Cleft Palate Clinical Trial
Official title:
Articulatory and Phonological Competence at 3 and 5 Years of Age in Children With Unilateral Cleft Lip and Palate Who Have Undergone Different Methods of Primary Palatal Surgery
The purpose of the study is to assess if there are any differences in the articulatory and phonological competence in pre-school children with unilateral cleft lip and palate (UCLP) who are treated with different surgical methods of palatal repair.
A cleft palate may influence important functions such as eating, function of the
ear/hearing, speech, occlusion, and in addition social skills and acceptability related to
appearance. Surgical treatment is aiming to minimize the impact of the cleft on these
functions. Nevertheless there is often a need of orthodontic treatment, and if the palate is
involved, speech therapy and speech improving secondary surgery. The incidence of otitis
media with effusion, and related hearing problems, is high among the children. The outcome
is affected by type of cleft as well as surgical method, although not yet fully clarified.
Some consider the growth of the mid-face to be better if primary surgery of the hard palate
is delayed, while speech development is considered to benefit from primary palate surgery
performed as early as possible. Yet we don´t know which surgical method is the best. In most
parts of the world and at three of six treatment centers in Sweden the palate is closed in
one stage between 12 and 18 months of age. At the three other Swedish centers the cleft in
the soft palate is closed at 4-6 months, and the cleft in the hard palate is repaired at 2-3
years of age.
Video-recordings of the children at 3 and 5 years of age will be used for evaluation. The
speech material at 3 years of age consists of spontaneous speech and word naming. At 5 years
sentence repetition and a re-telling task is added. Blindly transcription of the material
after randomization, according to the transcription used for cleft palate speech in Sweden
based on the IPA and ExtIPA conventions will be performed. About 30% of the material,
randomly selected, will be re-transcribed and about 30% will be transcribed by an additional
listener independently, for calculation of reliability. The results will be compared between
groups regarding articulatory deviancies and phonological processes, and will be
statistically analyzed. Impact of ear problems, hearing and speech therapy will be assessed.
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Observational Model: Cohort, Time Perspective: Prospective
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