title: Abrupt laryngeal engagement during stop plosive-vowel transitions in children with repaired cleft palate and adequate velopharyngeal closure: aerodynamic and sound pressure level evidence.
abstract: OBJECTIVE
  To determine whether children with repaired cleft palate and adequate velopharyngeal closure exhibit abrupt laryngeal engagement during stop plosive-vowel transitions as compared with children without cleft palate.
  
  
  METHODS
  A prospective group design was used with convenience sampling of patients at a university craniofacial center.
  
  
  METHODS
  PARTICIPANTS were 25 children (15 boys, 10 girls) with repaired cleft palate (mean age = 10.9 years, standard deviation = 1.5 years) and 20 children (10 boys, 10 girls) without cleft palate (mean age = 10.8 years, standard deviation = 1.8 years). All children with cleft palate had adequate velopharyngeal closure as determined by aerodynamic testing.
  
  
  METHODS
  (1) Peak oral airflow was determined during the release of /t/ in the word "two" during a counting task. (2) An index of laryngeal engagement defined as the ratio of the maximum oral airflow declination to peak oral airflow was calculated during the release of /t/. (3) Sound pressure level was determined during the vowel of the word "two."
  
  
  RESULTS
  Children with cleft palate exhibited significantly more negative laryngeal engagement ratios (i.e., more abrupt adduction) (P = .002) and greater sound pressure level (P = .049) than controls. There was a significant negative relationship between laryngeal engagement and sound pressure level for all children (r = -.428, P = .003).
  
  
  CONCLUSIONS
  Children with repaired cleft palate and adequate velopharyngeal function appear to use a strategy of abrupt laryngeal adduction during stop plosive-vowel transitions. This strategy-perhaps learned even prior to palate surgery-may help to achieve either adequate sound pressure level and/or velopharyngeal closure.
authors.forename: David J
authors.initials: DJ
authors.lastname: Zajac
authors.forename: Sarah
authors.initials: S
authors.lastname: Milholland
mesh_terms: D000403:Airway Resistance / Q000502:physiology*; D002648:Child; D002971:Cleft Lip / Q000503:physiopathology* / Q000601:surgery; D002972:Cleft Palate / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007830:Larynx / Q000503:physiopathology*; D008297:Male; D010700:Phonetics; D011184:Postoperative Period; D011312:Pressure; D011446:Prospective Studies; D013065:Speech Intelligibility; D013068:Speech Production Measurement; D014681:Velopharyngeal Insufficiency / Q000503:physiopathology*