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

OBJECTIVE: To evaluate correlations between values of articulation tests and language tests for children with articulation disorder in Korea. METHODS: Data of outpatients with chief complaint of an articulation problem were retrospectively collected. Patients who underwent Urimal Test of Articulation and Phonation (U-TAP) with Assessment of Phonology and Articulation for Children (APAC), Preschool Receptive-Expressive Language Scale (PRES), or Receptive and Expressive Vocabulary Test (REVT) simultaneously were identified. Patients whose word-level percentages of correct consonants in U-TAP (UTAP_wC) were more than 2 standard deviations below the mean as diagnostic criteria for articulation disorder were selected. Those whose receptive language age (P_RLA), expressive language age (P_ELA), or combined language age (P_CLA) in PRES was delayed more than 24 months compared to their chronological age in months as diagnostic criteria for language disorder were excluded. RESULTS: Thirty-three children aged 3–6 years were enrolled retrospectively. PRES and U-TAP showed significant correlations for most of value relationships. PRES and APAC showed significant correlations for all value relationships except for receptive language age. All values of REVT were significantly correlated with all values from U-TAP, but not with any value from APAC. Articulation tests U-TAP and APAC showed significant correlations between percentages of correct consonants. Language tests PRES and REVT showed significant correlations for all value relationships. CONCLUSION: This study suggests that articulation abilities and language abilities might be correlated in children with articulation disorder.
Articulation Disorders ; Child ; Humans ; Korea ; Language ; Language Disorders ; Language Tests ; Outpatients ; Phonation ; Retrospective Studies ; Speech Articulation Tests ; Speech Disorders

OBJECTIVETo develop a set of Mandarin monosyllabic list for the goal to use as a standardized speech recognition assessment tool in China with sufficient validity, reliability and sensitivity.

METHODSThirty lists were designed based on the following criteria: efficiency, phonemic-balance, familiarity and coverage, while each list was designed corresponding to 25 monosyllables. These lists were read by a male broadcaster, recorded digitally and composed into compact disc. Our work consisted of three phases. Phase I: Sixty adults with normal hearing were recruited from Beijing to repeat as many syllables which they heard as possible. According to the randomized block design, 30 lists were presented with 6 intensities including -1 dB, 5 dB, 11 dB, 15 dB, 21 dB and 27 dB HL(speech). The lists and intensities were counterbalanced across all participants. Recognition scores in individual intensities for each list were calculated, and then logistic regression was utilized to fit Performance-Intensity (P-I) function. Two-way (list No. and Intensity) repeated measurement analysis of variance and Post-Hoc Tukey HSD test indicated that 22 lists were equivalent. Phase II: Twenty-two oral/aural normal adults were recruited to assess monosyllable recognition scores with the 22 equivalent lists at 10 dB HL(Speech), according to the Latin-Square design. Tests were administered twice for all participants with the same procedure and situation during 6 to 35 day intervals. The differences in scores (after a "rationalized" arcsine transformation) among 22 lists across over the two sessions is 9.3%, the data were collected from 22 participants, the measurement error was calculated by SD (standard deviation), the critical difference (CD) for test score improvement was 18.3% (determined as SD x 1.96, in 95% confidence level). Phase III: Eighteen participants with sensorineural hearing loss were recruited to assess recognition perception using 18 equivalent monosyllable lists at 30 dB suprathreshold based on Latin-Square design. Tests were administered twice by using the same procedure and situation within 1 to 16 day intervals. The same approach in Phase II was utilized to calculate SD (8.3%). The CD was calculated as 16.3% (in 95% confidence level).

RESULTSA set of standardized Mandarin recognition assessment material had been developed and it consisted of 22 equivalent phonemic-balanced lists with 25 monosyllables each. Approximately, every single list took 2 minutes, and thus it might be appropriate for clinical assessment. The P-I functions reveal that the recognition threshold was (8.30 +/- 0.84) dB HL(speech) and the slope of PI functions was (4.0 +/- 0.3)%/dB for adults with normal hearing. When a set of Mandarin monosyllable lists was utilized as an assessment tool, the critical difference of 18.3% (for normal-hearing adults) and 16.3% (for hearing-impaired adults) would be a key for clinicians to assess the improvement of speech recognition ability appropriately with statistically significance.

