Harding A, Grunwell P
De Montfort University, Leicester, UK.
Eur J Disord Commun. 1996;31(4):331-57. doi: 10.3109/13682829609031326.
In recent years, interest in the nature of cleft palate speech and the influences on speech quality has increased. This overview of contemporary research reveals new perspectives on cleft palate speech development and the phonological consequences of early articulatory constraints. Cleft palate speech is perceived as the result of the synthesis between physical, physiological, cognitive and linguistic development. Developmental influences on cleft palate speech are considered in the context of early vocalisations of cleft and non-cleft children, followed by an examination of the literature on the development of babble, the emergence of early words and consonant development in children born with cleft palate. Speech development is then discussed from a phonological perspective interpreting reported characteristics as 'cleft-type developmental processes', for example, lack of target stabilisation; compensatory articulations; active/passive strategies; and systematic sound preference. Given these influences on speech development the extent to which cleft palate speech should be regarded as an 'articulatory disorder' has been reconsidered. Descriptions and interpretations of nasal resonance, nasal emission, and nasal turbulence are followed by discussion of articulatory errors in place and manner and patterns of change in cleft palate speech. Finally, some of the available evidence on speech in relation to structural imperfections, such as unrepaired clefts, velopharyngeal insufficiency, oro-nasal fistulae, dental and occlusal deviations, and open-mouth posture is summarised briefly. These new perspectives aim to facilitate more effective clinical management and to provide indications for future research.
近年来，人们对腭裂语音的本质及其对语音质量的影响的兴趣有所增加。对当代研究的这一综述揭示了腭裂语音发展以及早期发音限制的语音学后果的新观点。腭裂语音被视为身体、生理、认知和语言发展综合作用的结果。在腭裂儿童和非腭裂儿童早期发声的背景下，考虑对腭裂语音的发育影响，随后考察关于咿呀学语发展、早期词汇出现以及腭裂儿童辅音发展的文献。然后从语音学角度讨论语音发展，将所报道的特征解释为“腭裂型发展过程”，例如缺乏目标稳定性、代偿性发音、主动/被动策略以及系统性的语音偏好。鉴于这些对语音发展的影响，人们重新考虑了腭裂语音应在多大程度上被视为“发音障碍”。在对鼻共鸣、鼻漏气和鼻湍流进行描述和解释之后，讨论了腭裂语音在发音部位和方式上的错误以及变化模式。最后，简要总结了一些关于与结构缺陷相关的语音的现有证据，如未修复的腭裂、腭咽闭合不全、口鼻瘘、牙齿和咬合偏差以及张口姿势。这些新观点旨在促进更有效的临床管理，并为未来研究提供方向。
