speech understandability of repaired cleft palate patients pre and post caregiver training

ABSTRACT

Background: Treating speech and language problems in repaired cleft palate patients in india is still an uphill task due to lack of facilities. this study attempted to use parents as team members for the speech management of cleft palate patients in andhra pradesh, india. objectives: to investigate whether a positive change in speech understandability for individuals with cleft palate will result froma parent-administered intervention program.Materials and methods: Twenty-eight parents had enrolled for the speech camp held in september 2004. the parent-training program at the speech camp ensured that parents were given adequate awareness. out of the 28, 18 (64.28%) reported for one follow-up, referred to in this article as group i. ten (35.72%) out of the 28 came for two consecutive follow-ups, referred to in this article as group ii.Results: Pre and post training understandability scores obtained in the known context (reciting a familiar poem in the native language, counting 1 to 10) and unknown context (peer group names, family information, describing their journey from home to hospital) for group i and group ii were evaluated. results revealed that a higher percentage of cases showed significant improvement in understandability in the unknown context after treatment. unknown context can be considered a measure to assess speech understandability after training. further, it shows that parent training without practice at home may not show the desired results.Conclusion: This study reveals that parents can effect a positive change in the speech understandability of their children following training, provided the exercises are carried out regularly at home and the parents report for the follow-up assessments and guidance.

KEY WORDS

corrective babbling - understandability

• 1 American Cleft Palate-Craniofacial Association. 2000 Available from http://www.cleftline.org
• 2 Peterson-Falzone SJ, Hardin-Jones MA, Karnell MP. Communication disorders associated with cleft palate. Cleft palate speech 3rd ed. Mosby: St. Louis 2001: p.162-98
• 3 Peterson-Falzone SJ, Trost-Cardamone J, Karnell MP, Hardin-Jones MA. The clinician’s guide to treating cleft palate speech. Mosby. Elsevier; 2006: p.17-37
• 4 Long N, Dalston RM. Paired gestural and vocal behavior in one-year-old cleft lip and palate children. J Speech Hear Disord 1982; 47: 403-6
• 5 Chapman KL, Hardin MA. Communicative competence in children with cleft lip and palate. In Bardach J, Morris HL. editors Multidisciplinary management of cleft lip and palate. WB Saunders: Philadelphia: 1990
• 6 Chisum L, Shelton Jr RL, Arndt Jr WB, Elber TM. The relationship between remedial Speech Instruction activities and articulation change. Cleft Palate J 1969; 6: 57-64
• 7 Shelton RL, Ruscello DM. Palatal and articulation training in patients with velopharyngeal closure problems. Proceedings of the annual meeting of the American Cleft Palate Association San Diego: 1979
• 8 Van DRDemark. Some results of intensive speech therapy for children with cleft palate. Cleft Palate J 1974; 11: 41-9
• 9 Van DRDe Mark, Hardin MA. Effectiveness of intensive articulation therapy for children with cleft palate. Cleft Palate Journal 1986; 23: 215-24
• 10 Whitehill TL. Assessing intelligibility in speakers with cleft palate: A critical review of the literature. Cleft Palate Craniofac J 2002; 39: 50-8
• 11 Peterson-Falzone SJ, Trost-Cardamone JE, Karnell MP, Hardin-Jones MA. Perceptual assessment and diagnosis of the cleft palate speech errors. The Clinician’s Guide to Treating Cleft Palate Speech Mosby Pub: St. Louis 2006; p.69-97
• 12 Nagarajan R, Murthy J, Raman SV. Providing speech and language services for individuals with cleft lip and palate in India - The Challenge. Cleft Journal 2005; 1: 50-8
• 13 Raju S. In search of a smile-study of children born with cleft lip and palate in India. Tata Institute of Social Sciences: Mumbai 2000 Available from http://www.smiletrain.org
• 14 D’Antonio LL, Nagarajan R. Use of a consensus building approach to plan speech services for children with cleft palate in India. Folia Phoniatr Logop 2003; 55: 306-13
• 15 Nikam S. Hearing impairment - Role of parents. In Status of Disability in India. Kundu, editor An RCI Publication; New Delhi: 2000
• 16 Jobe A. Speech Training Manual: A tool for Children and adults with repaired cleft lip and palate. Devised by RSF-EARTHSPEAK USA. Unpublished manual. Available from http://www.rsf-earthspeak.org
• 17 Srinivasarao B. Speech training manual: A speech therapy tool for children and adults with repaired cleft lip and palate. (Telugu Language Version) Originally in English by Andrea LJ. Richard PJ. RSF-EARTHSPEAK: USA 2004
• 18 Kumar S. Speech training manual: A speech therapy tool for children and adults with repaired cleft lip and palate. (Hindi Language Version) Originally in English by Andrea LJ. Richard PJ. RSF-EARTHSPEAK: USA 2005