Speech Intelligibility Testing in Children with Repaired Cleft Palate

腭裂修复儿童的言语清晰度测试

基本信息

批准号：
7484853
负责人：
DAVID J ZAJAC
金额：
$ 32.49万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-01 至 2010-08-31
项目状态：
已结题

项目摘要

Cleft palate is one of the most frequently occurring birth defects in the United States. Current standards of care emphasize early surgical correction of clefts of the secondary palate (soft and hard) but not primary palate (alveolar ridge). Following surgical repair of the secondary palate, the majority of children experience deficits in speech intelligibility to various degrees. Most of these children exhibit anomalies of the alveolar/palatal vault as a result of either not repairing the primary palate and/or as consequences of repairing the secondary palate (i.e., oro-nasal fistula, growth restrictions). The overarching hypothesis of this proposal is that anomalies of the posterior velopharyngeal and anterior alveolar/palatal structures contribute to different speech intelligibility deficits. The specific objectives are to identify the structural and phonetic factors that underlie speech intelligibility in young children with repaired clefts of the secondary palate with or without cleft lip (Aim 1). A single-word intelligibility test will be used to study 150-200 children (age range 4 to 8 years) with cleft palate and 50 children without cleft palate in the same age range. Eleven (11) different phonetic contrasts will be used to determine overall speech intelligibility. It is hypothesized that among all children with cleft palate, velopharyngeal (VP) followed by alveolar/palatal factors will account for global speech intelligibility. It is further hypothesized that alveolar/palatal factors will contribute to specific phonetic contrast deficits, especially involving backed or palatalized consonants, that have traditionally been attributed to VP factors. Acoustic characteristics of selected phonetic contrasts (Aim 2) and specific alveolar/palatal factors (Aim 3) will also be explored in subgroups of children who exhibit complete and incomplete VP closure. Multiple regression and descriptive discriminant analysis techniques will be employed. The findings are expected to a) provide meaningful data to guide both surgical and behavioral interventions relative to patient selection and/or phonetic contrast priorities, b) suggest a different etiology for frequently occurring backed compensatory articulations, c) advance current trends toward early surgical repair of alveolar clefts, and d) stimulate future clinical trials to investigate the efficacy of early surgery to correct structural defects of the primary and/or second palates via single-word intelligibility testing.

腭裂是美国最常见的出生缺陷之一。现行标准护理强调早期手术矫正次级腭裂（软腭裂和硬腭裂），但不是原发性腭裂腭（牙槽嵴）。二次腭手术修复后，大多数儿童都会经历不同程度的言语清晰度缺陷。这些孩子大多数都表现出异常由于未修复初级腭和/或以下原因导致的牙槽/腭穹窿修复次级腭（即口鼻瘘、生长限制）。本研究的总体假设建议认为后腭咽和前牙槽/腭结构的异常有助于不同的言语清晰度缺陷。具体目标是识别结构和语音二级腭裂修复幼儿言语清晰度的因素无唇裂（目标 1）。单个单词的可懂度测试将用于研究 150-200 名儿童（年龄范围 4 至 8 岁）患有腭裂的儿童和 50 名同一年龄范围内无腭裂的儿童。十一 (11) 种不同语音对比将用于确定整体语音清晰度。据推测，在所有患有腭裂、腭咽 (VP) 的儿童以及牙槽/腭部因素将占全球的语音清晰度。进一步假设齿槽/腭因素将有助于特定的语音对比缺陷，特别是涉及背辅音或腭化辅音，传统上归因于 VP 因素。选定语音对比（目标 2）和特定齿槽/腭音的声学特征因素（目标 3）也将在表现出完全和不完全 VP 的儿童亚组中进行探讨关闭。将采用多元回归和描述性判别分析技术。研究结果预计 a) 提供有意义的数据来指导相关的手术和行为干预患者选择和/或语音对比优先级，b) 提示经常发生的不同病因支持代偿关节，c) 推进当前牙槽裂隙早期手术修复的趋势， d) 刺激未来的临床试验，以研究早期手术纠正结构缺陷的功效通过单字可懂度测试来确定第一和/或第二味觉。