J. Van Borsel

Effect of Cleft Type on Overall Speech Intelligibility and Resonance

The main purpose of this study was to measure and compare the effect of an unilateral cleft lip and palate (UCLP) and a bilateral cleft lip and palate (BCLP) on overall speech intelligibility, nasalance and nasality. An additional objective was to compare the nasalance and nasality patterns of cleft palate children with the available normative data for normal children. The subjects were 37 children with an UCLP (19/37) or a BCLP (18/37) with normal cognitive and motor functions and normal hearing levels. All subjects had a non-syndromic cleft, followed the same surgical protocol and did not undergo secondary pharyngeal surgery. To measure and compare the effect of cleft type, objective and subjective assessment techniques were used. For the objective assessment of nasal resonance the nasometer and the mirror-fogging test were used. Nasalance scores were obtained, while patients produced sounds, read three standard passages or repeated sentences focusing on specific consonants. A perceptual evaluation of speech, the Gutzmann (1913) test and the tests of Bzoch (1989) were used as subjective assessment techniques. The perceptual assessment of the overall speech intelligibility was based on the spontaneous speech and reading or repeating of the nasometric sentences. These samples were judged by three speech pathologists using a 4-category nominal scale. A subjective test (Morley, 1945) was used to evaluate the velopharyngeal mechanism. The findings of the present study show no statistically significant differences for nasalance values, nasality and overall speech intelligibility between the UCLP and BCLP children. Significant differences were found between the data of the normal group and the cleft palate children. These differences included nasalance values as well as nasality data and overall speech intelligibility.

Disfluency in Tourette syndrome: Observational study in three cases

It is often stated that stuttering is a common speech disorder in individuals with Tourette syndrome (TS). It has also been suggested, however, that the fluency failures observed in people with TS do not completely conform to the classic pattern of stuttering. The present paper describes the results of an analysis of the speech patterns of three individuals with TS. A picture emerged that bears some resemblance to stuttering, cluttering, and palilalia but that is also different from each of these disfluency types.

Speech patterns in children with velo-cardio-facial syndrome: Two case studies

The purpose of this study was to document the articulation patterns in children with velo-cardio-facial syndrome. The subjects were 2 children with this syndrome, aged 6 years 6 months and 3 years 11 months. Phonetically transcribed speech samples collected by means of a picture naming test formed the basis for this study. The speech samples were subjected to two types of analyses: independent analyses describing the children’s sound productions regardless of their relation to the adult targets and relational analyses comparing the children’s productions with the adult standard form. It was found that the articulatory problems in velo-cardio-facial syndrome are not simply due to a delay in speech sound acquisition. Articulation errors found in this syndrome are uncharacteristic of normal speech development. Whether errors are syndrome-specific awaits further investigation.

The Differential Diagnosis of Late-Onset Stuttering

Neurogenic stuttering, by definition, is stuttering caused by damage to the central nervous system. In this respect neurogenic stuttering clearly differs from developmental stuttering of which the cause to date is unknown. The fact that in neurogenic stuttering there is an evident cause does not mean, however, that the diagnosis of neurogenic stuttering is always straightforward. As reported in a number of studies, stuttering, when not developmental, may also occur as a side-effect of medication (see for instance Nurnberg and Greenwald, 1981 or McClean and McLean, 1985). Also, cases of non-developmental stuttering have been reported in which the stutter was of psychogenic origin (see for instance Deal, 1982; Deal and Doro, 1987; Roth et al., 1989; Tippet and Siebens, 1991; Mahr and Leith, 1992). In this paper a case of stuttering is presented which illustrates this problem of differential diagnosis in non-developmental stuttering. The patient presented with stuttering for the first time after she had suffered brain damage.Yet, there are reasons to believe that her dysfluency was not of neurogenic origin.