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Investigating the Impact of Additional Congenital Malformations on Speech Outcomes at age Five in Children with a Cleft Palate

Lookup NU author(s): Dr Stephanie Van EedenORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© 2024, American Cleft Palate Craniofacial Association.Objective: To determine whether children born with a cleft palate ± lip (CP ± L) and additional congenital differences (ACDs – including ‘Congenital malformations and deformations’ as coded in ICD-10), are less likely to meet the three national speech outcome standards at age five compared to children with CP ± L and no ACDs. Design: An observational study, utilizing national data from the UK Cleft Registry and Audit NEtwork (CRANE) Database linked to national administrative data of hospital admissions. Setting: National Health Service, England. Patients: 2191 children (993 female, 1198 male) with CP ± L, born 2006-2012 in England, with complete speech data and consent to data linkage. Outcome Measure: Perceptual speech analysis utilised the Cleft Audit Protocol for Speech – Augmented (CAPS-A) rating and United Kingdom National Speech Outcome Standards (Speech Standard 1 (SS1), Speech Standard 2a (SS2a) and Speech Standard 3 (SS3)). Results: Of 2191 children, 759 (35%) had at least one ACD. Presence of one ACD did not significantly impact speech outcomes but two or more ACDs reduced the odds of achieving all three speech standards: SS1 aOR 0.602 (CI 0.45-0.82, P =.002), SS2a aOR 0.563 (CI 0.41-0.77, P =.001), SS3 aOR 0.606 (0.43-0.84, P =.003). When exploring ACDs by ICD-10 groupings, congenital malformations of the ‘Eye, ear, face and neck’, ‘Circulatory system’, ‘Digestive system’, ‘Musculoskeletal system’ and ‘Other congenital malformations’ reduced a child's odds of achieving the speech standards. Conclusions: ACDs, in the absence of a known syndrome, have a significant impact on speech outcome at age five. Incorporating these factors into risk-adjustment models for service level outcome reporting is recommended.

Publication metadata

Author(s): Butterworth S, Fitzsimons KJ, Britton L, Van Eeden S, Medina J, van der Meulen J, Russell CJH

Publication type: Article

Publication status: Published

Journal: Cleft Palate Craniofacial Journal

Year: 2024

Volume: 62

Issue: 12

Pages: 2155-2166

Print publication date: 01/12/2025

Online publication date: 09/10/2024

Acceptance date: 02/04/2018

Date deposited: 29/10/2024

ISSN (print): 1055-6656

ISSN (electronic): 1545-1569

Publisher: Sage Publications Ltd

URL: https://doi.org/10.1177/10556656241287759

DOI: 10.1177/10556656241287759

PubMed id: 39380396

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