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Articulatory Additions to the Classical Description of the Speech of Persons with Cleft Palate

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Articulatory Additions to the Classical Description of the Speech of Persons with Cleft Palate Articulatory Additions to the Classical Description of the Speech of Persons with Cleft Palate JUDITH E. TROST, Ph.D. Chicago, Illinois, 60611 Three types of compensatory articulation used by speakers with cleft palate and velopha- ryngeal inadequacy are described: the pharyngeal stop, the mid-dorsum palatal stop, and the posterior nasal fricative. These articulatory characteristics have not been previ- ously reported in the literature. Each is defined radiographically to depict deviant place of production. Each is also described in terms of perceptually distinct speech character- istics. Production features of these articulatory compensations are contrasted and com- pared with those of the glottal stop and pharyngeal fricative. The use of compensatory articulation as replacements for target phonemes is distinguished from their occurrence as aberrant co-articulations with target phonemes. Additionally, phonetic symbols for use in narrow phonetic transcription are presented, and implications for speech remedia- tion are discussed. KEY WORDS: articulation, compensatory articulation, cleft palate Introduction snort" (Backus, et al., 1943), "hissing noise" Throughout the literature on cleft palate, (Van Riper and Irwin, 1961), "distortion-na- the deviant speech characteristics associated sal" and "substitution-nasal" (VanDemark, with impairment to the velopharyngeal valve 1964), and nasal emission as distinguished have included four chief stigmata: hyperna- from "nasal turbulence" (McWilliams and sality, nasal air emission, weak pressure con- Philips, 1979). Although this assortment of | sonants, and compensatory articulation. labels implies variable expression of nasal FHypernasality is the resonance disturbance emission with respect to articulatory contrib- which accompanies vowels and vocalic con- utors to air turbulence or audible resistance, sonants, the glides or liquids, and gives rise to specific articulatory gestures associated with deviant voice quality in speech production. nasal escape of air have been neither docu- Nasal air emission is the nasal airflow which mented nor agreed upon among clinicians. accompanies production of pressure conso- Van Riper and Irwin (1961) alluded to pos- nants-the stops, affricates, and fricative pho- teriorly generated frication in their descrip- nemes. It is most often characterized in the tion of the "nasopharyngeal snort," and Pe- literature as an audible speech sound distor- terson (1975) noted aberrant lingual 'postur- tion. Several authors have commented on the ing to be associated with nasal emission that variable auditory perceptual qualities associ- is confined to production of sibilant fricatives ated with nasal air emission with the result and affricate phonemes. McWilliams (1980) that many labels have been applied to this has commented on "posterior distortions" phenomenon. These have included "nasal stating that these occur " . .. when the sound is produced through a channel created by the blade of the tongue articulating with the hard Dr. Trost is Associate Professor and Director of Re- palate well behind the maxillary arch or with search and Speech and Language Services at the North- western University Cleft Lip and Palate Institute, and the soft palate." (p. 408). The third feature, Associate Professor in the Department of Communicative weak pressure consonants, like nasal emission, Disorders of Northwestern University. occurs secondary to the open velopharyngeal Material included in this report was presented, in port. It has its direct consequence upon man- part, at the 1978 American Cleft Palate Association annual meeting in Atlanta, Georgia, April 5-8 and also ner of production, that is, upon the stop-con- at the 1978 Convention of the American Speech and tinuant feature dimension of articulatory Hearing Association, San Francisco, November 18-21. valving. Although these two aspects of speech 193 194 Cleft Palate Journal, July 1981, Vol. 18 No. 3 impairment are derived from the same struc- has been identified by Dalston and Trost tural or valving inadequacy, each has a dif- (1979) through phonetic transcription analy- ferent impact upon speech. Nasal air emission ses of young speakers with cleft palate. _ distorts or replaces the target phoneme, Several authors have viewed both the glot- whereas reduced intraoral pressure diminishes tal stop and the pharyngeal fricative as the plosive power and often renders even a correct speaker's attempt to valve the articulators labial or lingual articulatory gesture ineffec- where the most success can be obtained. This tive. Compensatory articulations comprises the place occurs below the level of