Timing of Palatal Surgery and Speech Outcome

• Published in: The Cleft palate-craniofacial journal Vol. 45; no. 3; pp. 297 - 308
• Main Authors: Chapman, Kathy L., Hardin-Jones, Mary A., Goldstein, Jeffrey A., Halter, Kelli Ann, Havlik, Robert J., Schulte, Julie
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-05-2008; American Cleft Palate-Craniofacial Association; SAGE PUBLICATIONS, INC
• Subjects: Age Factors; Articulation Disorders - etiology; Biological and medical sciences; Birth defects; Child, Preschool; Cleft Palate - complications; Cleft Palate - physiopathology; Cleft Palate - surgery; Dentistry; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Humans; Infant; Language Development; Male; Maxillofacial surgery; Medical sciences; Non tumoral diseases; Otorhinolaryngology. Stomatology; Preschool children; Speech - physiology; Speech Production Measurement; Studies; Voice Disorders - etiology; timing of palatal surgery; cleft palate; speech outcome; Cleft palate; Prognosis; Stomatology; Congenital cleft; Congenital disease; Treatment; Malformation; Surgery; Evolution; Speech; Oral cavity disease; Palate; Timing
• ISSN: 1055-6656; 1545-1569
• DOI: 10.1597/06-244

Objective:
To examine the impact of age and lexical status at the time of primary palatal surgery on speech outcome of preschoolers with cleft palate.
Participants:
Forty children (33 to 42 months) with nonsyndromic cleft palate participated in the study. Twenty children (Group 1) were less lexically advanced and younger (mean age  =  11 months) and 20 children (Group 2) were more lexically advanced and older (mean age  =  15 months) when palatal surgery was performed.
Main Outcome Measures:
Samples of the children's spontaneous speech were compared on 11 speech production measures (e.g., size of consonant inventory, total consonants correct, % correct for manner of articulation categories, compensatory articulation usage, etc.). Next, listeners rated a 30-second sample of each child's connected speech for articulation proficiency and hypernasality, separately, using direct magnitude estimation (DME).
Results:
Group differences were noted for 4 of the 11 speech production measures. Children in Group 1 exhibited larger consonant inventories (and true consonant inventories) and more accurate production of nasals and liquids compared to children in Group 2. On the DME task, significant group differences were found for ratings of articulation proficiency and hypernasality. Children in Group 1 exhibited better articulation and less hypernasality than children in Group 2.
Conclusions:
The findings suggested that children who were less lexically advanced and younger at the time of palatal surgery exhibited better articulation and resonance outcomes at 3 years of age.