Articulation Patterns of Preschool Cleft Palate Children

Abstract

Information available about the incidence of speech problems among cleft palate individuals is so variant that it is difficult to determine the extent to which speech habilitation services may be needed. For example , Bzoch (2) found that 45% of 60 cleft palate children, ages three to seven years, had speech that was difficult to understand and that an additional 45% had speech that was occasionally difficult to understand. His five-year-old cleft palate subjects had not developed articulation skills commensurate with the three-year-old control group. He concluded that the findings suggest a need for early articulation training, especially when the error types are of a gross nature involving the glottal stop and pharyngeal fricative substitutions. Morley (5), however, reports that the majority of children gain normal speech spontaneously, having passed through a period of defective articulation. Her data on cleft palate children show that 60% of those three to four years of age, 42% of those four to five years of age, and 25% of those five to six years of age were found to have misarticulations. She, therefore, recommends delaying remedial speech services until the child is at least four years of age and suggests that it is indicated then only if the child exhibits a " severe " speech problem. These two studies suggest that anywhere from 25% to 90% of the preschool cleft palate children may have speech problems. These studies also illustrate the controversy which exists as to Whether or not speech training should be initiated early or should be postponed until the effects of maturational development of speech skills can be determined. Studies of the misarticulations of cleft palate speakers demonstrate some characteristic patterns that are different from noncleft speakers. In a recent publication, M011 (4) comments on the need for further research about the misarticulations of cleft palate speakers. He suggests that the developmental aspects of articulation skills of children with cleft palates deserve study. We extend that comment by suggesting that knowledge of the developmental patterns would help define the need and time for