Speech and language development in toddlers with and without cleft palate

from the International Journal of Pediatric Otorhinolaryngology

Objective
The effect of early palate closure on speech and language development in children with cleft palate.

Design
Comparative study.

Setting
University Medical Center Groningen, Cleft Palate Team (The Netherlands).

Materials and methods
Forty-three toddlers with cleft palate and thirty-two toddlers without cleft palate were analyzed with standardized tests for language comprehension and language production. Moreover articulation and hyper nasality were examined by trained speech therapists.

Results
For language comprehension, language production and articulation there were no significant differences between the children with and without cleft lip and/or palate. This is despite the high percentage of conductive hearing loss (55%) in children with clefts. Significant difference was found for hyper nasality (mean: 35% vs. 0%, p = 0.001). In both groups articulation problems raise to a higher percentage than language production problems (63–20%; 24–4%).

Conclusions
Early surgical treatment is effective for a part of the communicative development, i.e. language development and articulation. Besides conductive hearing loss hyper nasality remains a serious problem in 30–50% of the children with cleft palate. Therefore, speech therapy and pharyngoplasty also are part of the treatment procedure. Because of the high amount articulation problems in all children, standards for articulation development are perhaps too strict. Future research should be carried out after normal variations in articulation development.

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