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Everaert E, Selten I, Boerma T, Houben M, Vorstman J, de Wilde H, Derksen D, Haverkamp S, Wijnen F, Gerrits E. The Language Profile of Preschool Children With 22q11.2 Deletion Syndrome and the Relationship With Speech Intelligibility. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:128-144. [PMID: 36512754 DOI: 10.1044/2022_ajslp-21-00328] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Young children with 22q11.2 deletion syndrome (22q11DS) often have impaired language development and poor speech intelligibility. Here, we report a comprehensive overview of standardized language assessment in a relatively large sample of preschool-aged children with 22q11DS. We furthermore explored whether speech ability explained variability in language skills. METHOD Forty-four monolingual Dutch preschoolers (3-6 years) with a confirmed genetic 22q11DS diagnosis participated in this prospective cohort study. Standardized tests (Clinical Evaluation of Language Fundamentals Preschool-2-NL and Peabody Picture Vocabulary Test-III-NL) were administered. Speech intelligibility was rated by two expert speech and language therapists using a standardized procedure. RESULTS Most children had impaired language skills across all tested domains. The composite score for expressive language was significantly lower than that for receptive language, but the two were strongly correlated. Only small differences between the mean scores on the various subtests were observed, with the lowest scores for expressive morphosyntactic skills. Language scores showed a moderate positive relation with speech intelligibility, but language abilities varied greatly among the children with intelligible speech. CONCLUSIONS We show that the majority of preschool children with 22q11DS have a broad range of language problems. Other than the relatively larger impairment in expressive than in receptive language skills, our results do not show a clearly delineated language profile. As many of the children with intelligible speech still had below-average language scores, we highlight that language problems require a broad assessment and care in all young children with 22q11DS. Future research using spontaneous language and detailed speech analysis is recommended, to provide more in-depth understanding of children's language profile and the relationship between speech and language in 22q11DS.
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Affiliation(s)
- Emma Everaert
- Utrecht Institute of Linguistics OTS, Utrecht University, the Netherlands
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Iris Selten
- Utrecht Institute of Linguistics OTS, Utrecht University, the Netherlands
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Tessel Boerma
- Utrecht Institute of Linguistics OTS, Utrecht University, the Netherlands
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Michiel Houben
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Jacob Vorstman
- Program in Genetics and Genome Biology, SickKids Research Institute, Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Hester de Wilde
- Speech and Language Therapy, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Desiree Derksen
- Speech and Language Therapy, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Sarah Haverkamp
- Speech and Language Therapy, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands
| | - Frank Wijnen
- Utrecht Institute of Linguistics OTS, Utrecht University, the Netherlands
| | - Ellen Gerrits
- Utrecht Institute of Linguistics OTS, Utrecht University, the Netherlands
- Research Group Speech and Language Therapy - Participation is Communication, HU University of Applied Sciences, Utrecht, the Netherlands
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Glinianaia SV, McLean A, Moffat M, Shenfine R, Armaroli A, Rankin J. Academic achievement and needs of school-aged children born with selected congenital anomalies: A systematic review and meta-analysis. Birth Defects Res 2021; 113:1431-1462. [PMID: 34672115 PMCID: PMC9298217 DOI: 10.1002/bdr2.1961] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 09/21/2021] [Indexed: 11/09/2022]
Abstract
Children with congenital anomalies have poorer intellectual and cognitive development compared to their peers, but evidence for academic achievement using objective measures is lacking. We aimed to summarize and synthesize evidence on academic outcomes and special education needs (SEN) of school‐aged children born with selected major structural congenital anomalies. Electronic databases (MEDLINE, EMBASE, Scopus, PsycINFO, CINAHL, ProQuest Natural Science and Education Collections), reference lists and citations for 1990–2020 were systematically searched. We included original‐research articles on academic achievement in children with non‐syndromic congenital anomalies that involved school test results, standardized tests and/or SEN data. Random‐effects meta‐analyses were performed to estimate pooled mean test scores in mathematics and/or reading where possible and pooled odds ratios (ORs) for SEN in children with severe congenital heart defects (CHDs) and children with orofacial clefts (OFCs). Thirty‐nine eligible studies (n = 21,066 children) were synthesized narratively. Sixteen studies were included in meta‐analyses. Children with non‐syndromic congenital anomalies were at a higher risk of academic underachievement than controls across school levels. Children with severe CHD (pooled OR = 2.32, 95% CI: 1.90, 2.82), and children with OFC (OR = 1.38 (95% CI: 1.20, 1.57), OR = 3.07 (95% CI: 2.65, 3.56), and OR = 3.96 (95% CI: 3.31, 4.72) for children with cleft lip, cleft palate and cleft lip/palate, respectively) had significantly higher ORs for SEN than controls. Children with non‐syndromic congenital anomalies underperform academically and have higher SEN rates compared to their peers. Early monitoring and development of differential SEN are important to promote academic progress in these children.
