Alighieri Cassandra, Allemeersch Fien, Vandewiele Febe, Van Lierde Kristiane
Department of Rehabilitation Sciences, Centre of Speech and Language Sciences, Ghent University, Belgium.
J Speech Lang Hear Res. 2025 Aug 12;68(8):3823-3842. doi: 10.1044/2025_JSLHR-24-00800. Epub 2025 Jul 11.
This study compared the effects of motor-phonetic and combined phonetic-phonological intervention on the speech, health-related quality of life (HRQoL), and parent-reported intelligibility in Dutch-speaking children with cleft (lip and) palate (CP ± L) and non-oral compensatory misarticulations (CMAs).
Fourteen children with CP ± L were randomly assigned to one of two interventions, that is, motor-phonetic intervention ( = 7, = 7.39 years) or combined phonetic-phonological intervention ( = 7, = 6.86 years) stratified by age and gender. Intervention was provided with a total duration of 1 week, a dose frequency of two sessions per day, and a session duration of 1 hr and targeted non-oral CMAs. Speech was assessed at different data points. HRQoL and intelligibility by different communication partners were assessed before and after the intervention using the VPI Effects on Life Outcomes questionnaire and the Intelligibility in Context Scale. Groups were compared over time using linear mixed models.
Significant Time × Group effects were observed for "non-oral CMAs" and "Percentage Consonants Correct-Revised for word imitation and sentence imitation." These outcomes improved in both groups, but improvements were significantly larger in the combined intervention group. Similar effects were observed for holistic outcomes such as speech understandability and acceptability. In the group that received the combined intervention, improvements were maintained 3 months after the intervention period, whereas in the motor-phonetic group, the initial improvements were not sustained. HRQoL and intelligibility by the child's friends and acquaintances also improved in both groups, but improvements were higher in the combined intervention group.
This study demonstrates the superior effects of combined phonetic-phonological interventions over motor-phonetic interventions in eliminating non-oral CMAs. While motor-phonetic approaches tend to result in short-term gains, combined phonetic-phonological intervention strategies may lead to more long-lasting changes by promoting generalization. This underscores the importance of addressing both phonetic and phonological aspects of speech.
本研究比较了运动语音干预和语音-音系联合干预对患有唇腭裂（CP±L）且存在非口腔代偿性错音（CMA）的荷兰语儿童的言语、健康相关生活质量（HRQoL）以及家长报告的可懂度的影响。
14名CP±L儿童按年龄和性别分层，随机分配到两种干预措施之一，即运动语音干预（n = 7，平均年龄 = 7.39岁）或语音-音系联合干预（n = 7，平均年龄 = 6.86岁）。干预总时长为1周，每天进行两次，每次时长1小时，针对非口腔CMA。在不同数据点对言语进行评估。使用《语音产生缺陷对生活结果的影响》问卷和《语境可懂度量表》在干预前后评估不同沟通伙伴的HRQoL和可懂度。使用线性混合模型对不同时间的组间差异进行比较。
在“非口腔CMA”和“单词模仿和句子模仿的正确辅音百分比-修订版”方面观察到显著的时间×组效应。两组的这些结果均有改善，但联合干预组的改善幅度明显更大。在言语可懂度和可接受性等整体结果方面也观察到类似效果。在接受联合干预的组中，干预期结束3个月后改善情况得以维持，而在运动语音组中，最初的改善并未持续。两组中儿童的朋友和熟人所评估的HRQoL和可懂度也有所改善，但联合干预组的改善程度更高。
本研究表明，在消除非口腔CMA方面，语音-音系联合干预比运动语音干预具有更优效果。虽然运动语音方法往往会带来短期收益，但语音-音系联合干预策略可能通过促进泛化导致更持久的变化。这凸显了同时解决言语的语音和音系方面问题的重要性。
