Speech Outcomes of Korean Children with Bilateral Cleft Lip and Palate Following Primary Palatal Surgery

Abstract

This study is supported by Hallym University Research Fund (HRF-201809-008). Objectives: This study aimed to examine speech outcomes in Korean-speaking children with bilateral cleft lip and palate (BCLP) at 3 or 4 years of age after primary palatal surgery using the Cleft Audit Protocol for Speech-Augmented-Korean modification. Methods: This study selected 58 children born with non-syndromic BCLP who received primary palatal surgery. Blind analyses were conducted based on the children's audio-recorded speech samples to determine the presence and severity of resonance and articulation problems, and to rate whether there is a perceived need for secondary palatal repair or speech therapy. Results: Among the 58 children with BCLP, 40% showed significantly affected speech intelligibility, which indicated that less than 70% of their speech could be understood. Posterior nasal fricatives, back to velar, co-articulated glottal/pharyngeal errors, and nasal realization had more than 40% prevalence. The results also showed that 37.9% of children with BCLP exhibited moderate or more severe hypernasality and 51.7% had audible nasal emission. The listeners also judged that 62.1% of children required speech therapy and 36.2% of children needed to receive secondary palatal surgery for their persistent speech problems. Conclusion: This study evaluated speech outcomes of primary palatal surgery in Korean-speaking children with BCLP while controlling the related factors to speech outcomes, such as cleft type and surgeon. This study ultimately contributes to improving our current clinical care for children with cleft palate.