Nancy J. Scherer

Early speech and language development in children with velocardiofacial syndrome.

Speech-language impairment is one of the most common clinical features in velocardiofacial syndrome (VCFS). This report describes the speech and language development of four children with VCFS studied longitudinally from 6 to 30 months of age and compares their performance with three groups of children: (1) normally developing children, (2) children with cleft lip and palate, and (3) children with isolated cleft palate. The data show that young children with VCFS show a receptive-expressive language impairment from the onset of language. Further, speech and expressive language development were severely delayed beyond a level predicted by their other developmental or receptive language performance. The children with VCFS showed severe limitations in speech sound inventories and early vocabulary development that far exceeded those shown by the children with cleft lip and palate and children with isolated cleft palate. This study indicates that young children with VCFS emerge from a critical speech and language learning period with severe limitations in their communicative abilities. Further studies are required to describe the later course of these early speech and language impairments and to explore the relationship to learning disabilities described for older children with VCFS. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 88:714-723, 1999.

Early and later vocalization skills in children with and without cleft palate

OBJECTIVE The purpose of this study was to describe the early vocalization skills in children with cleft lip and palate (CLP) at 6 and 12 months of age and compare these early vocalization measures to later speech and vocabulary development at 30 months of age. METHODS The participants in the study included 13 children without cleft lip or palate (NCLP) who were typically developing and 13 children with CLP matched for age, gender and socioeconomic status. Standardized measures of cognition, language, hearing, and prelinguistic vocalization measures were administered at 6 and 12 months and speech production, and vocabulary measures were collected at 30 months of age. RESULTS Group differences were observed in both receptive and expressive language development at 12 and 30 months of age. Group differences were observed in the frequency of babbling and Mean Babbling Level at 12 months and speech sound accuracy and vocabulary production at 30 months of age. Significant correlation coefficients were observed between babbling frequency at 6 months and consonant inventory size, vocabulary at 30 months for the children with clefts and PCC-R for noncleft children. CONCLUSIONS This study documented that young children with clefts have persistent vocalization and vocabulary deficits well beyond palate closure. Measures of babbling frequency, Mean Babbling Level and consonant inventories provide clinically effective means of identifying these early deficits. Additionally, these measures may provide a tool for monitoring the effects of early intervention programs that promote facilitation of sound and vocabulary development.

Early Intervention for Speech Impairment in Children With Cleft Palate

Objective: This study explored the effectiveness of a parent-implemented, focused stimulation program on the speech characteristics of children younger than 3 years with cleft lip and palate. The research questions included the following: (1) Can parents be trained to deliver an early intervention (EI) program for children with cleft palate? (2) Does a parent-implemented EI program result in positive changes in speech characteristics? Participants: Ten mother-child pairs in which the child had cleft lip and palate (CLP) and 10 mother-child pairs in which the child did not have a cleft (NCLP). The children ranged in age from 14 to 36 months of age and were matched between the CLP and the NCLP groups for vocabulary size, age, and socioeconomic status. Main Outcome Measures: Group differences (CLP and the NCLP) for preintervention and postintervention language and speech measures were compared. Results: The results of this study showed that the mothers could be trained to deliver the intervention reliably. Furthermore, the results indicated that the intervention resulted in increased sound inventories, increased speech accuracy, and reduced use of glottal stops for the children with clefts. Conclusions: While the intervention resulted in speech gains for the children with clefts, speech measures did not exceed those made by the children without clefts. The results of the study have implications for service delivery models where the services of speech-language pathologists are limited.

Parent questionnaire for screening early language development in children with cleft palate.

This study investigated the efficacy of a parent questionnaire as a component for screening early language development of children 16 to 30 months of age with cleft lip and palate. Thirty nonsyndromic children with cleft lip and palate and 30 children without clefts received the MacArthur Communicative Development Inventory: Toddler (CDI: Toddler), administered by a pediatrician. In addition, a speech-language screening was performed by a speech-language pathologist. Results of the two assessments indicated that the CDI:Toddler was a valid screener of language development when compared with a comprehensive speech-language screening. Language and speech characteristics of the subject populations are discussed. In particular, differences between the cleft and noncleft groups demonstrated evidence of delays in expressive language development in the children with cleft lip and palate.

