Pre-linguistic children with cleft palate: growth of gesture, vocalization, and word use.

Children with cleft lip and/or palate show early delays in speech and vocabulary development that may have an impact on later communication and social development. While delays in the complexity of babbling may put children at risk for later delays in speech and language development, there is considerable variability in development. This study focused on the rate of children's communication acts, canonical vocalizations, and word use as they made the transition from the pre-linguistic to linguistic development. The study included 15 children with non-syndromic cleft lip and/or palate who were seen at three time points between 17-34 months age. Communication rates were calculated from parent-child language samples collected during play activities. Assignment to linguistic stages was based on the children's expressive vocabulary, as reported on the MacArthur Communicative Development Inventory: Words and Sentences. From the pre-linguistic to linguistic level, the children's average rate per minute of: communicative acts overall increased significantly from 1.49 to 3.07 per minute; canonical vocalizations from 0.21 to 0.90 per minute; and word use from 0.16 to 3.61 per minute. Rates of communicative acts were associated with later word use. It appears that children with clefts rely on non-verbal communicative acts when verbal development is delayed.