Primary Language Spoken at Home and Speech Outcomes Among Children With Cleft Palate

OBJECTIVES: Following cleft palate repair, early detection of maladaptive compensatory mechanisms and hypernasality may determine the need for additional intervention. Our goal is to understand if primary language influences rates of subsequent intervention among children with cleft palate in the United States. METHODS: Within a single urban cleft team, patients with a history of palate repair evaluated at least 2 years postoperatively were analyzed using Fisher's exact test. RESULTS: There were 124 patients representing 6 languages: 101 English, 9 Spanish, and 14 other (Vietnamese, Haitian Creole, Portuguese, and Tamil). Some patients were repaired elsewhere and presented to our clinic secondarily for evaluation. Among English and non-English speaking children, similar rates of symptomatic and asymptomatic postoperative fistula (17.8% vs. 17.4%, p = 1.00), hypernasality and/or audible nasal emissions (ANEs) (44.6% vs. 30.4%, p = 0.25), persistent hypernasality/ANE after speech therapy (ST) (22.8% vs. 13.0%, p = 0.40), and revision surgery (33.7% vs. 17.4%, p = 0.14) were observed. However, higher rates of hypernasality/ANE (45.5% vs. 14.3%, p = 0.04), persistent hypernasality/ANE after ST (23.6% vs. 0.0%, p = 0.04), and revision surgery (33.6% vs. 7.1%, p = 0.06) were noted among English and Spanish speakers. [Correction added on 08 May 2026, after first online publication: The preceding sentence has been revised in this version.] CONCLUSION: Within a single urban practice in the United States, lower rates of hypernasality and revision surgery were observed among non-English and non-Spanish speaking patients. Such findings may suggest disparities in resources available for detecting speech abnormalities in this population.