Speech Results in 10-Year-Old Children With Isolated Cleft Palate

Isolated cleft palate (CP) is the most common cleft type in Finland, and it is often associated with an additional syndrome.

We investigated speech outcomes in 10-year-old children with isolated CP with (CP+) or without (CP-) syndrome/malformation or with Robin sequence (RS).

A retrospective single-center study comprising 210 ten-year-old children with CP (139 hard and soft CP, 44 soft CP, and 27 submucous CP) born in 2000 to 2013. Data on speech (VPC-Rate, hypernasality, articulation, and intelligibility), speech therapy visits, and speech-correcting surgery were collected. Of the speech data, 30% were reevaluated from standardized audio recordings by 2 experienced speech pathologists.

Of the CP children in this study, 22% had an additional syndrome/malformation and 12% had RS. Sufficient velopharyngeal competence was found in 85%, 57%, and 73% of CP-, CP+, and RS children, respectively. Moderate-to-severe hypernasality was more common in patients with CP+ (CP- 7%, CP+ 26%, RS 12%). In all groups, the incidence of oral articulation errors was high (CP- 33%, CP+ 53%, RS 58%). Nonoral errors were uncommon. Intelligibility was high in patients with CP- (91%). Of patients with RS, 81% had completely intelligible speech, while the corresponding figure in patients with CP+ was only 68%. The incidence of speech therapy visits was highest in the CP+ group (75% versus CP- 50% and RS 58%). There was no significant difference between CP- (18%), CP+ (26%), and RS (31%) in the incidence of speech-correcting surgery. The intra- and inter-rater agreement between the 2 speech pathologists was acceptable.

Most children had sufficient velopharyngeal function and fully intelligible speech at 10 years; however, only 58% had normal articulation. CP+ children had generally poorer speech than CP- children. Robin sequence patients had significantly more oral articulation errors than CP- patients.