Can Peripheral Hearing Justify the Speech Disorders in Children with Operated Cleft Palate?

Abstract

Introduction Any impairment in the hearing ability of a child with cleft lip and palate may cause difficulties in receptive and expressive language. Purpose Check the association between velopharyngeal dysfunction (VPD), compensatory articulation (CA), and peripheral hearing loss in children with cleft palate surgery. Methods Retrospective study with 60 children (group 1: presence of VPD and CA; group 2: absence of VPD, presence of CA; group 3: presence of VDP, absence of CA; group 4: absence of VPD and CA), age 4 to 5 years old, with cleft palate surgery, through the analysis of the hearing, VP, and speech evaluations. Results Group 4 presented 80% normal hearing; group 1 had 60% hearing loss. The conductive hearing loss type was the most frequent. The glottal stop was the most frequent in group 1 and the middorsum palatal plosive in group 2. There was no significant association (p = 0.05) between hearing loss and the presence of compensatory articulations (groups 2 and 4), nor between hearing loss and the presence of VPD (groups 3 and 4; p = 0.12). Statistical significance (p = 0.025) was found when the group with VPD was associated with the group with CA, that is, group 1 with the control group (group 4). Conclusion Significant association between peripheral hearing loss, compensatory articulations, and VPD was verified for the children in group 1, which not only presented compensatory articulations but also VPD.

Global and communicative development skills in preschool children with cleft lip and palate

“…Owing to frequent speech disorders in children with CLP caused by velopharyngeal dysfunction, few studies focus on the performance of linguistic skills in this population. The focus of this study is on the possible hearing and stimulus risks 10‐12 that may affect receptive and expressive language, which can worsen speech disorders caused by the anatomical and functional conditions in these children 2,3 …”

“…The alterations in speech development of children with CLP are associated with damage to middle‐ear functioning and is the primary cause of impaired cognitive development. This is because of insufficient stimulus or may be a consequence of speech disorders 10‐12 …”

Desempenho de linguagem receptiva e expressiva em crianças com e sem Fissura Labiopalatina

“…One of the frequently discussed aspects as to receptive skills in individuals with CLP refers to the presence of hearing impairments, as in the case of recurrent otitis (14)(15)(16) that can interfere with the reception of auditory stimuli and understanding messages, as well as bring relevant consequences for the acquisition of language skills. In this sample, 40% had history of otitis.…”

“…Receptive skills involve processing information through the development of perceptual processes such as attention, concentration, memory, among others. Hearing care is critical to the development of receptive skills; however, studies on the process of attention in the population with cleft lip and palate are recent and little explored in the specific literature (16) . Other considerations are necessary.…”

“…Regarding receptive language, studies suggest that the presence of early hearing loss could explain the difficulties in the development of language in children with CLP (14,15) . Some studies have reported the relationship between hearing loss associated with otitis media with effusion in reducing language scores (16,17) . The early identification and treatment of language disorders in children with CLP are extremely important in order to avoid future emotional problems, socialization, school learning and personal fulfillment (13,(18)(19)(20) .…”