This study investigated the associations between hypernasality and intelligibility, and language and reading skills in 10-year old children with a cleft palate ± lip.
Design:
Cross-sectional data collected during routine assessments of speech and language in a centralized treatment setting.
Participants:
Children aged 10, born with cleft palate ± lip from 4 birth cohorts (N = 123).
Outcome Measures:
Hypernasality and intelligibility: Swedish Articulation and Nasality Test-N; language: Language 6-16 (Sentence recall, Serial recall, Vocabulary); reading: word chain test and reading comprehension test.
Results:
A total of 71.3% of the children had no occurrence of hypernasality and 82.8% had intelligibility scores within the normal range. For all children with hypernasality and intelligibility within the normal range, reading and language scores were also within normal ranges. Children with presence of hypernasality had significantly lower language skills, with mean scores within the lower normal range. Children with reduced intelligibility had lower scores on reading comprehension.
Conclusions:
The findings highlight a possible association between hypernasality and language skills, and intelligibility and reading skills. Cleft teams should consider routine assessments of language and reading skills in children with speech impairment, in order to identify potential needs for intervention as early as possible.
BergESivertsenÅAriansenAMFilipCVindenesHAFeragenKBMosterDLieRTHaalandØA. Socio-economic status and reproduction among adults born with an oral cleft: a population-based cohort study in Norway. PLoS One. 2016;11(9):e0162196. doi:10.1371/journal.pone.0162196.
2.
BessellASellDWhitingPRoulstoneSAlberyLPerssonMVerhoevenABurkeMNessAR. Speech and language therapy interventions for children with cleft palate: a systematic review. Cleft Palate Craniofac J. 2013;50(1):e1–e17.
3.
BishopDVSnowlingMJ. Developmental dyslexia and specific language impairment: same or different?Psychol Bull. 2004;130(6):858–886.
4.
BoyceJOKilpatrickNReillySDa CostaAMorganAT. Receptive and expressive language characteristics of school-aged children with non-syndromic cleft lip and/or palate. Int J Lang Commun Disord. 2018;53(5):959–968.
5.
BrentRCStott-MillerMKapp-SimonKACunninghamMLSpeltzML. Reading in children with orofacial clefts versus controls. Journal of Pediatric Psychology. 2010;35(2):199–208.
6.
BrunnegårdKLohmanderA. A cross-sectional study of speech in 10-year-old children with cleft palate: results and issues of rater reliability. Cleft Palate Craniofac J. 2007;44(1):33–44.
7.
CasbyMW. Otitis media and language development: a meta-analysis. Am J Speech Lang Pathol. 2001;10(1):65–80.
8.
ChapmanKL. The relationship between early reading skills and speech and language performance in young children with cleft lip and palate. Cleft Palate Craniofac J. 2011;48(3):301–311.
9.
ChapmanKLGrahamKTGoochJViscontiC. Conversational skills of preschool and school-age children with cleft lip and palate. Cleft Palate Craniofac J. 1998;35(6):503–516.
10.
CollettBRLerouxBSpeltzML. Language and early reading among children with orofacial clefts. Cleft Palate Craniofac J. 2010a;47(3):284–292.
11.
CollettBRStott-MillerMKapp-SimonKACunninghamMLSpeltzL. Reading in children with orofacial clefts versus controls. J Pediatr Psychol. 2010b;35(2):199–208.
12.
ConradALMcCoyTEDeVolderIRichmanLCNopoulosP. Reading in subjects with an oral cleft: speech, hearing and neuropsychological skills. Neuropsychology. 2014;28(3):415–422.
13.
ConradALRichmanLNopoulosP. Reading achievement in boys with non-syndromic cleft palate only: relationship to neuropsychological skill and neurocircuitry. Dev Neuropsychol. 2015;40(7-8):395–406.
14.
FeragenKBAuknerRSærvoldTKHideØ. Speech, language and reading skills in 10-year-old children with palatal clefts: the impact of additional conditions. J Commun Disord. 2017;66:1–12.
15.
FeragenKBStockNMRumseyN. Toward a reconsideration of inclusion and exclusion criteria in cleft lip and palate: implications for psychological research. Cleft Palate Craniofac J. 2014;51(5):569–578.
16.
Hardin-JonesMChapmanKL. Cognitive and language issues associated with cleft lip and palate. Semin Speech Lang. 2011;32(2):127–140.
17.
Hardin-JonesMChapmanKL. Early lexical characteristics of toddlers with cleft lip and palate. Cleft Palate Craniofac J. 2014;51(6):622–631.
18.
HavstamCLaaksoKLohmanderARingsbergKC. Taking charge of communication: adults’ descriptions of growing up with a cleft-related speech impairment. Cleft Palate Craniofac J. 2011;48(6):717–726.
ImpieriDTønsethKAHideØBrinckELHøgevoldHEFilipC. The impact on orthognatic surgery on velopharyngeal function by evaluating speech and cephalometric radiographs. J Plast Reconstr Aesthet Surg. 2018;71(12):1786–1795.
22.
JocelynLJPenkoMARodeHL. Cognition, communication, and hearing in young children with cleft lip and palate and in control children: a longitudinal study. Pediatrics. 1996;97(4):529–534.
23.
JohannissonTBLohmanderAPerssonC. Assessing intelligibility by single words, sentences and spontaneous speech: a methodological study of the speech production of 10-year-olds. Log Phoniatr Vocol. 2014;39(4):159–168.
24.
