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Strandberg E, Lieberman M, Lohmander A. Babbling in extremely premature infants at 12 months corrected age. CLINICAL LINGUISTICS & PHONETICS 2024; 38:82-96. [PMID: 36600483 DOI: 10.1080/02699206.2022.2160658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Babbling is an important precursor to speech in infancy, and deviations from the typical babbling development can predict later difficulties in speech, language, and communication. This cross-sectional study aimed to investigate babbling and early speech in Swedish extremely premature infants. Samples of babbling were collected from 20 extremely premature infants (EPT group) at the corrected age of 12 months. Data collection was home-based and consisted of an audio-video recording of each infant playing with a parent. Presence of canonical babbling (CB), and three oral stop variables distinctive of typical babbling, and consonant inventory were assessed. The assessment was performed during a standardised observation of babbling. Data from the EPT group were compared to previously collected data of a reference group of 20 10-month-old infants without known medical diagnoses. The results showed that the EPT group had a lower proportion of infants producing CB, and that they used a significantly smaller consonant inventory compared to the reference group. Although not statistically significant, oral stops were less frequently found in the EPT group. The findings of a restricted consonant inventory and low proportion of CB in the EPT group are not surprising considering that the group has been found to be at risk of speech and language delay in toddlerhood. Still, further research is needed to explore whether babbling at 12 months can predict speech and language skills at an older age in extremely premature infants.
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Affiliation(s)
- Ellinor Strandberg
- Medical Unit Speech & Language Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Marion Lieberman
- Division of Speech and Language Pathology, Department CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Anette Lohmander
- Medical Unit Speech & Language Pathology, Karolinska University Hospital, Stockholm, Sweden
- Division of Speech and Language Pathology, Department CLINTEC, Karolinska Institutet, Stockholm, Sweden
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2
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Hardin-Jones M, Heimbaugh L, Chapman KL, Baylis A, Hatch Pollard S. Transcribing toddler vocalizations: comparison of a modified naturalistic listening approach with phonetic transcription. CLINICAL LINGUISTICS & PHONETICS 2023; 37:157-168. [PMID: 35100931 PMCID: PMC9339019 DOI: 10.1080/02699206.2022.2029574] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/13/2021] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
Previous investigations have demonstrated that naturalistic listening in real time (NLRT) can be used reliability to assess prelinguistic vocalizations and is less time-consuming than phonetic transcription. The current investigation was performed to examine the correspondence of syllable and consonant information obtained using a modified naturalistic listening in real time (NLRT) methodology compared to broad phonetic transcription for 20 toddlers with repaired cleft palate. A forty-minute vocalization sample was obtained for each toddler. Two listeners listened to each recording independently and coded the number of syllables and consonant types produced by each toddler using NLRT. Each recording was phonetically transcribed by each listener 2 to 16 months following the NLRT analysis. High reliability was evident between the modified NSRT method and phonetic transcription for identification of both syllables and consonants. Differences were evident in the actual number of syllables and consonants identified between the two types of assessment across the 20 participants. Possible explanations for those differences are addressed. The results of this investigation indicate that the modified NLRT procedure is a reliable method for determining consonant/inventories of young children. It is less labor intensive than traditional phonetic transcription and may be useful clinically when documentation of early sound development is needed to support early intervention decisions.
