Exploring the speech and language of individuals with non‐syndromic submucous cleft palate: a preliminary report

Abstract

Background: Submucous cleft palate (SMCP) has a heterogeneous presentation and is often identified late or misdiagnosed. Diagnosis is prompted by speech, resonance or feeding symptoms associated with velopharyngeal insufficiency. However, the broader impacts of SMCP on communication have rarely been examined and therefore are poorly understood. Aim: To describe the communicative profile of individuals with non-syndromic SMCP by examining speech, language and pragmatics (social language). Methods & Procedures: Fifteen participants with SMCP aged 5;1-12;8, without a genetic diagnosis, participated in the study. Participants completed standardized assessments examining language, resonance, speech and non-verbal intellect. Parents also completed the Children's Communication Checklist (CCC-2), which provided a measure of overall communicative ability, including pragmatic skills. Formal language outcomes were compared with two cohorts: 36 individuals with overt non-syndromic clefts and 129 individuals with no history of clefting. Outcomes & Results: Speech intelligibility was reduced secondary to hypernasality, disordered articulation and/or impaired phonology (n = 7) in children with SMCP. Poorer overall language outcomes were observed for children with SMCP compared with both those with overt clefts and no history of clefting (p < 0.001). Language scores for children with SMCP ranged from impaired (n = 6) to above the standardized mean (n = 4). Receptive and expressive language performance were independently correlated with non-verbal IQ (p < 0.01). Those with severe language impairment (n = 4) also had borderline or impaired non-verbal IQ. Parents reported that speech and semantics were the most affected sub-domains of communication, while scores were the highest for the initiation domain. Speech and language skills were correlated strongly with pragmatics (r = 0.877, p < 0.01). Conclusions & Implications: Overall, performance was variable within the SMCP group across speech, language and pragmatic assessments. In addition to well-documented speech difficulties, children with SMCP may have language or pragmatic impairments, suggesting that further neurodevelopmental influences may be at play. As such, for individuals with SMCP, additional clinical screening of language and pragmatic abilities may be required to ensure accurate diagnosis and guide both cleft and non-cleft related therapy programmes.

Orofacial Function, Articulation Proficiency, and Intelligibility in 5-Year-Old Children Born With Cleft Lip and Palate

“…The questionnaire targeted the domains speech, language, communication and pragmatic/social interaction skills. Speech was rated to cause the greatest difficulties with communication in everyday live, which is in line with a previous study on children with SMCP aged 5 to 12:8 (Boyce et al, 2019). In addition, interesting results were found in the parental rating of Syntax, which was below -2 SD scores for all participants with CAS+DLD (n=7).…”

Prognostic Factors for Speech Outcome among Patients with Submucous Cleft Palate Managed by Furlow Palatoplasty or Posterior Pharyngeal flap

“…18,61 Too early surgical intervention solely based on physical and magnetic resonance imaging examination may not be necessary, as speech development is variable even in the presence of obvious levator muscle dehiscence. 14,62 Although most previous studies reported an average age at operation younger than 9.5 years, none of them provided sufficient data to define the late range of SMCP operation timing. 22,30,44 Our data were not against the principle of delivering SMCP surgical intervention as early as hypernasality or nasal emission is diagnosed by reliable speech analyses.…”

“…18,61 Too early surgical intervention solely based on physical and magnetic resonance imaging examination may not be necessary, as speech development is variable even in the presence of obvious levator muscle dehiscence. 14,62 Although most previous studies reported an average age at operation younger than 9.5 years, none of them provided Copyright © 2023 American Society of Plastic Surgeons. Unauthorized reproduction of this article is prohibited.…”

Epidemiologischer Vergleich und Analyse der operativen Versorgung von Patienten mit Lippen-, Kiefer-, Gaumenspalten - eine Mono-Center Analyse

“…Sie können allerdings auch unvollständig oder als vollständige Spaltung der oralen Schleimhaut, der Muskulatur und der nasalen Schleimhaut auftreten (Bernheim et al 2006). Als Sonderform der unvollständigen Weichgaumenspalten ist hier die submuköse Gaumenspalte zu erwähnen, bei der nur die Muskulatur des weichen Gaumens gespalten und fehlorientiert ist, weswegen die Spaltbildung häufig erst im Laufe der Sprachentwicklung entdeckt wird (Boyce et al 2019;Calnan 1954).…”