CONCLUSIONIn this study, a new Mandarin monosyllabic lists has been successfully developed with a sufficient validity, reliability and sensitivity for clinical evaluations, thus it might be convenience and helpful to be used as a standardized speech recognition assessment tool in China.

Adolescent ; Adult ; Audiometry, Speech ; Female ; Humans ; Male ; Phonetics ; Reproducibility of Results ; Speech Articulation Tests ; Speech Discrimination Tests ; Young Adult

Time to time, we face patients who missed the proper time for primary palatal repair. Although we do not have enough available documents, it is important to establish efficacy of palatal repair in patients more than 4 years old. From May 1995 to March 2005, we selected 14 patients who underwent palatal repair in more than 4 years old patients and they are able to tolerate speech articulation tests. Out of 14 patients 5 males an 9 females in sex, aged form 4 to 50 years old. 6 patients with incomplete cleft palate and 8 patients with submucous cleft palate. Double reversing Z-plasty(n=5), pushback palatoplasty(n=4), two flap palatoplasty(n=2), von Langenbeck palatoplasty(n=2), and intravelar veloplasty(n=1) were performed. Preoperative and postoperative speech articulation test, "Simple method of speech evaluation in Korean patients with cleft palate", were conducted. Satisfaction rate was sorted into 5 levels. There is no significant statistical correlation in the speech improvement, satisfaction rate, patients sex, cleft type and operative method. But there is significant statistical correlation between the speech improvement and patienet's age. There were better result in younger patient group than aged patients group.
Child, Preschool* ; Cleft Palate ; Female ; Humans ; Male ; Middle Aged ; Speech Articulation Tests

The velopharyngeal dysfunction usually occurs in patients with previous operation of the cleft palate or with submucosal cleft palate. In case of velopharyngeal dysfunction without cleft palate, no study has been made when it comes to operative method and postoperative results. Here, we would like to present the operative methods and the postoperative results with the cases we've experienced. This study is based on seven cases of velopharyngeal dysfunction without cleft palate from 1999 to 2004. Analysis of age, sex, etiology, operative methods, satisfaction rate and speech evaluation was done. The patients were 3 males and 4 females, with an age ranged from 10 to 28 at the time of surgery. The follow-up period was more than six months. One case had bifid uvula, another had atypical anomaly in palate, and five cases had no anatomical abnormality. The palatal lengthening was done on one patient, the levator muscle repositioning on another patient and to the rest of them, the superiorly based posterior pharyngeal flap was done. It was difficult to determine the etiology of the velopharyngeal dysfunction without cleft palate. The speech improvement and the satisfaction rate of the patients and parents were diverse. Although the authors had a problem with statistical analysis between the operative age and the speech improvement, it was reasonable to perform a surgical operation because post operative speech improvement was observed in most cases regardless of age. There is little statistical correlation, but significantly higher outcomes were observed in palatal lengthening and levator muscle repositioning than in pharyngeal flap.
Cleft Palate* ; Female ; Follow-Up Studies ; Humans ; Male ; Palate ; Parents ; Speech Articulation Tests ; Uvula ; Velopharyngeal Insufficiency

This study aimed at examining speech defects of open bite patients, which were analized in terms of formant frequency for vowels and word pronunciation length for consonants. In addition, the upper and lower lip (perioral m.) activity was tested by the EMG. The tongue force was measured by the strain gauge, and the speech discrimination test was carried out. One experimental group and one control group were used for this study and they were respectively composed of six female openbite patients and six normal-occlusion females. Eight monophthongs, two fricatives and two affricatives were chosen for speech analysis. Speeches of the above-mentioned groups were recorded and then analized by the ILS/PC-I software. Four hundred most frequently used monosyllables were also chosen for discrimination score. Openbite patients showed the following characteristics: 1. Abnormality in case of /a/, /epsilon/, /e/, /i/ F2 and /e/, /a/ F1. 2. Significantly elongated length in their pronunciation of /h/ and /Ch/ and somewhat elongated length also in their pronunciation of /s/ and /c/. 3. Significant upper lip activity according to the EMG test during pronunciation of the bilabial consonants. 4. Relatively weak tongue force according to the strain gauge measurement. 5. According to the speech discrimination test, high rate of misarticulation in case of (a) initial /p/ /s'/ and /ts'/, (b) /a/, /epsilon/, /e/, /je/, /o/, /phi/, /jo/, /u/, /we/, and /i/ (c) final /eta/.
Articulation Disorders ; Discrimination (Psychology) ; Female ; Humans ; Lip ; Open Bite* ; Speech Discrimination Tests ; Tongue

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 the Chinese intelligibility of patients with velopharyngeal incompetence (VPI).

