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Orofacial Function, Articulation Proficiency, and Intelligibility in 5-Year-Old Children Born With Cleft Lip and Palate.

OBJECTIVE: To explore and describe orofacial function in 5-year-old children born with clefts affecting the palate and to investigate potential relationship with articulation proficiency and intelligibility.

DESIGN: A prospective cohort study of 88 consecutive patients born with cleft lip and palate (CLP) between July 2009 and June 2011.

PARTICIPANTS: Excluding internationally adopted children and children with no speech production resulted in 52 children with different cleft types and additional malformations, examined at age 5. Data on orofacial function were available for 43 children.

OUTCOME MEASURES: Screening of orofacial function resulted in a profile and a total score, narrow phonetic transcription of test consonants produced a percentage of consonants correct (PCC) score, and ratings of intelligibility by speech and language pathologists (SLPs) and by parents gave 2 estimates. Inter- and intra-transcriber agreement was calculated.

RESULTS: Orofacial dysfunction was found in 37% of children, with results not significantly different between cleft types but significantly more frequent than in children born without CLP. Age-appropriate articulation proficiency was found in 39%, 49% presented below -2 standard deviations. Just above 50% had good intelligibility and were always understood by different communication partners according to both SLP and parent ratings. No significant correlation was found between orofacial dysfunction and PCC or intelligibility.

CONCLUSIONS: Orofacial dysfunction was not found to be an explanatory factor for speech outcome in children born with CLP.

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