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Pereira VJ, So JYT, Tsang JMK, Choi WS, Tong MCF, Lee KYS. Speech Telepractice and Treatment Intensity in a Cantonese-Speaking Case with 22q11.2 Deletion Syndrome Following Late Diagnosis and Management of Velopharyngeal Dysfunction. Cleft Palate Craniofac J 2023; 60:1505-1512. [PMID: 35678611 DOI: 10.1177/10556656221106042] [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] [Indexed: 11/16/2022] Open
Abstract
This case report explores clinical treatment efficacy in a Cantonese-speaking child with 22q11.2 Deletion Syndrome where diagnosis and management of velopharyngeal dysfunction can be considered late. All treatment sessions were undertaken via telepractice during the peak of the COVID-19 pandemic in Hong Kong. A hybrid of specialized cleft palate speech treatment techniques and traditional treatment approaches in Speech Sound Disorders were utilized. Treatment intensity components including dose, dose form, session duration, and total intervention duration were documented.
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Affiliation(s)
- Valerie J Pereira
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
- Institute of Human Communicative Research, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Janet Y T So
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Joy M K Tsang
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Wing S Choi
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Michael C F Tong
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
- Institute of Human Communicative Research, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Kathy Y S Lee
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
- Institute of Human Communicative Research, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
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Everaert E, Selten I, Boerma T, Houben M, Vorstman J, de Wilde H, Derksen D, Haverkamp S, Wijnen F, Gerrits E. The Language Profile of Preschool Children With 22q11.2 Deletion Syndrome and the Relationship With Speech Intelligibility. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:128-144. [PMID: 36512754 DOI: 10.1044/2022_ajslp-21-00328] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Young children with 22q11.2 deletion syndrome (22q11DS) often have impaired language development and poor speech intelligibility. Here, we report a comprehensive overview of standardized language assessment in a relatively large sample of preschool-aged children with 22q11DS. We furthermore explored whether speech ability explained variability in language skills. METHOD Forty-four monolingual Dutch preschoolers (3-6 years) with a confirmed genetic 22q11DS diagnosis participated in this prospective cohort study. Standardized tests (Clinical Evaluation of Language Fundamentals Preschool-2-NL and Peabody Picture Vocabulary Test-III-NL) were administered. Speech intelligibility was rated by two expert speech and language therapists using a standardized procedure. RESULTS Most children had impaired language skills across all tested domains. The composite score for expressive language was significantly lower than that for receptive language, but the two were strongly correlated. Only small differences between the mean scores on the various subtests were observed, with the lowest scores for expressive morphosyntactic skills. Language scores showed a moderate positive relation with speech intelligibility, but language abilities varied greatly among the children with intelligible speech. CONCLUSIONS We show that the majority of preschool children with 22q11DS have a broad range of language problems. Other than the relatively larger impairment in expressive than in receptive language skills, our results do not show a clearly delineated language profile. As many of the children with intelligible speech still had below-average language scores, we highlight that language problems require a broad assessment and care in all young children with 22q11DS. Future research using spontaneous language and detailed speech analysis is recommended, to provide more in-depth understanding of children's language profile and the relationship between speech and language in 22q11DS.
