Persisting speech difficulties at 7–8 years of age – a longitudinal study of speech production in internationally adopted children with cleft lip and palate

Figures & data

Table 1. Individual data on all 17 participants at different timepoints.

Part.	AaA (months)	Highest level of education in (adoptive) family	Language status pre-adoption	Surgical repair in China	Age at SPR (months)	Age at HPR (months)	SVP prior to T3	PC C T1 (%)	PCC T2 (%)	PCC T3 (%)	Cons inv T1 (n)	Cons inv T2 (n)	Cons inv T3 (n)	VPC-Rate T1	VPC-Rate T2	VPC-Rate T3
1	23	4	0	lp			n	*	57.1	69.0	*	9	14	*	2	1
2	17	2	2	l	20	31	y	0.0	28.8	54.2	0	7	11	2	2	1
3	31	4	4	lp			n	56.9	72.4	86.4	11	18	18	0	0	0
4	19	2	2	l	26	34	n	33.3	67.3	83.1	6	17	17	2	1	1
5	19	4	1	l	26	38	n	*	72.4	81.4	*	11	17	*	0	0
6	18	3	1	l	24	34	y	3.7	17.9	79.7	6	5	14	2	2	0
7	17	4	3	–	19	55	y	15.8	65.5	71.2	6	15	15	2	2	2
8	16	3	2	–	21	27	n	14.8	42.4	66.1	3	12	14	2	1	0
9	20	4	2	–	23	30	y	29.2	71.2	84.7	5	15	15	2	2	1
10	28	2	2	–	32	39	y	11.8	37.5	81.4	4	10	17	2	2	1
11	21	4	2	l	29	36	y	*	61.0	71.9	*	12	15	*	2	2
12	18	4	2	–	24	35	n	16.1	96.6	98.3	8	16	18	2	1	1
13	16	4	0	–	20	28	n	9.4	42.1	74.1	5	12	16	2	2	2
14	21	3	2	–	27	35	n	1.8	66.1	86.4	3	12	16	2	2	0
15	27	4	0	lp			n	22.9	41.4	78.0	5	9	17	**	0	0
16	33	4	0	l	42	49	n	50.0	56.9	67.8	8	14	15	2	1	1
17	29	4	3	l	37	44	n	*	60.0	81.0	*	14	17	*	1	0

Part = Participant; AaA = Age at adoption; Highest level of education: 1 = Lower-secondary school, 2 = Upper-secondary school, 3 = University degree, maximum of 3 years, 4 = University degree, more than 3 years; Language status pre-adoption: 1 = No babbling or speech at all, 2 = Babbling, 3 = Use of words in the native language, 4 = Use of sentences in the native language, 0 = Do not know; Surgical repair in China: l = Lip repair only, lp = Lip and palate repair; SPR = Soft-palate repair; HPR = Hard-palate repair; SVP = Secondary velopharyngeal surgery, y = Yes, n = No; PCC = Percent consonants correct, T1 = Timepoint 1, T2 = Timepoint 2, T3 = Timepoint 3; Cons inv = Consonant inventory; Velopharyngeal competence; VPC-Rate: 0 = competent, 1 = marginally incompetent, 2 = incompetent.

*=Missing data.

**At T1, the VP competence of one additional child could not be perceptually assessed by two of the three raters and was therefore excluded.

Figure 1. Percent consonants correct (PCC) at the three-time points (T1–T3). The solid black line represents norm values for 3-, 5- and 7-year-old Swedish children without cleft lip and palate [15].

A box-plot showing median, minimum and maximum values of percent consonants correct (PCC) at three-time points. Included in the figure is also a line graph plotting the normative values for each age corresponding to the timepoints.

Figure 2. Development of the median PCC score for each participant between T1 and T3. The red dotted line represents the age-specific norms for 3-, 5- and 7-year-old children [15].

A line chart, with each of the 17 participants plotted at each timepoint. The chart shows the development of the median PCC score from timepoint 1 to timepoints 3. The age-specific norms for each timepoint are also plotted in the chart.

Figure 3. Mean consonant inventory at the three timepoints (T1–T3).

A box plot showing the mean consonant inventory at the three timepoints.

Figure 4. Percentage of children having established each consonant phoneme at T1, T2 and T3 (since the/ɧ/phoneme was not elicited for six and five children at T1 and T2, respectively, it is not included).

A bar chart showing the percentage of children having established each consonant phoneme at the different timepoints.

Table 2. Frequency of consonant errors (percentage of instances across the material) at different timepoints, presented as median (minimum-maximum) values.

Consonant error	T1 (n = 13)		T2 (n = 17)		T3 (n = 17)		Significance
Non-oral articulation (%)	22.2	(0–52.9)	1.7	(0–21.1)	0	(0–18.6)	T1–T2; z = −2.9, p <.01 T2–T3; z = −2.1, p <.05
Retracted oral articulation (%)	8.3	(0–70.4)	6.8	(0–35.6)	11.9	(0–28.8)	T1–T2; z = −1.7, p =.1 T2–T3; z = −0.35, p =.7
Deletion of target consonant (%)	15.8	(0–56.1)	8.8	(0–53.6)	0	(0–10.3)	T1–T2; z = −2.9, p <.01 T2–T3; z = −2.3, p <.05
Developmental speech characteristics (%)	17.5	(9.3–40.7)	12.3	(3.4–43.1)	3.5	(0–15.3)	T1–T2; z = −1.4, p =.2 T2–T3; z = −3.6, p <.01

T1: timepoint 1, T2: timepoint 2, T3: timepoint 3.

Table 3. Number and percentage of children with different velopharyngeal-competence rates at each timepoint.

VPC-Rate	T1  (n = 12*)	T2 (n = 17)	T3 (n = 17)
Competent VP function	1 (8%)	3 (18%)	7 (41%)
Marginally incompetent VP function	0 (0%)	5 (29%)	7 (41%)
Incompetent VP function	11 (92%)	9 (53%)	3 (18%)

T1 = timepoint 1, T2 = timepoint 2, T3 = timepoint 3, VPC-Rate = velopharyngeal-competence rate, VP = velopharyngeal.

*At T1, one additional child could not be perceptually assessed by two of the three raters and was therefore excluded.

Lohmander A, Lundeborg I, Persson C. SVANTE – The Swedish Articulation and Nasality Test – Normativedata and a minimum standard set for cross-linguistic comparison. Clin Linguist Phon. 2017;31(2):137–154.

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