The Speech and Language Status of Toddlers With Cleft Lip and/or Palate Following Early Vocabulary Intervention

This study examined the effects of a vocabulary intervention for 3 children with cleft lip and/or palate who showed limited consonant inventories and delayed expressive language. In a multiple base...

Profiles of communication disorder in children with velocardiofacial syndrome: Comparison to children with Down syndrome

Purpose: To describe communication profiles in children with velocardiofacial syndrome (VCFS) compared with children with Down syndrome.Methods: Four children with VCFS and four children with Down syndrome underwent cognitive and speech and language assessment.Results: Communication profiles of children with Down syndrome showed a flat profile, indicating all measures were similar and delayed relative to chronological age. Children with VCFS showed vocabulary, pattern of sound types, and Mean Babbling Length below cognitive and other language ages.Conclusion: Communication profiles of children with VCFS differed qualitatively and quantitatively from children with Down syndrome and support the hypothesis that some children with VCFS present with a profile of communication impairment that may be distinctive to the syndrome.

Early intervention for children with cleft palate

Clefts of the lip and palate are one of the most frequently occurring birth defects, affecting approximately 1 in 700 births in the United States. Early childhood special educators are often among the first professionals to provide intervention for children with cleft lip and palate. Early intervention for children with clefts often focuses on speech production skills; however, results of recent research suggest that early intervention in language skills including parent training is warranted. A model of early intervention that uses language intervention to facilitate vocabulary and speech sound development is described. This model has been successful in improving productive vocabulary use and speech sound repertoires and shows promising reduction in compensatory articulation errors. Developmentally appropriate application of the model includes provision of direct intervention to children and parent training to promote naturalistic intervention in everyday settings. Strategies for working collaboratively with speech-language pathologists and members of cleft palate and craniofacial multidisciplinary teams are also described. Finally, answers are provided to frequently occurring questions from parents about cleft palate.

Language and Play Development in Toddlers With Cleft Lip and/or Palate

The relationship between play gesture performance and language milestones was examined for 6 children with cleft lip and/or palate at 20, 24, and 30 months of age. Standardized measures of language...

Assessment of Single-Word Production for Children under Three Years of Age: Comparison of Children with and without Cleft Palate

Background. This study reports comparative phonological assessment results for children with cleft lip and/or palate (CLP) to typically developing peers using an evaluation tool for early phonological skills. Methods. Children without clefts (NC = noncleft) and 24 children with CLP, ages of 18–36 months, were evaluated using the Profile of Early Expressive Phonological Skills (PEEPSs) [1]. Children interacted with toy manipulatives to elicit a representative sample of target English consonants and syllable structures that are typically acquired by children between 18 and 27 months of age. Results. Results revealed significant differences between the two groups with regard to measures of consonant inventory, place of articulation, manner of production, accuracy, and error patterns. Syllable structure did not indicate differences, with the exception of initial consonant clusters. Conclusions. findings provide support for PEEPS as a viable option for single-word assessment of children with CLP prior to 3 years of age.

Longitudinal comparison of early speech and language milestones in children with cleft palate: A comparison of US and Slovak children

The purpose of this study was to compare early speech and language development of children with and without cleft lip and/or palate (CLP) in the US and Slovakia from 6 to 24 months of age. Thirty-two children from the US (eight with CLP and eight noncleft) and Slovakia (eight with CLP and eight noncleft) participated in this study. The children were videotaped at four time points for 30 minutes during mother–child interaction with play sets controlled for early-developing sounds in each language. Mean Babbling Level, consonant inventories, number of different words and mean length of utterance were calculated for 6- to 24-month samples. Results indicated that the US and Slovak groups showed similar performance across the ages. Cleft and noncleft groups showed significant differences in acquisition of all of the speech and language measures. High-pressure consonants, particularly alveolar place of articulation, were problematic for children with CLP.