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Do children with cleft palate have expressive and receptive language impairment ?

Do children with cleft palate have expressive and receptive language impairment ?. The NSW Cleft Palate EBP Group. The NSW Cleft Palate EBP Group. Jana Carr Sharyn Greig Melissa Parkin Amanda Simon Alison Purcell*. Background Information – Cleft Lip and Palate. Incidence.

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Do children with cleft palate have expressive and receptive language impairment ?

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  1. Do children with cleft palate have expressive and receptive language impairment? The NSW Cleft Palate EBP Group

  2. The NSW Cleft Palate EBP Group • Jana Carr • Sharyn Greig • Melissa Parkin • Amanda Simon • Alison Purcell*

  3. Background Information – Cleft Lip and Palate

  4. Incidence • Internationally • 0.4 – 2.2 per 1000 live births • Australia • 1 per 700 live births

  5. Treatment Challenges • Feeding • Surgical repair • Hearing loss • Communication disorders • Dental development • Psychosocial problems

  6. Communication disorders • Speech • Articulation • Phonology

  7. Resonance • Hypernasality • Hyponasality • Mixed resonance

  8. Phonation • Soft • Hoarse • Dysphonic

  9. Other CLP phenotypic features • Asymmetry • Non-right handedness • Craniofacial morphology • Dental anomalies • Obicularis oris muscle defects • Structural brain and vertebral anomalies • Minor physical anomalies • Velopharyngeal dysfunction

  10. Family Traits • Unaffected relatives • Facial morphology differs from controls • Increased facial width • Dentition differs

  11. CLP Phenotype • Language • Learning • Reading • Cognition • Social skills

  12. Nation (1970) “Cleftness” syndrome

  13. Clinical question Do children with cleft lip and palate have a higher incidence of expressive and expressive language impairment compared to children without cleft palate?

  14. Search of the evidence • Cleft palate EBP members • Hearing and Speech students • Selection Criteria • The last 10 years • Any type of cleft but no additional syndrome • Language and learning • Not pre-linguistic language

  15. Information sources • Cochrane library • Medline • CIAP • OVID

  16. Evidence reviewed

  17. Strength of the evidence Number of Studies Level of Evidence

  18. Speech Pathology Practice Guidelines – (Clinic bottom line) Limited evidence that children with CP have increased receptive and expressive language impairment

  19. Risk factors • On-going hearing loss • Co-occurring articulation impairment • Low socio-economic status

  20. Speech Pathology Practice Guidelines • Specialist Cleft Palate Clinics • Cross centre annual language assessments • 12 months • 24 months • 3 years • 4 years etc

  21. Speech Pathology Practice Guidelines • Community Speech Pathology Clinics • Monitor language development • Parent language enrichment and education • School readiness programs • Monitor later language development • Monitor academic achievement

  22. Speech Pathology Practice Guidelines • Further research to expand the phenotype • Language development • Family history of language impairment • Genetics

  23. Thank You!

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