1. Phonological Development in Children with Cleft Palate Virginia Dixon-Wood, MA University of Florida

2. Phonological Development Young children are active problem solvers who are attempting to produce speech that sounds like the speech they hear Broen, P. and K. Moeller in Cleft Palate – Interdisciplinary Issue and Treatment

3. Phonological Development Process is cognitive Child is actively experimenting to match the visual and acoustic attributes of speech avoiding words modifying features simplifying assimilating place or manner

4. Phonological Development The accuracy of speech is constrained by the child’s perception of what is to be produced and the child’s physical ability to produce what is perceived Impaired by: vpi hearing loss palatal fistula

5. Phonological Development Children with cleft palate don’t compensate like other children. Their productions do not seem to be reasonable approximations of the speech to which they are exposed Some make errors that cannot be accounted for by the difference in their oral mechanism, i.e. glottal articulation

6. Phonological Development These children accommodate in 3 ways: 1)Nasal emission distortion with appropriate sounds high pressure /p, b, s/

7. Phonological Development Accomodations: 2)Substitutes a sound which the child can produce that matches some of the features /n/ for /d/

8. Phonological Development Accomodations: 3)Glottal/pharyngeal substitution which also can keep some features, i.e. glottal stop for oral stop

9. Phonological Development 2 Common Patterns Described by Ferguson and Farrell: Child 1 Used words with sounds they were able to produce-75% sonorant Single syllable words-75% of the time As vocabulary increases, however, speech becomes less accurate

10. Phonological Development Child 2 Used words that they were unable to produce – 25% sonorant 50% of words were multisyllabic Productions were not very accurate

11. Phonological Development Differences among children w/o cleft palate and each other Child 1 Did not begin talking until age 2 Conservative approach

12. Phonological Development Child 2 Talked with open palate Word initial consonants accurate 30% of the time Developed template-used it for several words

13. Phonological Development Child 2 Unlike normal children, used -back velar stops -pharyngeal fricatives -glottal stops

14. Phonological Development Broen 1986 30 month old children 3 groups of 5 children each vpi cleft palate w/o vpi controls

15. Phonological Development Broen, 1986 Cleft palate group w/o VPI -Were still slower at acquiring normal/accurate speech production

16. Phonological Development Broen, 1986 Vpi group-more voicing errors place errors-fewer (more evenly distributed) *most significant-frequency with which sonorants were substituted for non-sonorants (22.0, 2.0, 0.2)

17. Phonological Development VPI group a)Preserving voice but sacrificing place - nasal stops for voiced nasal stops (m/b) -non-voiced (h/p)

18. Phonological Development b)Neutralizing voice but preserving place- Nasals or voiced glides for non-sonorant consonants, i.e. l/d

19. Phonological Development c)Some children used 2-3 different consonants as substitution for one phoneme /y,h/ Trade-offs necessary to produce audible speech that approximates target

20. Phonological Development “Early Speech Production of Children with Cleft Palate” Teresa Estrem and Patricia Broen JSHR 1989 What’s the role of physiology in shaping early lexical choice?

21. Phonological Development Lexical choice -10 children / 2 groups -cleft palate/ non-cleft -analyzed speech at 10, 20, 30, 40, 50 word levels

22. Lexical Choice - results Cleft group: 1)Difference in class features – more sonorants 2)Very young children tended to target words with sounds with less intraoral pressure

23. Phonological Development Lexical Choice-results 3)Place of articulation-more labials and glottals 4)Manner of production – -produced fewer stops than targeted -targeted more words with nasal and approximates -produced more than targeted

24. Phonological Development Lack of VP closure does not “cause” glottal stops or pharyngeal fricatives

25. Phonological Development As vocabulary increases Intelligibility decreases

26. Phonological Development Post operative characteristics: Active vs. Passive Nasal emission- can be active or passive Passive- goes away with surgery Active – stays as a feature of the child’s speech development Glottalizing-active