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Persson A, Flynn T, Miniscalco C, Lohmander A. Impact of auditory variables on consonant production in babbling and early speech in children with moderate hearing loss - a longitudinal study. CLINICAL LINGUISTICS & PHONETICS 2022; 36:833-848. [PMID: 34324384 DOI: 10.1080/02699206.2021.1958260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/09/2021] [Accepted: 07/16/2021] [Indexed: 06/13/2023]
Abstract
This longitudinal study aimed to investigate early consonant production and the impact of hearing aid (HA) use, and aided audibility in Swedish children with moderate hearing loss (CHL) who received amplification before 6 months of age. CHL (n = 11) and children with normal hearing (CNH) (n = 11) were followed-up at 10, 18, and 36 months of age. At 10 months of age, the CHL used significantly fewer oral stops (p < 0.01), dental/alveolar stops (p < 0.05) and had a significantly fewer number of different true consonants (p < 0.01). At 18 months, there were no significant differences between the groups regarding presence of oral stops, and dental/alveolar stops, but the significant difference in the number of different true consonants remained (p < 0.00). At 36 months of age, consonant proficiency did not differ between the groups. A higher number of hours of HA use was associated with the presence of consonant variables at 10 months. Aided audibility showed weak to moderate correlations with number of consonants produced and proficiency. This group of children presented with initial delays in their early consonant production but seemed to catch up as they aged. Consistency of HA use from initial fitting is an important factor that may decrease the possible delays in the development of early consonant production and proficiency in CHL by 36 months of age.
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Affiliation(s)
- Anna Persson
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Hearing Habilitation for Children and Youth, Karolinska University Hospital, Stockholm, Sweden
| | - Traci Flynn
- School of Humanities and Social Sciences, College of Human and Social Futures, University of Newcastle, Callaghan, Australia
| | - Carmela Miniscalco
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child Neuropsychiatry, Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Anette Lohmander
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Speech and Language Pathology, Karolinska University Hospital, Huddinge, Sweden
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4
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Persson A, Marklund U, Lohmander A, Flynn T. Expressive vocabulary development in children with moderate hearing loss - the impact of auditory variables and early consonant production. CLINICAL LINGUISTICS & PHONETICS 2022; 36:547-564. [PMID: 34231440 DOI: 10.1080/02699206.2021.1944321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/08/2021] [Accepted: 06/12/2021] [Indexed: 06/13/2023]
Abstract
In this study, the early expressive vocabulary development was investigated in a group of children with moderate hearing loss (HL). Size and development of expressive vocabulary from 18 30 months were analyzed and compared to a group of children with normal hearing (NH). For the children with HL, the impact of auditory variables on number of words were examined. The relationship of early consonant production to number of words produced of both groups were examined and the phonological complexity of reported words was compared between the groups. The results showed that children with HL (n = 8) produced a similar number of words as the NH (n = 8) at 18 months, but fewer at 24 and 30 months. Hours of HA use showed significant correlations to number of words. The number of different true consonants at 18 months for the whole group showed a significant relationship to number of words produced at 24 months. No significant differences were found between children with HL and NH children regarding phonological complexity of reported words. The findings indicate that the children born with moderate HL who were fitted with hearing aids (HAs) before 6 months of age are at risk in their development of expressive vocabulary. Full-time use of HAs and monitoring of early consonant use should be encouraged in the early intervention of this target group.
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Affiliation(s)
- Anna Persson
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Hearing Habilitation for Children and Youth, Karolinska University Hospital, Stockholm, Sweden
| | - Ulrika Marklund
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication, Linköping University, Sweden
- Department of Neurology, Speech-Language Pathology Clinic, Danderyd Hospital, Stockholm, Sweden
| | - Anette Lohmander
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Speech and Language Pathology Speech and Language Pathology, Karolinska University Hospital, Huddinge, Sweden
| | - Traci Flynn
- School of Humanities and Social Sciences, College of Human and Social Futures, University of Newcastle, Newcastle, Australia
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Gipson TT, Ramsay G, Ellison EE, Bene ER, Long HL, Oller DK. Early Vocal Development in Tuberous Sclerosis Complex. Pediatr Neurol 2021; 125:48-52. [PMID: 34628143 DOI: 10.1101/2021.01.06.21249364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Our goal was to assess for the first time early vocalizations as precursors to speech in audio-video recordings of infants with tuberous sclerosis complex (TSC). METHODS We randomly selected 40 infants with TSC from the TSC Autism Center of Excellence Research Network dataset. Using human observers, we analyzed 74 audio-video recordings within a flexible software-based coding environment. During the recordings, infants were engaged in developmental testing. We determined syllables per minute (volubility), the number of consonant-vowel combinations, such as 'ba' (canonical babbling), and the canonical babbling ratio (canonical syllables/total syllables) and compared the data with two groups of typically developing (TD) infants. One comparison group's data had come from a laboratory setting, while the other's had come from all-day Language Environment Analysis recordings at home. RESULTS Compared with TD infants in laboratory and all-day Language Environment Analysis recordings, entry into the canonical babbling stage was delayed in the majority of infants with TSC, and the canonical babbling ratio was low (TD mean = 0.346, SE = 0.19; TSC mean = 0.117, SE = 0.023). Volubility level in infants with TSC was less than half that of TD infants (TD mean = 9.82, SE = 5.78; TSC mean = 3.99, SE = 2.16). CONCLUSIONS Entry into the canonical stage and other precursors of speech development were delayed in infants with TSC and may signal poor language and developmental outcomes. Future studies are planned to assess prediction of language and developmental outcomes using these measures in a larger sample and in more precisely comparable recording circumstances.
