This study investigated vocalization and language environment longitudinally in infants with cleft palate (CP) based on day-long audio recordings collected in their natural environments.
Design
Language Environment Analysis (LENA) data from all-day recordings at home were collected at 3-month intervals for infants from 4-6 to 16-18 months of age. The recordings were analyzed using experimentally blinded human coding as well as LENA automated analysis.
Participants
Ten infants with CP (± cleft lip) and 10 age-matched infants without CP.
Main Outcome Measures
Several measurements were obtained from the LENA automated analysis software. In addition, human coded measurements of vocalization and language environment, including the true canonical babbling ratio and the infant-directed speech ratio, were analyzed for each time point of data collection for each infant. Statistical analyses were performed to conduct group and age comparisons for each measure of vocalization and language environment.
Results
No group differences emerged in number of syllables produced. Infants with CP exhibited late onset and fewer productions of canonical syllables compared to infants without CP. Infants with CP did not show significant differences from infants without CP in measures related to language environment across ages.
Conclusion
This study provides detailed information through naturalistic all-day home recordings about vocal development and early language environments in infants with CP before and after palatal repair. Clinical implications for early intervention are discussed.
BuntonKHoitJ. Devleopment of velopharyngeal closure for vocalization during the first 2 years of life. J Speech Lang Hear Res.2018;61(3):549-560.
2.
CanaultMLe NormandMTFoudilSLoundonNThai-VanH. Reliability of the language ENvironment analysis system (LENA™) in European French. Behav Res Methods.2015;48:1109–1124.
3.
CaskeyMVohrB. Assessing language and language environment of high risk infants and children: a new approach. Acta Paediatr.2013;102(03):1-11.
4.
ChapmanKL. Vocalizations of toddlers with cleft lip and palate. Cleft Palate-Craniofac J.1991;28(2):172-178.
5.
ChapmanKLHardinM. Language input of mothers interacting with their young children with cleft lip and palate. Cleft Palate-Craniofac J.1991;28(1):78-85.
6.
ChapmanKLHardin-JonesMHalterK. Relationship between early speech and later speech and language performance for children with cleft lip and palate. Clin Linguist Phon.2003;17(3):173-197.
7.
ChapmanKLHardin-JonesMSchulteJHalterK. Vocal development of 9-month-old babies with cleft palate. J Speech Lang Hear Res.2001;44(6):1268-1283.
EilersREOllerDKLevineSBasingerDLynchMPUrbanoR. The role of prematurity and socioeconomic status in the onset of canonical babbling in infants. Infant Behav Dev.1993;16(3):297-315.
10.
EshghiMAdatorwovorRPreisserJSCraisERZajacDJ. Vocabulary growth from 18 to 24 months of age in children with and without repaired cleft palate. J Speech Lang Hear Res.2019;62(9):3413-3430.
11.
EshghiMVallinoLDBaylisALPreisserJSZajacDJ. Velopharyngeal status of stop consonants and vowels produced by young children with and without repaired cleft palate at 12, 14, and 18 months of age: a preliminary analysis. J Speech Lang Hear Res.2017;60(6):1467-1476.
12.
FeraganKBRumseyNHeliövaaraABoysenBMJohannessenECHavstamCMarcussonANybergJPedersenNHBogh-NielsenJ, et al.Scandcleft randomized trials of primary surgery of social and emotional experiences related to their 5-year-old child’s cleft diagnosis. J Plast Surg Hand Surg.2017;51(1):73-80.
13.
FlynnRMöllerCJönssonRLohmanderA. The high prevalence of otitis media with effusion in children with cleft lip and palate as compared to children without clefts. Int J Pediatr Otorhinolaryngol.2009;73(10):1441-1446.
14.
GangerJBrentMR. Reexamining the vocabulary spurt. Dev Psychol.2004;40(4):621-632.
15.
GilkersonJZhangYXuDRichardsJAXuXJiangFToppingK. Evaluating LENA system performance for Chinese: a pilot study in shanghai. J Speech Lang Hear Res.2015;58(2):445-452.
16.
GoldsteinMHSchwadeJA. Social feedback to infants’ babbling facilitates rapid phonological learning. Psychol Sci.2008;19(5):515-523.
17.
GoudySLottDCanadyJSmithRJH. Conductive hearing loss and otophathology in cleft palate patients. Otolaryngol-Head Neck Surg.2006;134(6):946-948.
18.
Gros-LouisJMillerJL. From ‘ah’ to ‘bah’: social feedback loops for speech sounds at key points of developmental transition. J Child Lang.2018;45(3):807-825.