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Affiliation(s)
- Emma Everaert
- Utrecht Institute of Linguistics OTS, Utrecht University, the Netherlands
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Iris Selten
- Utrecht Institute of Linguistics OTS, Utrecht University, the Netherlands
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Tessel Boerma
- Utrecht Institute of Linguistics OTS, Utrecht University, the Netherlands
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Michiel Houben
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Jacob Vorstman
- Program in Genetics and Genome Biology, SickKids Research Institute, Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Hester de Wilde
- Speech and Language Therapy, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Desiree Derksen
- Speech and Language Therapy, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Sarah Haverkamp
- Speech and Language Therapy, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Frank Wijnen
- Utrecht Institute of Linguistics OTS, Utrecht University, the Netherlands
| | - Ellen Gerrits
- Utrecht Institute of Linguistics OTS, Utrecht University, the Netherlands
- Research Group Speech and Language Therapy - Participation is Communication, HU University of Applied Sciences, Utrecht, the Netherlands
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Selten I, Boerma T, Everaert E, Vansteensel MJ, Vorstman J, Wijnen F. Narrative comprehension and production abilities of children with 22q11.2 deletion syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 119:104109. [PMID: 34655956 DOI: 10.1016/j.ridd.2021.104109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The 22q11.2 Deletion Syndrome (22q11DS) is associated with language deficits and weak intellectual functioning. In other clinical groups, linguistic and cognitive difficulties have been associated with impaired acquisition of narrative abilities. However, little is known about the narrative abilities of children with 22q11DS. AIMS To describe the ability of children with 22q11DS to produce and comprehend narrative macrostructure. Additionally, to examine the role of intellectual functioning in explaining their narrative difficulties. METHODS AND PROCEDURES Narrative skills of 14 school-aged children with 22q11DS were compared to those of younger typically developing (TD) children matched on mental age and same-aged peers with Developmental Language Disorder (DLD). OUTCOMES AND RESULTS Children with 22q11DS had significantly lower scores on narrative comprehension than younger TD children. No significant differences emerged on narrative production. Children with 22q11DS and children with DLD did not differ significantly on any of the narrative measures. CONCLUSIONS AND IMPLICATIONS Narrative comprehension in children with 22q11DS seems more affected than production. Narrative comprehension difficulties cannot be entirely explained by a low level of intellectual functioning. Narrative comprehension and production abilities in 22q11DS require further consideration.
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Affiliation(s)
- Iris Selten
- Utrecht Institute of Linguistics OTS, Utrecht University, Trans 10, 3512 JK, Utrecht, The Netherlands; Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands.
| | - Tessel Boerma
- Utrecht Institute of Linguistics OTS, Utrecht University, Trans 10, 3512 JK, Utrecht, The Netherlands; Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands.
| | - Emma Everaert
- Utrecht Institute of Linguistics OTS, Utrecht University, Trans 10, 3512 JK, Utrecht, The Netherlands; Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands.
| | - Mariska J Vansteensel
- UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, P.O. Box 85060, 3508 AB, Utrecht, The Netherlands.
| | - Jacob Vorstman
- Program in Genetics and Genome Biology, Research Institute, and Department of Psychiatry, Hospital for Sick Children, 686 Bay St, 14th Floor, Toronto, M5G 0A4, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario, M5T 1R8, Canada.
| | - Frank Wijnen
- Utrecht Institute of Linguistics OTS, Utrecht University, Trans 10, 3512 JK, Utrecht, The Netherlands.
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Birch AL, Jordan ZV, Ferguson LM, Kelly CB, Boorman JG. Speech Outcomes Following Orticochea Pharyngoplasty in Patients With History of Cleft Palate and Noncleft Velopharyngeal Dysfunction. Cleft Palate Craniofac J 2021; 59:277-290. [PMID: 34085559 DOI: 10.1177/10556656211010623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To report speech outcomes following Orticochea pharyngoplasty in 43 patients with cleft palate and noncleft velopharyngeal dysfunction. DESIGN A retrospective surgical audit of patients undergoing Orticochea pharyngoplasty between 2004 and 2012, with speech as a primary outcome measure. SETTING Patients known to a regional UK cleft center. METHODS Forty-three patients underwent Orticochea pharyngoplasty by a single surgeon in a UK regional cleft center. Twenty-one patients had undergone a prior procedure for velopharyngeal dysfunction. Pre- and postoperative speech samples were assessed blindly using the Cleft Audit Protocol for Speech-Augmented by a specialist cleft speech and language therapist, external to the team. Speech samples were rated on the following parameters: hypernasality, hyponasality, audible nasal emission, nasal, turbulence, and passive cleft speech characteristics. Statistical differences in pre- and postoperative speech scores were tested using the Wilcoxon matched-pairs signed-ranks test. Inter- and intrareliability scores were calculated using weighted Cohen κ. RESULTS Whole group: A statistically significant difference in pre- and postoperative scores for hypernasality (P < .001), hyponasality (P < .05), nasal emission (P < .01), and passive cleft speech characteristics (P < .01) were reported. Patients with cleft diagnoses: A statistically significant difference in scores for hypernasality (P < .001), nasal emission (P < .01), and passive cleft speech characteristics (P < .01) were reported for this group of patients. Patients with noncleft diagnoses: The only parameter to demonstrate a statistically significant difference was hypernasality (P < .01) in this group. CONCLUSIONS Orticochea pharyngoplasty is a successful surgical procedure in treating velopharyngeal dysfunction in both the cleft and noncleft populations.
