To compare consonant proficiency, consonant errors, and the perceived velopharyngeal (VP) competence in internationally adopted (IA) children with unilateral cleft lip and palate (UCLP) and nonadopted (NA) children with the same cleft–palate type at age 5.
Design:
Case–control study based on phonetic transcriptions of standardized speech recordings of 5-year-olds at a tertiary hospital.
Participants:
Twenty-five IA children were compared to 20 NA children. All consecutive patients at a cleft lip and palate center participated.
Main Outcome Measure(s):
Consonant proficiency was measured using percentage consonants correct, percentage consonants correct–adjusted for age, percentage correct place, percentage correct manner, and consonant inventory. Cleft speech characteristics (CSCs), developmental speech characteristics (DSCs), and the perceived VP competence were also measured.
Results:
The IA children had significantly lower values for all consonant proficiency variables (p < .05) and a smaller consonant inventory (p = .001) compared to the NA children. The IA children had a higher frequency of CSCs (IA = 84%, NA = 50%, p < .05) and DSCs (IA = 92%, NA = 65%, p = .057), and twice as many IA children as NA children had perceived VP incompetence (IA = 52%, NA = 25%, p = .17).
Conclusions:
Severe speech disorder was more common in IA children than in NA children at age 5. Most importantly, the speech disorders seem to be not only cleft-related. More detailed speech assessments with a broader focus are needed for IA children with UCLP. Longitudinal studies are recommended to further investigate the impact of speech difficulties in IA children’s daily lives.
BoersmaP. Praat, a system for doing phonetics by computer. Glot Int. 2001;5:341–345.
2.
BrittonLAlberyLBowdenMHarding-BellAPhippenGSellD. A cross-sectional cohort study of speech in five-year-olds with cleft palate ± lip to support development of national audit standards: benchmarking speech standards in the United Kingdom. Cleft Palate Craniofac J. 2014;51(4):431–451.
3.
BrunnegårdKLohmanderA. A cross-sectional study of speech in 10-year-old children with cleft palate: results and issues of rater reliability. Cleft Palate Craniofac J. 2007;44(1):33–44.
4.
CookeMSWeiSH. A comparative study of southern Chinese and British Caucasian cephalometric standards. Angle Orthod. 1989;59(2):131–138.
5.
FollmarKEYuanNPendletonCSDorafsharAHKolkCVRedettRJ. Velopharyngeal insufficiency rates after delayed cleft palate repair: lessons learned from internationally adopted patients. Ann Plast Surg. 2015;75(3):302–305.
6.
GlennenS. A longitudinal study of language and speech in children who were internationally adopted at different ages. Lang Speech Hear Serv Sch. 2014;45(3):185–203.
7.
HanssonESvenssonHBeckerM. Adopted children with cleft lip or palate, or both, require special needs cleft surgery. J Plast Surg Hand Surg. 2012;46:75–79.
8.
HavstamCSandbergADLohmanderA. Communication attitude and speech in 10-year-old children with cleft (lip and) palate: an ICF perspective. Int J Speech Lang Pathol. 2011;13(2):156–164.
9.
KayeACheCChewWLStueveEAJiangS. Cleft care of internationally adopted children from China. Cleft Palate Craniofac J. 2019;56(1):46–55.
10.
KlintöKSalamehEKLohmanderA. Phonology in Swedish-speaking 5-year-olds born with unilateral cleft lip and palate and the relationship with consonant production at 3 years of age. Int J Speech Lang Pathol. 2016;18(2):147–156.
11.
KlintöKSalamehEKSvenssonHLohmanderA. The impact of speech material on speech judgement in children with and without cleft palate. Int J Lang Commun Disord. 2011;46(3):348–360.
12.
KummerAW. Evaluation of speech and resonance for children with craniofacial anomalies. Facial Plast Surg Clin North Am. 2016;24(4):445–451.
13.
LarssonASchölinJMarkHJönssonRPerssonC. Speech production in 3-year-old internationally adopted children with unilateral cleft lip and palate. Int J Lang Commun Disord. 2017;52(5):626–636.
14.
LiljaJFriedeH.JohansonB.Changing philosophy of surgery of the cleft lip and palate in Göteborg, Sweden. In: BerkowitzS, ed. Cleft Lip and Palate. Vol. 2. San Diego, CA: Singular; 1996:155–l70.
15.
