Are Vowels Normalized After Maxillary Osteotomy? An Acoustic Study in Cleft Lip and Palate.

BACKGROUND: Maxillary hypoplasia is a common skeletal condition in cleft lip and palate (CLP). Maxillary osteotomy is typically used to reposition the maxilla in CLP with maxillary hypoplasia. Previous studies have suggested that vowel articulations are adjusted postsurgically due to altered vocal tract configuration and articulatory reorganization. This acoustic study aims to investigate whether vowels are normalized postoperatively and to explore the nature of articulatory reorganization. METHODS AND PROCEDURES: A prospective study was conducted to examine the vowel production of a group of individuals with CLP (N = 17) undergoing maxillary osteotomy and a group of normal controls (N = 20), using speech acoustic data. The data were collected at 0 to 3 months presurgery (T1), 3-months (T2), and 12-months (T3) postsurgery. General linear model repeated measures and independent t-tests were undertaken on F1, F2, and vowel space area. RESULTS: General linear model repeated measures revealed no main effects of time for F1 (F [2, 22] = 1.094, P = 0.352), F2 (F [2, 22] = 1.269, P = 0.301), and vowel space area (F [2, 28] = 0.059, P = 0.943). Independent t-tests showed statistically significant differences (P < 0.05) for all acoustic parameters and all vowels between the CLP and the normal groups at all time points. CONCLUSIONS: Vowels were not normalized after maxillary osteotomy despite positive anatomical changes within the oral cavity. Individuals with CLP tended to adjust their vowel articulatory gestures to match presurgical patterns. The nature of articulatory reorganization appears to be prompt, sensory-driven, complete, and permanent.

Computerised Handwriting Speed Test System (CHSTS): Validation of a handwriting assessment for Chinese secondary students.

BACKGROUND/AIM: Handwriting difficulties can be detrimental to students' performance in school tests and even in public examinations. It is crucial for school-based occupational therapists to identify students with handwriting difficulties and support them with appropriate adaptive strategies. The purpose of this study is to validate a computerised assessment - the Computerised Handwriting Speed Test System (CHSTS) of both Chinese and English handwriting for Chinese secondary students and provide an objective reference for extra time allowance in paper-based examinations. METHODS: The internal consistency, test-retest reliability, convergent and discriminant validity of CHSTS were examined using the data from 512 typically developing students and 64 students with special educational needs (SEN) in Hong Kong mainstream secondary schools. RESULTS: Handwriting performance of senior students was better than that of junior students. High internal consistency was shown by over 0.80 Cronbach's α in all measurement items and over 0.90 item-total correlations in temporal domain items. Intra-class correlation indicated good to excellent test-retest reliability of CHSTS (all P < 0.0001). Principal Component Analysis revealed that four components in CHSTS accounted for over 80% of the variance. Handwriting performance was positively associated with manual coordination, automaticity and oculomotor control (all P < 0.05) in linear regression analyses. Students with SEN could be effectively differentiated from typically developing students (over 75% sensitivity and specificity) based on the CHSTS items. CONCLUSION: Validation of CHSTS is the groundwork for identifying students with handwriting difficulties and providing adaptive strategies including fair special examination arrangements for these students.

The Relationship Between Sensorimotor and Handwriting Performance in Chinese Adolescents with Autism Spectrum Disorder.

Impaired sensorimotor control, as a common feature of autism spectrum disorder (ASD), could be a driving factor to handwriting problems. This study examined the Chinese and English handwriting and sensorimotor skills of 15 ASD and 174 typically developing Chinese adolescents. Participants with ASD had lower writing speed and poor manual dexterity (MD) than the typically developing participants. MD was a significant mediator between ASD and handwriting speed. Ground time and airtime represent the length of time when the pen touches the paper and is held in air, respectively. Participants with ASD who had better performance in MD showed shorter ground time in Chinese handwriting and shorter airtime in English handwriting. Training for adolescents with ASD on their MD may improve their handwriting performance.

Handwriting assessment to distinguish comorbid learning difficulties from attention deficit hyperactivity disorder in Chinese adolescents: A case-control study.

OBJECTIVES: Attention deficit hyperactivity disorder (ADHD) and learning difficulties (LDs) are proposed as 2 overlapping disorders. The objective of this study was to investigate the handwriting performance in ADHD and comorbid ADHD-LD adolescents. METHODS: The study examined the Chinese and English handwriting performance and sensorimotor skills of 32 ADHD, 12 ADHD-LD, and their matched controls. RESULTS: Participants with ADHD had comparable writing time and speed, but the readability was lower than their controls. Participants with ADHD-LD had lower writing speeds in both Chinese and English handwriting than their controls. The ADHD and ADHD-LD groups also showed larger variations in either speed or pen pressure than their controls. Chinese handwriting assessment effectively classified ADHD and ADHD-LD with good sensitivity and positive predictive value. CONCLUSIONS: Clinicians should be aware of the fundamental difference between the 2 disorders and make good use of handwriting assessment as a reference to deliver effective therapies and trainings.