Transcript Normalization - Speech

Pacifier Use and Speech Sound Development
ASHA Convention, 2013
Tamara Nagoda, M.S.1 & Peter Flipsen Jr., Ph.D.2
1Idaho
INTRODUCTION
State University, Meridian, ID
METHOD
• Anywhere from 55-80% of infants
may use pacifiers for various periods.
Test Protocol
• Pacifiers may reduce the risk of
SIDS; they may also improve feeding
skills in premature infants.
• Language skills assessed with PPVT-4.
• However, pacifiers may also increase
the incidence of both middle ear
disease and oral myofunctional
disorders such as tongue thrust.
• Studies of pacifier use and speech
development have been mixed to date
(Barbosa et al., 2009; Fox, Dodd, &
Howard, 2002; McNally, 1997;
Schotts, McDaniel, & Neeley, 2008).
Why Might Pacifiers Affect Speech?
1. May influence tooth eruption,
position, and/or alignment?
2. May alter tongue resting posture?
3. May be a link through increased
middle ear disease?
4. Parents and others may be less likely
to initiate communication when
something is in the child’s mouth
(fewer speech models)?
5.Pacifier in mouth may reduce child’s
time to practice speech and/or receive
specific feedback about their speech?
• Speech skills assessed with GFTA-2.
• Oral facial exam.
• Bilateral hearing screening at 25 dB HL.
Participants
• 20 children (11 males; 9 females) age 41-64
months. Referred by parents or local SLPs.
• No other known concerns. All passed oral
facial exam and hearing screening. All scored
at least 85 on PPVT-4.
TD Group: n = 15 (7 males; 8 females);
achieved standard scores of 93+ on the GFTA-2.
SD Group: n = 5 (4 males; 1 female);
achieved standard scores of <82 on GFTA-2.
2Pacific
Chicago, IL
University, Forest Grove, OR
RESULTS
DISCUSSION
• Overall, use of pacifiers was reported for 13/20
(65%) participants. This is consistent with
published reports.
• Small sample size likely precluded finding
any group effects.
• Pacifier use was reported for 2/5 in the SD
Group and 11/15 in the TD Group. No
significant difference (Chi-square p = .1760).
• Trend in Figure 1 suggests dose effect for
TD children. Longer use of pacifiers may
result in lower speech skill scores.
• Months of pacifier use was 6-8 months for the
SD Group and 5-48 months for the TD Group.
No significant difference (MW p = .1671).
• Daytime (awake) use was reported for 1/2 in the
SD Group and 7/11 in the TD Group. No
significant difference (Fisher Exact p = 1.000).
• Data on average hours of pacifier use were
available for the 7 daytime users in the TD
group but not for the one SD participant who
used a pacifier.
• Total dose of pacifier use (hours/day X months
of use) are plotted against GFTA-2 scores for
the 7 TD participants in Figure 1.
• Note: outlier in lower left of Figure 1
was the only child where thumb sucking
was reported. Stopped using pacifier
early on but may have substituted thumb.
Barbosa et al. (2009) suggested thumb
sucking may also affect speech.
• Additional study with larger samples clearly
indicated.
References
Barbosa, C., Vasquez, S., Parada, M. A., Gonzalez, J. C. V., Jackson,
C., Yanez, N. D., Gelaye, B., & Fitzpatrick, A. L. (2009). The
relationship of bottle feeding and other sucking behaviors with speech
disorder in Patagonian preschoolers. BMC Pediatrics, 9, 66.
Parent Survey
Fox, A.V., Dodd, B., & Howard, D. (2002). Risk factors for speech
disorders in children. International Journal of Language &
Communication Disorders, 37(2), 117-131.
• Did child use a pacifier or suck thumb or
fingers?
McNally, J. (1997) Speech development and dummy sucking and
other comfort habits. Health Visitor, 70(5), 191-193.
• If pacifiers were used, at what age did they
start and stop?
• Were pacifiers used at naptime/bedtime only
or also during the day (i.e., when awake)?
•
If daytime use, approximately how many
hours per day of use on average?
Shotts, L. L., McDaniel, D. M., & Neeley, R. A. (2008). The impact
of prolonged pacifier use on speech articulation: A preliminary
investigation. Contemporary Issues in Communication Science and
Disorders, 35, 72-75.
Acknowledgments
Many thanks to Jeanne Johnson, Diane Ogiela, and Judith
Crews for their assistance with the project. Thanks especially to
the children who participated and their parents.