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Affiliation(s)
- Svetlana V Glinianaia
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ashleigh McLean
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Malcolm Moffat
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Rebekka Shenfine
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Annarita Armaroli
- Center for Clinical and Epidemiological Research, University of Ferrara, Ferrara, Emilia-Romagna, Italy
| | - Judith Rankin
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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Speech Outcomes Comparison Between Adult Velopharyngeal Insufficiency and Patients With Unrepaired Cleft Palate. J Craniofac Surg 2021; 32:655-659. [PMID: 33705003 DOI: 10.1097/scs.0000000000006994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study compared the speech outcomes of adult velopharyngeal insufficiency patients and adult cleft palate (ACP) patients, and explored whether there was any difference in the phonological level of these 2 types of patients. METHODS Perceptual evaluation was used to assess speech intelligibility, hypernasality and compensatory articulation in 89 adult patients with velopharyngeal insufficiency and 35 adult patients with unrepaired cleft palate. Each group was divided into complete cleft palate and incomplete cleft palate (including submucous cleft palate). The phonological differences were compared between the 2 groups of patients and 2 types of cleft palate. RESULTS The mean speech intelligibility was 43.04% in velopharyngeal insufficiency group and 32.87% in ACP group. There was a significant difference in speech intelligibility between the 2 groups by T test, t = 2.916 (P < 0.01), speech intelligibility between 2 types of cleft palate was no significant difference. Also, there was a significant difference between the 2 groups in the constitution of hypernasality degree by Chi-Square test, x2 = 31.650 (P < 0.01), compensatory articulation were present in 74.3% ACP patients (26/35) and 47.2% velopharyngeal insufficiency patients (42/89), x2 = 7.446 (P < 0.01), there was a significant difference in incidence of compensatory articulation between the 2 groups. CONCLUSIONS Adult patients with unpaired cleft palate present an even worse speech intelligibility and hypernasality degree than velopharyngeal insufficiency patients after cleft palate repair, regardless of the cleft type. Additionally, patients in ACP group have a higher incidence of compensatory articulation than that in incomplete cleft palate group. In sequenced treatments of cleft lip and palate, evaluation and treatment of speech disorders cannot be ignored.
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Weinfeld JP, Johnels JÅ, Persson C. Prevalence of Reading Difficulties in 9- to 10-Year Old Children in Sweden Born With Cleft Palate. Cleft Palate Craniofac J 2021; 59:427-435. [PMID: 33955267 DOI: 10.1177/10556656211013236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate the prevalence of reading difficulties in children born with cleft palate at ages 9 and 10 in Sweden. DESIGN Using a cross-sectional design, a parental questionnaire assessing dyslexia-like reading difficulties (Short Dyslexia Scale, SDS) was administered together with separate questions regarding background data. PARTICIPANTS Families with a child born with overt cleft palate with or without cleft lip in 4 regions of Sweden. A total of 245 families were approached of which 138 families responded. Data from 136 (56%) were complete with information on cleft type and could be analyzed. RESULTS Twenty-two percent (95% CI, 15-30) of the whole study group displayed risk for dyslexic reading difficulties on the SDS corresponding to the 7th to 10th percentiles in the population. Children with cleft palate only had a significantly higher prevalence of reading difficulties (37%) compared to children with unilateral cleft palate (19%) and bilateral cleft palate (10%). The frequency of reading difficulties in participants with comorbidity was 32%. Among a subgroup with reported comorbidity in areas of attention, language, and learning problems, there was a 2.5 times higher risk of reading disability compared to participants without this reported comorbidity. CONCLUSION The prevalence of reading difficulties in the cleft palate population was higher than in the general population. Results showed that co-occurring difficulties were common in the cleft group and that reading difficulties often appear together with other, co-occurring neurodevelopmental difficulties.