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Affiliation(s)
- Tanjala T Gipson
- University of Tennessee Health Sciences Center, Boling Center for Disabilities, Le Bonheur Children's Hospital, Memphis, Tennessee.
| | - Gordon Ramsay
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Ellen E Ellison
- University of Tennessee Health Sciences Center, Boling Center for Disabilities, Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Edina R Bene
- School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee
| | - Helen L Long
- School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee
| | - D Kimbrough Oller
- University of Memphis, School of Communication Sciences and Disorders, Institute for Intelligent Systems, Memphis, Tennessee; Konrad Lorenz Institute for Evolution and Cognition Research, Klosterneuburg, Austria
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Nyman A, Strömbergsson S, Lohmander A. Canonical babbling ratio - Concurrent and predictive evaluation of the 0.15 criterion. JOURNAL OF COMMUNICATION DISORDERS 2021; 94:106164. [PMID: 34773732 DOI: 10.1016/j.jcomdis.2021.106164] [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: 04/23/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Canonical babbling ratio (CBR) is a commonly used measure to quantify canonical babbling (CB), and 0.15 is the commonly accepted criterion for the canonical babbling stage. However, this has not been thoroughly investigated. The aim of this study was to evaluate the validity of this criterion using concurrent and predictive comparisons. METHODS Longitudinal data from 50 children recruited in different clinical projects were used. At 10 months of age, CBR was calculated based on counted utterances from audio-video recorded parent-child interactions. The videos were also assessed by CB observation, where an observer made an overall judgement on whether the child was in the canonical babbling stage or not. For the concurrent evaluation, CBR was compared to CB observation as a reference test, using area under the curve (AUC). The criterion resulting in the best combination of sensitivity and specificity was identified using positive likelihood ratios. In the predictive comparisons CBR was analyzed as a predictor of speech/language difficulties at 30-36 months. Participants presenting with difficulties in consonant production and/or parent-reported vocabulary were considered to have speech/language difficulties. Sensitivity and specificity were compared for CBR using the 0.15 criterion and the new criterion identified in this study. RESULTS An AUC of 0.87 indicated that CBR is a valid measure of canonical babbling in 10-month-old children. The best combination of sensitivity and specificity was found at a criterion of 0.14 (sensitivity 0.96, specificity 0.70). In the predictive comparison, CBR with a 0.14 or 0.15 criterion revealed the same sensitivity (0.71) but 0.14 showed a slightly better specificity (0.52 versus 0.42). CONCLUSIONS CBR is a valid measure of CB (at 10 months). However, when using CBR to classify children's babbling as canonical or non-canonical, researchers need to carefully consider the implications of the chosen criterion.