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Affiliation(s)
- Alison L Birch
- South Thames Cleft Service, Evelina London, 8945Guys and St Thomas' NHS Foundation Trust, Northern Ireland, United Kingdom
| | - Zoe V Jordan
- South Thames Cleft Service, Evelina London, 8945Guys and St Thomas' NHS Foundation Trust, Northern Ireland, United Kingdom
| | - Louisa M Ferguson
- South Thames Cleft Service, Evelina London, 8945Guys and St Thomas' NHS Foundation Trust, Northern Ireland, United Kingdom
| | - Clare B Kelly
- Department of Women and Children's Health, 4616Kings College London, Northern Ireland, United Kingdom
| | - John G Boorman
- South Thames Cleft Service, Evelina London, 8945Guys and St Thomas' NHS Foundation Trust, Northern Ireland, United Kingdom
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Solot CB, Sell D, Mayne A, Baylis AL, Persson C, Jackson O, McDonald-McGinn DM. Speech-Language Disorders in 22q11.2 Deletion Syndrome: Best Practices for Diagnosis and Management. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:984-999. [PMID: 31330115 PMCID: PMC6802924 DOI: 10.1044/2019_ajslp-16-0147] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 05/01/2017] [Accepted: 02/20/2019] [Indexed: 05/20/2023]
Abstract
Purpose Speech and language disorders are hallmark features of 22q11.2 deletion syndrome (22qDS). Learning disabilities, cognitive deficits, palate abnormalities, velopharyngeal dysfunction, behavioral differences, and various medical and psychiatric conditions are also major features of this syndrome. The goal of this document is to summarize the state of the art of current clinical and scientific knowledge regarding 22qDS for speech-language pathologists (SLPs) and provide recommendations for clinical management. Method Best practices for management of individuals with 22qDS were developed by consensus of an expert international group of SLPs and researchers with expertise in 22qDS. These care recommendations are based on the authors' research, clinical experience, and literature review. Results This document describes the features of 22qDS as well as evaluation procedures, treatment protocols, and associated management recommendations for SLPs for the often complex communication disorders present in this population. Conclusion Early diagnosis and appropriate management of speech-language disorders in 22qDS is essential to optimize outcomes and to minimize the long-term effects of communication impairments. Knowledge of this diagnosis also allows anticipatory care and guidance regarding associated features for families, health care, and educational professionals.
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Affiliation(s)
- Cynthia B. Solot
- Center for Childhood Communication, 22q and You Center, Cleft Lip and Palate Program, Children's Hospital of Philadelphia, PA
| | - Debbie Sell
- North Thames Regional Cleft Lip and Palate Service, Speech and Language Therapy Department and Centre for Outcomes and Experiences Research in Children's Health, Illness, and Disability, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Anne Mayne
- North Thames Regional Cleft Lip and Palate Service, Great Ormond Street Hospital/Broomfield Hospital, Essex, United Kingdom
| | - Adriane L. Baylis
- Department of Plastic Surgery, The Ohio State University College of Medicine, Columbus, OH
- Velopharyngeal Dysfunction Program and 22q Center, Section of Plastic and Reconstructive Surgery, Nationwide Children's Hospital, Columbus, OH
| | - Christina Persson
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Sweden
- Speech and Language Pathology Clinic, Department of Otolaryngology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Oksana Jackson
- Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Donna M. McDonald-McGinn
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Section of Genetic Counseling, 22q and You Center, Clinical Genetics Center, Children's Hospital of Philadelphia, Philadelphia, PA
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Baylis AL, Shriberg LD. Estimates of the Prevalence of Speech and Motor Speech Disorders in Youth With 22q11.2 Deletion Syndrome. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:53-82. [PMID: 30515510 PMCID: PMC6503865 DOI: 10.1044/2018_ajslp-18-0037] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/14/2018] [Accepted: 07/10/2018] [Indexed: 05/21/2023]
Abstract
Purpose Speech sound disorders and velopharyngeal dysfunction are frequent features of 22q11.2 deletion syndrome (22q). We report the first estimate of the prevalence of motor speech disorders (MSDs) in youth with 22q. Method Seventeen children and adolescents with 22q completed an assessment protocol that included a conversational speech sample. Data reduction included phonetic transcription, perceptual speech ratings, prosody-voice coding, and acoustic analyses. Data analyses included 3 motor speech measures and a cross-classification analytic. Prevalence estimates of speech and MSDs in youth with 22q were compared with estimates in speakers with other complex neurodevelopmental disorders: Down syndrome, fragile X syndrome, and galactosemia. Results Results indicated that 58.8% of the participants with 22q met criteria for speech delay, and 82.4% of the participants met criteria for MSDs, including 29.4% with speech motor delay, 29.4% with childhood dysarthria, 11.8% with childhood apraxia of speech, and 11.8% with concurrent childhood dysarthria and childhood apraxia of speech. MSDs were not significantly associated with velopharyngeal dysfunction. Conclusions In summary, 82.4% of the participants with 22q met criteria for 1 of 4 MSDs, predominantly speech motor delay and childhood dysarthria. Cross-validation of the present findings would support viewing MSDs as a core phenotypic feature of 22q.
