[The language and speech skills in 417 children with cleft formations]

Children with cleft palate often suffer from hearing, speech, and language articulation disorders. In order to design an efficient rehabilitation program for children thus affected, it is mandatory to acquire knowledge of the long term results achieved by the various therapeutical strategies including velopharyngoplasty and speech therapy. In this follow-up study 417 children with cleft palate (excluding isolated cleft lip) were examined in an interdisciplinary approach by maxillofacial surgeons, orthodontists, otolaryngologists, audiologists, and speech and language pathologists. The examinations determined that 93% of the children had speech or language disorders and 80% of these children suffered from mild to severe conductive hearing loss with or without clinical signs of otitis media with effusion. In 58 children (14%) with rhinolalia aperta, which had not been improved after one year of speech therapy, velopharyngoplasty with a cranial based pharyngeal flap was performed. The study showed that language skills do not correlate to the type of cleft palate, but rather to the frequency and degree of hearing loss. Using an interdisciplinary approach in early detection and the prompt clinical correction of cleft palate disorders resulted in only 49% of the affected children having to undergo speech and language therapy. In 51% of the affected children no speech therapy was necessary at all. The results presented in this study lead to the conclusion that our program for managing the rehabilitation of children with cleft palate is efficient.