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Investigating the Impact of Patient-Related Factors on Speech Outcomes at 5 Years of Age in Children With a Cleft Palate

Lookup NU author(s): Dr Stephanie Van EedenORCiD

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This is the authors' accepted manuscript of an article that has been published in its final definitive form by SAGE Publications Inc., 2023.

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Abstract

© 2022, American Cleft Palate-Craniofacial Association. Objective : To investigate the relationship between patient-related factors (sex, cleft type, cleft extent, and Robin Sequence [RS]) and speech outcome at 5 years of age for children born with a cleft palate ± lip (CP ± L). Participants : 3157 Children (1426 female:1731 male) with a nonsyndromic CP ± L, born between 2006 and 2014 in England, Wales, and Northern Ireland. Outcome Measure : Perceptual speech analysis utilized the Cleft Audit Protocol for Speech–Augmented (CAPS-A) rating and UK National Speech Outcome Standards: Speech Standard 1 (SS1)—speech within the normal range, SS2a—no structurally related speech difficulties or history of speech surgery, and SS3—speech without significant cleft-related articulation difficulties. Results : Odds of achieving SS1 were lower among boys (aOR 0.771 [CI 0.660-0.901]), those with clefts involving the lip and palate (vs palate only) (UCLP—aOR 0.719 [CI 0.591-0.875]; BCLP—aOR 0.360 [CI 0.279-0.463]), and clefts involving the hard palate (incomplete—aOR 0.701 [CI 0.540-0.909]; complete—aOR 0.393 [CI 0.308-0.501]). Similar relationships with these patient factors were observed for SS3. SS2 was affected by the extent of hard palate involvement (complete; aOR 0.449 [CI 0.348-0.580]). Although those with CP and RS were less likely to meet all 3 standards than those without RS, odds ratios were not significant when adjusting for sex and cleft extent. Conclusion : Sex, cleft type, and extent of hard palate involvement have a significant impact on speech outcome at 5 years of age. Incorporating these factors into risk-adjustment models for service-level outcome reporting is recommended.

Publication metadata

Author(s): Butterworth S, Fitzsimons KJ, Medina J, Britton L, Van Eeden S, Wahedally H, Park MH, van Der Muelen J, Russell CJH

Publication type: Article

Publication status: Published

Journal: Cleft Palate-Craniofacial Journal

Year: 2023

Volume: 60

Issue: 12

Pages: 1578-1590

Print publication date: 01/12/2023

Online publication date: 22/06/2022

Acceptance date: 02/04/2018

Date deposited: 14/12/2023

ISSN (print): 1055-6656

ISSN (electronic): 1545-1569

Publisher: SAGE Publications Inc.

URL: https://doi.org/10.1177/10556656221110094

DOI: 10.1177/10556656221110094

PubMed id: 35733360

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