Predictors of Vocabulary and Morphosyntax Ability in 2-Year-Old Children with Repaired Cleft Palate

ObjectiveTo identify morphosyntax and lexical ability predictors in children with repaired cleft palate (CP) with or without cleft lip (CP ± L).DesignProspective longitudinal cohort study.SettingMultisite institutional.ParticipantsEighty-eight toddlers with nonsyndromic CP ± L.ProceduresParticipants' parents completed the MacArthur-Bates Communicative Development Inventories (CDI) Words and Gestures and background information questionnaires at 16-month visits. They also recorded 2 to 4 hours of their child's vocalizations/words using Language Environmental Analysis (LENA™) recorders. Recordings were analyzed for the number and type of consonants produced. At 24-month visits, parents completed the CDI Words and Sentences.Main Outcome MeasuresMean utterance length of the child's three longest utterances (M3L) and expressive vocabulary reported on the CDI Words and Sentences.ResultsThe results showed significant associations for vocabulary and M3L at 24 months with maternal education level (MEL), total consonants, stop consonants, CDI words produced, and CDI words understood at 16 months. Additionally, vocabulary and the area deprivation index were significantly correlated. Age at palatoplasty, cleft Veau classification, Pierre Robin Sequence, preterm birth, and family history of speech-language delay/disorder were not significantly associated with M3L or vocabulary. Linear regression indicated that MEL, stop consonant production, and CDI words understood at 16 months significantly predicted expressive vocabulary and M3L at 24 months.ConclusionStop consonant production remained a significant predictor of expressive vocabulary and morphosyntax skills, after controlling for other factors. These findings suggest early intervention targeting stop production should promote expressive language skills. Children's stop consonant inventory should be closely monitored following palatoplasty.