Changes in Articulation and Phonological Patterns During Early Intervention in Children with Cleft Palate With or Without Cleft Lip

This study investigated speech errors and the role that they play in the participants’ speech development. Speech encompasses articulation (i.e., physical production of sound) and phonology (i.e., rules that control the use of sounds in words). Errors can occur at either level. Young children typically display a developmental progression in their learning of the rules of speech sound production that results in adult-like word pronunciation (StoelGammon & Cooper, 1984). Once children start using their first words at about 12 months of age, they enter a period of highly variable sound production during which they are experimenting with how to produce sounds in words (Stoel-Gammon, 2011). During this process, their speech is characterized by many speech errors such as sound deletions and substitutions (Sosa & Stoel-Gammon, 2012). Progress from one stage to the next indicates a maturing sound system. One of the early signs of progress towards acquiring a mature sound system is reduction in use of consonant deletions. That is, “mo” becomes “mom” and “ajamas” becomes “pajamas”. Simplification of word forms would indicate a less mature phonological system. A second sign of progress is the reduction of consonant substitutions in which one sound replaces another in systematic ways such as “wabbit” becomes “rabbit” or “tat” becomes “cat”. Substitutions reflect the child’s active generation of speech production rules and these rules progressively approach adult pronunciation patterns. INTRODUCTION Cleft palate with or without cleft lip (CP+/-L) is a craniofacial abnormality affecting approximately 1 in 750 live births in the United States each year which negatively impacts speech development (ACPA, 2009). The current understanding of early speech and language development of children with CP+/-L indicates that surgical palate repair (typically by 12 months of age) alone is not sufficient to normalize speech development (Jones, Chapman & Hardin-Jones, 2003). Understanding the factors that impact early speech development is critical to creating effective early speech intervention for these children. One such factor is how speech errors change over time in response to intervention. Changes in Articulation and Phonological Patterns During Early Intervention in Children with Cleft Palate With or Without Cleft Lip