19.
Gros-LouisJWestMJGoldsteinMHKingAP. Mothers provide differential feedback to infants’ prelinguistic sounds. Int J Behav Dev.2006;30(6):509-516.
20.
Gros-LouisJWestMJKingAP. The influence of interactive context on prelinguistic vocalizations and maternal responses. Lang Learn Dev.2016;12(3):280-294.
21.
GrunwellPRussellJ. Vocalizations before and after cleft palate surgery: a pilot study. Br J Disord Commun.1987;22(1):1-17.
22.
HaS. Profiles of vocal development in Korean children with and without cleft palate. Clin Linguist Phon.2018;32(1):46-69.
23.
HartBRisleyTR. Meaningful differences in the everyday experience of young American children. Baltimore, MD Paul H: Brookes Publishing; 1995.
24.
HoffE. The specificity of environmental influence: socioeconomic status affects early vocabulary development via maternal speech. Child Dev.2003;74(5):1368-1378.
25.
HurtadoNMarchmanVAFernaldA. Does input influence uptake? Links between maternal talk, processing speed and vocabulary size in Spanish-learning children. Dev Sci.2008;11(6):F31-F39.
26.
HuttenlocherJWaterfallHVasilyevaMVeveaJHedgesLV. Sources of variability in children’s language growth. Cogn Psychol.2010;61(4):343-365.
27.
IyerSNDensonHLazarNOllerDK. Volubility of the human infant: effects of parental interaction (or lack of it). Clin Linguist Phon.2016;30(6):470-488.
28.
JonesCEChapmanKHardin-JonesM. Speech development of children with cleft palate before and after palatal surgery. Cleft Palate-Craniofac J. 2003;40(1):1545-1569.
29.
Koopmans-van BeinumFJClementCJcan den Dikkenberg-PotI. Influence of lack of auditory speech perception on sound productions of deaf infants. IFA Proc. 1998;22:47-60.
30.
Koopmans-van BeinumFJvan der SteltJM. Early stages in the development of speech movements. In: LindblomBZetterstromR, eds. Precursors of early speech. New York: Stockton Press; 1986:37-50.
31.
KrochmalDJZajacDJAlhudaibOMEmodiOvan AalstJA. The assessment of velopharyngeal function using nasal ram pressure testing following palatoplasty. Cleft Palate-Craniofac J. 2013;50(5):542-547.
32.
LeeCJhangYRelyeaGChenLOllerK. Babbling development as seen in canonical babbling ratios: a naturalistic evaluation of all-day recordings. Infant Behav Dev. 2018;50:140-153.
33.
LeeYHaS. Parental responses to infants’ prelinguistic vocalization. Commun Sci Disord.2021;26(1):13–21.
34.
LiangKYZegerS. Longitudinal data analysis using generalized linear models. Biometrike. 1986;73(1):13-22.
35.
LynchMPOllerDKSteffensMLLevineSLBasingerDLUmbelV. Onset of speech-like vocalizations in infants with down syndrome. Am J Ment Retard.1995;100(1):68-86.
MolemansIVan den BergRVan SeverenLGillisS. How to measure the onset of babbling reliably. J Child Lang.2012;39(3):523-552.
38.
NathaniSErtmerDJStarkRE. Assessing vocal development in infants and toddlers. Clin Linguist Phone J. 2006;20(5):351-369.
39.
O’GaraMLogemannJRademakerAW. Phonetic features by babies with unilateral cleft lip and palate. Cleft Palate-Craniofac J. 1994;31(6):1545-1569.
40.
OllerDK. The emergence of the speech capacity. Mahwah, NJ: Erlbaum; 2000.
41.
OllerDKEilersRE. The role of audition in infant babbling. Child Dev.1988;59(2):441-449.
42.
OllerDKEilersREBasingerD. Intuitive identification of infant vocal sounds by parents. Dev Sci.2008;4(1):49-60.
43.
OllerDKEilersRESteffensMLLynchMPUrbanoR. Speech-like vocalizations in infancy: an evaluation of potential risk factors. J Child Lang.1994;21(1):33-58.
44.
OllerDKEilersREUrbanoRCobo-LewisAB. Development of precursors to speech in infants exposed to two languages. J Child Lang.1997;27:407-425.
45.
OllerDKGriebelUWarlaumontA. Vocal development as a guide to modeling the evolution of language. Top Cogn Sci.2016;8(2):382-392.
46.
