1. Pacifier Use and Speech Sound Development Tamara Nagoda, M.S. 1 & Peter Flipsen Jr., Ph.D. 2 1 Idaho State University, Meridian, ID 2 Pacific University, Forest Grove, OR INTRODUCTION Anywhere from 55-80% of infants may use pacifiers for various periods. Pacifiers may reduce the risk of SIDS; they may also improve feeding skills in premature infants. However, pacifiers may also increase the incidence of both middle ear disease and oral myofunctional disorders such as tongue thrust. Studies of pacifier use and speech development have been mixed to date (Barbosa et al., 2009; Fox, Dodd, & Howard, 2002; McNally, 1997; Schotts, McDaniel, & Neeley, 2008). Why Might Pacifiers Affect Speech? 1. May influence tooth eruption, position, and/or alignment? 2. May alter tongue resting posture? 3. May be a link through increased middle ear disease? 4. Parents and others may be less likely to initiate communication when something is in the child’s mouth (fewer speech models)? 5.Pacifier in mouth may reduce child’s time to practice speech and/or receive specific feedback about their speech? METHOD Test Protocol Speech skills assessed with GFTA-2. Language skills assessed with PPVT-4. Oral facial exam. Bilateral hearing screening at 25 dB HL. Participants 20 children (11 males; 9 females) age 41-64 months. Referred by parents or local SLPs. No other known concerns. All passed oral facial exam and hearing screening. All scored at least 85 on PPVT-4. TD Group: n = 15 (7 males; 8 females); achieved standard scores of 93+ on the GFTA-2. SD Group: n = 5 (4 males; 1 female); achieved standard scores of <82 on GFTA-2. Parent Survey Did child use a pacifier or suck thumb or fingers? If pacifiers were used, at what age did they start and stop? Were pacifiers used at naptime/bedtime only or also during the day (i.e., when awake)? If daytime use, approximately how many hours per day of use on average? RESULTS Overall, use of pacifiers was reported for 13/20 (65%) participants. This is consistent with published reports. Pacifier use was reported for 2/5 in the SD Group and 11/15 in the TD Group. No significant difference (Chi-square p =.1760). Months of pacifier use was 6-8 months for the SD Group and 5-48 months for the TD Group. No significant difference (MW p =.1671). Daytime (awake) use was reported for 1/2 in the SD Group and 7/11 in the TD Group. No significant difference (Fisher Exact p = 1.000). Data on average hours of pacifier use were available for the 7 daytime users in the TD group but not for the one SD participant who used a pacifier. Total dose of pacifier use (hours/day X months of use) are plotted against GFTA-2 scores for the 7 TD participants in Figure 1. Acknowledgments Many thanks to Jeanne Johnson, Diane Ogiela, and Judith Crews for their assistance with the project. Thanks especially to the children who participated and their parents. ASHA Convention, 2013 Chicago, IL DISCUSSION Small sample size likely precluded finding any group effects. Trend in Figure 1 suggests dose effect for TD children. Longer use of pacifiers may result in lower speech skill scores. Note: outlier in lower left of Figure 1 was the only child where thumb sucking was reported. Stopped using pacifier early on but may have substituted thumb. Barbosa et al. (2009) suggested thumb sucking may also affect speech. Additional study with larger samples clearly indicated. References Barbosa, C., Vasquez, S., Parada, M. A., Gonzalez, J. C. V., Jackson, C., Yanez, N. D., Gelaye, B., & Fitzpatrick, A. L. (2009). The relationship of bottle feeding and other sucking behaviors with speech disorder in Patagonian preschoolers. BMC Pediatrics, 9, 66. Fox, A.V., Dodd, B., & Howard, D. (2002). Risk factors for speech disorders in children. International Journal of Language & Communication Disorders, 37(2), 117-131. McNally, J. (1997) Speech development and dummy sucking and other comfort habits. Health Visitor, 70(5), 191-193. Shotts, L. L., McDaniel, D. M., & Neeley, R. A. (2008). The impact of prolonged pacifier use on speech articulation: A preliminary investigation. Contemporary Issues in Communication Science and Disorders, 35, 72-75.