Caregiver-reported outcomes of speech and social function among cleft palate patients operated with palatoplasty, at different age groups, using CLEFT-Q: A cross-sectional questionnaire study.

Abstract

Objective: Cleft palate significantly impacts a child's ability to speak clearly and interact socially, often affecting psychosocial development. While early palatoplasty is known to support better speech outcomes, limited data exists from the caregiver's perspective, particularly in diverse cleft severities. This study aimed to assess the influence of age at surgery and cleft severity on caregiver-reported outcomes in speech and social function using the CLEFT-Q tool.

Materials and methods: A retrospective cohort study was conducted at a tertiary cleft center. Caregivers of 237 children aged 3-15 years who underwent primary palatoplasty between 2019 and 2022 were interviewed using the Hindi version of the CLEFT-Q. Participants were grouped by age at surgery: Group A (before 18 months) and Group B (after 18 months), and by Veau cleft classification (I-IV). Outcomes in speech distress, speech function, and social function were compared using one-way ANOVA.

Results: Group A (n=94) had higher mean scores than Group B (n=143): speech distress (83.03 vs. 75.10), speech function (82.27 vs. 75.29), and social function (80.42 vs. 75.78). Differences were statistically significant across Veau types I-III. In Veau type IV, Group A showed better speech scores, while social scores were not significantly different. Intragroup comparisons across Veau types showed no significant score variations.

Conclusion: Early palatoplasty before 18 months is associated with improved caregiver-reported speech and social outcomes, irrespective of cleft severity. These findings support timely surgical intervention and can guide caregiver counseling in cleft care.