Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC.
Department of Human Services, University of Virginia, Charlottesville.
Am J Speech Lang Pathol. 2021 May 18;30(3):993-1007. doi: 10.1044/2021_AJSLP-20-00072. Epub 2021 Mar 30.
Purpose The purpose of this clinical focus article is to provide a descriptive case study of a late-adopted, bilingual adolescent with cleft palate speech errors. Specifically, we examined the cross-linguistic generalization of remediated compensatory cleft errors, following treatment in English (second language) only. The overarching goal of this study is to gain insights into the complexity of speech intervention for the adopted population with delayed cleft palate repair. Method A 14-year-old female adopted from China with a repaired unilateral cleft lip and palate and maladaptive articulation errors underwent 55 one-hour sessions of a motor-based, speech therapy approach over a 15-month span, targeting English phonemes only. Pre-, mid-, and posttreatment evaluation included perceptual and instrumental assessment of speech and resonance. Outcome measures at each time point included perceptual speech and resonance ratings, nasometry scores, and percent consonants correct (PCC) in both English and Mandarin. Results PCC in English improved from 60% in single words and 35% in sentences pretreatment to 100% in single words and sentences during posttreatment assessment. Without direct treatment in Mandarin, PCC in Mandarin improved from 56% in single words and 50% in sentences pretreatment to 100% in single words and 99% in sentences during posttreatment assessment. Posttreatment nasometry scores decreased by 20% for the nasal sample and 17% for the oral sample compared to pretreatment. Conclusions This descriptive case study demonstrated successful remediation of cleft palate speech errors, following 15 months of treatment in a late-adopted bilingual adolescent using a motor-based therapy approach. Treatment of errors in English (second language) led to generalization of correct productions in Mandarin (first language). This study presents the potential for bilingual late adoptees to achieve intelligible speech in both languages when motor-based therapy principles are applied to intervention.
目的 本临床重点文章旨在提供一个迟发型双语青少年腭裂语音错误的描述性案例研究。具体来说，我们研究了仅在英语（第二语言）中进行治疗后，矫正的补偿性腭裂错误的跨语言泛化。本研究的总体目标是深入了解延迟腭裂修复的收养人群的语音干预的复杂性。 方法 一名 14 岁的女性，来自中国，单侧唇腭裂修复后出现适应性发音错误，接受了 55 个小时的基于运动的语音治疗，仅针对英语音位，历时 15 个月。治疗前、中、后评估包括语音和共鸣的感知和仪器评估。每个时间点的结果测量包括语音和共鸣的感知评分、鼻音计评分以及英语和普通话的辅音百分比（PCC）。 结果 在英语中，PCC 从治疗前单词的 60%和句子的 35%提高到治疗后的 100%。在没有直接治疗普通话的情况下，PCC 从单词的 56%和句子的 50%提高到治疗后的 100%和句子的 99%。与治疗前相比，治疗后鼻音计的鼻音样本减少了 20%，口腔样本减少了 17%。 结论 本描述性案例研究表明，在使用基于运动的治疗方法对迟发型双语青少年进行 15 个月的治疗后，腭裂语音错误得到了成功矫正。英语（第二语言）错误的治疗导致了普通话（第一语言）正确发音的泛化。本研究表明，当基于运动的治疗原则应用于干预时，双语迟发型接受者有可能在两种语言中实现清晰的语音。
