Velopharyngeal Function During Oral Sound Production in Healthy Children

描述（申请人提供）：舌咽部是语音产生机制的关键组成部分。当成年人说话时，舌咽部大部分时间是闭合的，尤其是在发出口音（非鼻音）时。相反，当很小的婴儿发出声音时，腭咽通常是张开的。令人惊讶的是，舌咽部持续关闭以发出声音的年龄仍然不为人所知。本申请中提出的研究旨在纵向跟踪健康儿童，直到观察到一致的腭咽闭合。它将解决以下具体目标：(a)确定口音产生时始终发生腭咽闭合的年龄；(b)确定语音、语言和/或运动变量是否有助于解释儿童和儿童之间在口腔发声过程中腭咽功能的差异。该研究将包括60名儿童（男女人数相等），从4个月开始，每月进行一次观察，直到连续观察3个月。舌咽部的状态（打开或关闭）将使用无创空气力学方法（在我们的实验室开发）来确定，该方法包括监测与声信号相关的鼻气压。根据孩子当时的年龄，可以通过玩具、面部表情、绘本、模仿和语言探测来激发孩子发声/说话。在每次会议期间，还将获得反映儿童语音曲目，表达和接受语言技能以及运动发展的措施，并将用于帮助解释年龄之外的任何变化。这项研究的结果将回答一个对理解正常语言发展至关重要的问题（“在什么年龄，腭咽部会持续关闭以发出语音？”）。通过这样做，它还将为未来对有腭咽功能损害风险的婴儿（例如已知或怀疑有神经运动障碍的婴儿）的研究奠定基础，并为最终应用于此类婴儿的临床评估和管理奠定基础。

DESCRIPTION (provided by applicant): The velopharynx is a critical component of the speech production mechanism. When adults speak, the velopharynx is closed most of the time, especially during oral (nonnasal) sound production. In contrast, when very young infants produced sound, the velopharynx is usually open. Surprisingly, the age at which the velopharynx closes consistently for oral sound production is still not known. The study proposed in this application is designed to follow healthy children longitudinally until consistent velopharyngeal closure is observed. It will address the following specific aims: (a) to determine the age at which velopharyngeal closure occurs consistently for oral sound production; and (b) to determine if phonetic, linguistic, and/or motor variables help to explain differences in velopharyngeal function during oral sound production within and among children. The study will include 60 children (equal numbers of boys and girls), beginning at age 4 months, with observations being made monthly until consistent closure is observed for 3 consecutive months. The status of the velopharynx (open vs closed) will be determined using a noninvasive aeromechanical approach (developed in our laboratory) that involves the monitoring of nasal air pressure in relation to the acoustic signal. Vocalizations/speech will be elicited using toys, facial expressions, picture books, imitation, and verbal probes, depending on the age of the child at the time. Measures reflecting the child's phonetic repertoire, expressive and receptive language skills, and motor development will also be obtained during each session, and will be used to help explain any variability not accounted for by age. The results of this study will answer a question that is fundamental to the understanding of normal speech development ("At what age does the velopharynx close consistently for oral sound production?"). By doing so, it will also lay the groundwork for future research on infants who are at risk for impairment of velopharyngeal function, such as those with known or suspected neuromotor disorders, and for eventual application to clinical evaluation and management of such infants. PUBLIC HEALTH RELEVANCE: When adults speak, the back of the nose is closed off from the mouth (except for nasal sounds like 'm') by a valve in the back of the throat called the velopharynx, whereas when very young infants make sounds, they usually leave the velopharynx open. This study will determine when the infant (or young child) learns to close the velopharynx for speech production. This is important to understanding normal speech development, but more importantly, it is critical to being able to identify infants who are developing abnormally so that they can be offered early treatment.