A Longitudinal Study of Speech Production in Swedish Children with Unilateral Cleft Lip and Palate and Two-stage Palatal Repair

Abstract

Objective: To describe speech production longitudinally in a group of children with unilateral cleft lip and palate (UCLP). Participants: Twenty consecutive children with UCLP and nine age-matched children without clefts in a comparison group. Intervention: A two-stage palatal repair procedure with soft palate closure at 6 months and hard palate repair at 3 to 4 years. Main Outcome Measures: Percent correct consonants (PCC), percent correct places (PCP), and percent correct manners (PCM) at 3, 5, and 7 years of age. Cleft speech errors at the same ages. Previously collected data on number of consonant tokens, consonant types, frequency of occurrence of places and manners of articulation at 18 months. Results: PCC and PCP were significantly lower in the UCLP group than in the comparison group at all ages. Number of consonant types and frequency of occurrence of dental plosives at 18 months correlated significantly with PCC at age 3. A high frequency of velar plosives at 18 months correlated significantly with a high prevalence of retracted oral articulation (dental/alveolar to palatal or velar) at both 3 and 5 years of age. Conclusions: The UCLP group performed worse than the comparison group at all ages. A high occurrence of dental plosives as well as a high number of consonant types in babbling and first words seem to be good indicators for better consonant production in later speech. The same prevalence of retracted oral articulation as in previous studies is attributed to the surgical technique.