Cleft Palate-Craniofacial Journal最新文献

{"title":"Predicting Underweight Status in Infants With Cleft Lip and/or Palate in 10 US Children's Hospitals.","authors":"Ioanna Ormanidou, Waylon Howard, Kiley Bijlani, Donna M Denno, Peter Amoako-Yirenkyi, Carrie Heike, Abraham Owusu Adusei, Heather Oliphant, Canice E Crerand, Oksana Jackson, Christopher Discolo, Sarah Vetter, Kristina Wilson, Yeraldi Geronimo, Rhona Galera, Natalie Lyman, Vanessa Whyte, Nate Pajor, Christy M McKinney","doi":"10.1177/10556656261494318","DOIUrl":"https://doi.org/10.1177/10556656261494318","url":null,"abstract":"<p><p>ObjectiveTo develop and compare models predicting which infants with cleft lip and/or palate (CL/P) will be underweight at 4 months, using multicenter electronic health record data.DesignUsing data from birth to 3 months, we evaluated 63 anthropometric, clinical, healthcare-utilization, and demographic variables across 6 regression and machine-learning models to identify the strongest predictors of underweight status, overall and by cleft type.SettingTen US children's hospitals in PEDSnet, a national pediatric learning health network, 2009 to 2024.PatientsInfants with CL/P aged 0 to 4.5 months.Main Outcome MeasureUnderweight status at 4 months (range 3.5-4.5), defined as weight-for-age z-score (WAZ) < -2.ResultsAmong 5717 infants with CL/P (19% cleft lip, 35% cleft lip and palate, 46% cleft palate), 25.9% were underweight at 4 months. The strongest predictors were early (0-3 months) growth measures: mean WAZ (58% of predictive value), WAZ velocity, mean length-for-age z-score (LAZ), and LAZ velocity, plus the Child Opportunity Index (a neighborhood socioeconomic measure; ∼2%). These 5 predictors accounted for >85% of predictive value in every cleft type. All 6 models discriminated similarly (area under the receiver operating characteristic curve 0.87-0.90); GPBoost, which also accounts for hospital differences, produced risk estimates closest to the actual proportion of underweight infants.ConclusionsRoutine early-life growth measures (WAZ, LAZ, and their trajectories), together with neighborhood socioeconomic status, can identify infants with cleft at elevated risk of being underweight before 4 months, helping craniofacial and primary care teams provide timelier feeding and nutrition support and referrals to the highest-risk infants.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261494318"},"PeriodicalIF":1.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidimensional Language Performance in Turkish-Speaking School-Aged Children with Nonsyndromic Cleft Lip and Palate.","authors":"Fatma Yurdakul Çınar","doi":"10.1177/10556656261496023","DOIUrl":"https://doi.org/10.1177/10556656261496023","url":null,"abstract":"<p><p>ObjectiveLanguage difficulties are increasingly recognized in children with nonsyndromic cleft lip and palate (NSCLP), yet little is known about their language profile in Turkish-speaking populations. This study aimed to examine multidimensional language performance in Turkish-speaking children with a history of NSCLP.DesignCross-sectional study.SettingAcoustically controlled University-affiliated audiology laboratory.ParticipantsTwenty-three children aged 4-8 years with repaired NSCLP and clinically normal hearing.InterventionLanguage abilities were evaluated using the Test of Turkish School-Age Language Development (TODIL).Main Outcome MeasurePerformance on TODIL subtests and composite language scores was compared with age-based normative data using one-sample <i>t</i>-tests.ResultsChildren with NSCLP performed significantly below normative expectations across all TODIL subtests and composite language measures (all <i>p</i> < .001), with large effect sizes. The pattern of results indicated widespread deficits across receptive, expressive, lexical, syntactic, and phonological domains.ConclusionTurkish-speaking children with NSCLP may exhibit widespread language difficulties despite clinically normal peripheral hearing. These findings support the inclusion of comprehensive language assessment and long-term language monitoring as part of routine clinical follow-up in this population.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261496023"},"PeriodicalIF":1.