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Phonological development in children with obstructive sleep-disordered breathing

Inger Lundeborg1, Anita McAllister, Christina Samuelsson

  • 1Division of Speech and Language Pathology, Linköping University, Sweden.

Clinical Linguistics & Phonetics
|November 4, 2009
PubMed

Insights

Obstructive sleep disordered breathing (OSDB) significantly impacts children's phonology. Both total tonsillectomy and tonsillotomy improve speech, but the gap with healthy peers persists.

Area of Science:

  • Pediatric Otolaryngology
  • Speech-Language Pathology
  • Sleep Medicine

Background:

  • Adeno-tonsillar hypertrophy causing obstructive sleep disordered breathing (OSDB) is prevalent in children.
  • OSDB negatively affects oral-motor function, behavior, and academic performance.
  • Adeno-tonsillectomy (total or partial) is a common surgical intervention for OSDB.

Purpose of the Study:

  • To compare the effects of total tonsillectomy (TE) versus tonsillotomy (TT) on phonological outcomes in children with OSDB.
  • To assess the impact of OSDB on phonological function.
  • To evaluate changes in oral motor function post-surgery.

Main Methods:

  • A randomized controlled trial involving 67 children (50-65 months) with OSDB, assigned to TE or TT.
  • Phonological assessment pre-operatively and 6 months post-operatively.
  • Comparison with two control groups of children without OSDB.

Main Results:

  • Pre-operatively, 62.7% of OSDB children had phonological deficits compared to 34% in controls (p < .001).
  • Phonological function improved significantly 6 months after both TE and TT, with no difference between surgical methods.
  • Despite improvement, the phonological gap between OSDB children and controls widened post-surgery.
  • Oral motor function normalized irrespective of surgical approach.

Conclusions:

  • OSDB is a significant contributing factor to phonological impairment in children.
  • While both TE and TT improve phonology, they do not fully close the gap with unaffected peers.
  • Oral motor function recovery is independent of the surgical method used for OSDB treatment.

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