Linguistic development in cleft palate patients with and without compensatory articulation disorder

Introduction: Cleft palate patients frequently show compensatory articulati on disorder (CAD). CAD severely affects speech intelligibility and requires a prolonged period of speech intervention. CAD has been considered a phono logic disorder. Thus, it seems necessary to explore the relationship betwee n CAD and language development. Objective: To study the relationship betwee n language development and the presence of CAD in cleft palate patients. Ma terials and Methods: Cleft palate children with residual velopharyngeal ins ufficiency (VPI) after palatal closure, with and without CAD were studied. Only patients with an age ranging from 3 to 8 years were included in the st udy group. Twenty-nine cleft palate patients with residual VPI and CAD were included in the first group (active). The second group was assembled with 29 cleft palate patients with residual VPI without CAD, matched by age and sex (control). For evaluating language development, all patients were analy zed using the Situational-Discourse-Semantic (SDS) Model [13]. This Model i s a valuable tool for conducting naturalistic observation and descriptive a ssessment of language development. The SDS Model provides a detailed descri ption of three contexts (situational, discourse, and semantic) in ten level s of cognitive and linguistic organization. Results: In all contexts consid ered by the model of cognitive and linguistic organization used for this st udy, i.e. SDS, a Fischer exact test demonstrated that patients with CAD sho wed a significantly higher frequency of language delay as compared with pat ients without CAD. None of the patients present with CAD showed an adequate level of language development. The degree of language delay was greater in the situational context as compared to the semantic and discourse contexts . Conclusions: Cleft palate patients present with CAD, demonstrated a signi ficantly higher frequency of delay in language development as compared with cleft palate patients present with VPI without CAD. From the results of th is paper, it seems that a detailed evaluation of all aspects of cognitive a nd linguistic organization should be performed in cleft palate patients, es pecially in patients present with CAD. Moreover, it seems that speech inter vention in cleft palate patients with CAD should address not only the artic ulation process, but also specific aspects of language development. (C) 200 0 Elsevier Science Ireland Ltd. All rights reserved.