Derakhshandeh Fatemeh, Nikmaram Mohammadreza, Hosseinabad Hedieh Hashemi, Memarzadeh Mehrdad, Taheri Masoud, Omrani Mohammadreza, Jalaie Shohreh, Bijankhan Mahmood, Sell Debbie
Department of Speech Therapy, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran; Craniofacial Anomalies and Cleft Palate Research Center, Isfahan university of Medical Sciences, Isfahan, Iran.
Department of Physiology, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran.
Int J Pediatr Otorhinolaryngol. 2016 Jul;86:104-13. doi: 10.1016/j.ijporl.2016.04.025. Epub 2016 Apr 22.
The aim of this study was to investigate the impact of an intensive 10-week course of articulation therapy on articulation errors in cleft lip and palate patients who have Velopharyngeal Insufficiency (VPI), non-oral and passive cleft speech characteristics.
Five children with cleft palate (+/-cleft lip) with VPI and non-oral and passive cleft speech characteristics underwent 40 intensive articulation therapies over 10 weeks in a single case experimental design. The percentage of non-oral CSCs (NCSCs), passive CSCs (PCSCs), stimulable consonants (SC), correct consonants in word imitation (CCI), and correct consonants in picture naming (CCN) were captured at baseline, during intervention and in follow up phases. Visual analysis and two effect size indexes of Percentage of Nonoverlapping Data and Percentage of Improvement Rate Difference were analyzed.
Articulation therapy resulted in visible decrease in NCSCs for all 5 participants across the intervention phases. Intervention was effective in changing percentage of passive CSCs in two different ways; it reduced the PCSCs in three cases and resulted in an increase in PCSCs in the other two cases. This was interpreted as intervention having changed the non-oral CSCs to consonants produced within the oral cavity but with passive characteristics affecting manner of production including weakness, nasalized plosives and nasal realizations of plosives and fricatives. Percent SC increased throughout the intervention period in all five patients. All participants demonstrated an increase in percentage of CCI and CCN suggesting an increase in the consonant inventory. Follow-up data showed that all the subjects were able to maintain their ability to articulate learned phonemes correctly even after a 4-week break from intervention.
This single case experimental study supports the hypothesis that speech intervention in patients with VPI can result in an improvement in oral placements and passive CSCs.
本研究旨在调查为期10周的强化发音治疗对患有腭咽功能不全（VPI）、具有非口腔和被动腭裂语音特征的唇腭裂患者发音错误的影响。
五名患有腭裂（±唇裂）且有VPI以及非口腔和被动腭裂语音特征的儿童，在单病例实验设计中，于10周内接受了40次强化发音治疗。在基线期、干预期间和随访阶段，记录非口腔辅音替代错误（NCSCs）、被动辅音替代错误（PCSCs）、可诱导辅音（SC）、单词模仿中的正确辅音（CCI）以及图片命名中的正确辅音（CCN）的百分比。分析视觉分析以及非重叠数据百分比和改善率差异百分比这两个效应量指标。
在整个干预阶段，发音治疗使所有5名参与者的NCSCs明显减少。干预以两种不同方式有效改变了被动辅音替代错误的百分比；在三例中降低了PCSCs，在另外两例中导致PCSCs增加。这被解释为干预将非口腔辅音替代错误转变为口腔内发出但具有影响发音方式的被动特征的辅音，包括发音无力、鼻音爆破音以及爆破音和摩擦音的鼻化发音。在所有五名患者中，整个干预期内SC百分比均增加。所有参与者的CCI和CCN百分比均有所增加，表明辅音储备增加。随访数据显示，即使在干预中断4周后，所有受试者仍能够保持正确发出所学音素的能力。
这项单病例实验研究支持以下假设，即对VPI患者进行言语干预可改善口腔发音位置和被动辅音替代错误。