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Affiliation(s)
- Anna Nyman
- Division of Speech and Language Pathology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Habilitation and Health, Region Stockholm, Stockholm, Sweden.
| | - Sofia Strömbergsson
- Division of Speech and Language Pathology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Anette Lohmander
- Division of Speech and Language Pathology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Medical Unit Speech-Language Pathology, Karolinska University Hospital, Stockholm, Sweden
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Nyman A, Strömbergsson S, Lindström K, Lohmander A, Miniscalco C. Speech and Language in 5-year-olds with Different Neurological Disabilities and the Association between Early and Later Consonant Production. Dev Neurorehabil 2021; 24:408-417. [PMID: 33849395 DOI: 10.1080/17518423.2021.1899327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The primary aim was to describe speech and language abilities in a clinical group of verbal 5-year-old children diagnosed with neurological disability (ND) in infancy, and the secondary aim was to trace precursors to consonant production at age 5 years (T2) in data from 12 to 22 months (T1). The participants (n = 11, with Down syndrome (DS), cerebral palsy, and chromosomal deletion syndromes) were tested with a battery of speech and language tests. Consonant production at T2 was compared to data on consonant use at T1. At T2, two participants had age appropriate speech and language and another three had age-appropriate speech, but low results on language tests. The remaining six participants had severe speech and language difficulties. Participants with DS had significantly lower results on consonant production measures. An association between consonant production at T1 and T2 for participants with DS indicates that number of different true consonants might be a predictive measure when evaluating young children with DS.
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Affiliation(s)
- Anna Nyman
- Division of Speech and Language Pathology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Habilitation and Health, Region Stockholm, Stockholm, Sweden
| | - Sofia Strömbergsson
- Division of Speech and Language Pathology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Katarina Lindström
- Department of Child Neurology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Division of Paediatrics, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Anette Lohmander
- Division of Speech and Language Pathology, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Medical Unit Speech-Language Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Carmela Miniscalco
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Child Neuropsychiatry, Queen Silvia's Children and Youth Hospital,Sahlgrenska University Hospital
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Persson C, Conroy EJ, Gamble C, Rosala-Hallas A, Shaw W, Willadsen E. Adding a fourth rater to three had little impact in pre-linguistic outcome classification. CLINICAL LINGUISTICS & PHONETICS 2021; 35:138-153. [PMID: 32372661 PMCID: PMC7644573 DOI: 10.1080/02699206.2020.1758793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 06/11/2023]
Abstract
The consequence of differing levels of agreement across raters is rarely studied. Subsequently, knowledge is limited on how number of raters affects the outcome. The present study aimed to examine the impact on pre-linguistic outcome classifications of 12-month-old infants when using four raters compared to three. Thirty experienced Speech and Language Therapists (SLTs) from five countries assessed 20 minute video recordings of four 12-month-old infants during a play session with a parent. One recording was assessed twice. A naturalistic listening method in real time was used. This involved: (1) assessing, each syllable as canonical or non-canonical, and (2) following the recording, assessing if the infant was babbling canonically and listing the syllables the infant produced with command. The impact that four raters had on outcome, compared to three, was explored by classifying the outcome based on all possible combinations of three raters and determining the frequency that the outcome assessment changed when a fourth assessor was added. Results revealed that adding a fourth rater had a minimal impact on canonical babbling ratio assessment. Presence/absence of canonical babbling and size of consonant inventory showed a negligible impact on three out of four recordings, whereas the size of syllable inventory and presence/absence of canonical babbling was minimally affected in one recording by adding a fourth rater. In conclusion, adding a forth rater in assessment of pre-linguistic utterances in 12-month-old infants with naturalistic assessment in real time does not affect outcome classifications considerably. Thus, using three raters, as opposed to four, is recommended.
