Conversational Skills of Preschool and School-Age Children with Cleft Lip and Palate

Abstract

Objective

The purpose of this study was to examine the conversational skills of preschool and school-age children with cleft lip and palate.

Design

The children were audio- and videotaped during interactions with an unfamiliar adult. In addition, standardized measures of speech and language were administered, and ratings of resonance were obtained. Comparisons were made between the children with cleft lip and palate and their same-age peers on measures of conversational participation and a standardized test of pragmatic skills.

Participants

Participants were 20 children with unilateral cleft lip and palate (10 preschoolers and 10 school-age children) recruited from the Craniofacial Team at Rainbow Babies and Children's Hospital, Cleveland (OH) and 20 noncleft peers matched for gender, age, and socioeconomic status.

Main outcome Measures

Separate comparisons were made for the preschool children with cleft lip and palate and their noncleft peers, and the school-age children with cleft lip and palate and their noncleft peers on eight measures of conversational assertiveness/responsiveness and the standardized tests of pragmatics. Next, each child with cleft lip and palate was classified for level of conversational participation.

Results

Paired t tests revealed no significant differences between the preschool and school-age children with cleft lip and palate and their noncleft peers in level of conversational participation. However, individual child comparisons revealed less assertive profiles of conversational participation for 50% of the preschool and 20% of the school-age children with cleft lip and palate.

Conclusions

Children with cleft lip and palate may show a less assertive style of conversational participation, at least during the preschool years. Therefore, craniofacial team evaluations should include examination of conversational competency, particularly for children who are demonstrating difficulty with other aspects of speech, language, or social development.

Keywords

children with cleft lip and palate language skills pragmatics social skills

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References

Axton

Hearing Loss, Otologic Care, and Language Retardation in Cleft Palate Children. Pittsburgh, PA: University of Pittsburgh; 1972. Thesis.

Black

, Hazen

N.L.

Social status and patterns of communication in acquainted and unacquainted preschool children.

Dev Psychol 1990; 26: 379–387.

Brinton

, Fujiki

Conversational Management with Language-Impaired Children: Pragmatic Assessment and Intervention. Rockville: Aspen Publishers; 1989.

Brinton

, Fujiki

Conversational intervention with children with specific language impairment. In: Fey

M.E.

, Windsor

, Warren

S.F.

, eds. Language Intervention: Preschool Through the Elementary Years. Baltimore: Paul Brookes; 1995: 183–213.

Broder

H.L.

, Strauss

R.P.

Self-concept of early primary school age children with visible or invisible defects.

Cleft Palate J 1989; 26: 114–117.

Bzoch

K.R.

An Investigation of the Speech of Preschool Cleft Palate Children. Chicago, IL: Northwestern University; 1956. Dissertation.

Bzock

K.R.

A study of the speech of a group of preschool cleft palate children.

Cleft Palate Bull 1959; 9: 2–3.

Bzoch

K.R.

Articulatory proficiency and error patterns of preschool cleft palate and normal children.

Cleft Palate J 1965; 2: 340–349.

Chapman

, Hardin

Communicative competence in children with cleft lip and palate. In: Bardach

, Morris

H.L.

, eds. Multidisciplinary Management of Cleft Lip and Palate. Philadelphia: WB Saunders; 1990: 721–726.

10.

Chapman

Phonological process usage in children with cleft palate.

Cleft Palate J 1993; 30: 64–71.

11.

Dalston

Communication skills of children with cleft lip and palate: a status report. In: Bardach

, Morris

H.L.

, eds. Multidisciplinary Management of Cleft Lip and Palate. Philadelphia: WB Saunders; 1990: 746–749.

12.

Eliason

M.J.

, Richman

L.C.

Language development in preschoolers with cleft.

Dev Neuropsychol 1990; 6: 73–182.

13.

Fey

M.E.

Language Intervention with Young Children. San Diego: College Hill; 1986.

14.

Fey

M.E.

, Leonard

L.B.

Pragmatic skill of children with specific language impairment. In: Gallagher

, Prutting

, eds. Pragmatic Assessment and Intervention Issues in Language. San Diego: College Hill; 1983.

15.

Goldman

, Fristoe

The Goldman-Fristoe Test of Articulation. Circle Pines, MN: American Guidance Service; 1986.

16.

Hammill

D.D.

, Newcomer

P.L.

Test of Language Development-2-Primary. Austin, TX: Pro-Ed; 1988a.

17.

Hammill

D.D.

, Newcomer

P.L.

Test of Language Development-2-Intermediate. Austin, TX: Pro-Ed; 1988b.

18.

Hazen

N.L.

, Black

Preschool peer communication skills: the role of social status and interaction context.

Child Dev 1989; 60: 867–876.

19.

Huberty

C.J.

, Morris

J.D.

Multivariate analysis versus univariate analyses.

Psychol Bull 1989; 105: 302–308.

20.

Kapp-Simon

Self-concept of primary-school-age children with cleft lip, cleft palate, or both.

Cleft Palate J 1986; 23: 24–27.

21.

Kapp-Simon

K.A.

, Simon

D.J.

, Kristovich

Self-perceptions, social skills, adjustment, and inhibition in young adolescents with craniofacial anomalies.

