Head of unit
I am a speech language pathologist and professor in speech language pathology, since Dec 2008 employed at the Department of Clinical Science, Intervention, and Technology/and Head of Division of Speech and Language Pathology at the Karolinska Institute (KI). The position is conjoint with the Clinical Department of Speech and Language Pathology at Karolinska University Hospital. Director of the Speech and Language Pathology Programme 2000-2008 at University of Gothenburg, and 2009 at KI. Since 2012 member of the Board of Higher Education at KI.
My clinical work, lecturing and research are within the field of cleft palate and related orofacial anomalies/dysfunctions. Graduated (KI) and worked as a speech pathologist from 1982, BA (GU) in Philosophy and Linguistics 1983, received my doctoral degree in Speech and Language Pathology from GU, 1996, associate professor 2003, and professor 2007.
Lecturers on speech development and disorders associated with cleft palate, early speech development and deviances, methods for speech assessment, course coordinator and supervises master’s theses and PhD students (Kristina Klintö, Jill Nyberg, Petra Petersson, Ann Malmenholt, and Anna Persson at KI, Ann Nordberg at GU).
Development of homepages for training and research within the area of cleft palate and speech disorders. PUMA-Cleft palate is a Swedish website with interactive activities for undergraduate students and clinicians. CLeft palate International SPeech Issue – CLISPI, is an international website originally developed via the Eurocran project, which can be of support the development of best practice for clinical work and research. It can also be used for calibration within research projects.
Speech Development and Precursors for Speech Disorders in Individuals with Cleft Palate and other adverse conditions, Implications for Intervention, and Evaluation of Treatment
Speech development from babbling to speech in children with cleft palate and typically developing children is longitudinally investigated with the purpose to find predictors for the development of speech disorders. Impact of type and timing of palatal surgery (Scandcleft samt Timing of Primary Surgery in cleft palate, TOPS) and hearing impairment (Tidig Utveckling av Tal och Hörsel, TUTH) on the development is investigated. The purpose is also to identify and develop efficient intervention procedures (surgical, audiological, speech/communicative) in order to predict or minimize the impact of the structural defect of dysfunction on speech and the impact of speech deviances on communicative activity and participation. The area comprise:
1 )Speech development and speech and language disorders in individuals born with cleft palate, and the impact of surgical procedure & timing, and ear and hearing problems.
2) Early identification of individuals at risk for speech disorders related to cleft palate, hearing impairment or other adverse conditions.
3) Assessment methods: screening, documentation and analysis (perceptual, acoustic and physiological) including cross-linguistics aspects.
4) Treatment strategies for speech disorders
Aims of the projects are to
- Describe the speech development and speech and communication disorders (babbling, speech and language characteristics, intelligibility, self-reported attitude to speech and communication) in individuals born with cleft lip and/or palate.
- Develop methods for assessment of speech and communications disorders related to orofacial clefts and dysfunction.
- Explore early precursors and prevention possibilities for later speech disorders in individuals with cleft lip and/or palate (surgical, audiological).
- Develop treatment methods and strategies of persistent speech and communication disorders related to orofacial clefts and dysfunction.
Examples of current subprojects are
I. Effect of surgical strategy for primary palatal repair on speech outcome at age 5 years in children born with unilateral cleft lip and palate - the Scandcleft project: a prospective randomised trial.
II. Audiological characteristics of children with cleft lip and/or palate by cleft type and age and comparison with children without cleft lip and palate.
III. Relationship between speech production in babbling and in later speech years of age in children with and without cleft lip and palate.
IV. Development of a screening procedure for infants at risk for speech disorders.
V. Effectiveness of visual feedback from Electropalatography (EPG) on persistent articulation disorders and the effect on intelligibility.
VI. Development of early speech and hearing in babies born with cleft palate or without cleft palate but with early otitis media with effusion (TUTH – Tidig Utveckling av Tal och Hörsel)
Within two RCT projects with universities and hospitals in the Nordic countries, UK, and Brazil.
Associate professor Christina Persson, University of Gothenburg
Associate professor Elisabeth Willadsen, University of Copenhagen
Professor Fransisco Lacerda, University of Stockholm
Professor Gunvor Semb, University of Manchester
Professor Bill Shaw, University of Manchester
Professor Inge Trindade, University of Sao Paolo
* The Scandcleft-project – a prospective randomized multicenterstudy of the impact of method for operation of the cleft palate on speech, hearing, occlusion and growth in children born with unilateral cleft lip and palate. Leader of the Speech project. Participation of ten treament centres in Sweden, Finland, Norway, Denmark and the UK.