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Affiliation(s)
- Adriane L. Baylis
- Department of Plastic and Reconstructive Surgery, Nationwide Children's Hospital, Columbus, OH
- Department of Plastic Surgery, The Ohio State University College of Medicine, Columbus
| | - Lawrence D. Shriberg
- Intellectual & Developmental Disabilities Research Center, Waisman Center, University of Wisconsin-Madison
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Persson C, Laakso K, Edwardsson H, Lindblom J, Hartelius L. Signs of dysarthria in adults with 22q11.2 deletion syndrome. Am J Med Genet A 2017; 173:618-626. [DOI: 10.1002/ajmg.a.38038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/11/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Christina Persson
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Katja Laakso
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Hannah Edwardsson
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Johanna Lindblom
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Lena Hartelius
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Habel A, Herriot R, Kumararatne D, Allgrove J, Baker K, Baxendale H, Bu’Lock F, Firth H, Gennery A, Holland A, Illingworth C, Mercer N, Pannebakker M, Parry A, Roberts A, Tsai-Goodman B. Towards a safety net for management of 22q11.2 deletion syndrome: guidelines for our times. Eur J Pediatr 2014; 173:757-65. [PMID: 24384789 PMCID: PMC4032642 DOI: 10.1007/s00431-013-2240-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Revised: 12/05/2013] [Accepted: 12/09/2013] [Indexed: 01/13/2023]
Abstract
UNLABELLED The commonest autosomal deletion, 22q11.2 deletion syndrome (22q11DS) is a multisystem disorder varying greatly in severity and age of identification between affected individuals. Holistic care is best served by a multidisciplinary team, with an anticipatory approach. Priorities tend to change with age, from feeding difficulties, infections and surgery of congenital abnormalities particularly of the heart and velopharynx in infancy and early childhood to longer-term communication, learning, behavioural and mental health difficulties best served by evaluation at intervals to consider and initiate management. Regular monitoring of growth, endocrine status, haematological and immune function to enable early intervention helps in maintaining health. CONCLUSION Guidelines to best practice management of 22q11DS based on a literature review and consensus have been developed by a national group of professionals with consideration of the limitations of available medical and educational resources.
