Verification of the therapeutic process in cleft
					patients

Bautzer, Ana Paula Doi; Guedes, Zelita Caldeira Ferreira

doi:10.1590/2317-1782/20140000099

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Original Articles • CoDAS 26 (6) • Dec 2014 • https://doi.org/10.1590/2317-1782/20140000099 copy

Verification of the therapeutic process in cleft patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

PURPOSE:

This study was conducted to verify the origin of a longer or even failed therapeutic process in patients with cleft lip and palate as to its difficulty.

METHODS:

Eighteen children undergoing therapeutic process were observed for at least 6 months and divided into two groups: presenting isolated cleft lip and palate (group I) and having been diagnosed by a Speech-Language Pathologist with reading and writing disorders, with manifestation of phonological awareness deficit (group II). Two tests were applied for the evaluation of speech and language: ABFW Language Test for Young Children (phonology) and Phonological Awareness: Instrument of Sequential Assessment (CONFIAS).

RESULTS:

Group I presented higher percentages in ABFW test than group II, except in the "simplification of consonant cluster" and "plosive devoicing" variables. It was also observed that, in the process of omission, group I hardly omits the vibrant consonant, as observed in group II. At the syllable level of CONFIAS, the percentages observed in group I tended to be higher than in group II, with the exception of the following tasks: "medial syllable," "production of rhyme," and "exclusion." At the phoneme level, the percentages observed in group II tended to be higher than in group I, with the exception of the following tasks: "starts with given sound," "exclusion," "synthesis," and "segmentation." No significant difference was observed between percentage distributions in groups I and II (p>0.118).

CONCLUSIONS:

The differences found between groups I and II, although not statistically significant, may suggest that the presence of malformation hinders speech and language acquisition and development and prolongs the therapeutic process if directive interventions are not carried out, including phonological awareness therapy.

Variable	n	Mean±SD	Min–Max	Amplitude	p-value*
Phonetic inventory
I	11	45.8±31.1	6–94	88
II	7	58.9±19.0	38–94	56
Total	18	52.4±	6–94	88	0.199

Variable	n	Mean±SD	Min–Max	Mediana	Amplitude	p-value
Palatal anteriorization
I	11	100.0±0.0	100–100	100	0
II	7	77.1±35.5	0–100	80	100
Total	25	92.8±20.7	0–100	100	100	0.013*
Simplification of liquid
I	11	91.8±10.2	73–100	100	27
II	7	88.4±11.3	73–100	82	27
Total	25	91.0±12.2	55–100	100	45	0.565
Simplification of consonant cluster
I	11	25.5±38.9	0–100	2	100
II	7	50.0±47.9	0–100	25	100
Total	25	37.7±41.5	0–100	25	100	0.364
Simplification of final consonant
I	11	70.9±25.9	20–100	80	80
II	7	82.9±21.4	60–100	100	40
Total	25	79.2±23.4	20–100	80	80	0.269
Fricative voicing
I	11	99.4±2.1	93–100	100	7
II	7	96.0±6.8	86–100	100	14
Total	25	98.6±4.0	86–100	100	14	0.219
Plosive devoicing
I	11	98.7±2.8	93–100	100	7
II	7	100.0±0.0	100–100	100	0
Total	25	98.9±3.3	86–100	100	14	0.526
Fricative devoicing
I	11	100.0±0.0	100–100	100	0
II	7	100.0±0.0	100–100	100	0
Total	25	99.4±2.8	86–100	100	14	>0.999

Variable	n	Mean±SD	Min–Max	Amplitude	p-value
Omission
I	11	100±0	100–100	0
II	7	98.6±1.9	96–100	4
Total	18	99.3±	96–100	4	<0.055*
Glottal stop
I	11	87.9±9.4	73–100	27
II	7	100±0	100–100	0
Total	18	93.9±	73–100	27	0.124
Pharyngeal fricative
I	11	95.5±4.9	86–100	14
II	7	100±0	100–100	0
Total	18	97.75±	86–100	14	0.016*
Nasal lisp
I	11	99.4±1.4	96–100	4
II	7	100±0	100–100	0
Total	18	99.7±	96–100	4	0.266

	n	Mean±SD	Min–Max	Amplitude	p-value
Syllable
I	11	85.9±17.1	37–97	60
II	7	82.3±9.8	70–95	25
Total	18	84.1±	37–97	60	0.094
Synthesis
I	11	95.5±15.1	50–100	50
II	7	89.3±19.7	50–100	50
Total	18	92.4±	50–100	50	0.609
Segmentation
I	11	97.7±7.5	75–100	25
II	7	89.3±19.7	50–100	50
Total	18	93.5±	50–100	50	0.558
Identification of initial syllable
I	11	95.5±15.1	50–100	50
II	7	89.3±19.7	50–100	50
Total	18	92.4±	50–100	50	0.609
Identification of rhyme
I	11	90.9±23.1	25–100	75
II	7	85.7±13.4	75–100	25
Total	18	88.3±	25–100	75	0.347
Syllable given
I	11	97.7±7.5	75–100	25
II	7	85.7±13.4	75–100	25
Total	18	91.7±	75–100	25	0.088
Medial syllable
I	11	86.4±30.3	25–100	75
II	7	89.3±13.4	75–100	25
Total	18	87.8±	25–100	75	0.255
Production of rhyme
I	11	65.9±25.7	25–100	75
II	7	71.4±22.5	50–100	50
Total	18	68.7±	25–100	75	0.747
Exclusion
I	11	72.5±27.9	12–100	88
II	7	82.0±17.7	62–100	38
Total	18	77.3±	12–100	88	0.435
Transposition
I	11	86.4±30.3	0–100	100
II	7	82.1±18.9	50–100	50
Total	18	84.3±	0–100	50	0.242

	n	Mean±SD	Min–Max	Amplitude	p-value
Phoneme
I	11	77.2±8.5	63–96	33
II	7	77.6±12.8	60–94	34
Total	18	77.4±	60–96	34	0.747
Starts with given sound
I	11	100.0±0.0	100–100	0
II	7	96.4±9.4	75–100	25
Total	18	98.2±	75–100	25	0.609
Identification of the initial phoneme
I	11	100.0±0.0	100–100	0
II	7	100.0±0.0	100–100	0
Total	18	100.0±0.0	100–100	0	>0.999
Identification of the final phoneme
I	11	84.1±20.2	50–100	50
II	7	85.7±13.4	75–100	25
Total	18	84.9±	50–100	50	0.375
Exclusion
I	11	74.0±20.3	50–100	50
II	7	68.7±22.5	33–100	67
Total	18	71.4±	33–100	67	0.134
Synthesis
I	11	72.7±13.5	50–100	50
II	7	71.4±17.3	50–100	50
Total	18	72.1±	50–100	50	0.845
Segmentation
I	11	75.0±25.0	25–100	75
II	7	60.7±24.4	25–100	75
Total	18	67.9±	25–100	75	0.431
Transposition
I	11	38.6±20.5	0–100	75
II	7	64.3±28.3	25–100	75
Total	18	51.5±	0–100	75	0.118

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E-mail: revista@codas.org.br

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[1] Correspondence address: Ana Paula Doi Bautzer Rua José Nabantino Ramos, 135 Jardim Umuarama, São Paulo (SP), Brasil, CEP: 04649-140. E-mail: apbautzer@uol.com.br