Metacognitive strategies for enhancing language development in children with cleft palate

Abstract

Background Children born with cleft palate frequently show compensatory articulation errors (CA), and they are also at risk for language delays. There is a need of studies on speech-language intervention in this patient group. The purpose of this paper is to study metacognitive strategies for enhancing language development in children with cleft palate. Methods Twenty-six children with unilateral cleft lip and palate (UCLP) were studied and divided in two groups. The age of the patients ranged from 5 to 8 years. Language and articulation measurements for evaluating language development were made at the beginning and the end of the study. Both groups were treated with previously reported strategies routinely used for enhancing language. In addition, children from one group (active group) were exposed to metacognitive strategies which have been described as useful for enhancing expert thinking processes, such as think-aloud. For evaluating language development, all children were analyzed using the Situational-Discourse-Semantic Model. ResultsThe results indicate that children with UCLP and CA benefit from an intervention which also addresses specific aspects of language development. The patients included in the active group in which the metacognitive strategies were used showed a greater improvement as compared with the patients from the control group.Conclusions Intervention in children with cleft palate and CA should address not only the articulation processes, but also specific aspects of language development. Metacognitive strategies could be an adequate option for enhancing language performance in this patient group. Level of Evidence: Level III, therapeutic study

Language Proficiency in Children with Cleft Palate

“…Through the use of metacognitive strategies, children become more able to incorporate details in their narrations and they can take different perspectives when analyzing the plot of a story. Thus, it may be concluded that metacognitive strategies can be useful for enhancing higher-order language for narration, interpretation, evaluation and organization, and this could be reflected in both, written and oral language [24]. This conclusion agrees with The Local Homology Model described by Bates, et al, which argues that language is an interactive system that depends crucially on processes and representations from a variety of cognitive domains [29].…”

“…Many of them are developed naturally. However, it is now recommended that they should be explicitly taught during stimulation or intervention [24]. It has been described that expert readers use the strategies described herein for making meaning from text [27].…”

“…CCP who learn how to use metacognitive strategies improve their language levels by using more complex discourse structures and higher order language processing [24]. They are also able to improve their level of abstraction [23].…”

“…Most of the emphasis has been aimed to enhance speech development and treat speech and sound disorders. Thus, the use of strategies for enhancing language development in this population has been somehow overlooked [24].…”

“…When CCP with CA and low linguistic performance were followed during intervention, the objective was to reinforce correct speech sounds while enhancing language processing [24]. For this purpose, some strategies described for language intervention such as modeling and/or expansions were used.…”