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Affiliation(s)
- Christina Persson
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- School of Medical Sciences, Division of Dentistry, The University of Manchester, Manchester, Greater Manchester, UK
| | - Elizabeth J Conroy
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK
| | - Carrol Gamble
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK
| | - Anna Rosala-Hallas
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK
| | - William Shaw
- School of Medical Sciences, Division of Dentistry, The University of Manchester, Manchester, Greater Manchester, UK
| | - Elisabeth Willadsen
- School of Medical Sciences, Division of Dentistry, The University of Manchester, Manchester, Greater Manchester, UK
- Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen, Denmark
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Lohmander A, Westberg LR, Olsson S, Tengroth BI, Flynn T. Canonical Babbling and Early Consonant Development Related to Hearing in Children With Otitis Media With Effusion With or Without Cleft Palate. Cleft Palate Craniofac J 2020; 58:894-905. [PMID: 33084358 DOI: 10.1177/1055665620966198] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate and compare babbling, early consonant production and proficiency from 10 to 36 months of age and its relationship with hearing in children with otitis media with effusion (OME) with or without cleft palate. DESIGN Prospective, longitudinal group comparison study. SETTING University hospital. PARTICIPANTS Fifteen children born with nonsyndromic cleft palate with or without cleft lip (CP±L) and 15 age-matched children with hearing loss (HL) associated with OME but without cleft palate (noncleft group). MAIN OUTCOME MEASURES Canonical babbling (CB) and early consonant variables (presence of oral stops, anterior stops, dental/alveolar stops, number of different true consonants) at 10 and 18 months, and percentage of consonants correct proficiency (PCC) at 36 months. RESULTS A total of 54% of the CP±L group and 77% of the noncleft group had CB. The noncleft group had a significantly higher prevalence of all consonant variables. Percentage of consonants correct was 61.9% in the CP±L group and 81.6% in the noncleft group. All early consonant variables except CB were significantly related to PCC. Hearing sensitivity at 18 and 30 months correlated with PCC and explained 40% of the variation. CONCLUSIONS Mild HL impacted presence of CB at 10 months and was related to consonant proficiency at 36 months in children with HL associated with OME and children with cleft palate. The noncleft group showed results at 36 months similar to children with normal hearing; however, the CP±L group did not. Although the cleft palate may have a bigger impact on the speech development, management of hearing sensitivity would also be beneficial.
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Affiliation(s)
- Anette Lohmander
- Division, Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, 59562Karolinska Institutet, Stockholm, Sweden.,Medical Unit of Speech and Language Pathology and Stockholm Craniofacial Team, 59562Karolinska University Hospital, Stockholm, Sweden
| | - Liisi Raud Westberg
- Medical Unit of Speech and Language Pathology and Stockholm Craniofacial Team, 59562Karolinska University Hospital, Stockholm, Sweden
| | - Sofia Olsson
- Division of Speech and Language Pathology, 72250Södertälje Hospital, Södertälje, Sweden
| | | | - Traci Flynn
- School of Humanities and Social Sciences, Faculty of Education and Arts, 5982University of Newcastle, Newcastle, Australia
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Peryer H, Slator R, Thomson J, Richard B. The Method of Surgical Lip Repair Affects Speech Outcomes in Children With Bilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2020; 58:419-428. [PMID: 32959681 DOI: 10.1177/1055665620956872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE It was hypothesized that lip repair protocols in children with bilateral cleft lip and palate (BCLP) would affect development of bilabial consonants /m/ /b/ /p/. This study compared speech outcomes in 2 surgical groups. DESIGN A retrospective case note investigation. SETTING UK Cleft Centre (2000-2009). PATIENTS Forty-nine children with complete BCLP, of whom 26 had a 1-stage and 23 a 2-stage bilateral cleft lip repair. INTERVENTIONS One-stage cleft lip repair versus a 2-staged cleft lip repair. MAIN OUTCOME MEASURES Bilabial consonant production at 18 months, 3 and 5 years of age. Cleft Speech Characteristics (CSCs) at age 5. RESULTS At age 18 months, 81% of the 1-stage lip repair group and 4% of the 2-stage lip repair group produced bilabial consonants (P <·0001, Fisher test). At age 3 years, 81% of the 1-stage and 26% of the 2-stage lip repair groups produced bilabial consonants (P =·0133, Fisher test). At age 5 years, both groups had similar bilabial consonant production, but children in the 2-stage lip repair group had more frequent and severe CSCs (P = ·0037, χ2). CONCLUSION A 1-stage lip repair for children with complete BCLP resulted in better bilabial consonant production at 18 months and 3 years of age than a 2-stage lip repair. At age 5 years both groups had bilabial consonants but children in the 2-stage lip repair group had worse CSCs. The surgical protocol for bilateral cleft lip repair affected speech outcome in children with BCLP.
