Alveolar Backing in 3-Year-Old Children with and without Repaired Cleft Palate: Preliminary Findings Related to Cleft Type and History of Otitis Media.

Objective: The purpose of this preliminary study was to determine if cleft type and/or history of otitis media with effusion (OM) contribute to backing of /t/ and/or /s/ in young children with and without repaired cleft palate.

Method: Participants were 39 children (mean age=36 months, range 34 to 41). Ten children had repaired unilateral cleft lip and palate (CLP), nine had repaired cleft palate only (CP), twelve had no clefts but histories of OM, and eight were typically-developing (TD) without clefts or OM history. All children were video and audio recorded during administration of the Goldman-Fristoe Test of Articulation-3 (GFTA-3). Standard scores of articulation, frequency of alveolar backing, and first spectral moments of the /t/-/k/ and /s/-/ʃ/ phonetic contrasts were obtained.

Results: Children with CLP had lower GFTA-3 scores than both TD (p=.012) and OM (p=.001) groups. Fisher's Exact test showed that significantly more children with CLP backed alveolar targets, mostly /s/, than children with CP (p=.020). Children with CLP also had (a) reduced /t/-/k/ spectral difference compared to TD children (p=.016) and (b) reduced /s/-/ʃ/ spectral difference compared to both children with CP (p=.010) and children with OM (p=.018). Children with OM had reduced /t/-/k/ spectral difference compared to TD children (p=.009).

Conclusions: Cleft type contributes to alveolar backing and reduced spectral contrast of /s/-/ʃ/ in 3-year-old children with repaired cleft palate. History of OM affects spectral contrast of /t/-/k/ in non-cleft children. Etiology and clinical implications of alveolar backing are discussed.