METHODS100 patients with VPI and 32 normal students were selected for this study. Of 10 patients, 15 with cleft palate, 21 with congenital velopharyngeal incompetence, 56 with post-palatoplasty VPI and 8 with post-pharyngoplasty VPI. Chinese intelligibility was measured by three speech pathologists and relation between degree of abnormal articulation and Chinese intelligibility were studied.

RESULTSChinese intelligibility of the controls was 99.0% and the patients with VPI were 35.2%. Of the patients, the cleft palate was 19.9%, the congenital velopharyngeal incompetence was 32.8%, the post-palatoplasty VPI was 40.3% and the post-pharyngoplasty VPI was 35.2%. The data showed obvious difference among the controls and sub-types of VPI (P < 0.01).

CONCLUSIONS(1) Chinese intelligibility of VPI accompanied with hypernasality is worse. (2) Of misarticulation of VPI, the cleft palate is the worst, in turn the others are the congenital velopharyngeal incompetence, the post-pharyngoplasty VPI and the post-palatoplasty VPI.

Adolescent ; Adult ; Articulation Disorders ; etiology ; Child ; Child, Preschool ; Cleft Palate ; complications ; Female ; Humans ; Male ; Speech Articulation Tests ; Velopharyngeal Insufficiency ; complications ; Voice Quality

OBJECTIVE: To study the early and long term effect on velopharyngeal closure function by children adenoidectomy. METHOD: An investigation on parents or person who attended the children to be executed adenoidectomy, blowing soak test and computerized phonography were carried on 1 week, 1 month, and 3 months preoperatively and postoperatively, respectively. RESULT: 1) The investigation showed that 22 in 31 cases presented hypernasality, in which 9 lasted more than 3 months after operation, Seven children presented nasal regurgitation of food and hypernasality only within 1 month. 2) Blowing soak test showed velopharyngeal insufficiency within 1 week (P <0.01) after operation. 3) Some voice figures appeared consonant and formants incomplete, and nasalization in the early period after operation. The value of F3 in /i:/ decreased after operation, especially within 1 week. CONCLUSION Velopharyngeal insufficiency appears on most children after adenoidectomy transiently. There is no evidence shows a long term influence on velopharyngeal function for children after adenoidectomy.
Adenoidectomy ; adverse effects ; Child ; Child, Preschool ; Female ; Humans ; Male ; Speech Articulation Tests ; Surveys and Questionnaires ; Velopharyngeal Insufficiency ; epidemiology ; Voice Quality

OBJECTIVETo study the aerodynamic characteristics of low-resistance Groningen voice prosthesis for total laryngectomees and the related clinical significance.

METHODSThree aerodynamic parameters were measured in 24 laryngectomees implanted with low-resistance Groningen voice prosthesis: the sound pressure level (SPL), intratracheal pressure (pressure) and airflow rate (flowrate). Among them, 6 cases were initially implanted with other prosthesis which was replaced by the Groningen buttons later. The parameters were measured for both old and new prosthesis. The relationship between the variables were computed with means of Pearson' s product-moment correlations.

RESULTSThe parameters were measured repeatedly among all cases, 180 group data were collected. Screening test showed that the median of sound pressure level, intratracheal pressure and airflow rate are respectively 88.0 dB, 73.6 cm H2O (1 cm H2O = 0.098 kPa) and 123.2 ml/s. Thirty times measurement of patients phonation showed that the correlation between SPL and pressure was not significant (r = -0.058, P > 0.05). The relationship between flow rate and SPL was not significant(r = -0.119, P > 0.05). The correlation between pressure and flow rate was significant(r = 0.699, P < 0.05). CONCLUSIONS When pseudoglottis vibration is produced by sub pseudoglottis air flow, pseudoglottis vibration and voice loudness can not be increased by continuous air flow.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kinetics ; Laryngeal Neoplasms ; rehabilitation ; surgery ; Laryngectomy ; rehabilitation ; Larynx, Artificial ; Male ; Middle Aged ; Prosthesis Design ; Speech Articulation Tests ; Speech, Alaryngeal