Language profiles of children with speech sound disorder with and without cleft palate

Background: It is well documented that children born with cleft palate +/- lip (CP+/-L) are at high risk of speech difficulties. Recently there has been increased interest in the language skills of these children. However, very little has been studied about the relationship between the speech profiles of these children and their language skills. Moreover, no studies have compared the language skills of children with cleft-related speech disorder to children with a diagnosis of isolated speech sound disorder (SSD).

Aim: To detail the language profiles in relation to the speech profiles of children with CP+/-L and non-CP+/-L children with SSD.

Method: Two studies were undertaken: (1) Observational cross-sectional study of children with non-syndromic CP+/-L aged 5–8 years old (n=95); (2) Matched case study of children with speech difficulties aged 5–8 years old. Group 1 CP+/- L (n=10). Group 2 non-CP+/-L SSD (n=10). Children were matched for percent consonants correct (PCC), age, socioeconomic status, gender and hearing history. All children were assessed using the Clinical Evaluation of Language Fundamentals – 5^th edition (UK).

Results: The receptive and expressive language of children with CP+/-L correlated with their PCC and was lower than predicted by normative data. Those with developmental speech errors also scored lower than children with cleft-related articulation errors only. The non- CP+/-L SSD group scored lower than the norms for expressive language only. Children with CP+/-L SSD scored one scaled score lower than non-CP+/-L children on five of six language subtests.

Conclusions: Children with CP+/-L are at risk of both speech and language problems. Those with developmental speech errors are at increased risk. Language skills in children with CP+/-L are poorer than non-CP+/-L SSD children. Clinicians and parents should be aware of this risk and its potential impact on educational outcomes.

Implications for children and families: Children with CP+/-L may have language difficulties. If you are concerned that your child finds it difficult to follow instructions or express themselves, contact your speech and language therapy team for assessment and advice.

Implications for practitioners: Children with CP+/-L may have language difficulties as well as speech difficulties. You should be aware of the impact of this and provide screening for language skills at a young age and intervention as appropriate. You should be particularly mindful of those children presenting with developmental speech errors.

Funding: Health Education England/National Institute for Health and Care Research (HEE/NIHR) ICA-CDRF-2017-03-002

Key words: communication, cleft palate

This presentation relates to the following United Nations Sustainable Development Goals:

• SDG 3: Good Health and Well-being
• SDG 4: Quality Education
• SDG 10: Reduced Inequality