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Affiliation(s)
- Holly Peryer
- West Midlands Cleft Lip and Palate Centre, 156630Birmingham Children's Hospital, Birmingham, United Kingdom
| | - Rona Slator
- West Midlands Cleft Lip and Palate Centre, 156630Birmingham Children's Hospital, Birmingham, United Kingdom
| | - Jenny Thomson
- Department of Human Communication Sciences, 7315The University of Sheffield, Mushroom Lane, Sheffield, United Kingdom
| | - Bruce Richard
- West Midlands Cleft Lip and Palate Centre, 156630Birmingham Children's Hospital, Birmingham, United Kingdom
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Brunnegård K, Hagberg E, Havstam C, Okhiria Å, Klintö K. Reliability of Speech Variables and Speech-Related Quality Indicators in the Swedish Cleft Lip and Palate Registry. Cleft Palate Craniofac J 2020; 57:715-722. [PMID: 31906706 DOI: 10.1177/1055665619894497] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To assess the reliability of speech variables and speech-related quality indicators in the Swedish quality registry for cleft lip and palate (CLP). DESIGN Retrospective study. SETTING Primary care university hospitals. PARTICIPANTS Fifty-two 5-year-old children with unilateral CLP and 41 with bilateral CLP. MAIN OUTCOME MEASURES Registry data for "percent nonoral errors" and "perceived velopharyngeal competence" (VPC) were compared to reassessments by 4 independent judges based on audio recordings. Interjudge agreement for "percent consonants correct" (PCC) and the reliability of 3 quality indicators were also assessed. Agreement was calculated with single measures intraclass correlation coefficient (ICC) for articulation outcomes, quadratic weighted κ and ICC for VPC, and percentage agreement and κ for quality indicators. RESULTS When the agreement between registry data and the judges' reassessments was assessed, the ICC was 0.79 for percent nonoral errors. For VPC, the κ coefficient was 0.66 to 0.75 and the ICC was 0.73. Interjudge agreement for PCC calculated with ICC was 0.85. For the quality indicator "proportion of children with ≥86% correct consonants," all 4 judges were in agreement for 72% of the cases. For "proportion of children without nonoral speech errors" and "proportion of children with competent or marginally incompetent velopharyngeal function," the agreement between registry data and the 4 judges was 89% and 85%, respectively. CONCLUSIONS The results indicate that registry data on PCC, percent nonoral errors, VPC, and the quality indicators "proportion of children without nonoral speech errors" and "proportion of children with competent or marginally incompetent velopharyngeal function" are reliable.
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Affiliation(s)
- Karin Brunnegård
- Department of Clinical Sciences/Speech and Language Pathology, Umeå University, Umeå, Sweden
| | - Emilie Hagberg
- Karolinska University Hospital, Stockholm Craniofacial Team and Functional Area Speech & Language Pathology, Stockholm, Sweden.,Division of Speech and Language Pathology, Karolinska Institutet, CLINTEC, Stockholm, Sweden
| | - Christina Havstam
- Department of Otorhinolaryngology/Speech-Language Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Neuroscience and Physiology/Speech-Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Åsa Okhiria
- Department of Speech Language Pathology, Uppsala University Hospital, Uppsala, Sweden.,Department of Surgical Sciences, Plastic Surgery, Uppsala University, Uppsala, Sweden
| | - Kristina Klintö
- Division of Speech and Language Pathology, Department of Otorhinolaryngology, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
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Löfkvist U, Bäckström K, Dahlby-Skoog M, Gunnarsson S, Persson M, Lohmander A. Babbling and consonant production in children with hearing impairment who use hearing aids or cochlear implants – a pilot study. LOGOP PHONIATR VOCO 2019; 45:172-180. [DOI: 10.1080/14015439.2019.1695929] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ulrika Löfkvist
- Division of Otorhinolaryngology, Department of Clinical Science, Intervention and Technology, (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Kristin Bäckström
- Habilitation and Health, Stockholm County Council, Stockholm, Sweden
| | | | | | | | - Anette Lohmander
