Citation: Platte, M. & Neumann, S. (2021, June). Phonological and Articulatory Speech Therapy Interventions for Children with Cleft Palate: A Systematic Review. Poster presented at the symposium of the International Clinical Phonetics and Linguistics Association (ICPLA 2020/21). online
Phonological and articulatory Speech Therapy Interventions for Children With Cleft Palate: A Systematic Review
preregistered at PROSPERO
Background: Even in 2021, the evidence of duration, intensity and type of speech therapy for cleft palate ± cleft lip (CP+/L) remains unclear. The objective of the present study was (1) to investigate effectiveness of phonological and/or articulation therapy for children and adolescents (1;0-19;11 yrs.) with CP+/L and
cleft type characteristics (CTCs) and (2) to identify different types of interventions assessed.
Method: A systematic review of journal publications was conducted in November 2020 by an extensive electronic search and analysis of the databases of Cochrane Library, PubMed, ISI Web of Science, APA PsycINFO and The Health Technology Assessment Database. The search strategy was amended by a manual search of published articles and by checking reference lists of identified publications. There
was no limitation in publication year or language. Inclusion criteria for studies were: phonological or motor-speech therapy without any technical instruments, experimental group ≥ 90% of children with CP+/L and CTCs, therapy by SLT/SLP, reported outcome measures for speech-language assessment.
Results: The searches identified 581 references. After screening for title and abstract 513 papers had to be excluded, while another 50 publications dropped out by full text analyses regarding missing inclusion criteria. Finally, a total of 18 studies could be included in the analysis. Two studies were conducted prior 2000, 6 were conducted between 2000 and 2015, and the remaining 10 studies took place after
2015. The publications reflect different study designs with various levels of evidence. In terms of intervention approaches, 11 studies evaluated phonological approaches, 3 evaluated phonetic approaches and 4 a mixture of both.
Conclusion: Data analyses according to PRISMA standards are still in progress. In detail, therapy concepts found, their effectiveness and risk of bias in studies will be presented.
Alighieri, C., Bettens, K., Bruneel, L., D'haeseleer, E., Van Gaever, E., & Van Lierde, K. (2020). Effectiveness of Speech Intervention in Patients With a Cleft Palate: Comparison of Motor-Phonetic Versus Linguistic-Phonological Speech Approaches. Journal of speech, language, and hearing research: JSLHR, 63 (12), 3909–3933. https://doi.org/10.1044/2020_JSLHR-20-00129
BMJ (OPEN ACCESS) Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi: 10.1136/bmj.n71
Cleft Lip & Palate Association (2018). Speech. Verfügbar unter www.clapa.com/treatment/early-years-1-4/speech/ (01.06.2021).
Derakhshandeh, F., Nikmaram, M., Hosseinabad, H. H., Memarzadeh, M., Taheri, M., Omrani, M., Jalaie, S., Bijankhan, M., & Sell, D. (2016). Speech characteristics after articulation therapy in children with cleft palate and velopharyngeal dysfunction - A single case experimental design. International journal of pediatric otorhinolaryngology, 86, 104–113. https://doi.org/10.1016/j.ijporl.2016.04.025
Hardin-Jones, M., & Chapman, K. L. (2008). The impact of early intervention on speech and lexical development for toddlers with cleft palate: a retrospective look at outcome. Language, speech, and hearing services in schools, 39 (1), 89–96. https://doi.org/10.1044/0161-1461(2008/009)
Herreras Mercado, R., Simpson, K. & Bellom-Rohrbacher, K.H. (2019). Effect of Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT) on Compensatory Articulation in Children With Cleft Palate/Lip. Global pediatric health, 6, 2333794X19851417. https://doi.org/10.1177/2333794X19851417
Jahanbin, A., Pahlavannezhad, M. R., Savadi, M., & Hasanzadeh, N. (2014). The effect of speech therapy on acoustic speech characteristics of cleft lip and palate patients: a preliminary study. Special care in dentistry: official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry, 34 (2), 84–87. https://doi.org/10.1111/scd.12031
Kaiser, A. P., Scherer, N. J., Frey, J. R., & Roberts, M. Y. (2016). The Effects of Enhanced Milieu Teaching With Phonological Emphasis on the Speech and Language Skills of Young Children With Cleft Palate: A Pilot Study. American journal of speech-language pathology, 26 (3), 806–818. https://doi.org/10.1044/2016_AJSLP-16-0008
Luyten, A., Bettens, K., D'haeseleer, E., Hodges, A., Galiwango, G., Vermeersch, H., & Van Lierde, K. (2016). Short-term effect of short, intensive speech therapy on articulation and resonance in Ugandan patients with cleft (lip and) palate. Journal of communication disorders, 61, 71–82. https://doi.org/10.1016/j.jcomdis.2016.03.006
Mossey, P.A. & Modell, B. (2012). Epidemiology of oral clefts 2012: an international perspective. Front Oral Biol 16, 1-18.
