BACKGROUND AND OBJECTIVES: Many research papers showed that the most common articulation disorder in tongue-tie children was the error of alveolar sound. We performed speech therapy on alveolar sound after lingual frenulotomy to prove that the speech therapy after lingual frenulotomy improves the articulation of alveolar sound and that this effect is maintained. MATERIALS AND METHODS: We collected 28 children who never had speech therapy but could afford to have the speech therapy. The accuracy rate of consonant sound was calculated using a picture consonant test 2 weeks following the lingual frenulotomy. The speech therapy, called the phonetic placement and paired-stimulus technique, was performed 18 times for 3 months. This therapy decreased incidence rate of error. RESULTS: The incidence rate of alveolar sound error, which was calculated before speech therapy, was about 65%. And the incidence rate of alveolar sound error after speech therapy was 5-10%, which proved the effect of speech therapy. We divided alveolar sounds into target sounds and non-target sounds. And we performed speech therapy only on target sounds so the appearance rate of alveolar sound error decreased and the incidence rate of non-target sounds also decreased. We performed speech therapy after 2 weeks and the effect was maintained. CONCLUSION: The incidence rate of alveolar sound error decreased by using speech therapy and the effect was maintained. So the speech therapy must be performed after lingual frenulotomy.
Articulation Disorders ; Child ; Humans ; Incidence ; Speech Therapy*

BACKGROUND AND OBJECTIVES: To determine the extent of speech articulation disorder in ankyloglossia patients and to determine whether picture consonant articulation test has potential as a screening test to predict the outcome of surgery. SUBJECTS AND METHOD: A total of 35 patients (25 boys and 10 girls with mean age of 3.69+/-1.18 years) with ankyloglossia who underwent frenotomy and recovered completely without complications were enrolled in this study. We examined the correlation between the subjective satisfaction of parents and the results of picture consonant articulation test. RESULTS: In the picture consonant articulation test, 20 patients (20/35, 57.14%) needed postoperative speech therapy. When the resutls of preoperative picture consonant articulation test and postoperative parents' subjective satisfaction were compared, "normal" had a satisfaction score of 4.53+/-0.74 points, "consider" had 3.89+/-1.05 points, and "demand" had 3.27+/-1.45 points. When a postoperative speech therapy was required, parents' satisfaction decreased (correlation coefficient r=-0.456). CONCLUSION: The preoperative picture consonant test in our study showed potential as a screening test for predicting the outcome of surgery for ankyloglossia patients.
Articulation Disorders ; Female ; Humans ; Mass Screening ; Parents ; Speech Articulation Tests ; Speech Therapy

PURPOSE: In order to determine the differences in speech outcome based on timing of operation in submucous cleft palate, we have reviewed our experiences in the Furlow palatoplasty over the last 11 years. METHODS: From March 1996 to March 2006, 38 submucous cleft palate patients received Furlow palatoplasty. 10 developmentally delayed patients were excluded and 5 patients were lost to follow up. The rest 23 patients were reviewed. Speech was evaluated preoperatively and postoperatively, and speech therapy was performed accordingly. Perceptual speech assessment included hypernasality, nasal emission and articulation disorder. Cinefluorography was performed to aid perceptual assessment. Based on timing of operation, the patients were divided into 3 groups as following: Group A under 24 months(8 patients), Group B from 25 to 48 months(6 patients), and Group C over 49 months (9 patients). Except 1 patient under speech therapy yet, resultant speech was compared. RESULTS: The rate of abnormal speech was higher in Group C(3/9, 33.3%) than in Group A(0%) or B(0%). All 3 patients who had been discontinued of speech therapy from the parent's judgment had abnormal speech. The reason for the discontinuation was that the regular speech therapy was a burden at school age. Any patients who had continued speech therapy had normal speech. CONCLUSION: The results of our study shows that operative timing is associated with speech development. Maintenance of speech therapy was an important factor for normal speech development. It will be helpful to perform a palatoplasty before 48 months of age to complete speech therapy before the school age.
Articulation Disorders ; Cineradiography ; Cleft Palate ; Humans ; Judgment ; Lost to Follow-Up ; Speech Therapy