OllerDKLevineSLCobo-LewisAEilersREPearsonBZ. Vocal precursors to linguistic communication: how babbling is connected to meaningful speech. In: PaulR, ed. Exploring the speech-language connection. Vol 8. Baltimore, MD: Paul H. Brookes Publishing; 1998:1-25.
47.
PaeSYoonHSeolAGilkersonJRichardsJMaLToppingK. Effects of feedback on parent-child language with infants and toddlers in Korea. First Lang.2016;36(6):549-569.
48.
PattenEBelardiKBaranekGWatsonLLabbanJOllerDK. Vocal patterns in infants with autism spectrum disorder: canonical babbling status and vocalization frequency. J Autism Dev Disord. 2014;44(10):2413-2428.
49.
PaulRElwoodT. Maternal linguistic input to toddlers with slow expressive language development, . J Speech Lang Hearing Res.1991;34(5):982-988.
50.
PhilipBJKentRD. Acoustic-phonetic descriptions of speech production in speakers with cleft palate and other velopharyngeal disorders. In: LassN, ed. Speech and Language: Advances in basic research and practice (Vol. 11. New York: Academic Press; 1984:113-167.
51.
RobertsJRosenfeldRZeiselS. Otitis media and speech and language: a meta-analysis of prospective studies. Pediatrics. 2004;113(3):e238-e248.
52.
RoweM. A longitudinal investigation of the role of quantity and quality of child-directed speech in vocabulary development. Child Dev.2012;83(5):1762-17774.
53.
RussellJGrunwellP. Speech development in children with cleft lip and palate. In: GrunwellP, ed. Analysing Cleft Palate Speech. London: Whurr Publishing; 1993:19-47.
54.
SchererNOravkinovaZMcbeeM. Longitudinal comparison of early speech and language milestones in children with cleft palate: a comparison of US and Slovak children. Clin Linguist Phon.2013;27(6):404-418.
55.
SchererNWilliamsALProctor-WilliamsK. Early and later vocalization skills in children with and without cleft palate. Int J Pediatr Otorhinolaryngol.2008;72(6):827-840.
56.
SchwarzI-CBotrosNLordAMarcussonATideliusHMarklundE. The LENA system applied to Swedish: reliability of the adult word count estimate. Proc Interspeech. 2017;2088-2092. doi:10.21437/Interspeech.2017-1287
57.
SheahanPMillerISheahanJNEarleyMJBalyneyAW. Incidence and outcome of middle ear disease in cleft lip and/or cleft palate. Int J Pediatr Otorhinolaryngol. 2003;67(7):758-793.
58.
ShribergLDFriel-PattiSFlipsenPBrwonR. Otitis media, fluctuant hearing loss, and speech-language outcomes. J Speech Lang Hear Res.2000;43(1):100-120.
59.
StarkRE. Stages of speech development in the first year of life. In: Yeni-KomshianGKavanaghJFergusonC, eds. Child Phonology, vol. 1. New York: Academic Press; 1980:73-90.
60.
VallinoLBaylisAZajacDJ. Production of stop consonants at 18 months of age by children with and without repaired cleft palate. Cleft Palate Craniofac J.2019;56(IS):9.
61.
VihmanMM. Phonological development: The Origins of Language in the Child. Cambridge, MA: Blackwell Publishers; 1996.
62.
VihmanMMMackenMAMillerRSimmonsHMillerJ. From babbling to speech: a re-assessment of the continuity issue. Language (Baltim). 1985;61(2):397-445.
63.
WarrenSFGilkersonJRichardsJOllerDKXuDYapanelUGrayS. What automated vocal analysis reveals about the vocal production and language learning environment of young children with autism. J Autism Dev Disord. 2010;40(5):555-569.
64.
WeislederAFernaldA. Talking to children matters: early language experience strengthens processing and builds vocabulary. Psychol Sci.2013;24(11):2143-2152. doi: 10.1177/0956797613488145
65.
WilladsenE. Lexical selectivity in Danish toddlers with cleft palate. Cleft Palate Craniofac J.2013;50(4):456-465.
66.
WilladsenEEnemarkH. A comparative study of prespeech vocalizations in two groups of toddlers with cleft palate and a noncleft group. Cleft Palate Craniofac J.2000;37(2):172-178.
67.
ZajacDJVallinoLDBaylisALAdatorwovorRPreisserJSVivaldiD. Emergence of prevocalic stop consonants in children with repaired cleft palate. J Speech Lang Hear Res.2021;64(1):30-39.
68.
ZegerSLLiangKYAlbertPS. Models for longitudinal data: a generalized estimating equation approach. Biometrics. 1988;44(4):1049-1060.
