Speech and Language Issues in the Cleft Palate Population: The State of the Art

There have been considerable research efforts in the area of vocal tract modeling but there is still a small body of information regarding direct 3-D measurements of the vocal tract shape. The purpose of this study was to acquire, using magnetic resonance imaging (MRI), an inventory of speaker-specific, three-dimensional, vocal tract air space shapes that correspond to a particular set of vowels and consonants. A set of 18 shapes was obtained for one male subject who vocalized while being scanned for 12 vowels, 3 nasals, and 3 plosives. The 3-D shapes were analyzed to find the cross-sectional areas evaluated within planes always chosen to be perpendicular to the centerline extending from the glottis to the mouth to produce an "area function." This paper provides a speaker-specific catalogue of area functions for 18 vocal tract shapes. Comparisons of formant locations extracted from the natural (recorded) speech of the imaged subject and from simulations using the newly acquired area functions show reasonable similarity but suggest that the imaged vocal tract shapes may be somewhat centralized. Additionally, comparisons of the area functions reported in this study are compared with those from four previous studies and demonstrate general similarities in shape but also obvious differences that can be attributed to differences in imaging techniques, image processing methods, and anatomical differences of the imaged subjects.

Speech production and age at palatal repair were investigated in 80 cleft palate children. Children whose palates were repaired prior to the onset of speech production demonstrated significantly better speech than those whose palates were repaired between 12 and 27 months of age. The supposition that earlier palatal repair results in more normal speech development was, in fact, demonstrated in these cases. Rather than using chronologic age alone as the deciding factor in determining timing of initial palatal repair, the stage of each child's phonemic development should be considered if maximum speech potential is to be achieved and if speech development is to parallel normal noncleft peers. Determining this stage of development through early speech and language evaluations, beginning at 6 months of age, thus becomes an essential component in the habilitation of children with cleft palate. Continued research is needed to ensure against giving the obtainment of early speech normalcy disproportionate emphasis over craniofacial growth considerations. To this end, continued cooperative research between surgeons and speech pathologists is imperative in order to base these important decisions on substantiated findings.

Magnetic resonance imaging (MRI) was used to acquire vocal tract shapes of ten vowels /i, I, [symbol: see text] a, [symbol: see text], o, [symbol: see text] u/ and two liquid approximants /3[symbol: see text], 1/ for a 27-year-old adult female. These images were complemented with additional images acquired with electron beam computed tomography (CT) of /i/ and /a/. Each 3-D shape was condensed into a set of cross-sectional areas of oblique sections perpendicular to the centerline of the vocal tract's long axis, resulting in an "area function." Formant frequencies computed for each area function showed reasonable similarity to those determined from the natural (recorded) speech of the imaged subject, but differences suggest that some of the imaged vocal tract shapes were articulated differently during imaging than during recording of natural speech, and also that imaging procedures may have compromised some accuracy for a few shapes. The formant calculations also confirmed the significant effect that the piriform sinus can have on lowering the formant frequencies. A comparison is made between area functions derived using both MRI and CT methods for the vowels /i/ and /a/. Additionally, the area functions reported in this study are compared with those from two previous studies and demonstrate general similarities in shape but also obvious differences that can be attributed to anatomical differences of the imaged subjects and to differences in imaging techniques and image processing methods.