LohmanderALundeborgIPerssonC. SVANTE—the Swedish Articulation and Nasality Test—normative data and a minimum standard set for cross-linguistic comparison. Clin Linguist Phon. 2017a;31(2):137–154.
16.
LohmanderAHagbergEPerssonCWilladsenELundeborgIDaviesJHavstamCBoersMKisling-MøllerMAlaluusuaS, et al.Validity of auditory perceptual assessment of velopharyngeal function and dysfunction—the VPC-Sum and the VPC-Rate. Clin Linguist Phon. 2017b;31(7-9):589–597.
17.
LohmanderAPerssonC. A longitudinal study of speech production in Swedish children with unilateral cleft lip and palate and two-stage palatal repair. Cleft Palate Craniofac J. 2008;45(1):32–41.
18.
LohmanderAPerssonCWilladsenELundeborgIAlaluusuaSAuknerRBauABoersMBowdenMDaviesJ, et al.Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 4. speech outcomes in 5-year-olds—velopharyngeal competency and hypernasality. J Plast Surg Hand Surg. 2017c;51(1):27–37.
19.
McCormackJMcLeodSCroweK. What do children with speech sound disorders think about their talking?Semin Speech Lang. 2019;40(2):94–104.
20.
McLeodSBakerE. Children´s Speech: An Evidence-Based Approach to Assessment and Intervention. Boston, MA: Pearson; 2017.
21.
McLeodSCroweK. Children’s consonant acquisition in 27 languages: a cross-linguistic review. Am J Speech Lang Pathol. 2018;21(27):1546–1571.
22.
MorganARBellucciCCCoppersmithJLindeSBCurtisAAlbertMO’GaraMMKapp-SimonK. Language development in children with cleft palate with or without cleft lip adopted from non-English-speaking countries. Am J Speech Lang Pathol. 2017;17(26):342–354.
23.
MorganAO’GaraMBellucciCCLindeSAlbertMCurtisAPatelPKapp-SimonKA. Speech production skills in children with cleft palate who were internationally adopted. Cleft Palate Craniofac J. 2018;55(9):1225–1235.
24.
PereiraVJSellDTuomainenJ. Effect of maxillary osteotomy on speech in cleft lip and palate: perceptual outcomes of velopharyngeal function. Int J Lang Commun Disord. 2013;48(6):640–650.
25.
SchererNJBakerSKaiserAFreyJR. Longitudinal comparison of the speech and language performance of united states-born and internationally adopted toddlers with cleft lip and palate: a pilot study. Cleft Palate Craniofac J. 2018;55(7):941–953.
26.
SellDSouthbyLWrenYWillsAKHallAMahmoudOWaylenASandyJRNessAR. Centre-level variation in speech outcome and interventions, and factors associated with poor speech outcomes in 5-year-old children with non-syndromic unilateral cleft lip and palate: The Cleftcare UK Study. Part 4. Orthod Craniofac Res. 2017;20:27–39.
27.
SellDSweeneyT. Percent consonant correct as an outcome measure for cleft speech in an intervention study. Folia Phoniatr Logop. 2019;15:1–9.
28.
SelmanP. Global trends in intercountry adoption: 2003-2012. In: BallardRLGoodnoNHCochranRFMilbrandtJA, eds. The Intercountry Adoption Debate Dialogues Across Disciplines. Newcastle upon Tyne: Cambridge Scholars Publishing; 2015:2–43.
29.
ShribergLDKwiatkowskiJ. Phonological disorders III: a procedure for assessing severity of involvement. J Speech Hear Disord. 1982;47(1):256–270.
30.
SwansonJWSmarttJMJrSaltzmanBSBirgfeldCBHopperRAGrussJSTseR. Adopted children with cleft lip and/or palate: a unique and growing population. Plast Reconstr Surg. 2014;134(2):283e–293e.
31.
WerkerCLvan den AardwegMTACoenraadSVan der MolenABMBreugemCC. Internationally adopted children with cleft lip and/or cleft palate: middle ear findings and hearing during childhood. Int J Pediatr Otorhinolaryngol. 2018;111:47–53.
32.
WilladsenELohmanderAPerssonCLundeborgIAlaluusuaSAuknerRBauABoersMBowdenMDaviesJ, et al.Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 5. Speech outcomes in 5-year-olds—consonant proficiency and errors. J Plast Surg Hand Surg.2017;51(3):38–51.