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Affiliation(s)
- Justin Parry Weinfeld
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Otorhinolaryngology, Sahlgrenska University Hospital, Sweden
| | - Jakob Åsberg Johnels
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Christina Persson
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Otorhinolaryngology, Sahlgrenska University Hospital, Sweden
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Conrad AL, Albert M, Crerand CE, Crilly Bellucci C, Heppner CE, Sheikh F, Woodard S, Kapp-Simon KA. Retrospective Evaluation of Number of Surgeries and Parent Ratings of Academic and Behavioral Functioning Among Children With Isolated Oral Clefts. Cleft Palate Craniofac J 2020; 58:1294-1303. [PMID: 33380226 DOI: 10.1177/1055665620982807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate possible relationships between number of surgeries and parent ratings of academic functioning among children with isolated oral clefts. DESIGN Multicenter, retrospective cohort study including structured interviews, questionnaires, and chart reviews. SETTING Completion of questionnaires occurred during clinical visits at 6 different cleft centers across North America. PARTICIPANTS Parents of 285 children with isolated clefts of the lip and/or palate, aged 8 to 10 years old, participated in structured interviews and completed questionnaires regarding the academic and behavioral functioning of their children. MAIN OUTCOME MEASURES Parent interview and medical chart review of number of surgeries to date and parent ratings on the Adaptive Behavior Assessment System, Third Edition-Functional Academics Scale (ABAS-FA) and Child Behavior Checklist (CBCL) Total Competency Scale. RESULTS Parent ratings of ABAS-FA were at or above normative expectations, while ratings across CBCL Competency Scales were lower than normative expectations. Socioeconomic status (SES), age, and race were consistent predictors of parent ratings (higher SES, older age, and Caucasian race were associated with better functioning). Number of surgeries did not add significantly to academic ratings but did significantly contribute to ratings of social and activity participation. Patients with more surgeries were rated with lower functioning in these domains. CONCLUSIONS Findings do not support a connection between number of surgeries and later ratings of academic functioning but do support a connection to social and activity involvement. Recommendations for conducting direct studies of the connection between surgeries and academic functioning as well as clinical considerations for surgeries and impact on social and activity involvement are discussed.
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Affiliation(s)
- Amy L Conrad
- Division of Developmental and Behavioral Pediatrics, The Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Meredith Albert
- Cleft-Craniofacial Clinic, Departments of Psychology and Pediatric Plastic Surgery, Shriners Hospitals for Children-Chicago, IL, USA.,Craniofacial Center, Department of Surgery, University of Illinois at Chicago, IL,USA
| | - Canice E Crerand
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Departments of Pediatrics and Plastic Surgery, The Ohio State University College of Medicine, OH, USA
| | - Claudia Crilly Bellucci
- Cleft-Craniofacial Clinic, Departments of Psychology and Pediatric Plastic Surgery, Shriners Hospitals for Children-Chicago, IL, USA
| | - Celia E Heppner
- Fogelson Plastic and Craniofacial Surgery Center, Children's Health/Children's Medical Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Farah Sheikh
- Division of Plastic and Reconstructive Surgery, the Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Kathleen A Kapp-Simon
- Cleft-Craniofacial Clinic, Departments of Psychology and Pediatric Plastic Surgery, Shriners Hospitals for Children-Chicago, IL, USA.,Craniofacial Center, Department of Surgery, University of Illinois at Chicago, IL, USA
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Alighieri C, Bettens K, Adriaansen A, Nevenjans E, Malfroid A, Van Lierde K. Technical Reading and Writing Skills and Their Relationship with Linguistic Processes in Children with a Cleft (Lip and) Palate: A Comparison with Peers. Folia Phoniatr Logop 2020; 73:502-512. [DOI: 10.1159/000512449] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> Poor word decoding skills and writing skills can impact job opportunities and psychosocial functioning. Despite the importance of identifying possible literacy problems for the child’s future performance, there seems to be no consensus on this topic in children with a cleft of the palate with or without a cleft of the lip (CP±L). The aim of this study was to investigate reading and writing skills and their relationship with linguistic processes in Dutch-speaking children with a CP±L compared to a group of children without a CP±L. <b><i>Methods:</i></b> Twelve children with a CP±L and 12 children without a CP±L (age range 7–12 years) were included in the study. The 2 groups were matched based on age, gender, and socioeconomic status. An assessment battery including language, reading, and writing tests was administered to both groups. <b><i>Results:</i></b> No statistically significant differences in reading and writing skills were found when comparing children with and without a CP±L. Interestingly, a moderate correlation was found between the children’s reading skills and phonological awareness. Moderate correlations were also revealed between writing skills and several working memory tasks. <b><i>Discussion/Conclusion:</i></b> Our findings did not provide evidence for any difference in word decoding skills and writing skills between children with a CP±L and their peers. Some linguistic processes, more specifically phonological awareness and working memory, are important factors that contribute to the child’s literacy development. Identification of these linguistic skills can provide important information on the child’s future reading and writing performance. Future studies should increase sample sizes to confirm these results.
