(Kummer, 2011). For example, in the Farsi data /z/ is affected by interdental articulation, palatal articulation, backing, pharyngeal articulation, glottal articulation, active nasal fricative, weak nasalized articulation, nasal realisation of fricative, gliding of fricative. In a clinical context, oral examination and instrumental investigation and hearing assessment would help to determine whether a particular child’s substitutions could be directly attributed to structural abnormalities associated with the cleft palate, to hearing loss or to developmental phonological difficulties. Analysis of the speech data facilitated identification of possible contributing factors and co-existing conditions. Maintaining the distinction between CSCs and non-cleft developmental patterns in this study facilitated the identification of aspects of speech that were not cleft related and might benefit from other management. For example, the lateral realisation of the target tap/trill in the current study was observed in the speech of four children. As lateral articulation/lateralisation as a cleft speech characteristic was not seen in their realisation of any other consonants, this type of articulation is most likely related to typical phonological development in Farsi. It is suggested that this pattern need not therefore be a priority in intervention because this is age appropriate. This pattern was found in the speech of typically-developing children who are the same age as the cleft group in this study. 10.3.4 Factors affecting take-up of speech therapy in Iran Although all the children in the cleft group had had palatal surgery several years before their speech was assessed for this study, most of them still showed residual speech difficulties which are related to cleft palate. As suggested in the previous section, use of the Farsi GOS.SP.ASS may help in more accurate assessment of the child’s speech difficulties as a basis for effective intervention. Speech therapy sessions are likely to be beneficial for such children, on the assumption that they attend regularly (Smith & Guyette, 2004; Persson 2006). However, in Iran et al., attending speech therapy sessions on a regular basis is not easy for children who live far from the capital city. Additionally, there are not enough hospitals that provide
(Kummer, 2011). For example, in the Farsi data /z/ is affected by interdental articulation, palatal articulation, backing, pharyngeal articulation, glottal articulation, active nasal fricative, weak nasalized articulation, nasal realisation of fricative, gliding of fricative. In a clinical context, oral examination and instrumental investigation and hearing assessment would help to determine whether a particular child’s substitutions could be directly attributed to structural abnormalities associated with the cleft palate, to hearing loss or to developmental phonological difficulties. Analysis of the speech data facilitated identification of possible contributing factors and co-existing conditions. Maintaining the distinction between CSCs and non-cleft developmental patterns in this study facilitated the identification of aspects of speech that were not cleft related and might benefit from other management. For example, the lateral realisation of the target tap/trill in the current study was observed in the speech of four children. As lateral articulation/lateralisation as a cleft speech characteristic was not seen in their realisation of any other consonants, this type of articulation is most likely related to typical phonological development in Farsi. It is suggested that this pattern need not therefore be a priority in intervention because this is age appropriate. This pattern was found in the speech of typically-developing children who are the same age as the cleft group in this study. 10.3.4 Factors affecting take-up of speech therapy in Iran Although all the children in the cleft group had had palatal surgery several years before their speech was assessed for this study, most of them still showed residual speech difficulties which are related to cleft palate. As suggested in the previous section, use of the Farsi GOS.SP.ASS may help in more accurate assessment of the child’s speech difficulties as a basis for effective intervention. Speech therapy sessions are likely to be beneficial for such children, on the assumption that they attend regularly (Smith & Guyette, 2004; Persson et al., 2006). However, in Iran attending speech therapy sessions on a regular basis is not easy for children who live far from the capital city. Additionally, there are not enough hospitals that provide
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