Association between velopharyngeal function and dental-consonant misarticulations in children with cleft lip/palate

We studied the association between velopharyngeal function and misarticulat ion of the dental consonants /r/, /s/ and /l/ in children with cleft lip/pa late. We assessed 278 6-year-old Finnish-speaking non-syndromic children (1 15 girls, 163 boys) with isolated cleft palate (n=81), cleft lip/alveolus ( n=82) or unilateral (n=84) or bilateral (n=31) cleft lip and palate. Audito ry analysis of speech and velopharyngeal function, the presence of fistulae , previous velopharyngoplasty and speech therapy, as well as surgical techn ique and timing of primary palatal surgery were obtained from the hospital records. The misarticulations of the sounds /r/, /s/ and /l/ were evaluated in spontaneous speech by two experienced speech pathologists from the clef t team. Velopharyngeal function was categorised, on the basis of the effect on speech, into competent, marginal incompetent and obvious incompetent. N asal grimace and distortions due to palatal fistulae were registered. The r esults indicated that velopharyngeal function was not significantly associa ted with misarticulation of any of the sounds /r/, /s/ and /l/ or their com binations in any cleft groups. The technique and timing of primary palatal surgery, the presence of fistulae and previous pharyngoplasty were not asso ciated with misarticulations. On the basis of these results we conclude tha t dental-consonant misarticulations occur independently of velopharyngeal f unction, primary palatal surgical technique and timing of palatoplasty. (C) 2001 The British Association of Plastic Surgeons.