Velopharyngeal dysfunction in cleft palate patients following the primary palate repair may result in nasal air emission, hypernasality, articulation disorder and poor intelligibility of speech. Among conservative treatment methods, speech aid prosthesis combined with speech therapy is widely used method. However because of its long time of treatment more than a year and low predictability, some clinicians prefer a surgical intervention. Thus, the purpose of this report was to increase an attention on the effectiveness of speech aid prosthesis by introducing a case that was successfully treated. In this clinical report, speech bulb reduction program with intensive speech therapy was applied for a patient with velopharyngeal dysfunction and it was rapidly treated by 5months which was unusually short period for speech aid therapy. Furthermore, advantages of pre-operative speech aid therapy were discussed.
Articulation Disorders ; Cleft Palate ; Humans ; Methods ; Palate ; Prostheses and Implants ; Speech Therapy* ; Velopharyngeal Insufficiency

OBJECTIVETo explore the clinical characteristics and speech therapy of 62 children with lingua-apical articulation disorder.

METHODSPeabody Picture Vocabulary Test (PPVT), Gesell development scales (Gesell), Wechsler Intelligence Scale for Preschool Children (WPPSI) and speech test were performed for 62 children at the ages of 3 to 8 years with lingua-apical articulation disorder. PPVT was used to measure receptive vocabulary skills. GESELL and WPPSI were utilized to represent cognitive and non-verbal ability. The speech test was adopted to assess the speech development. The children received speech therapy and auxiliary oral-motor functional training once or twice a week. Firstly the target sound was identified according to the speech development milestone, then the method of speech localization was used to clarify the correct articulation placement and manner. It was needed to change food character and administer oral-motor functional training for children with oral motor dysfunction.

RESULTSThe 62 cases with the apical articulation disorder were classified into four groups. The combined pattern of the articulation disorder was the most common (40 cases, 64.5%), the next was apico-dental disorder (15 cases, 24.2%). The third was palatal disorder (4 cases, 6.5%) and the last one was the linguo-alveolar disorder (3 cases, 4.8%). The substitution errors of velar were the most common (95.2%), the next was omission errors (30.6%) and the last was absence of aspiration (12.9%). Oral motor dysfunction was found in some children with problems such as disordered joint movement of tongue and head, unstable jaw, weak tongue strength and poor coordination of tongue movement. Some children had feeding problems such as preference of eating soft food, keeping food in mouths, eating slowly, and poor chewing. After 5 to 18 times of therapy, the effective rate of speech therapy reached 82.3%.

CONCLUSIONThe lingua-apical articulation disorders can be classified into four groups. The combined pattern of the articulation errors is the most common one. Most of the apical sounds are replaced by velar sounds. The speech localization method is very useful in the therapy of apical articulation disorder. For children with feeding problems and oral motor dysfunction, it is needed to improve food texture and administer oral motor skill training.

Articulation Disorders ; classification ; complications ; therapy ; Child ; Child Development ; Child, Preschool ; Feeding and Eating Disorders of Childhood ; complications ; therapy ; Humans ; Intelligence Tests ; Language Tests ; Motor Skills Disorders ; therapy ; Speech Therapy