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Affiliation(s)
- Alex Habel
- North Thames Regional Cleft Unit, Great Ormond Street NHS Trust, Great Ormond Street, London, WC1N 3JH, UK,
| | - Richard Herriot
- Pathology Department, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZD Scotland, UK
| | - Dinakantha Kumararatne
- Department of Clinical Immunology, Addenbrooke’s Hospital, Box 109, Cambridge, CB2 2QQ UK
| | - Jeremy Allgrove
- Royal London Children’s Hospital, Barts Health NHS Trust, Whitechapel, London, E1 1BB UK
| | - Kate Baker
- Department of Medical Genetics, Addenbrooke’s Hospital, Box 134, Cambridge, CB2 0QQ UK
| | - Helen Baxendale
- Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, CB23 3RE UK
| | - Frances Bu’Lock
- Congenital and Paediatric Cardiology Service, Glenfield Hospital, Groby Road, Leicester, LE3 9QP UK
| | - Helen Firth
- Department of Medical Genetics, Cambridge University Hospitals Foundation Trust, Cambridge, CB2 2QQ UK
| | - Andrew Gennery
- Old Children’s Outpatients, Great North Children’s Hospital, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne, NE1 4LP UK
| | - Anthony Holland
- Section of Developmental Psychiatry, University of Cambridge, 2nd Floor, Douglas House, 18b Trumpington Street, Cambridge, CB2 8AH UK
| | - Claire Illingworth
- East of England Cleft Network, Addenbrooke’s Hospital, Box 46, Cambridge, CB2 2QQ UK
| | - Nigel Mercer
- Cleft Unit of the South West of England, Frenchay Hospital, Bristol, BS16 1LE UK
| | - Merel Pannebakker
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN UK
| | - Andrew Parry
- Cardiac Centre, Bristol Royal Hospital for Children, Paul O’Gorman Building, Upper Maudlin Street, Bristol, BS2 8BJ UK
| | - Anne Roberts
- South West Cleft Unit, North Bristol NHS Trust, Beckspool Road, Bristol, BS16 1JE UK
| | - Beverly Tsai-Goodman
- Cardiac Centre, Bristol Royal Hospital for Children, Paul O’Gorman Building, Upper Maudlin Street, Bristol, BS2 8BJ UK
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Persson C, Friman V, Óskarsdóttir S, Jönsson R. Speech and hearing in adults with 22q11.2 deletion syndrome. Am J Med Genet A 2012; 158A:3071-9. [PMID: 23165987 DOI: 10.1002/ajmg.a.35589] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 06/27/2012] [Indexed: 11/06/2022]
Abstract
The purpose of the study was to investigate the prevalence of velopharyngeal impairment, compensatory articulation, reduced intelligibility, and to rate the general impression of speech in adults with 22q11.2 deletion syndrome. The second purpose was to study the prevalence and type of hearing impairment in these adults. A referred, consecutive series of 24 adults with confirmed 22q11.2 deletion, 16 female and 8 males, with a mean age of 25 years (19-38 years) was included in the study. A blind assessment of speech by three experienced speech-language pathologists was performed. Sixteen (66%) patients had a mild to severe velopharyngeal impairment. The most prevalent symptoms of velopharygeal impairment were hypernasality and audible nasal airflow. The mean nasalance score was 33% (6-66%). Only two patients had disordered articulation; one of these had glottal articulation. A mean of 96% (88-100%) of single words were rated to be intelligible. To achieve these results half of the patients previously had velopharyngeal flap surgery. Forty-one percent (9/22) had mild-moderate hearing impairment; three had sensorineural type, four conductive and two had a mixed type. In conclusion the majority of the patients had no articulation errors and good intelligibility; while one-third still had moderate to severe problems with velopharyngeal impairment. Around 40% still had some hearing impairment, in most cases with a mild to moderate conductive component. Thus, a high prevalence of speech and hearing problems seems to be a part of the phenotype in adults with 22q11.2DS.
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Affiliation(s)
- Christina Persson
- Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Gibbon F, Lee A, Yuen I, Crampin L. Clicks produced as compensatory articulations in two adolescents with velocardiofacial syndrome. Cleft Palate Craniofac J 2008; 45:381-92. [PMID: 18616363 DOI: 10.1597/06-232.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To report perceptual and dynamic articulatory electropalatography data on clicks produced as compensatory articulations by two adolescents (S1 and S2) with velocardiofacial syndrome and velopharyngeal dysfunction. RESULTS The perceptual analysis showed that both speakers produced click substitutions for English targets /t/, /d/, /k/, /g/, and S2 additionally produced clicks for /p/, /b/, and /tintegral/, //. The adolescents produced a range of clicks, which varied in placement (bilabial, dental, alveolar, palatal), voicing (voiced, voiceless), and nasality (nasal, nonnasal). Measurements from the electropalatography data for lingual clicks revealed two articulatory closures, one in the anterior and another in the posterior region of the hard palate. The data revealed how the two closures were timed precisely to produce the click sound. The clicks involved a complex and highly coordinated sequence of tongue maneuvers similar to clicks in some southern African languages. CONCLUSIONS Clicks are interpreted as compensatory articulations enabling some speakers with velopharyngeal dysfunction to produce plosive and affricate sounds with perceptually salient acoustic bursts in the oral cavity. Clicks as compensatory articulations merit further systematic investigation, and the procedures reported in this study are considered appropriate for such research.
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Affiliation(s)
- Fiona Gibbon
- Speech and Hearing Sciences, Queen Margaret University, Edinburgh, U.K.
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