KaiserAPSchererNJFreyJRRobertsMY. The effects of enhanced milieu teaching with phonological emphasis on the speech and language skills of young children with cleft palate: a pilot study. Am J Speech Lang Pathol. 2017;26(3):806–818.
25.
KlintöKSalamehEKOlssonMFlynnTSvenssonHLohmanderA. Phonology in Swedish- speaking 3-year-olds born with cleft lip and palate and the relationship with consonant production at 18 months. Int J Lang Commun Disord. 2014;49(2):240–254.
26.
KuehnDPMollerKT. Speech and language issues in the cleft palate population: the state of the art. Cleft Palate Craniofac J. 2000;37(4):348:1–35.
27.
LohmanderABorellEHenningssonGHavstamCLundeborgIPerssonC. SVANTE – Svenskt Artikulations- och Nasalitets Test (Swedish Articulation and Nasality Test). Skivarp, Sweden: Pedagogisk Design; 2005.
28.
LohmanderAPerssonC. A longitudinal study of speech production in Swedish children with unilateral cleft lip and palate and two-stage palatal repair. Cleft Palate Craniofac J. 2008; 45(1):32–41.
29.
LohmanderAFriedeHLiljaJ. Long-term, longitudinal follow-up of individuals with unilateral cleft lip and palate after the Gothenburg primary early veloplasty and delayed hard palate closure protocol: speech outcome. Cleft Palate Craniofac J. 2012;49(6):657–671.
30.
MuterVHulmeCSnowlingMJStevensonJ. Phonemes, rimes, vocabulary, and grammatical skills as foundations of early reading development: evidence from a longitudinal study. Develop Psychology. 2004;40(5):665–681.
31.
NathanLStackhouseJGoulandrisNSnowlingMJ. The development of early literacy skills among children with speech difficulties: a test of the ‘critical age hypothesis’. J Speech Lang Hear Res. 2004;47(2):377–391.
32.
NybergJPetersonPLohmanderA. Speech outcomes at age 5 and 10 years in unilateral cleft lip and palate after one-stage palatal repair with minimal incision technique – a longitudinal perspective. Int J Pediatr Otorhinolaryngol. 2014;78(10):1662–1670.
33.
NeumannSRomonathR. Effectiveness of nasopharyngoscopic biofeedback in clients with cleft palate speech: a systematic review. Log Phoniatr Vocol. 2012;37(3):95–106.
34.
OttemE. Språk 6-16: nye normer til bruk i forskning og utredning (Language 6-16: new norms for research and assessments). Skolepsykologi. 2007;4(2):13–23.
35.
OttemEFrostJ. Språk 6-16 Screeningtest (Language 6-16 Screening test). Manual III. Oslo, Norway: Bredtvet kompetansesenter; 2010.
36.
PenningtonBFBishopDV. Relations among speech, language, and reading disorders. Annu Rev Psychol. 2009;60:283–306.
37.
PerssonMBeckerMDConradALSvenssonH. Female and male differences in academic achievement in individuals with cleft: a population-based register study. Cleft Palate Craniofac J. 2018;55(2):196–203.
38.
PetersonRLPenningtonBFShribergLD. What influences literacy outcome in children with speech sound disorder?J Speech Lang Hear Res. 2009;52(5):1175–1188.
39.
RichmanLCEliasonMJLindgrenSD. Reading disability in children with clefts. Cleft Palate Craniofac J. 1998;25(1):21–25.
40.
RichmanLCRyanSWilgenbuschTHalT. Spontaneous verbal labeling: visual memory and reading ability in children with cleft. Cleft Palate Craniofac J. 2005;42(5):565–569.
41.
RobertsRMMathiasJLWheatonP. Cognitive functioning in children and adults with nonsyndromal cleft lip and/or palate: a meta-analysis. J Pediatr Psychol. 2012;37(7):786–797.
42.
SchererNJD’AntonioLL. Parent questionnaire for screening early language development in children with cleft palate. Cleft Palate Craniofac J. 1995;32(1):7–13.
43.
SchererNJWilliamsALProctor-WilliamsK. Early and later vocalization skills in children with and without cleft palate. Int J Pediatr Otorhinolaryngol. 2008;72(6):827–840.
44.
SchererNJBakerSKaiserAFreyJR. Longitudinal comparison of the speech and language performance of United States-born and internationally adopted toddlers with cleft lip and palate: a pilot study. Cleft Palate Craniofac J. 2018;55(7):941–953.
45.
SellD. Issues in perceptual speech analysis in cleft palate and related disorders: a review. Int J Lang Commun Disord. 2005;40(2):103–121.
46.
SolheimOJ. The impact of reading self-efficacy and task value on reading comprehension scores in different item formats. Read Psychol. 2011;32(1):1–27.
47.
StackhouseJ. Barriers to literacy development in children with speech and language difficulties. In: BishopDVMLeonardLB, eds. Speech and Language Impairments in Children. Causes, Characteristics, Intervention and Outcome. 2000. East Sussex: Psychology Press Ltd.
48.
StackhouseJWellsBPascoeMReesR. From phonological therapy to phonological awareness. Semin Speech Lang. 2002;23(1):27–42.
49.
WilladsenE. Lexical selectivity in Danish toddlers with cleft palate. Cleft Palate Craniofac J. 2013;50(4):456–465.
50.
WechslerD. Wechsler Intelligence Scale for Children – III. San Antonio, TX: Psychological Corporation; 1991.
51.
WehbyGLCollettBRBarronSRomittiPAnsleyT. Children with oral clefts are at greater risk for persistent low achievement in school classmates. Arch Dis Child. 2015;100(12):1148–1154.
