Intl J Lang Comm Disor - January 1996 - Stokes - Speech Error Patterns in Cantonese Speaking Children With Cleft Palate

European Journal of Disorders of Communication, 31,4564,1996 45
0 Royal College of Speech and Lunguage Therapists, London
Speech error patterns in Cantonese-speaking

children with cleft palate
Stephanie F. Stokes and Tara L. Whitehill
D e p a m n t of Speech and Hearing Sciences, University of Hong Kong, Hong Kong
ABSTRACTS
The subjects were seven Cantonese-speaking children with repaired clefi palate, aged between 3;2
and 10;2. Speech samples were obtained b y use of two word lists. Error patterns were described
b y use of a detailed analysis based on perceptual judgements. A ‘confusion matrix’ was con-
structed f o r each subject to illustrate the relative frequency of error type. The results showed high
within-subject and across-subject variability. The data partially support findings from other lan-
guages, f o r example, showing posterior placement for alveolar targets. However, some language-
specific errors were identified, such as initial consonant deletion. Four possible explanations for
the data are discussed.
Comme locuteurs l‘on a pris sept enfants dgts entre 3:2 ans et 10:2 ans, de langue maternelle can-
tonaise et dont les palais fendus avaient t t t rtparts. L’on a obtenu des tchantillons parlts au
moyen de listes de groupes de deux mots. L’on a dtcrit les types d’erreurs grdce d une analyse
dttaillte fondte sur des jugements perceptifs. L’on a construit une matrice de confusion pour
chaque locuteur afin d’illustrer les frtquences relatives des types d’erreurs. Les rtsultats ont. rtvtlt
une forte variabilitt au sein de chaque sujet et de locuteur a locuteur. Les donntes confirment en
partie les rtsultats en provenance d’autres langues, q u i montrent des lieux d’articulation
posttrieurs pour les cibles alvtolaires. Cependent, l’on a identifit aussi certaines erreurs propres
au cantonais, cornme la suppression de consonnes intiales. L a discussion porte sur quatre explica-
tions possibles des donntes.
Die Sprecher waren sieben kantonesischsprechende Kinder mit opereirten Gaumenspalten im
Alter zwischen 3; 2 und 10;2 Jahren. Das Sprachmaterial wurde mit zwei wortlisten definiert. Die
Fehlermuster wurden in einer detaillierten auf perzeptueller Beurteilung basierten Analyse eqahg
Fur jede(n) Sprecherln wurde die relative Haufigkeit der Fehlerarten in einer individuellen
Fehlennatrix dargestellt. A u s den Ergebnissen wurde starke Intra- und Intersprechervariabilitat
deutlich. Die Daten unterstiitzen z. T. Beobachtungen an anderen Sprachen; z.B. die Riickver-
Iagerung bei alveolarer zielposition. Einige sprachspezifische Fehler wurden jedoch beobachtet;
2.B. die Tilgung initialer Konsonanten. Veir mogliche Erklarungen fiir die Beobachtungen wer-
den erortert.
Key words: cleft palete, phonological analysis, Cantonese.
INTRODUCTION
Investigations studying the speech of children with cleft palate have identified
problems in the areas of resonance, nasal emission, and articulation. Reports
on articulation have shown that the manner classes most affected are plosives,
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46 STOKES AND WHITEHILL
fricatives and affricates, and that posterior articulatory placement (including

pharyngealisation, velarisation and glottalisation) is favoured (see Grunwell,
Sell & Harding, 1993, pp. 6-18; McWilliams, Morris & Shelton, 1990 for a
review). Double articulations, for example, simultaneous alveolar and velar
contact (Stengelhofen, 1989, pp. 1-30) and bilabial and velar contact (Gibbon
& Hardcastle, 1989) have also been recorded.
Such patterns have been attributed to several physiological factors: poor
velopharyngeal closure; dental malocclusion; oral-nasal fistulae; nasal obstruc-
tion; hearing impairment, and faulty somatesthesia (McWilliams et al., 1990).
Other factors include: delayed phonological development; phonological disor-
der (Russell & Grunwell, 1993, pp. 19-47); delayed maturation and faulty
learning (Bzoch, 1979, pp. 161-191). It is possible that, for at least some chil-
dren, there is overlap between physiological and other factors. For example,
misarticulations that appear to be due to a phonological delay may have had
structural deficits as a contributing factor (Albery & Grunwell, 1993, pp.
83-111; Chapman, 1993). Although common patterns and probable aetiologies
have been identified, methodological differences have made between-study
comparisons risky (Russell & Grunwell, 1993, pp. 1947).
Methods of analysis and description of error patterns have varied (see
McWilliams et al., 1990, for a review). Early studies used quantitative data
reduction techniques to identify phonetic features in large samples (e.g. Mor-
ley, 1970; Bzoch, 1979, pp. 161-191); whereas recent studiest (e.g. Hodson, Chin,
Redmond & Simpson, 1983; Albery & Russell, 1990, pp. 63-82; Chapman,
1995; Powers, Dunn & Erickson, 1990; Russell & Grunwell, 1993, pp. 19-47)
have provided detailed phonological analyses for a small number of subjects.
Although these recent developments have resulted in valuable descriptions of
cleft palate speech the isolation of physiological or psycholinguistic explana-
tions of the nature of the disability remain elusive. Recent developments in
instrumental techniques (such as electropalatography (EPG), for example,
Fletcher, 1985) may further contribute to description, and possibly explanation
of the disability. In addition to different methods of data collection and analy-
sis, cross-linguistic studies may contribute to our understanding of the disability
by isolating language-dependent phonetic and phonological differences (Hut-
ters & Brondsted, 1987).
The need for cross-linguistic studies of cleft palate speech has been recognised
(Hutters & Brondsted, 1987; Grunwell, 1993, pp. 1-5), although there have been
few such studies. Exceptions are Van Demark (1974), who investigated the rela-
tionship between velopharyngeal closure and articulatory accuracy in Danish
and American children, and the Eurocleft Speech Group (1993, pp. 142-165),
which described speech patterns of individuals with cleft palate across five Euro-
pean languages. Other investigators have identified patterns in specific lan-
guages. For example, Ainoda, Yamishita and Tsukada (1985) reported on
Japanese; Hutters and Brondsted (1987) reported on Danish; Wu, Chen and
Noordhoff (1988) reported on Mandarin Chinese; Sell and Grunwell (1993, pp.