BACKGROUND: Velopharyngeal insufficiency that accompanies speech resonance and articulation disorders can be managed through several intervention methods such as speech-language therapy, prosthetic aids, and surgery. However, for patients with severe hypernasality, surgical interventions are highly recommended. Among available surgical techniques, the posterior pharyngeal flap is most common. CASE PRESENTATION: Two adult males with high nasalance scores underwent superiorly based posterior pharyngeal flap surgery, followed by speech testing by an expert speech-language therapist. Nasalance scores and articulation accuracy were assessed up until 1 year after the surgery. Nasalance scores were measured five times using a nasometer, after which the average value was calculated. CONCLUSIONS: Consistent declines in hypernasality over time are not easy to explain since the pedicled pharyngeal flap narrowed over time, secondary to cicatrization. However, scar tethering of the soft palate in a posterior direction could reduce the velopharyngeal port size over time. Therefore, long-term follow-up with intensive speech therapy is suggested for patients with severe hypernasality.
Adult ; Articulation Disorders ; Cicatrix ; Cleft Palate ; Follow-Up Studies ; Humans ; Male ; Palate, Soft ; Speech Therapy ; Velopharyngeal Insufficiency

OBJECTIVETo analyze the formant frequency of vowels in the sequence therapy of patient with cleft palate.

METHODSThe formant frequency of vowels [a], [e], [i], [u] of normal children and postoperative patients with and without speech therapy was measured and analyzed by VS-99.

RESULTS1. The mean value of F1, F2, F3 of [a] did not show significant difference among the three groups (P > 0.05). 2. The difference of mean value of [e] was significant between control group and pre-speech-therapy group, and between pre-speech-therapy and post-speech-therapy group (P < 0.05), but no significant difference was found between post-speech-therapy and control group(P > 0.05). The mean value of the formant in post-speech-therapy was higher than that of pre-speech-therapy. 3. The difference of mean value of [i] was significant between pre-speech-therapy and post-speech-therapy (P < 0.05), the mean value of F2, F3 in post-speech-therapy group decreased significantly compared with control (P < 0.05). 4. The difference of mean value of [u] showed significance between pre-speech-therapy and post-speech-therapy (P < 0.05), while the differences among other groups were insignificant (P > 0.05).

CONCLUSIONSurgical repair of cleft palate cannot make all patients obtain perfect Velopharyngeal competence (VPC), while speech therapy can improve patient's pronunciation. Speech spectrum analysis can judge the effect of cleft palate therapy objectively.

Adolescent ; Adult ; Articulation Disorders ; etiology ; physiopathology ; Child ; Cleft Palate ; complications ; physiopathology ; surgery ; Female ; Humans ; Male ; Postoperative Period ; Sound Spectrography ; Speech ; physiology ; Speech Articulation Tests ; Speech Production Measurement ; Speech Therapy ; Velopharyngeal Insufficiency ; etiology ; physiopathology

OBJECTIVETo study classification of the articulation errors, find the related factors which affect the therapy effect, and compare the therapy effect in the different patterns of the phonemic errors and build up a clinical model of the speech therapy on the basis of more than 4 years speech therapy in the clinic.

METHODAfter excluding the organic articulation disorders, 91 cases of consonant phonemic errors were classified into different patterns according to the phonemic placement errors. The 91 cases were divided into two groups as effective one and ineffective one depending on whether the symptoms disappeared or not after the speech therapy. Ten factors including sex, age, oral-motor function problem, developmental delay, history of language development delay, history of middle ear affection, lingua frenata, mental retardation, the therapy frequency and times, were analyzed. The statistics software SPSS (SPSS Inc, 1997) was applied to show the factors related to the therapy effect by logistic multiple stepwise regression analysis. The therapy effect was compared between the single pattern (phonemic error < 2 groups) and multiple pattern (phonemic errors > or = 2 groups).

RESULTSThe 91 cases with consonant phonemic errors were classified into four groups. The multiple pattern of the articulation errors was the most common (37 cases, 41%) among the 4 groups, followed by velar errors (33 cases, 36%). The third one was the apico-dental errors (12 cases, 13%) and the last one was the linguo-alveolar errors (8 cases, 9%). Only one case had labiodental error (/f/). The logistic multiple stepwise regression analysis showed that the history of the positive developmental delay, language delay and the frequency of the speech therapy were related to the therapy effect. The effective rate of the speech therapy in the single pattern of the phonemic error was as high as 87% while the one in the multiple pattern group was only 2.7%. The difference was significant (P < 0.000 1) when the therapy effect in these two groups was compared. The clinical model of the speech therapy included speech assessment, designing of the goal, choice of the target sound, sound production and oral-motor functional training.

