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Chen YH, Lee MLC, Liow SJR, Ee-Li Young S. Exploring the relationship between cleft type and speech outcome in 4-to-6-year-olds with non-syndromic cleft palate using different measures: A preliminary report. CLINICAL LINGUISTICS & PHONETICS 2024:1-16. [PMID: 38832412 DOI: 10.1080/02699206.2024.2356035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 05/10/2024] [Indexed: 06/05/2024]
Abstract
Cleft type affects speech outcomes, but exact relationships remain unclear as outcome measures vary. The primary aim was to investigate the relationship between cleft type and speech outcome using different measures in 4-to-6-year-olds with non-syndromic clefts. Secondary aims were to explore the relationships between (i) speech measures used; and (ii) parent perception of speech intelligibility and listener familiarity. Twenty-two pre-schoolers with clefts, plus one parent for each child, were recruited through a hospital outpatient clinic. Children with cleft lip and palate (CLP; n = 11) and those with cleft palate only (CP; n = 11), matched on age and time of palate repair, were compared on Percentage Consonants Correct (PCC), clinician-reported speech intelligibility, and parent rating on the Intelligibility-in-Context Scale (ICS). Children with CLP had significantly lower PCC scores than children with CP (p = .020), but had no significant differences in their clinician- or parent-reported speech intelligibility. Clinician-reported speech intelligibility correlated significantly with both PCC (τ = .594, p < 0.01) and ICS (τ = .424, p = 0.009). No significant correlation was found between PCC and ICS (τ =.197, p = 0.113). Overall, parents rated their child's intelligibility higher for familiar compared to unfamiliar communication partners (τ = 2.325, p = 0.001, r = .76). Cleft type is crucial for intervention planning when objective measures are employed. Speech outcomes should be evaluated at impairment, activity, and participation levels, and by different communication partners, to comprehensively evaluate communicative effectiveness.
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Affiliation(s)
- Yu Hui Chen
- Division of Graduate Medical Studies, National University of Singapore, Singapore, Singapore
| | - Mary Lay Choo Lee
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Susan J Rickard Liow
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Selena Ee-Li Young
- Cleft and Craniofacial Centre, Department of Plastic, Reconstructive & Aesthetic Surgery, KK Women's and Children's Hospital, Singapore, Singapore
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Law C, Juraskova I, Lah S. [Formula: see text]Systematic review of pediatric memory questionnaires. Child Neuropsychol 2021; 27:734-781. [PMID: 33632075 DOI: 10.1080/09297049.2021.1888908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 02/07/2021] [Indexed: 10/22/2022]
Abstract
Memory disturbances are common in children with neurological and developmental conditions. One way to measure memory disturbances and their functional implications is via a memory questionnaire. Several pediatric memory questionnaires have been published but no systematic review has been conducted to establish their psychometric properties. This review evaluated currently available pediatric memory questionnaires using the Evidence-Based Assessment (EBA) criteria developed by the American Psychological Association Task force. A systematic search of CINAHL, EMBASE, Medline, and PsychINFO was completed on June 2019. The selection process was guided by pre-defined inclusion and exclusion criteria, followed by full manuscript reviews, and hand-search of reference lists of relevant papers. Selected questionnaires were evaluated by two independent raters against the EBA criteria and classified into "well established", "approaching well-established", and "promising" categories. The electronic searches yielded 9888 articles, 24 of which met the inclusion criteria. Hand searches identified additional 21 studies. The 45 identified studies reported on 24 versions of 10 memory questionnaires assessed working memory, everyday memory, prospective and retrospective memory, and self-awareness of memory functions. Based on EBA criteria, only one memory questionnaire (The Working Memory Rating Scale - 20 item version) was classified as "well-established", 3 as "approaching well-established", and 20 as "promising". Most (n = 19) had good reliability but lacked concurrent validity; had low or no correlations with objective memory tests, and low predictive power. In conclusion, this review highlights an urgent need for the development and validation of pediatric memory questionnaires to increase the evidence base and improve questionnaires' clinical utility.
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Affiliation(s)
- Cecilia Law
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Ilona Juraskova
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Suncica Lah
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
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Boyce JO, Kilpatrick N, Morgan AT. Speech and language characteristics in individuals with nonsyndromic submucous cleft palate-A systematic review. Child Care Health Dev 2018; 44:818-831. [PMID: 30136310 DOI: 10.1111/cch.12613] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 07/26/2018] [Accepted: 07/26/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Up to 80% of individuals with unrepaired submucous cleft palate (SMCP) experience speech difficulties secondary to velopharyngeal insufficiency. Language delays are reported in the broader cleft lip and/or palate population, suggesting that individuals with SMCP may also be at risk. However, contemporary understanding of this population remains limited as there has been no systematic examination of the literature. This review aims to systematically review and document the speech and language characteristics of individuals with nonsyndromic SMCP and, in addition, to identify factors reported to impact speech and language outcomes. METHOD This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five databases were comprehensively searched using keywords and indexed headings. Included studies had to report speech or language outcomes of individuals with nonsyndromic SMCP. Risk of bias and methodological design quality were examined using tools from the Scottish Intercollegiate Guidelines Network. Relevant data were extracted for analysis. RESULTS Eighteen studies met inclusion criteria, yielding 598 participants. Study results showed that individuals with unrepaired nonsyndromic SMCP may have speech difficulties secondary to velopharyngeal insufficiency including increased nasal resonance and palatalized or glottal articulation. Lower age at primary surgical repair led to better postsurgical speech outcomes. There is a paucity of literature outlining motor or phonological aspects of speech and receptive or expressive language abilities of this population. CONCLUSION Individuals with nonsyndromic SMCP present with speech difficulties similar to those experienced by individuals with overt cleft palate. Health care professionals should be aware of possible presenting symptoms and consider early SMCP diagnoses where appropriate. Further research is needed to specify the broader communication profile in this population.