112-141) reported on Sinhala, but all made few cross-linguisticcomparisons
Because little is known about language-specific and language-universal pat-
terns in the speech patterns of people with cleft palate, the purpose of this
study was to describe the error patterns of Cantonese-speaking children with
CANTONESE CHILDREN: SPEECH ERROR PATTERNS 47
cleft palate and to compare these patterns with those reported for other lan-
guages. This necessitated a brief review of the Cantonese phonological system
and normal developmental patterns.
The Cantonese phonological system is described in Cheung (1986), Zee
(1991), and Tse (1991). The system differs from English on four major dimen-
sions: phonotactic structure, contrastive segments, aspiration, and tone. The
phonotactic structure is relatively simple and consists of (Consonant and/or
Glide) Vowel (Consonant). The predominant structures are C(G)V/C(G)VC.
(See the Appendix for examples.)
Table 1 shows the segments that occur at initial and final positions in the
phonotactic structure. All Cantonese stops are unvoiced, and have aspirated and
unaspirated cognates (Tse, 1991). There are only two clusters, /khw/and /kw/.
Table 1: Segments that occur at initial and final positions in the Cantonese phonotactic structure
~~~~
Labial LabDen* Alveolar Palatal Velar Glottal
Initials
Nasal m n D
Plosives P Ph t th k kh
Labiaiise kw khw
Affricate ts tsh
Fricative f S h
Glides W j
Liquids I
Finals Iml, Inl, Id, lp’l, lt’l, lk’l
*LabDen = Labiodental.
The description of final segments is controversial. In Zee (1991), the finals

include diphthongs, whereas Cheung’s (1986) system classified these segments
as glides. Here, Zee’s (1991) system is adopted. The number of segments that
occur initially and finally in Cantonese is considerably smaller than that of
English. There are 19 initial segments and six finals.
According to Zee (1991), there are 11 vowels (i, y, E , 3 ce,D, u, u, e, $1) and
10 diphthongs ( a ~i,, au, DU,ei, ey, 3i, ui, iu, ou).
Cantonese is a lexical tone language. That is, contrastive meaning is addi-
tionally carried by tone. Again, the number of contrastive tones is controver-
sial. For example, Zee (1991) describes nine tones, and Cheung (1986), six.
Normal Cantonese-speaking children typically master the vowel and tone
systems by 2 years of age (Tse, 1991). Phonological errors in normally develop-
ing children occur up to the age of 4 years (So & Dodd, in press). Phonological
processes are similar to those of English-speaking children, and are both struc-
tural (e.g. cluster reduction) and systemic (e.g. deaspiration, stopping and
fronting). Some patterns that would be considered uncommon in English are
normal in developing Cantonese: affrication of fricatives (e.g. [ts] for M), and
fronting of /kw/ to [p]. Other processes affecting syllable structure (final conso-
nant deletion and assimilation) do not usually occur in normal development,
due to the phonotactic structure of Cantonese (So & Dodd, in press).
METHOD
Subjects
The subjects, participants in a larger study, were seven Cantonese-speaking
children with repaired cleft palate referred by the University cleft palate team
to the speech-language clinic for assessment. The mean age was 7;7, with a
range of 3;2-10;2. The age of surgical repair varied, with a range of 12-24
months. Three subjects had residual alveolar clefts (or fistulae) awaiting later
secondary bone grafting. Five of the subjects had had previous speech therapy.
Biographical data are shown in Table 2.
Table 2: Subjects’biographical data
Subject
CSY LYM SHW HMC LWK KHS KYM
Age 9;3 10;2 78 5;8 9;lO 8;l 3;2

Type of cleft UCLP PSP UCLP UCLP UCLP UCLP UCLP
Age of palate repair 12 12 24 12 16 12 22
Res cleft No N/A Yes Yes No Yes No
Resonance MOD WNL MOD MOD WNL WNL WNL
Nasometer WSEV MOD MAR WSEV WNL WNL WNL
Dental I11 X/B 111 111 111 I11 111
Hearing 1 WNL 2 3 4 WNL WNL
Language WNL WNL WNL WNL WNL WNL WNL
Voice WNL WNL WNL WNL WNL WNL WNL
Prior therapy Yes Yes Yes No Yes Yes No
Other OM - PHAR VPI -
UCLP = Unilateral cleft lip and palate; PSP = Partial cleft of the soft palate; MOD = Moderate;
WNL = Within normal limits; WSEV = Moderatelsevere; MAR = Marginal; X/B = cross bite; I11
= Class 111 malocclusion; 1 = (L)+(R) failed 250 Hz and 500 Hz; 2 = (R) normal, (L) failed 250
Hz;3 = (L) failed 250 Hz and 500 Hz; 4 = (L) normal, (R) failed 250 Hz and 500 Hz; OM = Otitis
media; PHAR = Pharyngoplasty; VPI = Nasendoscopy showed mild velopharyngeal incompe-
tence: Res Cleft = Residual cleft.
Data Collection
Speech data were recorded on a Sony TCD-D3 Digital (DAT) tape recorder
and an AKG C525S microphone. Each assessment was videotaped and
included administration of the Cantonese Segmental Phonology Test (So,
1992), the Cantonese Electropalatography Protocol (EPG) (Whitehill &
Stokes, 1993, adopted from Kwok, 1992), assessment of nasalance by use of
the Kay Nasometer 6200 and Cantonese nasometric speech materials
(Whitehill & Chan, 1991), a narrative sample obtained by story telling, and
an oral motor examination. The latter two procedures allowed verification of
normal language development and absence of neuromotor involvement. Sec-
tion 1 of the Cantonese Segmental Phonology Test (So, 1992) is a single-word
picture test of 31 items. The EPG Protocol focused on lingual targets, in
monosyllabic and dissyllabic structures, as a repetition task (see Appendix).
Hearing status was screened across 250-8000 Hz at 20 dB (American
National Standards Institute, 1969). The assessment was completed within
1.5 hours.
Transcription
Each audiotape of the two articulation tests was transcribed by one of two
student speech-language pathologists by use of the International Phonetic
Association narrow phonetic transcription conventions. The authors indepen-
dently re-transcribed each tape. The three transcriptions were compared.
Discrepancies were resolved through discussion which ensured inclusion of
all data.
