Phonological Development
in Children with Cleft Palate
Virginia Dixon-Wood, MA
University of Florida
Phonological Development
• Young children are active problem solvers
who are attempting to produce speech that
sounds like the speech they hear
Broen, P. and K. Moeller
in Cleft Palate – Interdisciplinary Issue and Treatment
Phonological Development
Process is cognitive
Child is actively experimenting to match
the visual and acoustic attributes of
speech
avoiding words
modifying features
simplifying
assimilating place or manner
Phonological Development
The accuracy of speech is constrained by
the child’s perception of what is to be
produced and the child’s physical ability to
produce what is perceived
Impaired by:
vpi
hearing loss
palatal fistula
Phonological Development
Children with cleft palate don’t
compensate like other children. Their
productions do not seem to be reasonable
approximations of the speech to which
they are exposed
Some make errors that cannot be
accounted for by the difference in their oral
mechanism, i.e. glottal articulation
Phonological Development
• These children accommodate in 3 ways:
1)Nasal emission distortion with
appropriate sounds
high pressure
/p, b, s/
Phonological Development
Accomodations:
2)Substitutes a sound which the child can
produce that matches some of the
features
/n/ for /d/
Phonological Development
Accomodations:
3)Glottal/pharyngeal substitution which
also can keep some features, i.e.
glottal stop for oral stop
Phonological Development
2 Common Patterns
Described by Ferguson and Farrell:
Child 1
Used words with sounds they were able to
produce-75% sonorant
Single syllable words-75% of the time
As vocabulary increases, however, speech
becomes less accurate
Phonological Development
Child 2
Used words that they were unable to
produce – 25% sonorant
50% of words were multisyllabic
Productions were not very accurate
Phonological Development
Differences among children w/o cleft palate
and each other
Child 1
Did not begin talking until age 2
Conservative approach
Phonological Development
• Child 2
Talked with open palate
Word initial consonants accurate 30% of
the time
Developed template-used it for several
words
Phonological Development
Child 2
Unlike normal children, used
-back velar stops
-pharyngeal fricatives
-glottal stops
Phonological Development
Broen 1986
30 month old children
3 groups of 5 children each
vpi
cleft palate w/o vpi
controls
Phonological Development
Broen, 1986
Cleft palate group w/o VPI
-Were still slower at acquiring
normal/accurate speech production
Phonological Development
Broen, 1986
Vpi group-more voicing errors
place errors-fewer (more evenly
distributed)
*most significant-frequency with which
sonorants were substituted for
non-sonorants (22.0, 2.0, 0.2)
Phonological Development
VPI group
a)Preserving voice but sacrificing place
- nasal stops for voiced nasal stops
(m/b)
-non-voiced (h/p)
Phonological Development
b)Neutralizing voice but preserving place-
Nasals or voiced glides for non-sonorant
consonants, i.e. l/d
Phonological Development
c)Some children used 2-3 different
consonants as substitution for one
phoneme /y,h/
Trade-offs necessary to produce audible
speech that approximates target
Phonological Development
“Early Speech Production of Children with
Cleft Palate”
Teresa Estrem and Patricia Broen
JSHR 1989
What’s the role of physiology in shaping
early lexical choice?
Phonological Development
Lexical choice
-10 children / 2 groups
-cleft palate/ non-cleft
-analyzed speech at 10, 20, 30, 40, 50
word levels
Lexical Choice - results
Cleft group:
1)Difference in class features – more
sonorants
2)Very young children tended to target
words with sounds with less intraoral
pressure
Phonological Development
• Lexical Choice-results
3)Place of articulation-more labials and
glottals
4)Manner of production –
-produced fewer stops than targeted
-targeted more words with nasal and
approximates
-produced more than targeted
Phonological Development
Lack of VP closure does not
“cause” glottal stops or
pharyngeal fricatives
Phonological Development
As vocabulary increases
Intelligibility decreases
Phonological Development
Post operative characteristics:
Active vs. Passive
Nasal emission- can be active or passive
Passive- goes away with surgery
Active – stays as a feature of the child’s
speech development
Glottalizing-active