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Andersson K, Klintö K. Does the narrative ability during retelling differ in 5-year-olds born with and without unilateral cleft lip and palate? LOGOP PHONIATR VOCO 2020; 47:18-24. [PMID: 33966584 DOI: 10.1080/14015439.2020.1822441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND A previous study has indicated poorer narrative ability during retelling in 5-year-olds with unilateral cleft lip and palate (UCLP) as a group, compared to peers without UCLP. AIM To investigate if there are any differences between 5-year-olds with and without UCLP in narrative ability during retelling. METHODS A total of 83 children participated, 51 with UCLP and 32 without. They had no known additional malformations or syndromes. The children were audio recorded while performing the Bus Story Test (BST). The recordings were orthographically transcribed. From the transcriptions the BST information score was calculated. The macrostructure of the narratives was assessed with the Narrative Scoring Scheme (NSS), and the microstructure with mean length of utterance in words, grammaticality, grammatical complexity and lexical diversity. Results for children with and without UCLP were compared. RESULTS The group with UCLP performed better than the group without UCLP in the NSS sub-category Conclusion. No other significant differences were seen between the groups. The UCLP group had a larger standard deviation for the information score than the group without UCLP. CONCLUSIONS The group with UCLP displayed at least as good results as the group without UCLP, but the information score was more varied for the UCLP group than for the group without UCLP.
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Affiliation(s)
- Ketty Andersson
- Department of Clinical Sciences in Lund, Division of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Kristina Klintö
- Department of Otorhinolaryngology, Division of Speech and Language Pathology, Skåne University Hospital, Malmö, Sweden.,Department of Clinical Sciences in Malmö, Division of Surgery, Lund University, Lund, Sweden
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Rezaei P, Poorjavad M, Abdali H. Speech outcomes after palatal closure in 3-7-year-old children. Braz J Otorhinolaryngol 2020; 88:594-601. [PMID: 33268307 PMCID: PMC9422456 DOI: 10.1016/j.bjorl.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 08/02/2020] [Accepted: 08/22/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction One of the main goals of the team approach in management of oro-facial clefts is to help the children with cleft palate have adequate speech development. Objective The present study aimed to investigate the prevalence of articulation and resonance disorders following palate closure in children who were visited for routine examination by the Isfahan Cleft Care Team between 2011 and 2015, and to study the impact of cleft type and age at the time of palatoplasty on speech outcomes. Methods Clinical records of 180 preschool children with repaired cleft palate were reviewed. The percentage of children demonstrating hypernasality, nasal emission, nasal turbulence, and compensatory misarticulations was calculated. The relationship between cleft type and age at the time of palatal surgery, as independent variables, and speech outcomes were examined. Results 67.7 and 64.5 percent of the children demonstrated respectively moderate/severe hypernasality and nasal emission, and 71.1 percent produced compensatory misarticulations. Age at the time of palatal repair was significantly associated with compensatory misarticulations and also with moderate/severe hypernasality. The prevalence of compensatory misarticulations, significant hypernasality, nasal emission and also nasal turbulence was not significantly different in various types of cleft. Conclusions We observed a high prevalence of different speech disorders in preschool children with repaired cleft palate compared to other studies. This can be partly due to late palatal repair in the studied population. Despite many advances in cleft palate management programs in Iran, there are still many children who do not access the interdisciplinary team cares in their early childhood. We should, therefore, try to increase accessibility of appropriate and timely management services to all Iranian children with cleft lip/palate.