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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Raud Westberg L, Höglund Santamarta L, Karlsson J, Nyberg J, Neovius E, Lohmander A. Speech outcome in young children born with unilateral cleft lip and palate treated with one- or two-stage palatal repair and the impact of early intervention. LOGOP PHONIATR VOCO 2017; 44:58-66. [PMID: 29068267 DOI: 10.1080/14015439.2017.1390606] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The aim of this study was to describe speech at 1, 1;6 and 3 years of age in children born with unilateral cleft lip and palate (UCLP) and relate the findings to operation method and amount of early intervention received. METHODS A prospective trial of children born with UCLP operated with a one-stage (OS) palatal repair at 12 months or a two-stage repair (TS) with soft palate closure at 3-4 months and hard palate closure at 12 months was undertaken (Scandcleft). At 1 and 1;6 years the place and manner of articulation and number of different consonants produced in babbling were reported in 33 children. At three years of age percentage consonants correct adjusted for age (PCC-A) and cleft speech errors were assessed in 26 of the 33 children. Early intervention was not provided as part of the trial but according to the clinical routine and was extracted from patient records. RESULTS At age 3, the mean PCC-A was 68% and 46% of the children produced articulation errors with no significant difference between the two groups. At one year there was a significantly higher occurrence of oral stops and anterior place consonants in the TS group. There were significant correlations between the consonant production between one and three years of age, but not with amount of early intervention received. CONCLUSIONS The TS method was beneficial for consonant production at age 1, but not shown at 1;6 or 3 years. Behaviourally based early intervention still needs to be evaluated.
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Affiliation(s)
- Liisi Raud Westberg
- a Functional Area Speech and Language Pathology , Karolinska University Hospital , Stockholm , Sweden.,b Department of Reconstructive, Plastic Surgery, Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden
| | - Lena Höglund Santamarta
- c Division of Speech and Language Pathology, Department of Clinical Science , Intervention and Technology, Karolinska Institutet , Stockholm , Sweden.,d Speech and Language Pathology Unit , Stockholm Health Care Services, Stockholm County Council , Stockholm , Sweden
| | - Jenny Karlsson
- c Division of Speech and Language Pathology, Department of Clinical Science , Intervention and Technology, Karolinska Institutet , Stockholm , Sweden.,d Speech and Language Pathology Unit , Stockholm Health Care Services, Stockholm County Council , Stockholm , Sweden
| | - Jill Nyberg
- a Functional Area Speech and Language Pathology , Karolinska University Hospital , Stockholm , Sweden.,b Department of Reconstructive, Plastic Surgery, Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.,c Division of Speech and Language Pathology, Department of Clinical Science , Intervention and Technology, Karolinska Institutet , Stockholm , Sweden
| | - Erik Neovius
- b Department of Reconstructive, Plastic Surgery, Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.,e Department of Molecular Medicine and Surgery , Karolinska Institutet , Stockholm , Sweden
| | - Anette Lohmander
- a Functional Area Speech and Language Pathology , Karolinska University Hospital , Stockholm , Sweden.,b Department of Reconstructive, Plastic Surgery, Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.,c Division of Speech and Language Pathology, Department of Clinical Science , Intervention and Technology, Karolinska Institutet , Stockholm , Sweden
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Lohmander A, Holm K, Eriksson S, Lieberman M. Observation method identifies that a lack of canonical babbling can indicate future speech and language problems. Acta Paediatr 2017; 106:935-943. [PMID: 28271541 DOI: 10.1111/apa.13816] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 02/10/2017] [Accepted: 03/02/2017] [Indexed: 11/30/2022]
Abstract
AIM We investigated how accurate observations of canonical babbling (CB) were and explored predictive babbling measures in children with and without medical diagnoses of conditions that can lead to speech and language problems. METHODS From 2012 to 2014 this Stockholm-based study recruited 38 children aged nine months to 21 months with medical diagnoses and 30 children aged 10 months without diagnoses and included 21 previously studied 12-month-old children without medical diagnoses. CB and consonant sound production were directly observed by video recording natural play with a caregiver. The percentage of CB was calculated from each recording, and a validated observation form was used. How accurately the children with and without CB were classified was investigated with sensitivity and specificity. The groups were compared using predictive babbling variables. RESULTS The observation method identified children with and without CB well, with a specificity of 0.89 and sensitivity of 0.93, respectively. Children with predictive babbling measures were identified in the clinical group (specificity 0.93-0.97), and a lack of these measures indicated a risk of being in the clinical group (odds ratios > 10). The sensitivity was low (0.32-0.42). CONCLUSION Observation effectively identified a lack of CB and supported the importance of assessing babbling measures.