CONCLUSIONThe consonant phonemic errors in the clinic represent four groups. The developmental delay, the language delay and frequency of the speech therapy influence the therapy effect. The frequency of the speech therapy should be increased every week, for example not less two times a week. The therapy effect of the single pattern of the phonemic errors is much better than that of the multiple pattern. The primary model of the speech therapy has been built in the clinics.

Articulation Disorders ; diagnosis ; etiology ; therapy ; Child ; Child, Preschool ; Female ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Risk Factors ; Speech Therapy ; Voice Training

The cleft lip and palate (CLP) is one of the most common craniofacial malformations in humans. We collected functional magnetic resonance data of 23 CLP patients before rehabilitation training (Bclp) and 23 CLP patients after rehabilitation training (Aclp), who were performing Chinese character pronunciation tasks, and performed brain activation analysis to explore the changes of brain mechanism in CLP patients after articulation disorder rehabilitation training. The study found that Aclp group had significant activation in the motor cortex, Broca area, Wernicke area and cerebellum. While the Bclp group had weak activation in the motor cortex with a small activation range. By comparing the differences and co-activated brain regions between the two groups, we found that rehabilitation training increased the activity level of negatively activated brain areas (cerebellum, left motor area, Wernicke area, etc.) to a positive level. At the same time, the activity level of weakly activated brain areas (right motor area, Broca area, etc.) was also increased. Rehabilitation training promoted the activity level of articulation-related brain regions. So that the activation intensity of articulation-related brain regions can be used as a quantifiable objective evaluation index to evaluate the effect of rehabilitation training, which is of great significance for the formulation of rehabilitation training programs.
Humans ; Articulation Disorders/therapy* ; Brain/diagnostic imaging* ; Cleft Lip/diagnostic imaging* ; Cleft Palate/diagnostic imaging* ; Magnetic Resonance Imaging ; Speech Therapy/psychology*

BACKGROUND AND OBJECTIVES: We aimed to develop a Korean version of the velopharyngeal insufficiency (VPI) speech corpus system. SUBJECTS AND METHOD: After developing a 3-channel simultaneous speech recording device capable of recording nasal/oral and normal compound speech separately, voice data were collected from VPI patients aged more than 10 years with/without the history of operation or prior speech therapy. This was compared to a control group for which VPI was simulated by using a french-3 nelaton tube inserted via both nostril through nasopharynx and pulling the soft palate anteriorly in varying degrees. The study consisted of three transcriptors: a speech therapist transcribed the voice file into text, a second transcriptor graded speech intelligibility and severity and the third tagged the types and onset times of misarticulation. The database were composed of three main tables regarding (1) speaker's demographics, (2) condition of the recording system and (3) transcripts. All of these were interfaced with the Praat voice analysis program, which enables the user to extract exact transcribed phrases for analysis. RESULTS: In the simulated VPI group, the higher the severity of VPI, the higher the nasalance score was obtained. In addition, we could verify the vocal energy that characterizes hypernasality and compensation in nasal/oral and compound sounds spoken by VPI patients as opposed to that characgerizes the normal control group. CONCLUSION: With the Korean version of VPI speech corpus system, patients' common difficulties and speech tendencies in articulation can be objectively evaluated. Comparing these data with those of the normal voice, mispronunciation and dysarticulation of patients with VPI can be corrected.
Aged ; Articulation Disorders ; Cleft Palate ; Compensation and Redress ; Database Management Systems ; Demography ; Humans ; Nasopharynx ; Palate, Soft ; Speech Intelligibility ; Speech Therapy ; Velopharyngeal Insufficiency ; Voice