ANALYSIS
The data were analysed by identifying the phonetic inventory, coding systemic
and structural phonological processes, and coding phonetic errors. Group data
were examined for manner and place of production (see tables 3 and 4 below).
A ‘confusion matrix’ was constructed for each subject (see figures 1-7 below).
Each cell shows the number of productions divided by the number of attempts
at the target, expressed as a percentage. Errors falling below the diagonal show
a more anterior placement, or stopping of fricatives and affricates. Errors
above the diagonal show a more posterior placement, frication of plosives, or
gliding of fricatives or plosives. At the extreme right of the grid is coding of ini-
tial consonant deletion, nasal emission, mid-dorsal stop, and bilabial fricative
production. Only initial segments are described on the matrix as final segments
were rarely in error.
RESULTS
Group Data
The data for all subjects were collapsed to look for group patterns. Table 3
shows the percentage of accuracy of production of phonemes by manner.
Table 3: Percentage of correct productions of consonants by manner of production
Subject* NAS PLO FRI AFF LIQ GLI Av

~
1 100 53 56 59 100 100 78

2 77 60 66 10 36 100 58
3 100 100 33 0 100 100 72
4 100 91 66 50 0 100 66
5 50 81 66 0 0 100 49
6 100 77 100 100 100 100 96
7 100 65 83 90 100 100 89
Av 89 72 67 44 62 100
*Subject number corresponds to the left-to-right sequence of subjects described in Table 2. /3/ is
not included; /hl is.
NAS = Nasal; PLO = Plosive; FRI = Fricative; AFF = Affricate; LIQ = Liquid; GLI: Glide; Av =
Average.
Fricatives and affricates are particularly vulnerable to errors with average

accuracy rates of 67% and 44%, respectively. (If /h/ is removed from the equa-
tion, the accuracy of fricatives is 35%, 50%, 0% , 50%, 50%, 100% and 75%,
50 STOKES AND WHlTEHILL
respectively, with an average of 51%.) However, error patterns are not uni-
form. Only one subject (Subject 2) had a normal developmental pattern of
stopping of /s/ to [t]. Other error patterns of /s/ included: fronting to a bilabial
fricative (maintaining manner of production); lateral production, and posterior
placement either as [h], [@I(a mid-dorsal stop), b] or [k]. The labial fricative
was susceptible to bilabial production (two subjects), and one subject produced
/f/ as [kw].
The affricates were either stopped to alveolar plosive or, like the /s/, under-
went posterior placement to [h], [@],b] or [k].
Alveolar and velar plosive targets were also in error. Although backing (to
[k]) and fronting (to [t]) were the usual errors, one subject affricated the Ith/,
and another fricated it to [s] or [h] variably.
Errors by place of articulation are shown in Table 4. Here, alveolar targets
were susceptible to error, with an average accuracy rate of 56%. Although
labiodental /f/ rates at 64% it should be noted that the inaccuracy occurred in
only two subjects, skewing the results.
Table4: Percentage of correct productions of consonants by place of production
Subject BIL LABD ALV PAL VEL Av
1 100 0 70 100 59 65.8

2 100 100 36 100 10 69.2
3 100 0 57 100 100 71.4
4 100 100 71 100 75 89.2
5 100 100 12 100 100 82.4
6 100 100 82 100 96 95.6
7 100 50 68 100 100 83.6
Av 100 64 56 100 71
Ihl, lwl and Id are not included.

BIL = Bilabial; LABD = Labiodental 1% ALV = Alveolar; PAL = Palatal; VEL = Velar; Av =
Average.
The intersubject variability within the group data reflects the heterogeneity
of this sample, necessitating a case-by-case analysis. Errors are described by
place and manner, and patterns are described as systemic (affecting contrast),
structural (affecting phonotactic structure), or mixed (affecting both).
Individual Data
' Subject 1: CSY (age 9;3)
CSY's grid (Elgure 1) shows a high incidence of errors of alveolar plosives and
affricates, fricatives /f/ and /s/ and the unaspirated velar plosive. Manner errors
were rare, with a much higher incidence of structural processes. There was high
variability in the error patterns for both affricates, both velar plosives, and the
alveolar fricative. The overall pattern was mixed (both systemic and struc-
tural), but the main error patterns were of syllable structure and nasal emis-
sion. It should be noted that CSY had moderate hypernasality as detected by
perceptual judgement and nasometry.
m n I) p’ p t’ t dtc k‘k f 8 h w 1 j 0 OR
m 100
a 100
D 100
# loo
P 100
P 10 3or
t 32 30 3I*
d 9 64 9 I8
11 54 1 42
r 9 82 9
k I 36 1 50
f 0 loob
3 70 18 90
100
100
100
100
&&. 0 = iaitirl oonwmnt dclccion; OR - otha (a = INUIaniuion; b = biLbirlbicrtivc; c = Ltcnl I@.

Figure 1: Confusion matrix - CSY (9;3).
Subject 2: LYM (age 10;2)

The percentage of correct targets shown on the diagonal (Figure 2) reflects dif-
ficulty with aspirated phonemes (/th/,/tsh/ and kh/) and alveolar fricative /s/, as
well as the continuants /n/ and /l/. The error patterns were of both manner and
place. The overall pattern was mixed and variable, with a high incidence of
fronting, backing, deaffrication, and gliding.
Subject 3: SHW (age 7;8)

The diagonal (Figure 3) reflects a high degree of accuracy of production.
Errors were limited to production of affricates and fricatives. The overall pat-
tern reflected backing (to [h] or [$]), fronting (to bilabial fricative), and initial
consonant deletion.
Subject 4: HMC (age 5;8)

As with SHW, there was a high level of accuracy for most phonemes (Figure 4).
Notable features of the system are the gliding of some alveolar targets and
deletion of initial /k/(50%). All other productions were accurate.
Subject 5: LWK (age 9;lO)

Again, there was a high degree of accuracy of production. Figure 5 shows that
the errors were of place and manner, and affected only the alveolar targets.
Note that the alveolar nasal is both denasalised and backed (to b]). The overall
pattern was of backing (to velar and mid-dorsal stop), gliding and deaffrication.