Pamplona, M. C., Ysunza, A., & Espinosa, J. (1999). A comparative trial of two modalities of speech intervention for compensatory articulation in cleft palate children, phonologic approach versus articulatory approach. International journal of pediatric otorhinolaryngology, 49 (1), 21–26. https://doi.org/10.1016/s0165-5876(99)00040-3
Pamplona, M. C., Ysunza, A., & Ramírez, P. (2004). Naturalistic intervention in cleft palate children. International journal of pediatric otorhinolaryngology, 68 (1), 75–81. https://doi.org/10.1016/j.ijporl.2003.09.007
Pamplona, C., Ysunza, A., Patiño, C., Ramírez, E., Drucker, M., & Mazón, J. J. (2005). Speech summer camp for treating articulation disorders in cleft palate patients. International journal of pediatric otorhinolaryngology, 69 (3), 351–359. https://doi.org/10.1016/j.ijporl.2004.10.012
Pamplona, M., Ysunza, A., & Morales, S. (2014). Strategies for treating compensatory articulation in patients with cleft palate. International journal of biomedical science: IJBS, 10 (1), 43–51.
Pamplona, M. D., Ysunza, P. A., & Morales, S. (2017). Audiovisual materials are effective for enhancing the correction of articulation disorders in children with cleft palate. International journal of pediatric otorhinolaryngology, 93, 17–23. https://doi.org/10.1016/j.ijporl.2016.12.011
Pamplona, M., & Ysunza, P. A. (2018). Deliberate Practice: Preliminary Results of a Useful Strategy for Correcting Articulation in Children With Cleft Palate. The Journal of craniofacial surgery, 29 (6), 1490–1494. https://doi.org/10.1097/SCS.0000000000004707
Scherer, N., Yamashita, R., Fukushiro, A., Trindade, I., Lien, K., De Oliveira, D., DiLallo, J., Scarmagnani, R. (2019). 256. Preliminary Results of an Early Speech and Language Intervention in Brazil. ACPA's 76th Annual Meeting Abstracts. Cleft Palate Craniofac J. 56 (1_suppl): 1-130. doi: 10.1177/1055665619829661. PMID: 30871366.
Scherer, N., Kaiser, A. & Frey, J. (2020). 211. Adaptive Early Intervention for Children with Cleft Palate: When to Focus on Speech Sound Production? ACPA’s 77th Annual Meeting Abstracts. (2020). The Cleft Palate-Craniofacial Journal, 57 (4_suppl), 1-143. https://doi.org/10.1177/1055665620901804
Scherer, N. J., Kaiser, A. P., Frey, J. R., Lancaster, H. S., Lien, K., & Roberts, M. Y. (2020). Effects of a naturalistic intervention on the speech outcomes of young children with cleft palate. International journal of speech-language pathology, 22 (5), 549–558. https://doi.org/10.1080/17549507.2019.1702719
Thompson, H., Redmond, S. & Smith, B. (2015). Effectiveness of a phonological intervention for preschool children with nonsyndromic cleft palate. Cleft palate-craniofacial journal, 52 (4), e105.
Van Demark, D. R., & Hardin, M. A. (1986). Effectiveness of intensive articulation therapy for children with cleft palate. The Cleft palate journal, 23 (3), 215–224.