Filtering by
- All Subjects: Cleft Palate
- All Subjects: Hispanic American children--Health and hygiene.
- Creators: Scherer, Nancy
Children with cleft lip and/or palate undergo an extensive series of surgical, orthodontic, speech, audiologic, genetic and medical assessments and treatments during their childhood. The purpose of this study was to examine the Velopharyngeal Insufficiency Effects on Life Outcomes – Parent (VELO-P) comparison of children who had surgery and those who did not in children 5 to 7 years old. The VELO is a quality-of-life questionnaire instrument consisting of 6 subscales, speech limitation, swallowing, situational difficulty, emotional impact, perception by others, and caregiver impact. We compared two groups of children with cleft lip and palate, those who had a secondary surgery for speech hypernasality and those who did not have secondary speech for hypernasality. It is predicted that those who had secondary surgery to repair speech hypernasality will be the group that will show a higher quality of life due to the effect the repair would have on improving their speech. The participants included 30 children between the ages of 5 to 7-years-old with cleft lip and/or palate. Ten of which were male and 20 were female. As for the cleft types, 14 had a unilateral cleft lip and palate, 3 had a bilateral cleft lip and palate, and 13 had a cleft palate only. Nineteen of the children did not have surgery for speech hypernasality and eleven did have surgery. The results of study indicated that the two groups differed significantly on total VELO scores (t=.773, p=0.046) indicating that children who did not have surgery had better quality of life than those who experienced speech hypernasality and had secondary surgery. While individual subscales did not show statistical significance, two subscales showed a moderate effect size difference; caregiver impact (d= .46) and emotional impact (d=.54), indicating that having a speech impairment that requires a secondary surgery may not repair the speech impairment to provide the child intelligible speech and therefore a higher quality of life.
Method: Three parent-child dyads participated in the study. All child participants had nonsyndromic CL/P and ranged in age from 21 to 27months. Participants received three weekly telepractice intervention sessions, along with a total of three in-person parent training sessions. Intervention and training were conducted by an SLP and trained graduate student.
Results: All speech measures indicated a gain in essential speech skills for all three children when comparing pre-intervention to post-intervention assessment results. Positive improvement was seen across multiple language measures for all participants.
Conclusion: A parent implemented EMT+PE intervention program using telepractice is an effective way to increase child speech and language outcomes for children with CL/P. Speech and language targets should be combined and delivered simultaneously in intervention.
Methods: After searching through PubMed and PsycINFO and screening each article to see if the studies matched our inclusion and exclusion criteria, 7 studies qualified for this meta-analysis. Across all studies, 274 children with NSCL/P were compared to 267 of their typically developing peers. The mean age for children with NSCL/P was 118.8 months (SD = 49.19) and 119.8 months (SD = 49.81) for typically developing children. Effect sizes and demographic information (i.e. study location, sample size, assessments used, etc.) were pulled from each study.
Results: The average effect size for this systematic review is -0.41, demonstrating that children with NSCL/P performed 0.41 standard deviations less than their typically developing peers on measures of word decoding. This was calculated using the RVE-model. Both the older and younger age range showed deficits in their word decoding abilities compared to their typically developing peers. Hearing status, language abilities, and speech abilities were reported minimally with many inconsistencies between studies.
Conclusions: These findings suggest that children with NSCL/P perform poorer on word decoding tasks than their noncleft peers. These differences are found in both the younger and older populations of our sample. More evidence and fewer inconsistencies in the research are needed to determine whether hearing, language, and speech abilities have an effect on the word decoding skills of children with NSCL/P.