The velar nasal was deleted, but this is a common dialectal pattern.
m n g d p t ' t tlb ts k ' k f s h w l j
m 100
n 55 44
g 100
P' 100
P 100
tb 42 8 16 33
t 100
tsb 71 14 15
tl 94 6
r 100 0
k 80 20
f 100
I 87 13 0
h 100
W 100
1 18 36 45
j 100
Figure 2: Confusion matrix - LYM (10;2).
m n IJ pb p I' t U'U P k I s h w I j 0 O R
rn 100
n 100
'1 100
P' 100
P 100
I' 100
I 100
U
' 0 55 9 36d
U 0 5 2 5 45 Zd
r 100
k loo
f 0 Iwb
I 0 10 3 336
53b
h loo
W
loo
I 100
j loo
&&. 0 = initial c0nH)mt deletion; OR = other (d = mid dorsal stop; b = bMi fiicativc)
Figure 3:Confusionmatrix - SHW (7;s).

m n g p' p I' I IS' tar k f I h w 1 j 0

m 100
n 100
P 100
'P 100
P 100
r 100
I I00
U' 100
U 0 100
k' 100
k 50 50
f I00
1 0 100
h 100
W 100
I 100
j 100
w.0 = initial wnsonant delelion.

Figure 4: Confusion matrix - H M C (5;s).
m n IJ p' p I' i U ' U k' k f I h w I j 0 OR

m 100
n 0 100
1 0 100
P' 100
P 100
P 36 64
I 50 so
U' 0 lood
U 0 lood
r 100
k 100
I 100
s 0
h I00
W 100
I 0 100
j 100
&&. 0 = initial consonant delelion; OR = other (d = mid dorsal stop; c = lateral fricative).
Figure 5: Confusion matrix - LWK (9;lO).
Subject 6: KHS (age 8;l)

There was an overall high degree of accuracy, with posterior placement pre-
dominating as the error pattern for alveolar plosives (Figure 6). However, alve-
olar affricates were produced accurately. The only other error was fronting of
/kh/to [t] (8%).
RodUCCd
m n I) p ' p t' t U' u P k f I h w I j OR

m 100
n 100
P 100
d 100
P loo
t' 33 47 206
t 42 38 2od
d loo
u 100
k' 8 92
k loo
f 100
I 100
h 100
W 100
1 100
100
j
&&.OR = other (d = mid d o d stop).

Figure 6c Confusion matrix - KHS (&l).
Subject 7: KYM (age 3;2)

The error patterns were variable (Figure 7). The overall pattern was one of
backing and frication (to [k], [s] and [h]) of some alveolar targets. Note that
aspirated segments (/th/and Itsh/)were fricated (to [s]. [h]), whereas the unaspi-
rated segment (/t/) was not ([k]). The labiodental fricative /f/ was produced as
[kw] for 50% of attempts.
Summary
Subject 1 used predominantly structural simplification (initial consonant dele-
tion); subjects 3 and 4 had mixed structural (initial consonant deletion) and sys-
temic simplifications; all other subjects had systemic simplifications.
DISCUSSION
There were four main findings from the study. These pertained to manner and
place of articulation, structural processes, and variability. These findings are
described in the context of previous literature followed by an explanatory dis-
cussion.
W I j 0 O R
100
100
100
0 33 66
0 100
80 20
100
100
100
SO SOC
100
100
100
100
&&. 0 = initkloo~~tunt
(c = /u->/hvn.
dc*cion; OR - other
Figure 7: Confusion matrix - KYM (3;2).
Firstly, the manner classes most affected in this Cantonese-speaking sample

were plosives, fricatives, and affricates, as occur in English (McWilliams et al.,
1990). Affricates were the most vulnerable which concurred with Mandarin
data (Wu et al., 1988). Error patterns for fricatives did not exactly mirror the
English data. Bilabial fricative realisations for /s/ and /f/ were noted; /s/ was
also backed to palatal or velar placement, which also tended to be fricative in
manner. Whilst the backing processes have been noted in other languages, the
occurrences of bilabial fricatives has been mentioned infrequently.
Secondly, posterior placement was favoured. The speech of children with
cleft palate has been characterised by posterior placement (Trost, 1981; Ain-
oda et al., 1985; Wu et al., 1988; McWilliams et al., 1990;). The errors identi-
fied in this sample are similar to those identified in other languages. Ainoda et
al. (1985) reported that early in development (before age 2) Japanese children
with cleft palate had a preponderance of glottal stops for alveolar targets;
after 2 and before 4 years of age palatalisation was the main error. They found
that 70% of their subjects had palatalised articulation, and cited Okazaki's fig-
ure of 59% (Okazaki, 1982, cited in Ainoda et al., 1985). Similarly, Albery and
Grunwell (1993, pp. 83-11 1) reported that secondary articulation errors still
evident at 10 years of age were usually palatisation or lateralisation. Our
group data show significant posterior placement but only for alveolar targets.
The most common realisation was palatal, although manner was diverse and
included glides and stops. Although posterior placements were noted for alve-
olars, velar substitutions did not dominate, and pharyngeal productions were
absent.
Thirdly, there was a high incidence of initial consonant deletion. Final con-
sonant deletion rarely occurred in our sample and is relatively rare in normal
Cantonese-speaking children after the age of 2 (So & Dodd, in press), unlike
English (Grunwell, 1981). However, three of the seven children had substan-
tial initial consonant deletion, which is rarely reported in the developmental
literature, although Dean, Howell, Hill and Waters (1990) list it as an unusual
developmental process in their Metaphon package. Exceptions in the cleft
palate literature are Lynch, Fox and Brookshire (1983), Hodson et al. (1983),
and Powers et al. (1990), all of whom reported initial consonant deletion for
one subject. The subject of Lynch et al. (1983) had incident rates of 20% dele-
tion of initial dental fricatives, and 19% of initial alveolar targets. Hodson et
al. (1983) reported 42% deletion of prevocalic obstruents, and Powers et al.
(1990) reported 19 incidences of deletion, although relative rate was not
reported. Unfortunately, there was no explanation as to why these deletions
occurred.
The subjects in our sample omitted a wide variety of initial consonants,
although no subject deleted any one consonant consistently. Given that the
subject of Powers et al. (1990) also had much lower rates of systemic errrors
(for example, no backing), the relative occurrence of systemic and structural
errors needs further investigation in this population. Stokes (1993) identified
categories of systemic and structural disorders in a study of preschool chil-
dren (who did not have cleft palate), and it is possible that these children
with structural deficits also show characteristics of these categories of
disability.
