Cleft Language and Auditory Skills (CLAS)
Research type
Research Study
Full title
Language and auditory processing in children with cleft palate: a description of the disorder and its relationship to speech outcomes
IRAS ID
249602
Contact name
Stephanie van Eeden
Contact email
Sponsor organisation
Newcastle upon Tyne Hospitals NHS Trust
Duration of Study in the UK
3 years, 7 months, 31 days
Research summary
Research Summary
Almost 1000 babies are born every year in the UK with a gap in their lip, palate or both; this is called a cleft lip, cleft palate or cleft lip and palate. This is usually repaired by surgery in the first year of life, but the consequences can last into adulthood. Outcomes for these children have improved over the last 20 years. Yet every year more than 300 children with a cleft lip and/or palate (CL/P) will still have problems with their speech as they start school.
Some children do not respond to the usual treatment used to teach how sounds are made. There appears to be a group of children with a CL/P who have specific language processing and/or auditory processing difficulties that persist after the age of five years, which can impact on their learning.
This study aims to find out if there is a group of children with CL/P in the UK who also have language and/or auditory processing difficulties which are affecting the way they make speech sounds.
One hundred children with CL/P aged between 5 1/2 and 6 years 11 months will be recruited from cleft centres in the North of England and Scotland. The study will last for 3 ½ years from recruitment to dissemination. A comparison group of age-matched children with speech disorder without cleft palate will also be recruited. All children will be assessed on a range of standard assessments for language and auditory processing. The assessment process will last 2 hours. Results from these tests will be linked to speech data to assess the impact on speech.
If we can identify children with specific auditory and/or language problems, targeted therapy can be implemented, with the aim of achieving age appropriate speech and language before they start school.Summary of Results
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. Despite this, little research has been carried out investigating the links between these aspects of development. Furthermore, there has been no research investigating the differences and commonalities in development between children born with CP+/-L and their nonCP+/-L peers with speech sound disorder (SSD); this would help our understanding of any specific risks for this population and allow us to tailor interventions accordingly.
This study aimed to investigate language and listening skills in children with CP+/-L, and their impact on speech outcomes. It compared outcomes with a control group of non-CP+/-L children with SSD. The study assessed children with non-syndromic CP+/-L aged 5;0 to 7;11 (n=95) and children with non-CP+/-L SSD (n=10). Participants were seen at school or home and their language and listening skills were assessed using a battery of standardised tests.
Both language and listening skills were lower than the scores expected for their age for the CP+/-L group. Fortythree percent presented with phonological errors +/- cleft articulation errors. The presence of these errors, and not cleft articulation errors alone, 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. The implications of high levels of phonological disorder and attention difficulties in this population are novel findings as are the comparisons with children with non-CP+/-L SSD. These findings will help guide clinical decisions when thinking about appropriate intervention in this patient group.REC name
East of Scotland Research Ethics Service REC 2
REC reference
19/ES/0071
Date of REC Opinion
5 Jul 2019
REC opinion
Further Information Favourable Opinion