Word Reading in Boys With Isolated Oral Clefts: Comparison to Unaffected Average and Dyslexic Readers Using the Dual-Route Model

Abstract

Objective: To examine word reading performance between boys with isolated cleft lip and/or palate (iCL/P), unaffected average reading (uAR), and unaffected impaired reading (uIR), using the dual-route model. Design: Case/control study. Setting: University children’s hospital. Participants: Males, between the ages of 8 to 11 years, with iCL/P (n = 26), uIR (n = 33), or uAR (n = 28). Methods: Single word reading and achievement were evaluated. Analyses of variance and analyses of covariance evaluated group differences in achievement. Medical records were reviewed for iCL/P participants for audiology and speech history. Spearman ρ correlations were calculated between hearing, speech, and reading achievement for the iCL/P group. Main Outcome Measure(s): Reading performance was evaluated using select subscales from the Woodcock Johnson Reading Mastery Test, 3rd Edition and the Test of Orthographic Competence. Results: Participants with iCL/P had higher than expected rates of reading impairment, differing across cleft type (0% iCL, 50% isolated cleft lip and palate [iCLP], 71.4% isolated cleft palate only [iCP]). On measures of word reading accuracy, iCL/P participants outscored uIR participants, with uAR participants scoring the highest. This pattern was specific to nonlexical reading tasks. Participants in the uAR and iCL/P groups outscored uIR participants on lexical tasks, with no significant differences between uAR and iCL/P. Evaluation of speech and hearing revealed no significant relationship to single word reading or achievement measures in the iCL/P group. Conclusions: Boys with iCL/P are at a higher risk of reading impairments, particularly within the iCP subset. Regular screening should be encouraged, with skills from both lexical and nonlexical routes assessed.