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Affiliation(s)
- Jessica O Boyce
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Victoria, Australia
| | - Nicky Kilpatrick
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Angela T Morgan
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia
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Morgan AR, Bellucci CC, Coppersmith J, Linde SB, Curtis A, Albert M, O'Gara MM, Kapp-Simon K. Language Development in Children With Cleft Palate With or Without Cleft Lip Adopted From Non-English-Speaking Countries. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:342-354. [PMID: 28329403 DOI: 10.1044/2016_ajslp-16-0030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 10/07/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE The purpose of this study was to determine whether language skills differed between children with cleft palate or cleft lip and palate (CP±CL) who were adopted into an English-speaking home from a non-English-speaking country (late English exposure [LE]) and children with CP±CL raised from birth in an English-speaking home (early English exposure [EE]). METHOD Children (51 LE, 67 EE), ages 3;0 (years;months) to 9;0, completed the Clinical Evaluation of Language Fundamentals (CELF), Preschool Second Edition or Fourth Edition. Linear regression analysis was used to assess the impact of age of adoption and time in an English-speaking home on language skills, as measured by the CELF-P2 and CELF-4. RESULTS Children with CP±CL who were adopted scored less well on all language indices, with mean adjusted differences between LE and EE children ranging from 0.4 to 0.7 SD on the CELF index scales. Only 53% of the EE children and 57% of the LE children obtained scores above 90 on all indices. For LE children, younger age at adoption was associated with better language skills. CONCLUSION CP±CL increases risk for language delay, with the highest risk for LE children. LE children with CP±CL should receive language services soon after adoption.
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Lee FSF, Young SEL, Chastan M, Tan SH. Vocabulary development of bilingual toddlers with cleft lip and/or palate. SPEECH LANGUAGE AND HEARING 2016. [DOI: 10.1080/2050571x.2015.1133038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mei Lee KS, Young SEL, Rickard Liow SJ, Purcell AA. Spelling Processes of Children with Nonsyndromic Cleft Lip and/or Palate: A Preliminary Study. Cleft Palate Craniofac J 2015; 52:70-81. [DOI: 10.1597/13-120] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective To compare the cognitive-linguistic processes underlying spelling performance of children with cleft lip and/or palate with those of typically developing children. Design An assessment battery including tests of hearing, articulation, verbal short-term and working memory, and phonological awareness, as well as word and nonword spelling, was administered to both groups. Participants A total of 15 children with nonsyndromic cleft lip and/or palate were case-matched by age and sex to 15 typically developing children. The children were aged between 6 and 8 years and were bilingual, with English the dominant language. Results Wilcoxon signed-rank tests revealed that the performance of children with cleft lip and/or palate was significantly poorer on phoneme deletion and nonword spelling ( P < .05) compared with typically developing children. Spearman correlation analyses revealed different relationships between the cognitive-linguistic and spelling measures for the cleft lip and/or palate and typically developing groups. Conclusions Children with cleft lip and/or palate underachieve in phonological awareness and spelling skills. To facilitate early intervention for literacy problems, speech-language pathologists should routinely assess the cognitive-linguistic processing of children with cleft lip and/or palate, especially phonological awareness, as part of their case management protocols.
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Affiliation(s)
- Karen Shi Mei Lee
- Department of Plastic, Reconstructive, and Aesthetic Surgery, KK Hospital, Singapore
| | - Selena Ee-Li Young
- Division of Graduate Medical Studies, Yong Loo Lin School of Medicine, National University of Singapore, and Head and Senior Principal Speech Therapist, Department of Plastic, Reconstructive, and Aesthetic Surgery, KK Hospital, Singapore, and Department of Otolaryngology, National University Health System, Singapore
| | - Susan Jane Rickard Liow
- Department of Otolaryngology, is Programme Director of the MSc (Speech and Language Pathology) at the National University of Singapore
| | - Alison Anne Purcell
- Discipline of Speech Pathology, University of Sydney, Sydney, Australia, and Certified Practicing Speech Pathologist, Sydney, Australia
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Chang CSE, Young SEL, Liow SR, Yin Chong CX. Story-retelling abilities of bilingual children with non-syndromic cleft lip and/or palate. SPEECH, LANGUAGE AND HEARING 2014. [DOI: 10.1179/2050572814y.0000000054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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