Fourthly, there was a high degree of within-subject variability as shown in
figures 1-7. Most variability occurred for alveolar targets. For example, one
subject’s production of /s/ was as variable as stopping (to [t]) and stopping and
backing (to [k]). Harding and Grunwell (1993, pp. 48-82) reported a high
degree of variability in /s/ production, limited to minor phonetic deviations, of
a fricative-type. Clearly, the patterns in this sample cannot be considered minor
phonetic variations. Other studies have reported variability in production
(Hardcastle, MorganBarry & Nunn, 1989, pp. 136-164; McWilliams et al., 1990;
Gibbon, Dent & Hardcastle, 1993; Russell & Grunwell, 1993, pp. 19-47) dis-
cussed below.
Explanations for the nature of cleft palate speech have included develop-
mental delay, phonological disorder, physiological limitations, and habituated
patterns.
Developmental Delay
Given the age of most of the subjects, it would be difficult to claim that the
articulatory errors reflect delayed phonological development. Most children
(who do not have a cleft palate) with isolated phonological delays outgrow the
condition (Bishop & Edmundson, 1987). It is unlikely that the velarised pro-
ductions of alveolar targets reflected a developmental delay, as Albery and
Grunwell(l993, pp. 83-111) stated that this process at 5 years of age is proba-
bly due to the cleft condition. As six of the seven subjects here were aged
approximately between 5;O-10;0, it is unlikely that the pattern reflects a devel-
opmental delay, that is, following a normal, albeit slow, pattern.
phono/ogica/Disorder
me patterns identified here are, in general, not similar to disordered phonol-
ogy. Most Cantonese-speaking phonologically disordered children show pat-
terns of disability similar to English-speaking children, with the exception of
structural errors, The occurrence of posterior placement errors and unusual
maintenance of frication do not concur with most of the disordered patterns
identified by So and Dodd (1992, pp. 356-361). Of 17 subjects these authors
found one who had difficulty with alveolar targets, and variability in produc-
tion. They suggested that the child may have ‘a deficit in the planning of
sequences of fine motor movements for speech production’ (So & Dodd,
1992, p. 360). This suggests that the problem may be at the phonetic level
identified by Hewlett (1985). Although the identification of phonological
processes in the speech errors of these children has been helpful in descrip-
tion of disability, it has little explanatory power. Sheldon (1993), in a criticism
of the application of phonological theory to speech disorders, claimed that a
lack of kalidation of phonological theories limits their explanatory value.
Indeed, McWilliams et al. (1990) stated that ‘phonological theory and analy-
sis have contributed little to the understanding or treatment of cleft palate
speech to date’ (p. 294).
Physiological Limitations
Physiological limitations may include: poor velopharyngeal closure; dental
malocclusion; oral-nasal fistulae; nasal obstruction: hearing impairment; and
faulty somatesthesia (McWilliams et al., 1990). (These factors were not con-
trolled in this study as participants were consecutive referrals.) Most of the lit-
erature has focused on errors related to velopharyngeal incompetence. Even
though three of our subjects had questionable velopharyngeal competence,
there was an absence of the gross substitution errors (Bzoch, 1979) or com-
pensatory patterns (Trost, 1981), such as glottal stops and pharyngeal frica-
tives, traditionally linked to velopharyngeal incompetence. Although others
have reported a similar absence and have attributed the lack of such gross
errors to improvements in surgical management (McWilliams et al., 1990),
here it is suggested that the relatively simple phonological system of Can-
tonese resulted in errors of omission or posterior placement rather than gross
substitution errors.
Ainoda et al. (1985) suggested that palatalisation may be due to deviated
morphology of the hard palate, reduced tactile and proprioceptive feedback,
and/or abnormal lingual morphology and activity. Hardcastle et al. (1989) also
suggested that posterior placement could be the result of poor somatesthesia.
Faulty somatesthesia may develop during early swallowing and feeding pat-
terns (Malek, Martinex, Mousset & Trichet, 1990, pp. 1-10) due to structural
deficits. If there was evidence of variable sensory feedback during the develop-
mental period (due to surgical or other intervention) this may help explain the
variability in production. As noted above, alveolar targets were particularly
vulnerable, and variable in our subjects. Not only did backing of plosives and
affricates occur but /s/ was usually misarticulated, mostly undergoing stopping
and/or backing (to [t] or [k]) or backing and gliding (to b]). Somatesthesia and
subsequent learning patterns need further study.
Habituated Patterns
Several authors (e.g. Van Demark, 1964, 1966; Bzoch, 1979; McWilliams et al.,
1990; Moller, 1990, pp. 726731; Russell & Grunwell, 1993, pp. 1 9 4 7 ) have sug-
gested that cleft error patterns are the result of learned neuromotor patterns.
These authors suggest that an initial physiological limitation may precipitate
patterns which become habitual and are maintained even after physiological
improvement or repair. Russell and Grunwell (1993, pp. 1 9 4 7 ) suggested that
backing of plosives and fricatives is an example of an error pattern resulting
from phonetic deviance and that ‘developmentally unusual fricatives may, there-
fore, have been the result of abnormal learned neuromotor patterns’ (p. 39).
Hardcastle et al. (1989, pp. 136164) suggested that errors in alveolar targets
may be due to scarring, which could be linked to faulty learning.
The success of EPG in the treatment of cleft palate speech (Hardcastle et al.,
1989, pp. 136-164; Hardcastle, Gibbon & Jones, 1991) supports the premise
that error patterns are learned. Double articulations (simultaneous velar and
alveolar/bilabial contact) have been observed during alveolar and bilabial tar-
gets, suggesting habitual posterior contact in these children. In treatment, chil-
dren have responded positively to visual feedback when traditional therapy has
failed. Gibbon et al. (1993) reported a case where EPG therapy was successful
in teaching alveolar placement, and concluded that the child had a learned
phonetic disorder (Dorf & Curtin, 1990, pp. 341-348; Hewlett, 1990, pp. 15-38).
Initial findings of the success of EPG therapy with Cantonese-speaking chil-
dren with cleft palate also supports this premise (Stokes, Whitehill, Yuen &
Tsui, in press).
One of the purposes of this study was to identify which features of cleft
palate speech may be universal. The Eurocleft Speech Group (1993, pp.
