Comparisons of longitudinal speech outcomes in children born with cleft palate ± cleft lip with and without additional conditions at 5 and 10 years –a registry study

Speech outcome differences in children with cleft palate ± cleft lip (CP ± L) with ( +) and without (-) additional conditions (i.e., diagnosed syndromes, additional malformations, and intellectual disabilities) are not fully explored. The Swedish cleft lip and palate (CLP) registry enables a longitudinal approach. Thus, the purpose was to compare longitudinal speech outcomes in children with different cleft types, with and without additional conditions, at ages 5 and 10 years, based on registry data. Included were all children with oral clefts involving the palate born in Sweden 2009–2012, with speech registrations at both 5 and 10 years in the Swedish CLP registry (n = 404): 16 cleft soft palate (SP) + , 37 SP-, 67 cleft soft and hard palate (SHP) + , 88 SHP-, 19 unilateral cleft lip palate (UCLP) + , 116 UCLP-, 15 bilateral cleft lip palate (BCLP) + and 46 BCLP-. The speech outcomes percentage of consonants correct, percentage of nonoral speech errors, velopharyngeal competence, and results of the Intelligibility in Context Scale were dichotomized. For group comparisons, Pearson’s chi-square test and Fisher’s exact test were performed. No significant differences were found between the UCLP + /UCLP- and BCLP + /BCLP- groups. In the SP group, a significantly lower proportion of participants with additional conditions than without had age-appropriate consonant production at age 5 (SP + 33.3%; SP- 79.4%), sufficient velopharyngeal function at age 10 (SP + 73.3%; SP- 97.3%), and always intelligible speech at age 10 (SP + 33.3%; SP- 78.6%). In the SHP group, a significantly lower proportion of participants with additional conditions than without had age-appropriate consonant production at age 5 (SHP + 60.6%; SHP- 82.1%) and 10 (SHP + 73.8%; SHP-95.5%), sufficient velopharyngeal function at age 5 (SHP + 82.1%; SHP- 95.5%), and always intelligible speech at age 10 years (SHP + 51.7%; SHP- 83.8%). For all cleft types with and without additional conditions and for all measured speech outcomes, speech improved between 5 and 10 years of age. Speech results were poorer for children with SP + and SHP + at both 5 and 10 years of age. The results highlight the need to consider heterogeneity within cleft subgroups when planning speech improving interventions.