Development of Stop Consonants in Children with Repaired Cleft Palate

腭裂修复儿童塞音的发展

• 批准号: 8824919
• 负责人: DAVID J ZAJAC
• 金额: $ 56.82万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-04 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8824919
• 关键词: 4 year old; Accounting; Age; Age-Months; Behavior Therapy; Behavioral; Child; Cleaved cell; Cleft Palate; Clinical; Conductive hearing loss; Congenital Abnormality; Data; Development; Early Intervention; Eustachian Tube; Exhibits; Face; Functional disorder; Health; Infant; Intervention; Judgment; Language; Life; Logistic Regressions; Measures; Modeling; Nose; Operative Surgical Procedures; Oral; Otitis Media with Effusion; Outcome; Play; Procedures; Production; Regression Analysis; Relative (related person); Reporting; Research; Severities; Speech; Speech Development; Structure; Subgroup; Surgical Management; Techniques; Testing; Time; Tympanometry; United States; Work; base; follow-up; middle ear; middle ear disorder; novel; palatal surgery; palate repair; pressure; repaired; sex; theories; 4 year old; Accounting; Age; Age-Months; Behavior Therapy; Behavioral; Child; Cleaved cell; Cleft Palate; Clinical; Conductive hearing loss; Congenital Abnormality; Data; Development; Early Intervention; Eustachian Tube; Exhibits; Face; Functional disorder; Health; Infant; Intervention; Judgment; Language; Life; Logistic Regressions; Measures; Modeling; Nose; Operative Surgical Procedures; Oral; Otitis Media with Effusion; Outcome; Play; Procedures; Production; Regression Analysis; Relative (related person); Reporting; Research; Severities; Speech; Speech Development; Structure; Subgroup; Surgical Management; Techniques; Testing; Time; Tympanometry; United States; Work; base; follow-up; middle ear; middle ear disorder; novel; palatal surgery; palate repair; pressure; repaired; sex; theories

DESCRIPTION (provided by applicant): Cleft palate is the most frequently occurring facial birth defect in the United States. Although infants typically undergo surgery to repair the palate by 10 months of age, most will exhibit delayed production of stop consonants well into the second year of life. The reasons for such delays are not entirely known. It is known, however, that even after the emergence of stop consonants, approximately 20% to 30% of infants with repaired cleft palate will eventually require secondary palatal surgery to achieve adequate velopharyngeal function for normal speech production. Typically, objective assessment of velopharyngeal function is not possible until children are 3 to 4 years of age and cooperative for clinical and instrumental techniques. The specific aims of the proposed project are to determine 1) the time course and factors - middle ear status, symbolic language, cleft type, and sex - that account for the emergence of stop consonants in children with cleft palate following surgical repair, 2) the time course and factors that account for consistent velopharyngeal closure for stop consonants in children with and without repaired cleft palate, and 3) if a novel aerodynamic measure of velopharyngeal closure for stop consonants at 24 months of age predicts velopharyngeal function at 36 and 48 months of age. Thirty-six infants with repaired cleft palate, 18 typically-developing infants without cleft palate, and 18 infants without cleft palate but with middle ear disease will be followed at two-month intervals from approximately 10 to 24 months of age. Symbolic language ability will be assessed through unstructured and structured play. Middle ear function will be assessed by tympanometry. Nasal ram pressure will be obtained as an indicator of velopharyngeal closure for stop consonants elicited during play. At 36 and 48 months, additional measures of velopharyngeal function will be obtained via nasal airflow and direct magnitude estimation of perceived hypernasality. Developmental trajectories of children relative to stop emergence and velopharyngeal closure for stops will be described using discrete-time survival and binomial logistic regression analyses. Covariates will be included in the models to determine the relative effects of middle ear status, language ability, cleft type, an sex. It is anticipated that the results will a) identify the cause(s) of delayed emergence of stops in children with repaired cleft palate, b) provide developmental data to optimize the timing of either behavioral and/or secondary surgical interventions, and c) further validate a novel and relatively simple assessment procedure to determine velopharyngeal closure of stop consonants in young children.

描述（由申请人提供）：left裂是美国最常见的面部出生缺陷。尽管婴儿通常接受手术以在10个月大的时候修复口感，但大多数会在生命的第二年表现出延迟的停止辅音的产生。此类延迟的原因并不完全是为了。然而，众所周知，即使在停止辅音的出现之后，约有20％至30％的修复left裂的婴儿最终将需要次要pal骨手术，以实现足够的静脉咽咽功能来进行正常的语音产生。通常，直到儿童年满3至4岁，就无法对咽咽功能进行客观评估，并且在临床和工具技术方面合作。拟议项目的具体目的是确定1）时间过程和因素 - 中耳状态，象征性语言，left类和性别 - 解释了在手术修复后的left裂儿童中停止辅音的出现，2）时间课程和因素及其始终如一地衡量cleperne clesiant and Natamine vernam coplate and affe clesy and affe clesiant and affe clesiant and affe clesiant and affe clesy and的因素。在24个月大的24个月时的停止辅音的闭合预测了36和48个月大的咽咽功能。有36名修复裂口的婴儿，通常有18岁的婴儿，没有left裂的婴儿，有18名没有left裂的婴儿，但中耳病的婴儿将以大约10到24个月大的间隔进行两个月的间隔。符号语言能力将通过非结构化和结构化的游戏进行评估。中耳功能将通过鼓膜法评估。鼻板压力将作为尾咽闭合的指标获得，以便在游戏过程中引起的停止辅音。在36和48个月时，将通过鼻气流和直接估计感知的性超麻液估算静脉咽功能的其他措施。儿童的发育轨迹相对于停止出现和静脉咽喉闭合的发展轨迹将使用离散的生存和二项式逻辑回归分析来描述。模型中将包括协变量，以确定中耳状态，语言能力，left类，性别的相对影响。预计结果将a）识别停止延迟出现的原因 在修复裂口的儿童中，b）提供发育数据，以优化行为和/或次级手术干预的时间，以及c）进一步验证一种新颖且相对简单的评估程序，以确定幼儿停止辅音的腹膜咽喉闭合。