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Patient Adherence to Cranial Orthosis Treatment Using Temperature Sensors and a Mobile Device Application.","authors":"Anna L Preisler, Jeffrey A Kasparek, Jerold N Luisi, Melody M Gordon, Jill L Findley, Werner Koele, Karl Strohmayer, Timothy R Littlefield","doi":"10.1177/10556656261493312","DOIUrl":"https://doi.org/10.1177/10556656261493312","url":null,"abstract":"<p><p>ObjectiveTo evaluate the feasibility of using temperature sensors and a mobile app to objectively measure cranial remodeling orthosis (CRO) wear time, assess adherence to the prescribed 23 h per day wear schedule, and examine the relationship between wear time and treatment outcomes.DesignProspective, multisite cohort study.SettingSix Cranial Technologies clinical sites across Arizona.Patients/ParticipantsInfants aged 3 to 18 months treated with a CRO equipped with a temperature sensor. A total of 87 infants who received a sensor were eligible for wear time analysis, and of those, 78 completed treatment with exit 3-dimensional imaging.Main Outcome Measure(s)Daily CRO wear time was objectively measured by a temperature sensor recording at 15-min intervals and changes in cranial shape, including cranial vault asymmetry index (CVAI(S)) and cephalic index (CI) were measured.ResultsThe average daily wear time was 15.9 ± 6.1 h across all infants and 18.0 h among those who completed treatment. No sensor-related complications occurred. Greater wear time was significantly associated with greater reduction in CVAI(S), but not CI, likely due to the small number of infants with brachycephaly. Notably, older infants derived significantly more benefit from increased wear time than younger infants.ConclusionsMeasuring CRO adherence using a temperature sensor with a mobile application is feasible and did not produce any observed safety concerns. Overall, the recorded average daily wear was lower than the prescribed treatment protocol, underscoring a gap between recommended and actual adherence.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261493312"},"PeriodicalIF":1.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Elevated Nasal Clip Application in Unilateral Cleft Lip Nasal Deformity Correction.","authors":"Shiming Zhang, Min Wu, Meijun Du, Jiali Chen, Ruixin Zeng, Xiang Li, Sining He, Bing Shi, Hanyao Huang","doi":"10.1177/10556656261493236","DOIUrl":"https://doi.org/10.1177/10556656261493236","url":null,"abstract":"<p><p>BackgroundThis study aims to characterize the long-term relapse patterns and evaluate the effectiveness of a novel elevated nasal clip in maintaining postoperative nasal symmetry in patients with unilateral cleft lip nasal deformity.MethodsThis study included a preliminary retrospective analysis to contextualize long-term relapse patterns, followed by a prospective randomized controlled trial, which constituted the principal component of the work. First, we conducted a preliminary retrospective analysis to contextualize long-term relapse patterns: we reviewed 2 independent cohorts of patients who underwent primary unilateral cleft lip repair and were followed up at 5 and 10 years postoperatively, respectively. Second, the main component of this study was a prospective randomized controlled trial designed to evaluate the efficacy of the elevated nasal clip, with postoperative follow-up at 6 and 12 months. Both parts employed standardized frontal and basal-view facial photographs and identical anthropometric parameters to quantitatively assess nasal symmetry.ResultsLong-term follow-up revealed progressive relapse in nasal morphology, particularly in deviation of the nasal tip and nostril height asymmetry by 10 years postoperatively. These findings provide a clinical context underscoring the importance of maintaining early nasal symmetry after cleft lip repair. On this basis, we designed a prospective randomized controlled study to rigorously evaluate the efficacy of an elevated nasal clip in patients with incomplete unilateral cleft lip. Compared with the traditional retainer group, the elevated nasal clip group demonstrated significantly better preservation of columella ratio, nostril height ratio, and nostril area ratio, supporting its clinical value as a targeted adjunct for early nasal symmetry maintenance.ConclusionOur study confirmed the progressive and multidimensional nature of long-term nasal symmetry relapse following primary cleft rhinoplasty, underscoring the need for early and effective interventions. Recognizing this long-term vulnerability underscores the need for effective early interventions. In this context, our prospective study demonstrates that the elevated nasal clip provides individually targeted improvement in columella and nostril symmetry, supporting its promise as a practical adjunct for postoperative nasal remodeling after unilateral cleft lip repair.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261493236"},"PeriodicalIF":1.