Original article. Articulation disorders and patterns in children with a cleft

Background: Compensatory articulation disorders (CAD) are the most common speech defects in patients with a cleft. Early prevention programs are needed to avoid CAD.

Objectives: To examine articulation disorders, patterns, and related speech outcomes in children with a cleft palate with or without lip defects.

Methods: Articulation test record forms and clinical records of 42 children were accessed retrospectively to provide the data of speech outcomes related to cleft palate. Double data entries and incorrect completion type errors were corrected.

Results: Prevalence of articulatory defects was 88% (functional articulation disorders, 12%; compensatory articulation disorders, 10%; functional articulation disorders and CAD, 67%), resonance disorder was 50%, and voice abnormalities was 19%. Abnormal backing of oral consonants, particularly glottal substitution was the most common pattern of CAD (40%), follow by velar substitution (36%), and nasal consonant for oral pressure consonant (21%). There was high incidence of functional articulation disorder in patients with a cleft (76%). Younger children (≤7 years old) had more articulation defects than older children (>7 years old) (mean difference = 3.308, P = 0.002, 95% confident interval 1.683-6.971). Levene’s test for equal variance found that resonance disorder seems unaffected by the number of articulation errors (mean difference = 0.253, P = 0.897, 95% confident interval -3.736-4.241).

Conclusion: CAD, particularly abnormal backing of oral consonants and hypernasality were the most common speech defects in children with cleft. Refinement and revision of timing for referring for early speech intervention should be reconsidered.