147-165) reported that over 100 speakers of European languages showed simi-
lar error patterns across five languages. Clusters of errors were identified and
included nasal air flow, glottal realisations, alveolar deviations, sibilant devia-
tions, and ‘others’. Direct comparison of their findings to our sample is difficult
given different analytical frameworks, but nonetheless is attempted. Reports
from Taiwan (Wu et al., 1988) and Japan (Ainoda et al., 1985) generally sup-
port the European literature. In this study, manner and placement errors gen-
erally support the extant literature.
Some patterns appear to be language-specific. In Cantonese-speaking chil-
dren with cleft palate, the manner of frication is maintained to a high degree,
resulting in bilabial and glottal fricatives. The high incidence of gliding of lsl
may be an attempt to maintain the continuance feature. The Eurocleft data
(Eurocleft Speech Group, 1993, pp. 142-165) showed a similar maintenance of
frication, although the error patterns were palatalisation, retraction, dentalisa-
tion, lateralisation, and ‘[sl-like deviations’ (p. 153). The occurrence of bilabial
and glottal fricatives seems to be higher in this Cantonese data. Palatal realisa-
tion of alveolar targets appears to be universal.
There were differences in the structural processes as well as systemic sirnpli-
fications. There was a high incidence of initial consonant deletion, not widely
reported in the English literature. It is proposed that this pattern is due to the
functional load of tones in Cantonese (So & Dodd, 1992), i.e. some of the chil-
dren maintain contrasts by relying on tone, rather than consonant production.
TWO findings require further investigation: one is the vulnerability of alveo-

lar targets - Cantonese may be particularly useful in this endeavour as it
includes alveolar affricates in the alveolar set (here, English affricates are con-
sidered to be post-alveolar); the other is variability.
Extensive variability, as was identified in this sample, has been reported else-
where (McWilliams et al., 1990; Gibbon et al., 1993; Russell & Grunwell, 1993,
pp. 19-47). There have been three main explanations for this phenomenon:
normal variation; phonetic context, and the limitations of perceptual judge-
ments. Russell and Grunwell (1993, pp. 1 9 4 7) suggested that the amount of
variability found in cleft palate speech was no greater than that found in nor-
mal children. The variability found in our speakers with cleft palate cannot be
directly compared with that of normal Cantonese speakers, as there are insuffi-
cient developmental data currently available. McWilliams et al. (1990) stated
that variability was due to the phonetic context. Our data were carefully exam-
ined for context-specific errors, but none were found. Similarly, Hardcastle et
al. (1989, pp. 136-164) identified variability in production of aveolars for the
two subjects studied, and phonetic context was ruled out as a factor. Identifica-
tion of variability may be due to the methodology employed. By use of EPG,
Gibbon et al. (1993) examined variability and identified subphonemic contrasts
which had not been identified perceptually. Validation of articulatory patterns
by instrumental investigation is indicated as it is possible that variability
detected in perceptual studies may be associated with factors not perceived by
the human ear. Clearly, sources of variability remain relatively unexplored,
warranting careful investigation (Hardcastle et al., 1989, pp. 136-164).
CONCLUSION
This study has identified language-universal and language-specific errors in the
speech of Cantonese-speaking children with cleft palate. Cantonese may be
particularly useful in the description and explanation of placement errors in
cleft palate speech, as it includes affricates in the alveolar set. Although inter-
subject variability is to be expected, given this diverse sample of children, the
substantial intra-subject variability in production was not expected. Further
investigation of variability is necessary, and instrumental techniques are recom-
mended. The vulnerability of the alveolar targets indicates the need for investi-
gation of contributing variables. It is suggested that the error patterns are
attributable to a combination of physiological factors and learned behaviours.
APPENDIX
Cantonese EPG Protocol*

Word List I**
Each lingual consonant is combined with /i/, /d,/y/, or /u/ in a CV or CVC for-
mat to form a meaningful Cantonese word. /i/-/e/ contrasts the high-low vowel
position and /y/-/u/ the front-back vowel position. The consonant /3/ is not
included on the list because it can only combine with /i/ to form a meaningful
word. (Total: 41 items).
Item no. Word Phonetic transcription Word meaning

(IPA system)
1 thin field
2 theq hear
3 t’yn group
4 WI bucket
5 tip plate
6 te father
7 tYn short
8 tuIJ winter
9 tYt fetch
10 nin year
11 ne (particle)
12 nYn warm
13 nw farm
14 khirJ whale
15 khE ride
16 hku fist
17 kbuq poor
18 si teacher
19 SE some
20 SY book
21 suk uncle
22 ji doctor
23 jE grandfather
24 jy fish
25 juq use
26 tshit cut
27 tShE Car
28 ts5 save
29 tshuq clever
30 tsi know
31 tSE cover
32 tSY t SY
33 tsuq centre
34 lin chain
35 % lek smart
36 %L lYn messy
37 E lw dragon
38 e kit knot
39 %€ ke (particle)
40 #El kYn donate
41 #i!i ku auntie
Word List I1
The two-syllable words in this section includes contrasts of place, manner, and
place and manner. (Total: 58 items).
Item no. Word Phonetic transcription Word meaning
(IPA system)
1 set kSu loss ball
2 thitkhiu iron bridge
3 pak thou rabbit
4 sik t5q eat sweet
5 pet keu soon
6 pat k:, eight (classifier)
7 hak tug black hole
8 tsuk tou catch (particle)
9 narJ !la caries
10 lan qeu lazy cow
11 tsh&nin youth
12 tsuq nin middle aged
13 pbut scey spill water
14 jet s q life
15 tit l:,k fall down
16 jek lik calendar
17 tsyn svm pay attention
18 wen set glass house
19 sen kei living
20 kuq ka public
21 t y khei fix deposit
22 sceq kSp senior
23 sen thai body
24 tsyn t e u brick
25 men tap questions

26 lan t3 lazy
27 pet nyn not warm
28 tshcetnin next year
29 hak qeu black cow
30 hak qan hyn darkened eye
31 n3k san student
32 pak sik white
33 nuk luk index
34 tsuk liu catch bird
35 tsbug set enrich
36 t s y sen refreshing
37 tsuq leu clock tower
38 sceg b k up down
39 tsuq t S u hour
40 tsmg thai Mrs Cheung
41 kurJ tou fair
42 PhYtY calm
43 ~ S U I jy
J at last
44 t s y ji justice
45 nin kh&i year
46 sen kh&i fresh
47 san kcek hill bottom
48 sen kai New Terrritories
49 syn ji grandchild
50 syn jau bad friends
51 pak jen Caucassians
52 sik juk eat meat
53 tscek niu bird
54 hek nei black mud
55 thitqau iron cow
56 tshat ga brush teeth
57 Pit jen iron man
58 pet jiu not want
*Adapted from Kwok (1992).

