Speech and Language Therapy Interventions for Children with Cleft Palate: A Systematic Review

Abstract

Objective : (1) To examine the evidence for the effectiveness of differences in timing and type of speech and language therapy for children with cleft palate with or without a cleft lip and (2) to identify types of interventions assessed. Design : Nine databases, including MEDLINE and EMBASE, were searched between inception and March 2011 to identify published articles relating to speech and language therapy for children with cleft palate with or without cleft lip. Studies that included at least 10 participants and reported outcome measures for speech and/or language measures were included. Studies where the experimental group had less than 90% of children with cleft palate with or without cleft lip were excluded. Two reviewers independently completed inclusion assessment, data extraction, and risk of bias assessment for all studies identified. Results : A total of 17 papers were evaluated: six randomized control trials and 11 observational studies. Studies varied widely on risk of bias, intervention used, and outcome measures reported. None of the studies had a low risk of bias. In terms of intervention approaches, seven studies evaluated linguistic approaches and 10 evaluated motor approaches. Outcomes measures did not support either approach over the other, and based on data reported it was difficult to ascertain which approach is more effective for children with cleft palate with or without cleft lip. Conclusions : The review found little evidence to support any specific intervention. Key uncertainties need to be identified and adequately powered, methodologically rigorous studies conducted to provide a secure evidence base for speech-language therapy practice in children with cleft palate with or without cleft lip.

Impact of Early Synchronous Lip and Palatal Repair on Speech

“…Correction of the vulnerable plosive /d/ and fricatives /s, z, v/ would be recommended in many patients of the current study. However, a phonological linguistic approach is preferred in case of phonological disorders, including introduction of sets of sounds to improve the child's understanding and production of the rule-based phonological sound system [53]. For some patients of the current study, treatment of cluster simplification, deletion of final consonants and backing might be appropriate.…”

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

“…The literature (1)(2)(3)(4)7,10,20) presents conflicting results regarding language development in children with CLP, specifically regarding the occurrence of receptive problems.…”

“…Children with complete or incomplete cleft lip and palate (CLP), present higher risk to develop changes in language, however, data in literature are controversial (1)(2)(3) . The literature lacks attention on the subject (4) .…”

Julgamento perceptivo-auditivo das oclusivas velares associadas à fissura labiopalatina por juízes com e sem experiência

“…When present, the CA can make the child's or the adult's speech unintelligible and bring in prejudices to their social lives, studies and even to their professional lives 2,3 . Speech therapy is essential for the establishment of standard production and different intervention approaches have been reported in the literature in order to facilitate typical speech production in this population 4,5 …”