Speech Results in 10-Year-Old Children With Isolated Cleft Palate.

INTRODUCTION

Isolated cleft palate (CP) is the most common cleft type in Finland, and it is often associated with an additional syndrome.

AIMS: We investigated speech outcomes in 10-year-old children with isolated CP with (CP+) or without (CP-) syndrome/malformation or with Robin sequence (RS).

METHODS

A retrospective single-center study comprising 210 ten-year-old children with CP (139 hard and soft CP, 44 soft CP, and 27 submucous CP) born in 2000 to 2013. Data on speech (VPC-Rate, hypernasality, articulation, and intelligibility), speech therapy visits, and speech-correcting surgery were collected. Of the speech data, 30% were reevaluated from standardized audio recordings by 2 experienced speech pathologists.

RESULTS

Of the CP children in this study, 22% had an additional syndrome/malformation and 12% had RS. Sufficient velopharyngeal competence was found in 85%, 57%, and 73% of CP-, CP+, and RS children, respectively. Moderate-to-severe hypernasality was more common in patients with CP+ (CP- 7%, CP+ 26%, RS 12%). In all groups, the incidence of oral articulation errors was high (CP- 33%, CP+ 53%, RS 58%). Nonoral errors were uncommon. Intelligibility was high in patients with CP- (91%). Of patients with RS, 81% had completely intelligible speech, while the corresponding figure in patients with CP+ was only 68%. The incidence of speech therapy visits was highest in the CP+ group (75% versus CP- 50% and RS 58%). There was no significant difference between CP- (18%), CP+ (26%), and RS (31%) in the incidence of speech-correcting surgery. The intra- and inter-rater agreement between the 2 speech pathologists was acceptable.

CONCLUSIONS

Most children had sufficient velopharyngeal function and fully intelligible speech at 10 years; however, only 58% had normal articulation. CP+ children had generally poorer speech than CP- children. Robin sequence patients had significantly more oral articulation errors than CP- patients.