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Final data Cleft Language and Auditory Skills (CLAS) study
Background - Children with cleft palate +/- lip (CP+/-L) are at risk of speech sound difficulties. These are most often described as articulation difficulties resulting from an orofacial structural anomaly. However, there is also evidence of poor auditory skills, language development and academic achievement.
Aims - To investigate language and auditory skills in children with CP+/-L, and the impact on speech outcomes. To compare outcomes with a control group of non-CP+/-L children with SSD.
Method - Participants: Children with non-syndromic CP+/-L aged 5;0 to 7;11 (n=95) and children with non-CP+/-L SSD (n=10). Design: An observational cross-sectional study of children with CP+/-L with a matched-case design comparing the CP+/-L group to a non-CP+/-L SSD group.
Assessments and data - A battery of language and listening assessments. Data from CELF-5 language assessment, DEAP speech assessment, TOVA attention assessment, SCAN auditory processing skills. Parent report from ECLiPS questionnaire also used.
Results - Both language and auditory skills were lower than the assessment normative means for the CP+/-L group. Forty-three percent presented with phonological errors +/- cleft articulation errors. The presence of these errors, and not cleft articulation errors, was associated with language outcomes. Auditory attention was poor in this group with some association with speech development. Children with CP+/-L SSD had poorer language and auditory skills than those with non-CP+/-L SSD and differed only in exposure to general anaesthesia.
Conclusions - There were high levels of language and auditory difficulties in this group of children with CP+/-L, with unexpected relationships with speech profiles. The implications of high levels of phonological disorder in this population are novel findings as are the comparisons with children with non-CP+/-L SSD. This study provides empirical data of multiple risk factors for speech outcomes in the CP+/-L population and contributes towards our theoretical understanding of development in this population.
Language and auditory processing in children with cleft palate: a description of the disorder and its relationship to speech outcomes
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