DEVELOPMENT OF EXPRESSIVE VOCABULARY AND GRAMMAR IN YOUNG CHILDREN WITH REPAIRED CLEFT PALATE, CHILDREN WITH A HISTORY OF OTITIS MEDIA, AND CHILDREN WITH TYPICAL DEVELOPMENT Public Deposited

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  • March 21, 2019
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  • Eshghi, Marziye
    • Affiliation: School of Medicine, Department of Allied Health Sciences, Division of Speech and Hearing Sciences
Abstract
  • This Dissertation composes of two related studies. Study1 aimed to investigate the expressive vocabulary skill of 40 children with repaired cleft palate (CP), 29 children with histories of otitis media (OM), and 25 typically developing (TD) children at 18 and 24 months of age and compared the three groups in terms of the vocabulary growth from 18 to 24 months of age. In addition, the contribution of factors such as hearing level, tympanogram status, size of consonant inventory, maternal education level, and gender to the development of expressive vocabulary was explored. The purpose of the second study was to examine the lexical-grammatical skills of 26 children with CP with consistent velopharyngeal (VP) closure, 27 children with OM, and 20 TD children at two years of age. Further, the association between early vocabulary skills and grammatical attainment as well as the precursors of early lexical-grammatical development were explored. The MacArthur Communicative Development Inventory: Words and Sentences (CDI-WS; Fenson et al., 2007) was employed to measure the size of vocabulary as well as the grammatical ability of children in the three groups. Consistency of VP function was made objectively through nasal ram pressure (NRP) monitoring. For the second study, however, NRP data for four children with CP were missing and assessment of VP function was based on perceptual judgments. Because these studies are part of a larger longitudinal study, sound-field audiometry screenings were performed at 12 and 24 months of age. Bilateral tympanogram data were obtained at 18 and 24 months of age. Results of the first study showed that children with CP produced a significantly smaller number of words at 24 months of age and a significantly slower rate of vocabulary growth from 18 to 24 months of age when compared to TD children (p< 0.05). The observed difference remained significant when the model was adjusted for the effect of hearing level, tympanogram status, size of consonant inventory, and sociodemographic variables. However, among all variables, only the tympanogram status significantly predicted the vocabulary growth from 18 to 24 months of age across the three groups. Findings of the second study revealed significant differences among the three groups with respect to the size of vocabulary and mean number of morphemes in their three longest utterances (M3L). The difference between CP and TD groups remained statistically significant when adjusting singly for hearing level, tympanogram status, and gender. Further, significant positive associations were found between the number of words and M3L and sentence complexity in each group (p< 0.05). Weak performance of children with CP on measures of expressive vocabulary and grammar were accounted for by poorer hearing levels, more frequent instances of abnormal tympanogram status, as well as lower levels of maternal education. Findings highlighted the importance of comprehensive speech and language assessments to identify children with CP who need intervention services as early speech and expressive language management has the potential to considerably mitigate the effects of later language delays.
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Advisor
  • Crais, Elizabeth
  • Zajac, David
  • Watson, Linda R.
  • Harrison, Melody
  • Preisser, John
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2018
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