Munday John H, Braden Maia N, Cho Daniel Y, Fujiki Robert Brinton
Department of Surgery, University of Wisconsin-Madison.
Department of Communication Sciences and Disorders, University of Wisconsin-Madison.
Perspect ASHA Spec Interest Groups. 2025 Jun 30. doi: 10.1044/2025_PERSP-25-00045.
CLINICAL SCENARIO: Although speech therapy (ST) has been frequently studied in children, the efficacy of motor-phonetic ST in adults with repaired cleft lip and palate (CLP) is unclear. CLINICAL QUESTION: How does articulation change over time for an adult with CLP engaged in motor-phonetic ST? STUDY SOURCES: This study describes articulation and motor-phonetic intervention in a 33-year-old, monolingual Spanish-speaking woman presenting with CLP and associated velopharyngeal insufficiency. Case history, initial evaluation, surgical intervention, and progress during ST are described with reference to current literature. RESULTS: Upon initial evaluation, the patient presented with speech characterized by pervasive compensatory articulation errors and moderate hypernasality. As such, the patient completed 22 sessions of ST and underwent palatal surgery (between ST Sessions 3 and 4). Follow-up data were collected 49 days following treatment. Progress in ST was tracked using percent consonants correct (PCC) on the targets /p, t, k, s/. All therapy targets were produced at baseline as glottal stops (0% PCC). Following surgery, PCC was 56% for /p/, 31% for /t/, and 0% for /s/. In Session 11, /k/ was introduced (PCC = 45%). At Session 22, PCC was 100% for /p/, 46% for /t/, 100% for /s/, and 70% for /k/. PCC values were maintained across all target phonemes at follow-up. CONCLUSIONS: PCC improved following intervention, and gains were maintained at follow-up. Data suggest that a motor-phonetic approach may effectively address speech sound disorders in adults with CLP. Future research is needed to explore this intervention on a larger scale and compare to other approaches.
临床案例:尽管言语治疗(ST)在儿童中已被频繁研究,但运动语音言语治疗对唇腭裂(CLP)修复后的成人的疗效尚不清楚。 临床问题:参与运动语音言语治疗的CLP成人患者的发音随时间如何变化? 研究来源:本研究描述了一名33岁、只会说西班牙语的单语女性患者的发音情况及运动语音干预,该患者患有CLP及相关的腭咽闭合不全。结合当前文献描述了病例史、初始评估、手术干预及言语治疗期间的进展。 结果:在初始评估时,患者的言语表现为普遍存在代偿性发音错误和中度鼻音过重。因此,患者完成了22次言语治疗课程并接受了腭部手术(在第3次和第4次言语治疗课程之间)。治疗后49天收集了随访数据。使用目标音/p、t、k、s/的正确辅音百分比(PCC)来跟踪言语治疗的进展。所有治疗目标在基线时均发成喉塞音(PCC为0%)。手术后,/p/的PCC为56%,/t/为31%,/s/为0%。在第11次治疗课程中,引入了/k/(PCC = 45%)。在第22次治疗课程时,/p/的PCC为100%,/t/为46%,/s/为100%,/k/为70%。随访时所有目标音素的PCC值均保持稳定。 结论:干预后PCC有所改善,且随访时保持了改善效果。数据表明,运动语音方法可能有效解决CLP成人患者的语音障碍问题。未来需要进行更大规模的研究来探索这种干预方法,并与其他方法进行比较。
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