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Longitudinal study of the development of obstruent correctness from ages 3 to 5 years in 108 Danish children with unilateral cleft lip and palate: a sub-study within a multicentre randomized controlled trial.
Int J Lang Commun Disord. 2020 01; 55(1):121-135.IJ

Abstract

BACKGROUND

Speech-sound development in preschoolers with unilateral cleft lip and palate (UCLP) as a group is delayed/disordered, and obstruents comprise the most vulnerable sound class.

AIMS

To evaluate the development of obstruent correctness (PCC-obs) and error types (cleft speech characteristics (CSCs) and developmental speech characteristics (DSCs)) from ages 3-5 and to investigate possible predictors (error types, velopharyngeal dysfunction (VPD) and gender) of PCC-obs at age 5 in two groups of children with UCLP.

METHODS & PROCEDURES

Subgroup analysis was conducted within a multicentre randomized controlled trial (RCT) of primary surgery (Scandcleft Project). A total of 125 Danish children with UCLP received lip and soft palate repair around 4 months of age and early hard palate closure at 12 months (EHPC group) or late hard palate closure at 36 months (LHPC group). Audio and video recordings of a naming test were available for 108 children at ages 3 and 5, and recordings were transcribed phonetically by blinded raters.

OUTCOMES & RESULTS

PCC-obs scores increased significantly from ages 3-5 in both groups, but with small effect sizes in the EHPC group that had higher scores at age 3 than the LHPC group. DSCs decreased in both groups whereas CSCs only decreased in the LHPC group that had more CSCs at age 3 than the EHPC group. The frequency of CSCs at age 3 was a significant predictor of PCC-obs scores at age 5 in both groups. DSCs significantly improved the logistic regression model in the EHPC group, whereas VPD and gender did not significantly improve the model in either group.

CONCLUSIONS & IMPLICATIONS

Although PCC-obs developed significantly from ages 3 to 5, children with UCLP as a group did not catch up to typically developing Danish children at age 5. Furthermore, the LHPC group at age 5 did not reach the 3-year level of the EHPC group, which means that delaying hard palate closure until age 3 is detrimental to obstruent development. Both CSCs and DSCs at age 3 were important predictors of PCC-obs at age 5 and should be considered when determining need for intervention.

Authors+Show Affiliations

University of Copenhagen, Department of Nordic Studies and Linguistics, Copenhagen, Denmark.University of Copenhagen, Department of Nordic Studies and Linguistics, Copenhagen, Denmark.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31710176

Citation

Jørgensen, Line Dahl, and Elisabeth Willadsen. "Longitudinal Study of the Development of Obstruent Correctness From Ages 3 to 5 Years in 108 Danish Children With Unilateral Cleft Lip and Palate: a Sub-study Within a Multicentre Randomized Controlled Trial." International Journal of Language & Communication Disorders, vol. 55, no. 1, 2020, pp. 121-135.
Jørgensen LD, Willadsen E. Longitudinal study of the development of obstruent correctness from ages 3 to 5 years in 108 Danish children with unilateral cleft lip and palate: a sub-study within a multicentre randomized controlled trial. Int J Lang Commun Disord. 2020;55(1):121-135.
Jørgensen, L. D., & Willadsen, E. (2020). Longitudinal study of the development of obstruent correctness from ages 3 to 5 years in 108 Danish children with unilateral cleft lip and palate: a sub-study within a multicentre randomized controlled trial. International Journal of Language & Communication Disorders, 55(1), 121-135. https://doi.org/10.1111/1460-6984.12508
Jørgensen LD, Willadsen E. Longitudinal Study of the Development of Obstruent Correctness From Ages 3 to 5 Years in 108 Danish Children With Unilateral Cleft Lip and Palate: a Sub-study Within a Multicentre Randomized Controlled Trial. Int J Lang Commun Disord. 2020;55(1):121-135. PubMed PMID: 31710176.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Longitudinal study of the development of obstruent correctness from ages 3 to 5 years in 108 Danish children with unilateral cleft lip and palate: a sub-study within a multicentre randomized controlled trial. AU - Jørgensen,Line Dahl, AU - Willadsen,Elisabeth, Y1 - 2019/11/11/ PY - 2019/03/14/received PY - 2019/09/23/revised PY - 2019/09/27/accepted PY - 2019/11/12/pubmed PY - 2020/6/2/medline PY - 2019/11/12/entrez KW - articulation KW - cleft palate KW - longitudinal KW - phonology KW - randomized controlled trial (RCT) KW - speech-sound disorders SP - 121 EP - 135 JF - International journal of language & communication disorders JO - Int J Lang Commun Disord VL - 55 IS - 1 N2 - BACKGROUND: Speech-sound development in preschoolers with unilateral cleft lip and palate (UCLP) as a group is delayed/disordered, and obstruents comprise the most vulnerable sound class. AIMS: To evaluate the development of obstruent correctness (PCC-obs) and error types (cleft speech characteristics (CSCs) and developmental speech characteristics (DSCs)) from ages 3-5 and to investigate possible predictors (error types, velopharyngeal dysfunction (VPD) and gender) of PCC-obs at age 5 in two groups of children with UCLP. METHODS & PROCEDURES: Subgroup analysis was conducted within a multicentre randomized controlled trial (RCT) of primary surgery (Scandcleft Project). A total of 125 Danish children with UCLP received lip and soft palate repair around 4 months of age and early hard palate closure at 12 months (EHPC group) or late hard palate closure at 36 months (LHPC group). Audio and video recordings of a naming test were available for 108 children at ages 3 and 5, and recordings were transcribed phonetically by blinded raters. OUTCOMES & RESULTS: PCC-obs scores increased significantly from ages 3-5 in both groups, but with small effect sizes in the EHPC group that had higher scores at age 3 than the LHPC group. DSCs decreased in both groups whereas CSCs only decreased in the LHPC group that had more CSCs at age 3 than the EHPC group. The frequency of CSCs at age 3 was a significant predictor of PCC-obs scores at age 5 in both groups. DSCs significantly improved the logistic regression model in the EHPC group, whereas VPD and gender did not significantly improve the model in either group. CONCLUSIONS & IMPLICATIONS: Although PCC-obs developed significantly from ages 3 to 5, children with UCLP as a group did not catch up to typically developing Danish children at age 5. Furthermore, the LHPC group at age 5 did not reach the 3-year level of the EHPC group, which means that delaying hard palate closure until age 3 is detrimental to obstruent development. Both CSCs and DSCs at age 3 were important predictors of PCC-obs at age 5 and should be considered when determining need for intervention. SN - 1460-6984 UR - https://www.unboundmedicine.com/medline/citation/31710176/Longitudinal_study_of_the_development_of_obstruent_correctness_from_ages_3_to_5_years_in_108_Danish_children_with_unilateral_cleft_lip_and_palate:_a_sub_study_within_a_multicentre_randomized_controlled_trial_ L2 - https://doi.org/10.1111/1460-6984.12508 DB - PRIME DP - Unbound Medicine ER -