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Affiliation(s)
- Parisa Rezaei
- Isfahan University of Medical Sciences, Craniofacial and Cleft Research Center, Isfahan, Iran; Isfahan University of Medical Sciences, School of Rehabilitation Sciences, department of Speech Therapy, Isfahan, Iran
| | - Marziyeh Poorjavad
- Isfahan University of Medical Sciences, School of Rehabilitation Sciences, department of Speech Therapy, Isfahan, Iran.
| | - Hossein Abdali
- Isfahan University of Medical Sciences, Craniofacial and Cleft Research Center, Isfahan, Iran; Isfahan University of Medical Sciences, Department of Plastic Surgery, Isfahan, Iran
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van Eeden S, Stringer H. Linguistic and auditory processing skills in non-syndromic children with cleft palate: A scoping review. JOURNAL OF COMMUNICATION DISORDERS 2020; 87:106029. [PMID: 32712335 DOI: 10.1016/j.jcomdis.2020.106029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 05/26/2020] [Accepted: 05/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Cleft lip and/or palate (CL/P) is the most common congenital craniofacial condition. Children born with CL/P are at increased risk of persistent speech difficulties related to velopharyngeal incompetence (VPI) and compensatory articulation problems. It has also been reported that they achieve poorer results academically than their peers. There is a further body of evidence to suggest delayed language skills. These potentially related outcomes are often reported separately. AIM To review published and unpublished research into the nature of difficulties related to spoken and written language across all non-syndromic cleft diagnoses. To review any evidence of associations between comorbidities. METHOD A scoping review was carried out in October 2016 and updated in June 2019 following published methodology (Arksey & O'Malley, 2005; Levac et al. 2010). RESULTS A search of the literature over the two time points found 38 papers in total. Three main themes were found: oral language skills, reading and auditory processing difficulties. CONCLUSIONS There is evidence of early language delay in children born with CL/P. Evidence of persistent oral language problems is less conclusive. Many studies have reported scores within the average range for language, auditory processing and reading but poorer outcomes when compared to non-cleft control groups. However, studies have used a range of outcome measures, making comparisons difficult. Moreover there is no clear evidence how these difficulties might relate to speech outcomes or educational achievement and no comparison to other populations with speech, language and communication needs (SLCN).
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Affiliation(s)
- Stephanie van Eeden
- School of Education, Communication and Language Sciences, Newcastle University, King George VIth Building, Queen Victoria Road, Newcastle upon Tyne, NE1 7RU, United Kingdom; Regional Cleft Lip and Palate Service, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, United Kingdom.
| | - Helen Stringer
- School of Education, Communication and Language Sciences, Newcastle University, King George VIth Building, Queen Victoria Road, Newcastle upon Tyne, NE1 7RU, United Kingdom.
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Kuhlmann EH, Conrad AL. Word Reading in Boys With Isolated Oral Clefts: Comparison to Unaffected Average and Dyslexic Readers Using the Dual-Route Model. Cleft Palate Craniofac J 2020; 57:310-320. [PMID: 31370691 PMCID: PMC6994360 DOI: 10.1177/1055665619867015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To examine word reading performance between boys with isolated cleft lip and/or palate (iCL/P), unaffected average reading (uAR), and unaffected impaired reading (uIR), using the dual-route model. DESIGN Case/control study. SETTING University children's hospital. PARTICIPANTS Males, between the ages of 8 to 11 years, with iCL/P (n = 26), uIR (n = 33), or uAR (n = 28). METHODS Single word reading and achievement were evaluated. Analyses of variance and analyses of covariance evaluated group differences in achievement. Medical records were reviewed for iCL/P participants for audiology and speech history. Spearman ρ correlations were calculated between hearing, speech, and reading achievement for the iCL/P group. MAIN OUTCOME MEASURE(S) Reading performance was evaluated using select subscales from the Woodcock Johnson Reading Mastery Test, 3rd Edition and the Test of Orthographic Competence. RESULTS Participants with iCL/P had higher than expected rates of reading impairment, differing across cleft type (0% iCL, 50% isolated cleft lip and palate [iCLP], 71.4% isolated cleft palate only [iCP]). On measures of word reading accuracy, iCL/P participants outscored uIR participants, with uAR participants scoring the highest. This pattern was specific to nonlexical reading tasks. Participants in the uAR and iCL/P groups outscored uIR participants on lexical tasks, with no significant differences between uAR and iCL/P. Evaluation of speech and hearing revealed no significant relationship to single word reading or achievement measures in the iCL/P group. CONCLUSIONS Boys with iCL/P are at a higher risk of reading impairments, particularly within the iCP subset. Regular screening should be encouraged, with skills from both lexical and nonlexical routes assessed.
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Affiliation(s)
- Emily Hope Kuhlmann
- Stead Family Department of Pediatrics, University of Iowa College of Medicine, Iowa City, IA, USA
| | - Amy Lynn Conrad
- Stead Family Department of Pediatrics, University of Iowa College of Medicine, Iowa City, IA, USA
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