Cleft Palate J 1992; 29: 352–356.

22.

Krueckeberg

S.M.

, Kapp-Simon

K.A.

, Ribordy

S.C.

Social skills of preschoolers with and without craniofacial anomalies.

Cleft Palate J 1993; 30: 475–481.

23.

Leonard

L.B.

Children with Specific Language Impairment. Cambridge: MIT Press; 1998.

24.

Loban

Language Development. Champaign-Urbana, IL: National Council of Teachers of English; 1976.

25.

Long

, Dalston

Paired gestural and vocal behavior in one-year-old cleft lip and palate children.

J Speech Hear Dis 1982; 47: 403–406.

26.

Long

S.H.

, Fey

M.E.

Computerized Profiling: User's Manual (Apple II Version 6.0–6.1A; MS-DOS Version 6.0–6.2). Ithaca, NY: Ithaca College Department of Speech Pathology & Audiology; 1988.

27.

Long

S.H.

, Fey

M.E.

Computerized Profiling: User's Manual (MacIntosh Version 1.0; MS—OSVeroinn 7.1). San Antonio: The Psychological Corporation; 1993.

28.

McTear

M.F.

, Conti-Ramsden

Pragmatic Disability in Children. San Diego: Singular Press; 1992.

29.

McWilliams

, Morris

, Shelton

Cleft Palate Speech. Philadelphia: BC Decker; 1990.

30.

McWilliams

B.J.

, Musgrave

Psychological implications of articulation disorders in cleft palate children.

Cleft Palate J 1972; 9: 294–303.

31.

Morris

H.L.

Communication skills of children with cleft lip and palate.

J Speech Hear Res 1962; 5: 79–90.

32.

Nation

Determinants of vocabulary development of preschool cleft palate children.

Cleft Palate J 1970; 7: 645–651.

33.

Newborg

, Stock

, Wnek

, Guidubaldi

, Snicicki

Battelle Developmental Inventory. Itasca, IL: Riverside; 1984.

34.

Pannbacker

Language skills of cleft palate children: a review.

Br J Dis Communication 1971; 6: 37–44.

35.

Peterson-Falzone

S.J.

A cross-sectional analysis of speech results following palatal closure. In: Bardach

, Morris

H.L.

, eds. Multidisciplinary Management of Cleft Lip and Palate. Philadelphia: WB Saunders; 1990: 750–757.

36.

Philips

B.J.

, Harrison

R.J.

Articulation patterns of preschool cleft palate children.

Cleft Palate J 1969; 6: 245–253.

37.

Place

K.S.

, Becker

J.A.

The influence of pragmatic competence on the likability of grade-school children.

Discourse Processes 1991; 14: 227–241.

38.

Richman

L.C.

Self-reported social, speech, and facial concerns and personality adjustment of adolescents with cleft lip and palate.

Cleft Palate J 1983; 20: 108–112.

39.

Richman

L.C.

, Eliason

Psychosocial characteristics of children with cleft lip and palate: intellectual, achievement, behavioral and personal variables.

Cleft Palate J 1982; 19: 249–257.

40.

Rosinski-McClendon

M.K.

, Newhoff

Conversational responsiveness and assertiveness in language-impaired children.

Lang Speech Hear Ser Sch 1987; 18: 53–62.

41.

Roth

, Spekman

N.J.

Assessing the pragmatic abilities of children: part I. Organizational framework and assessment parameters.

J Speech Hear Dis 1984; 49: 2–12.

42.

Shames

, Rubin

Psycholinguistic measures of language and speech. In: Bzoch

, ed. Communicative Disorders Related to Cleft Lip and Palate. Boston: Little, Brown; 1979: 201–220.

43.

Shulman

B.B.

Test of Pragmatic Skills. Tucson, AZ: Communication Skill Builders; 1985.

44.

Smith

R.M.

, McWilliams

B.J.

Psycholinguistic abilities of children with clefts.

Cleft Palate J 1968a; 5: 238–249.

45.

Smith

R.M.

, McWilliams

B.J.

Psycholinguistic considerations of the management of children with cleft palate.

J Speech Hear Dis 1968b; 33: 26–33.

46.

Spriesterbach

D.C.

, Darley

F.L.

, Morris

H.L.

Language skills in children with cleft palate.

J Speech Hear Res 1958; 1: 279–285.

47.

Templin

, Darley

The Templin-Darley Tests of Articulation. Iowa City, IA: Bureau of Educational Research and Service; 1969.

48.

Tobiasen

J.M.

, Hiebert

J.M.

Clefting and psychosocial adjustment: influence of facial aesthetics.

Clin Plast Surg 1993; 20: 623–631.

49.

Van Demark

D.R.

, Morris

H.L.

, Van De Haar

Patterns of articulation abilities in speakers with cleft palate.

Cleft Palate J 1979; 6: 230–239.

50.

Warr-Leeper

, Crone

, Carruthers

, Leeper

A comparison of the performance of preschool children with cleft lip and/or palate on the test of pragmatic skills. Presented at the Annual Meeting of the American Cleft Palate Association; 1988; Williamsburg, VA.

51.

Wiig

E.H.

Let's Talk Inventory for Adolescents. Columbus, OH: Charles Merrill; 1982.