Communicative Acts and Word Acquisition in Toddlers with Cleft Palate

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Studies of early communicative development have shown a relationship between rates of communicative acts (CA) and the acquisition of words for typically developing children. Rates of CA provide a measure that predicts vocabulary growth. For children with cleft lip and/or palate, early vocabulary delays are common. Examination of rates of CA may provide a means for predicting which children show readiness for vocabulary expansion. The purpose of this study was to examine children’s rates of CA, canonical vocalizations (CV), and words during the transition from prelinguistic to linguistic development. This retrospective study included 15 participants from northeast Tennessee that were drawn from a previous longitudinal study of nonsyndromic children with cleft lip and/or palate. There were nine females and six males; nine of the participants had cleft lip and palate, while the remaining six participants had cleft palate only. Through video recordings, children were evaluated at 18, 24, and 30 months of age, during which time they transitioned from the prelinguistic level (< 10 words on CDI) to the linguistic level (> 10). Data was recorded on the number of CA [e.g., protodeclaratives (PD) and protoimperatives (PI) to determine the purpose of communication], CV, and words the child produced at each age. The data was then converted to a rate per minute ratio. The results show that from the prelinguistic to the linguistic level, the children’s average rate of CA overall increased from 1.94 to 3.08; PD from 18.86 to 19.45; words from 0.46 to 2.66 and both CV and PI decreased from 0.39 to 0.36 and 0.21 to 0.00 respectively. Results indicate that when compared to typically developing children, children with cleft lip and/or palate demonstrated delays when transitioning from prelinguistic to the linguistic level in rates of CA, CV, and words. This study did not show a significant correlation between CA at the prelinguistic level and word use at the linguistic level. When compared to the study of typically developing children conducted by Proctor-Williams, Dixon, Brown, Ringley, Barber, and Light-Newell (2007), the participants in this study demonstrated a delayed progression in the rate of CA, CV and word acquisition. Scores for PI and PD were not found to be statistically different across age groups for children with cleft lip and/or palate. Measurement of rates of CA at the prelinguistic level could assist clinicians in better assessing early communicative development in children with cleft lip and/or palate beyond traditional measures of vocalization. While this study did not find a significant difference between prelinguistic CA and linguistic CDI, CV, and words, a study with more participants is necessary to identify potential predictive relationships. This study identified differences in rates of CA, CV, and words, which suggest that early delays are not restricted to developmental parameters associated with sound production. Future studies should also incorporate testing at closer age intervals to more specifically determine their development and provide a better indication of rates of CA and CV per minute.


Johnson City, TN

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