title: The impact of palatal repair before and after 6 months of age on speech characteristics.
abstract: OBJECTIVE
  Optimal timing of palatal repair is still subject of discussion. Although literature provides some evidence that palatal closure prior to 6 months positively influence speech outcome in children with clefts, only few studies verified this hypothesis. The purpose of this study was to describe and compare articulation and resonance characteristics following early (≤6 months) and later (>6 months) palatal repair, performed using the Sommerlad technique.
  
  
  METHODS
  Comparison was made between 12 Ugandan children with isolated cleft (lip and) palate following early palatal repair (mean age: 3.3 m) and 12 Belgian patients with later palatal repair (mean age: 11.1 m), matched for cleft type, age and gender. A Ugandan and Belgian age- and gender-matched control group without clefts was included to control for language, culture and other environmental factors. Articulation assessments consisted of consonant inventories and phonetic and phonological analyses that were based on consensus transcriptions. In addition, resonance was evaluated by perceptual consensus ratings and objective mean nasalance values.
  
  
  RESULTS
  The Belgian and Ugandan control groups were comparable for the majority of the variables. Comparison of cleft palate groups revealed no clinically relevant significant group differences for consonant inventory or phonological processes. Phonetic analysis showed significantly more distortions in the Belgian cleft palate group due to higher occurrence frequencies for (inter)dental productions of apico-alveolar consonants. Neither perceptual consensus ratings of hypernasality, hyponasality, cul-de-sac resonance and nasal emission/turbulence, nor objective mean nasalance values for oral speech samples revealed significant group differences (p>0.05).
  
  
  CONCLUSIONS
  Articulation and resonance characteristics of young children following palatal repair before and after 6 months of age seem to be at least comparable.
authors.affiliation: Ghent University, Department of Speech, Language and Hearing Sciences, De Pintelaan 185, 2P1, 9000 Gent, Belgium. Electronic address: Anke.Luyten@UGent.be.
authors.forename: Anke
authors.initials: A
authors.lastname: Luyten
authors.affiliation: Ghent University, Department of Speech, Language and Hearing Sciences, De Pintelaan 185, 2P1, 9000 Gent, Belgium. Electronic address: Kim.Bettens@UGent.be.
authors.forename: Kim
authors.initials: K
authors.lastname: Bettens
authors.affiliation: Ghent University, Department of Speech, Language and Hearing Sciences, De Pintelaan 185, 2P1, 9000 Gent, Belgium. Electronic address: Evelien.Dhaeseleer@UGent.be.
authors.forename: Evelien
authors.initials: E
authors.lastname: D'haeseleer
authors.affiliation: Ghent University, Department of Speech, Language and Hearing Sciences, De Pintelaan 185, 2P1, 9000 Gent, Belgium. Electronic address: Sophia.Deley@UGent.be.
authors.forename: Sophia
authors.initials: S
authors.lastname: De Ley
authors.affiliation: Comprehensive Rehabilitation Services in Uganda (CoRSU), PO Box 46, Kisubi, Uganda. Electronic address: andrewhodges3001@gmail.com.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hodges
authors.affiliation: Comprehensive Rehabilitation Services in Uganda (CoRSU), PO Box 46, Kisubi, Uganda. Electronic address: george.galiwango@corsu.or.ug.
authors.forename: George
authors.initials: G
authors.lastname: Galiwango
authors.affiliation: Ghent University, Department of Head and Neck Surgery, De Pintelaan 185, 2P2, 9000 Gent, Belgium. Electronic address: Kristiane.Vanlierde@UGent.be.
authors.forename: Katrien
authors.initials: K
authors.lastname: Bonte
authors.affiliation: Ghent University, Department of Head and Neck Surgery, De Pintelaan 185, 2P2, 9000 Gent, Belgium. Electronic address: Hubert.Vermeersch@UGent.be.
authors.forename: Hubert
authors.initials: H
authors.lastname: Vermeersch
authors.affiliation: Ghent University, Department of Speech, Language and Hearing Sciences, De Pintelaan 185, 2P1, 9000 Gent, Belgium. Electronic address: Katrien.Bonte@UZGent.be.
authors.forename: Kristiane
authors.initials: K
authors.lastname: Van Lierde
mesh_terms: D000367:Age Factors; D001184:Articulation Disorders / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D001530:Belgium; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010700:Phonetics; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D013065:Speech Intelligibility; D013068:Speech Production Measurement; D013070:Speech Therapy / Q000379:methods; D016896:Treatment Outcome; D014454:Uganda
keywords: Articulation; Cleft; Resonance; Sommerlad technique; Speech; Timing of palatoplasty