Articulation at age 4 in children with early repair of cleft palate

We report the articulation results in 87 4-year-old children with overt cleft palates who had been repaired at age 1 by the same surgeon and were found to have no factors obstructing their speech-language development. We further present data on developmental courses before age 4 in 81 subjects and after age 4 in 64 subjects. Forty-five of the 87 subjects showed normal articulation: 24 had already acquired normal speech sounds and 21 were still in the course of normal development. In this group only 1 patient showed incompetent velopharyngeal closure. Abnormal articulation was found in 42, among whom only 4 showed incompetent velopharyngeal closure. The most common abnormal articulatory type was palatalized articulation (70%), which had been seldom found in earlier studies. Palatalized articulation showed less of a tendency to correct itself spontaneously than did glottal stops. Abnormal articulation improved spontaneously after 4 years of age in some subjects. The significance of detailed postsurgical follow-up and the necessity of accumulation of more data are emphasized.