**Tone markers are omitted from the phonetic transcription.
ACKNOWLEDGEMENT
The work described in this paper was supported by a grant from T h e British CounciYHong
Kong Research Grants Council. We are grateful to Polly Lau Suk Han, Anita Tsui Man
Yee, and Kevin Yuen Chi Pun for their assistance in the assessment procedures. Thanks are
&o due t o the subjects and their families for their participation. And, thanks t o William
Hardcastle and Fiona Gibbon, and two anonymous reviewers, for their comments on an ear-
fier draft of this paper.
REFERENCES
ANOD N, YAMASHITA K & TSUKADA s (1985). Articulation at age 4 in children with early repair of cleft
palate. Annals of Plastic Surgery 15,415422.
UERY A & GRUNWELL P (1993). Consonant articulation in different types of cleft lip and palate. In P.
Gmwell (Ed.), Analysing ClefrPalate Speech. London: Whurr Publishers.
ALBERY E At RUSSELL J (1990). Cleft palate and orofacid abnormalities.In P. GNnWell (Ed.), Developmen-
tal Speech Disorders: Clinical Implications and Practical Implications. Edinburgh: Churchill Living-
stone.
AMERICAN NATIONAL STANDARDS INSTITUTE (1969). Specifications for Audiometers (ANSI S3.6). New
Yo&: ANSI.
BISHOP DV & EDMUNDSON A (1987). Language-impaired 4-year-olds: distinguishing transient from persis-
tent impairment. Journal of Speech and Hearing Disorders 52,156-173.
BZOCH KR (1979). Measurement and assessment of categorical aspects of cleft palate speech. In K. R.
Bzoch (Ed.), Communicative Disorders Related to Clefr Lip and Palate (2nd edition). Boston: Little
Brown & Co.
CHAPMAN KL (1993). Phonologic processes in children with cleft palate. Clefr Palate-Cranwfaciul Jour-
nal 30,6472.
cHEUNG KH (1986). The Present Day Phonology of Cantonese. Unpublished doctoral thesis. University of
London.
DEAN E, HOWELL I, HILL A & WATERS D (1990). Meraphon Resource Pack. Windsor: NFER-Nelson.
DORF DS & C U R ~ NJW (1990). Early cleft palate repair and speech outcome: a ten-year experience. In J.
Bardach & H. L. Moms (eds),Multidisciplinary Management of Clefr Lip and Palate. Philadelphia:
W. B. Saunders.
EUROCLEIT SPEECH GROW (1993). Cleft palate speech in a European perspective: Eurocleft Speech Pro-
ject. In P. Grunwell (Ed.), Analysing Cleft Palate Speech. London: Whurr Publishers.
PLETCHER SG (1985). Speech production and oral motor skill in an adult with an unrepaired palatal cleft.
Journal of Speech and Hearing Disorders 50,254-261.
GIBBON F At HARDCASTLE WJ (1989). Deviant articulation in a cleft palate child following late repair of the
hard palate: a description and remediation procedure using electropalatography (EFG). Clinical Lin-
guistics and Phonetics 3,93-110.
GIBBON F, DENT H & HARDCASTLEWJ (1993). Diagnosis and therapy of abnormal alveolar stops in a speech-
disordered child using electropalatography. Clinical Linguistics and Phonetics 7,247-267.
ORUNWELL P (1981). The Nature of Phonological Disability in Children. London: Academic Press.
GRUNWELL P (1993). Introduction. In P. Grunwell (Ed.), Analysing clefr Palate Speech. London: Whurr
Publishers.
GRUNWELL P, SELL D & HARDING A (1993). Describing cleft palate speech. In P. GNnwell (Ed.), m y s i n g
ClefrPalate Speech. London: Whurr Publishers.
HARDCASTLE WJ, MORGANBARRY RA & NUNN M (1989). h t r u m e n d artiCUhtoty phonetics in aSSeSSment
and remediation: case studies with the electropalatograph. In J. Stengelhofen (Ed.), Clefr Palate: The
Nature and Remediation of Communicative Problems. Edinburgh: Churchill Livingstone.
HARDCASTLE WJ, GIBBON F & JONES W (1991). Visual display Of tOtIgUe-pdate Contact: electropalatography
in the assessment and remediation of speech. Brirish Journal of Disorders of Communication 26,
41-74.
HARDJNG A & GRUNWELL P (1993). Relationship between speech and timing of hard palate repair. In P.
Grunwell (Ed.), Analysing Chfr Palate Speech. London: Whm Publishers.
HEWLETT N (1985). Phonologkal versus phonetic disorders: some suggested modifications to the current
use of the distinction. British Journal of Disorders of Communication 20,155-164.
HEWLEIT N (1990). Processes of development and production. In P. Grunwell (Ed.), Developmental
Speech Disorders. Edinburgh: Churchill Livingstone.
HODSON BW, CHIN, L, REDMOND B & SIMPSON R. (1983). Phonological evaluation Of speech deviations Of a
64 STOKES AND WHlTEH ILL
child with a repaired cleft palate: a case study. Journal of Speech and Hearing Disorders 48,93-98.
Hums B & BRONDSTED K (1987). Strategies in cleft - with special reference to Danish. cleft Palate
Journal 24,126-1 36.
KWOK CL (1992). Electropalatographic Investigation of Normal Cantonese Speech: A Qualitative and
Quantitative Analysis. Unpublished Master’s thesis: University of Hong Kong.
LYNCH 11, FOX, DR & BROOKSHIRE BL (1983). Phonological proficiency Of tW0 Cleft palate toddlers With
school-age follow up. Journal of Speech and Hearing Disorders 18,274-285.
MALEK R, MARTINEZ H, MOUSSET MR & TRICHET c (1990). Multidisciplinary management of cleft lip and
palate in Pans, France. In J. Bardach & H. L. Morris (eds), Multidisciplinary Management of Cleff
Lip and Palare. Philadelphia: W. B. Saunders.