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Affiliation(s)
- A Lohmander
- Division of Speech and Language Pathology; Department of Clinical Science, Intervention, and Technology; Karolinska Institutet; Stockholm Sweden
- Functional Area Speech and Language Pathology; Karolinska University Hospital; Stockholm Sweden
| | - K Holm
- Division of Speech and Language Pathology; Department of Clinical Science, Intervention, and Technology; Karolinska Institutet; Stockholm Sweden
- Functional Area Speech and Language Pathology; Karolinska University Hospital; Stockholm Sweden
| | - S Eriksson
- Division of Speech and Language Pathology; Department of Clinical Science, Intervention, and Technology; Karolinska Institutet; Stockholm Sweden
- Functional Area Speech and Language Pathology; Karolinska University Hospital; Stockholm Sweden
| | - M Lieberman
- Division of Speech and Language Pathology; Department of Clinical Science, Intervention, and Technology; Karolinska Institutet; Stockholm Sweden
- Functional Area Speech and Language Pathology; Karolinska University Hospital; Stockholm Sweden
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Nyman A, Lohmander A. Babbling in children with neurodevelopmental disability and validity of a simplified way of measuring canonical babbling ratio. CLINICAL LINGUISTICS & PHONETICS 2017; 32:114-127. [PMID: 28521525 DOI: 10.1080/02699206.2017.1320588] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Babbling is an important precursor to speech, but has not yet been thoroughly investigated in children with neurodevelopmental disabilities. Canonical babbling ratio (CBR) is a commonly used but time-consuming measure for quantifying babbling. The aim of this study was twofold: to validate a simplified version of the CBR (CBRUTTER), and to use this measure to determine if early precursors to speech and language development could be detected in children with different neurodevelopmental disabilities. Two different data sets were used. In Part I, CBRUTTER was compared to two other CBR measures using previously obtained phonetic transcriptions of 3571 utterances from 38 audio recordings of 12-18 month old children with and without cleft palate. In CBRUTTER, number of canonical utterances was divided by total number of utterances. In CBRsyl, number of canonical syllables was divided by total number of syllables. In CBRutt, number of canonical syllables was divided by total number of utterances. High agreement was seen between CBRUTTER and CBRsyl, suggesting CBRUTTER as an alternative. In Part II, babbling in children with neurodevelopmental disability was examined. Eighteen children aged 12-22 months with Down syndrome, cerebral palsy or developmental delay were audio-video recorded during interaction with a parent. Recordings were analysed by observation of babbling, consonant production, calculation of CBRUTTER, and compared to data from controls. The study group showed significantly lower occurrence of all variables, except for of plosives. The long-term relevance of the findings for the speech and language development of the children needs to be investigated.
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Affiliation(s)
- Anna Nyman
- a Division of Speech and Language Pathology, Department of Clinical Science , Intervention and Technology, Karolinska Institutet , Stockholm , Sweden
- b Habilitation & Health, Stockholm County Council , Stockholm , Sweden
| | - Anette Lohmander
- a Division of Speech and Language Pathology, Department of Clinical Science , Intervention and Technology, Karolinska Institutet , Stockholm , Sweden
- c Functional Area Speech & Language Pathology, Karolinska University Hospital , Stockholm , Sweden
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