflow in speech obtained with this flowmeter is discussed in relation to nasal airflow obtained by the more reliable pneumotachograph and in relation to nasal airflow data found in the literature. The tests made here suggest that, at least for the type of speech material and measurements used in the present study, reliable nasal airflow data can be obtained by the anemometer.

Strategies in cleft palate speech--with special reference to Danish.

In the first part of this paper speech problems as a consequence of cleft palate are described in the light of three strategies: one passive and two active. In the passive strategy, the speaker does not attempt to reduce the inevitable consequences of insufficient velopharyngeal closure. In the active strategies, the speaker attempts to reduce these consequences by compensation or by camouflage. In the second part of the article the strategies are applied to classify the persisting speech problems in five Danish children with cleft palate (4 to 5 years of age) based on a phonetic transcription of their consonant production.

Surgical and speech results following palatopharyngoplasty operations in Denmark 1959-1977.

This study analysed surgical results from 600 palatopharyngoplasties (PPP), performed from 1959-77 by Dr. Poul Fogh-Andersen, Copenhagen, and the speech results in 140 of these cases. There were 205 cases of cleft lip and palate (CLP), 133 of cleft palate (CP), 104 of submucous cleft palate (SMCP), 138 of velopharyngeal insufficiency (VPI), and 20 cases of velar paresis. At surgery 62% were younger than ten years, and 5% were older than 30 years. Speech results were evaluated from pre- and postoperative tape recordings. Normal nasal resonance was obtained in 74%, improvement to mild symptoms in 24%. Submucous cleft palate cases had the highest rate of normalization, VPI cases the lowest. The cases with severest hypernasality had the lowest normalization rate. Age and operative procedure were of minor importance in relation to speech results, but surgical complications were fewer in subjects younger than ten years. Postoperative speech therapy was given to 38%, predominantly to subjects with compensatory voice and articulation problems.