A Preschool Language Facilitation Program for Children with Cleft Palate

Abstract

202 Early intervention speech and language programs for preschool children with cleft palate have been undertaken because the majority of research on the language development of children with cleft palate had indicated a delay in both receptive and expressive skills at some period of development (Fox, Lynch, and Brookshire, 1978; McWilliams, 1973; Morris, 1962, Philips and Harrison, 1969a, b; Shames, Rubin, and Kramer, 1966; Smith and McWilliams, 1968; Spriestersbach, Darley, and Morris, 1958). T h e reasons for this delay remain unclear. T h e presence of a cleft may provide an adequate explanation for the defective speech and voice patterns heard in children with cleft palate, but not the language delay. This delay may therefore be attributed at least in part to (1) an intellectual deficit as part of a craniofacial syndrome, (2) high incidence of conductive hearing problems (Harrison and Philips, 1971; Paradise and Bluestone, 1969), (3) environmental factors, such as frequent hospitalizations, the timing of surgical intervention, separation from families at critical language learning periods, as well as other undetermined psychosocial factors (Evans and Renfrew, 1974; Smith, 1971), and (4) the child's retreat from unrewarding speaking attempts that had not been easily understood (Morris, 1962; Spriestersbach et al., 1958). The child with a cleft palate is therefore perceived to be at greater risk for language learning problems than children without clefts. It has been well documented that this population has difficulty developing intelligible speech. This may be due to the fact that these children learn to speak with articulatory organs that differ structurally and physiologically from those of noncleft children in terms of intraoral feedback. Dental and occlusal anomalies may also contribute to the development of aberrant speech sound development. The inability of this population to valve the velopharyngeal port adequately contributes heavily to the distortions heard (Bzoch, 1959; Philips and Harrison, 1969b, Thayer, 1978; Van Demark, 1966). Early intervention programs to facilitate language and cognitive growth in handicapped preschool children at risk for