MCWILLIAMS BJ, MORRIS HI. & SHELTON RL (1990). cleft Palate Speech (2nd edition). St. Louis: Mosby.
MOLLER KT (1990). Early speech development: the interaction of learning and structure. In J. Bardach & H.
L. Moms (eds), Multidisciplinary Management of Cle# Lip and Palate. Philadelphia: W. B . Saunders.
MORLEY ME (1970). Cleft Palate and Speech (7th edition). Baltimore: Williams & Wilkins.
POWERS GR, D U ” C & ERICKSON CB (1990). Speech analyses Of fOUr children With repaired Cleft palates.
Journal of Speech and Hearing Disorders 55,542-549.
RUSSELL J & GRUNWELL P (1993). Speech development in children with cleft lip and palate. In P. Grunwell
(Ed.), Analysing Cleft Palate Speech. London: W ~ U Publishers.
K
SELL D & GRUNWELL P (1993). Speech in subjects with late operated cleft palate. In P. Grunwell (Ed.),
Analysing Cleft Palate Speech. London: Whurr Publishers.
SHELTON RL (1993). Grand rounds for sound system disorder. Conclusion: what was learned. Seminars in
Speech and Lunguage 14,166-177.
so LKH (1992). Cantonese Segmental Phonology Test. Hong Kong: University of Hong Kong, Depart-
ment of Speech and Hearing Sciences.
SO LKH & DODD B (1992). Phonologically disordered Cantonese-speaking children. Proceedings of the
Fourth Australian International Conference on Speech Science and Technology.Brisbane.
SO LKH & DODD B (in press). The acquisition of phonology by Cantonese-speaking children. Journal of
Child Lunguage.
STENGELHOFEN J (1989). The nature and causes of communication problems in cleft palate. In J. Stengel-
hofen (Ed.), Cleft Palate. Edinburgh: Churchill Livingstone.
STOKES SF (1 993). Identification and Characterisation of Language Disability in 3-year-old Children.
Unpublished doctoral dissertation. Perth: Curtin University of Technology.
STOKES SF, WHITEHILL TL, YUEN CPK & TSUI MYA (in press). EPG treatment of sibilants in two Cantonese-
speaking children with cleft palate. Clinical Linguistics and Phonetics.
TROST J (1981). Articulatory additions to the classical description of the speech of persons with cleft
palate. Cleft Palate Journal 18,193-203.
TSE ACY (1991). The Acquisition Process of Cantonese Phonology. Unpublished Master’s thesis. Hong
Kong: University of Hong Kong.
VAN DEMARK DR (1964). Misarticulations and listener judgements of the speech of individuals with cleft
palates. Cleft Palate Journal 1,232-245.
VAN DEMARK DR (1 966). A factor analysis of the speech of children with cleft palate. cleft Palate Journal
3, 159-170.
VAN DEMARK DR (1974). A comparison of articulation abilities and velopharyngeal competency between
Danish and Iowa children with cleft palate. Cleft Palate Journal 11,463-470.
W m m L TL & CHAN BCW (1991). The Use of the Nasometer with Cantonese-speaking Adults: A Prelimi-
nary Study. Paper presented at the Second Asian Pacific Cleft Lip and Palate Conference. Taipai,
Taiwan, April 1991.
W H ~ H I L Ln. & STOKES SF (1993). Cantonese EPG Protocol. Hong Kong: University of Hong Kong:
Department of Speech and Hearing Sciences.
wu I, CHEN YR & NOORDHOFF MS (1988). Articulation proficiency and e m r pattern of cleft palate children
with delayed hard palate closure. Annals of rhe Academy of Medicine 17,384-387.
ZEE E (1991). Chinese (Hong Kong Cantonese). Journal of the International Phonetic Association 21,
46-48.
Address correspondence to Dr Stephanie F. Stokes, Department of Speech and Hearing Sciences,

University of Hong Kong, 5/F 34 Hospital Road, Hong Kong. (E-mail: sstokes@hkuxa.hku.hk)
Revised version received April 1995.

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European Journal of Disorders of Communication, 31,4564,1996 45

0 Royal College of Speech and Lunguage Therapists, London

Speech error patterns in Cantonese-speaking

Key words: cleft palete, phonological analysis, Cantonese.

fricatives and affricates, and that posterior articulatory placement (including

Labial LabDen* Alveolar Palatal Velar Glottal

Finals Iml, Inl, Id, lp’l, lt’l, lk’l

The description of final segments is controversial. In Zee (1991), the finals

Age 9;3 10;2 78 5;8 9;lO 8;l 3;2

Subject* NAS PLO FRI AFF LIQ GLI Av

1 100 53 56 59 100 100 78

Fricatives and affricates are particularly vulnerable to errors with average

Subject BIL LABD ALV PAL VEL Av

1 100 0 70 100 59 65.8

Ihl, lwl and Id are not included.

&&. 0 = iaitirl oonwmnt dclccion; OR - otha (a = INUIaniuion; b = biLbirlbicrtivc; c = Ltcnl I@.

Subject 2: LYM (age 10;2)

Subject 3: SHW (age 7;8)

Subject 4: HMC (age 5;8)

Subject 5: LWK (age 9;lO)

m n g d p t ' t tlb ts k ' k f s h w l j

Figure 2: Confusion matrix - LYM (10;2).

Figure 3:Confusionmatrix - SHW (7;s).

m n g p' p I' I IS' tar k f I h w 1 j 0

w.0 = initial wnsonant delelion.

m n IJ p' p I' i U ' U k' k f I h w I j 0 OR

Subject 6: KHS (age 8;l)

m n I) p ' p t' t U' u P k f I h w I j OR

&&.OR = other (d = mid d o d stop).

Subject 7: KYM (age 3;2)

Figure 7: Confusion matrix - KYM (3;2).

Firstly, the manner classes most affected in this Cantonese-speaking sample

TWO findings require further investigation: one is the vulnerability of alveo-

Cantonese EPG Protocol*

Item no. Word Phonetic transcription Word meaning

25 men tap questions

*Adapted from Kwok (1992).

Address correspondence to Dr Stephanie F. Stokes, Department of Speech and Hearing Sciences,

Revised version received April 1995.

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