defect (Bzoch, fourth variety of speech deviation. Within this 1971a; Morris, 1971; Lawrence and Philips, group, the glottal stop and the pharyngeal 1975). Little has been stated about the com- fricative have been given substantial thera- pensatory role(s) of the velar fricative in peutic and research attention. Bzoch (1971b) speakers with cleft palate and no systematic included the velar fricative in this category. data have been reported in the literature. In As its name implies, the glottal stop is a the author's opinion, the velar fricative occurs plosive consonant produced by vocal fold sometimes as a homorganic substitution for valving. The pharyngeal fricative, as will be the back velar stops /k/ and /I/ because of illustrated later in this report, results from the loss of the stop quality resulting from the narrowing of the pharyngeal airway by lin- velopharyngeal valve leak. It can also be spec- guapharyngeal articulatory constriction. The ulated that speakers with velopharyngeal in- velar fricative is a linguavelar articulation adequacy often use the back of the tongue to made in the approximate place of /k/ and aid in velopharyngeal valving so that it be- /9/. This third variety of articulatory devia- comes obligatory for lingual articulatory ma- tion has a high rate of occurrence in dysarthric neuvers to be shifted posteriorly. Such com- speakers because of the neuromotor involve- pensatory adjustments could underlie velar ment of the posterior tongue. The resulting fricative substitutions for sibilant fricatives velar fricative for the velar stop substitution and affricates. is often aggravated by co-existing velopharyn- Clinically, there are other frequently ob- geal incompetency. served compensatory articulations which are different from the classical descriptions of the The Nature of Compensatory Articulations glottal stop, pharyngeal fricative, and velar Several studies have demonstrated that, in fricative. These are the pharyngeal stop, mid- most instances where compensatory articula- dorsum palatal stop, and posterior nasal fricative. tions are substituted for target phonemes, the The purpose of this report is to describe per- correct manner of articulation is preserved ceptual and physiological aspects of these ad- while correct place of articulation is sacrificed ditional compensatory articulations and to (Counihan, 1956, 1960; Spriestersbach, et al., comment on their implications for diagnosis 1961). The frequently observed glottal stop and remediation. ' substitutions for stop consonants and pharyn- Procedure geal fricative substitutions for sibilant frica- tives and sometimes for affricates are compat- Listener judgment data on the six types of ible with the foregoing reports. Interestingly, compensatory articulation discussed in this the extreme anterior fricatives /f, v, 8, 0/ do report show that these productions are per- not show similar vulnerability. ceptually identifiable and distinct from one Findings from studies employing cineradi- another. Six speech pathologists, three expe- ographic and videofluoroscopic procedures rienced in craniofacial disorders and three have revealed a consistent tendency for lin- inexperienced in this area, served as judges. gual place targets to be shifted posteriorly in After a one-hour training session, each judge speakers with cleft palate (Powers, 1962; listened to audio-tape recordings of 24 pa- Brooks, et al., 1965, 1966; Lawrence and tients producing sentence pairs. Order of sen- Philips, 1975). A tendency toward backed tence pairs was randomized for presentation. lingual contacts in general is clinically evi- Each sentence contained one to several occur- dent, as demonstrated in the 1979 audiotape rences of the compensatory articulation to be presentations of McWilliams and Philips, and identified and some sentences contained other TI'OSt, ARTICULATORY ADDITIONS 195 types of articulatory errors as well. Listeners were asked only to identify the compensatory articulation type used by the speaker in un- derlined segments of the sentence and were not required to do narrow phonetic transcrip- tion. The percentage of correct identification of compensatory articulation types ranged from 66.7% to 96.3% correct, with a mean percentage of correct responses of 86.8. When the poorest listener was excluded, the scores ranged from 85.2% to 96.3% with a mean B | percentage correct of 90.8. Analysis of re-pre- @ | sentations of sentence pairs included in the task yielded an intrajudge reliability of 1.0 for © five of the judges and of only .33 for the sixth judge. Interestingly, this was the same judge @) who achieved only 66.7% correct identifica- tion. Overall, these data provide objective support for the perceptual distinctiveness of T these compensatory productions. FIGURE 1. Lateral view schematic illustration of pharyngeal stop compensatory articulation with broken Description
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