* Timing of Primary Surgery in infants with Cleft Palate (TOPS) – a prospective randomized multicenterstudy of the impact of method for operation of the cleft palate on speech and hearing in children born with isolated cleft palate. The study is financed by the NIH. Member of the team management group and the speech core group with a large number of participating cleft palate teams in Sweden, Norway, Denmark, The UK, and Brazil.
* Steering group member in the EuroCleftNet aiming for optimum treatment of orofacial clefting and prevention while building research capacity in collaboration with the World Health Organisation (WHO) the European Cleft Organisation (ECO) (2011-).
* Working group member in the Cleft lip and palate target condition for International Consortium for Health Outcomes Measurement ICHOM (2014-)
Professor Sara Howard, University of Sheffield, UK, Eds a book entitled Speech Production in Cleft Palate: Assessment and Intervention, Wiley Publ, UK, 2011.
Academic honors, awards and prizes
Received the pedagogical award "Pedalen" from the Medical Student Organisation (Medicinska föreningens i Göteborg pedagogiska pris).
Phonology in Swedish-speaking 3-year-olds born with cleft lip and palate and the relationship with consonant production at 18 months
International journal of language & communication disorders / Royal College of Speech & Language Therapists 2014;49(2):240-54
Speech and phonology in Swedish-speaking 3-year-olds with unilateral complete cleft lip and palate following different methods for primary palatal surgery
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association 2014;51(3):274-82
Speech outcomes at age 5 and 10 years in unilateral cleft lip and palate after one-stage palatal repair with minimal incision technique - A longitudinal perspective
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY 2014;78(10):1662-70
A longitudinal study of hearing and middle ear status in adolescents with cleft lip and palate
The Laryngoscope 2013;123(6):1374-80
Speech problems affect more than one in two children with cerebral palsy: Swedish population-based study
Acta paediatrica (Oslo, Norway : 1992) 2013;102(2):161-6
Comparison between perceptual assessments of nasality and nasalance scores
INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2012;47(5):556-66
Dental arch relationship outcomes in children with complete unilateral cleft lip and palate
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association 2012;49(4):512-3
Hearing and otitis media with effusion in young adults with cleft lip and palate
ACTA OTO-LARYNGOLOGICA 2012;132(9):959-66
Long-term, longitudinal follow-up of individuals with UCLP after the Gothenburg primary early veloplasty and delayed hard palate closure protocol: maxillofacial growth outcome
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association 2012;49(6):649-56
Long-term, longitudinal follow-up of individuals with unilateral cleft lip and palate after the Gothenburg primary early veloplasty and delayed hard palate closure protocol: speech outcome
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association 2012;49(6):657-71
Communication attitude and speech in 10-year-old children with cleft (lip and) palate: An ICF perspective
INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2011;13(2):156-64
Early Consonant Production in Swedish Infants With and Without Unilateral Cleft Lip and Palate and Two-Stage Palatal Repair
CLEFT PALATE-CRANIOFACIAL JOURNAL 2011;48(3):271-85
Electropalatography in the description and treatment of speech disorders in five children with cerebral palsy
CLINICAL LINGUISTICS & PHONETICS 2011;25(10):831-52
Exploring quantitative methods for evaluation of lip function
JOURNAL OF ORAL REHABILITATION 2011;38(6):410-22
Taking Charge of Communication: Adults' Descriptions of Growing Up With a Cleft-Related Speech Impairment
CLEFT PALATE-CRANIOFACIAL JOURNAL 2011;48(6):717-26
The impact of speech material on speech judgement in children with and without cleft palate
INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2011;46(3):348-60
Electropalatography in home training of retracted articulation in a Swedish child with cleft palate: Effect on articulation pattern and speech
INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2010;12(6):483-96
The effect of lip strengthening exercises in children and adolescents with myotonic dystrophy type 1
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY 2010;74(10):1126-34
Methodology for Speech Assessment in the Scandcleft Project-An International Randomized Clinical Trial on Palatal Surgery: Experiences From a Pilot Study
CLEFT PALATE-CRANIOFACIAL JOURNAL 2009;46(4):347-62
The Communication Attitude Test (CAT-S): normative values for 220 Swedish children
INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2009;44(6):813-25
The high prevalence of otitis media with effusion in children with cleft lip and palate as compared to children without clefts
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY 2009;73(10):1441-6
Untrained listeners' ratings of speech disorders in a group with cleft palate: a comparison with speech and language pathologists' ratings
INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2009;44(5):656-74
A longitudinal study of speech production in Swedish children with unilateral cleft lip and palate and two-stage palatal repair
CLEFT PALATE-CRANIOFACIAL JOURNAL 2008;45(1):32-41
Speech and satisfaction with outcome of treatment in young adults with unilateral or bilateral complete clefts
SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY 2008;42(4):182-9
CLEFT PALATE-CRANIOFACIAL JOURNAL 2008;45(4):452-3
A cross-sectional study of speech in 10-year-old children with cleft palate: Results and issues of rater reliability
CLEFT PALATE-CRANIOFACIAL JOURNAL 2007;44(1):33-44
Orofacial dysfunction in children and adolescents with myotonic dystrophy
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY 2007;49(1):18-22
Maxillary dental arch and occlusion in patients with unilateral cleft lip and palate treated with different delays in closure of the hard palate after early velar repair
SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY 2006;40(5):261-6
Speech development in patients with unilateral cleft lip and palate treated with different delays in closure of the hard palate after early velar repair: A longitudinal perspective
SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY 2006;40(5):267-74
Speech in children with an isolated cleft palate: A longitudinal perspective
CLEFT PALATE-CRANIOFACIAL JOURNAL 2006;43(3):295-309
Evaluation of VPI-assessment with videofluoroscopy and nasoendoscopy
BRITISH JOURNAL OF PLASTIC SURGERY 2005;58(7):922-31
Language skills at age 6 years in Swedish children screened for language delay at 2(1)/(2) years of age
ACTA PAEDIATRICA 2005;94(12):1798-806
Perceptual analysis of speech and the activity in the lateral pharyngeal walls before and after velopharyngeal flap surgery
SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY 2005;39(1):22-32
Methodology for perceptual assessment of speech in patients with cleft palate: A critical review of the literature
CLEFT PALATE-CRANIOFACIAL JOURNAL 2004;41(1):64-70
The impact of early infant jaw-orthopaedics on early speech production in toddlers with unilateral cleft lip and palate
CLINICAL LINGUISTICS & PHONETICS 2004;18(4-5):259-84
A prospective cross-sectional study of speech in patients with the 22q11 deletion syndrome
JOURNAL OF COMMUNICATION DISORDERS 2003;36(1):13-47
Perceptual evaluation of speech and velopharyngeal function in children with and without cleft palate and the relationship to nasal airflow patterns
CLEFT PALATE-CRANIOFACIAL JOURNAL 2002;39(4):409-24
Speech outcomes in isolated cleft palate: Impact of cleft extent and additional malformations
CLEFT PALATE-CRANIOFACIAL JOURNAL 2002;39(4):397-408
Unrepaired clefts in the hard palate: Speech deficits at the ages of 5 and 7 years and their relationship to size of the cleft
SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY 2002;36(6):332-9
A comparison of babbling and speech at pre-speech level, 3, and 5 years of age in children with cleft lip and palate treated with delayed hard palate closure
FOLIA PHONIATRICA ET LOGOPAEDICA 1998;50(6):320-34
Aerodynamic assessment of velopharyngeal function during normal speech containing different places of articulation
FOLIA PHONIATRICA ET LOGOPAEDICA 1998;50(2):53-63
[Improved treatment of cleft lip and palate is now available]
Speech outcome after cleft palate surgery with the Goteborg regimen including delayed hard palate closure
SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY 1998;32(1):63-80
Residual clefts in the hard palate: Correlation between cleft size and speech
CLEFT PALATE-CRANIOFACIAL JOURNAL 1997;34(2):122-8
Delayed closure of the hard palate: A comparison of speech in children with open and functionally closed residual clefts
SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY 1996;30(2):121-7
Speech and velopharyngeal function in children with an open residual cleft in the hard palate, and the influence of temporary covering
CLEFT PALATE-CRANIOFACIAL JOURNAL 1996;33(4):324-32
A longitudinal study of speech in 15 children with cleft lip and palate treated by late repair of the hard palate
Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi 1995;29(1):21-31
A LONGITUDINAL-STUDY OF SPEECH IN 15 CHILDREN WITH CLEFT-LIP AND PALATE TREATED BY LATE REPAIR OF THE HARD PALATE
SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY 1995;29(1):21-31