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Fungiform Papillae Density and Oral Health Status in Children with and Without Unilateral Cleft Lip and Palate: A Cross-Sectional Comparative Study.","authors":"Shweta Batra, Lipika Gopal, Aditya Talwar, Aadya Batra, Ashish Kumar Singh, Tanu Nangia, Puneet Batra, Rashika Singhania, Riddhi Bansal","doi":"10.1177/10556656261494275","DOIUrl":"https://doi.org/10.1177/10556656261494275","url":null,"abstract":"<p><p>ObjectiveTo evaluate the association between fungiform papillae (FP) density and oral health status in children with nonsyndromic unilateral cleft lip and palate (UCLP) compared with age-matched noncleft controls.DesignA cross-sectional comparative study.SettingsTwo calibrated examiners performed all measurements.PatientsAbout 160 children with and without cleft were divided into four groups (6-9 years and 12-15 years, respectively) (n = 40)Main Outcome MeasureCaries experience, oral hygiene status, fungiform papilla density on the tongue, and enamel defect status was assessed using the decayed, missing, and filled teeth (DMFT/dmft) index, simplified oral hygiene index (OHI-S), the modified developmental defects of enamel (DDE) Index, and standardized blue food dye-based digital imaging protocol respectively. Data analysis was performed using Mann-Whitney U tests, independent t-tests, and Pearson correlation.ResultsChildren with UCLP demonstrated significantly lower FP density than noncleft controls in both the 6-9-year (26.90 ± 2.97 vs. 29.70 ± 3.75) and 12-15-year cohorts (24.35 ± 2.46 vs. 27.65 ± 3.12; p < 0.05). DMFT/dmft scores and enamel defects were also significantly higher in cleft children than noncleft controls (p < 0.05).ConclusionReduced density of FP is observed in children with UCLP, but does not independently predict caries experience or oral hygiene status. However, significant intergroup differences in OHI-S were observed in the 12-15-year cohort, suggesting that oral hygiene disparities between cleft and noncleft children are more pronounced with increasing age. Children with UCLP also showed a higher prevalence of enamel defects consistent across both age strata; however, multivariate regression adjusting for FP density, cleft status, and age showed no correlation with DMFT/dmft/OHI-S.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261494275"},"PeriodicalIF":1.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Childhood Caries in Preschool Children With Cleft Lip and/or Palate: A Cross-Sectional Study of Prevalence and Contributing Factors.","authors":"Chotika Srinaul, Pornsuda Norchai, Saran Worasakwutiphong, Ruedee Sakulratchata","doi":"10.1177/10556656261493294","DOIUrl":"https://doi.org/10.1177/10556656261493294","url":null,"abstract":"<p><p>ObjectiveTo compare the prevalence, experience, and distribution of early childhood caries (ECC) between children with cleft lip and/or palate (CL/P) and children without CL/P and to identify associated risk factors.SettingUniversity cleft and craniofacial center and pediatric dental clinic.Patients and ParticipantsA total of 100 children aged 6 months to 6 years (50 with CL/P and 50 without CL/P), age-matched.MethodsClinical oral examinations were performed by a calibrated examiner using the decayed, missing, and filled teeth (dmft) index and International Caries Detection and Assessment System (ICDAS). Caregivers completed structured questionnaires on demographic characteristics, feeding practices, oral hygiene behaviors, and socioeconomic factors. Logistic regression analysis was used to identify independent predictors of ECC.InterventionsNone.Main Outcome Measure(s)ECC prevalence (dmft > 0), caries experience (dmft), tooth-specific distribution, and associated risk factors.ResultsECC prevalence was high in both groups (children with CL/P: 74.0%; children without CL/P: 66.0%), with no significant difference (<i>P</i> > 0.05). Caries experience and severity were comparable. Children with CL/P showed significantly greater caries involvement of the mandibular primary incisors, whereas children without CL/P exhibited significantly greater caries involvement of maxillary second primary molars (<i>P</i> < 0.05). Age >3 years was an independent predictor in both groups. Cleft palate involvement increased ECC risk in the CL/P group (OR = 11.1, <i>P</i> = 0.008), while frequent snacking (>2 times/day) was significant in controls (OR = 11.1, <i>P</i> = 0.016).ConclusionsECC burden was high and comparable between groups; however, risk profiles differed, indicating the need for tailored preventive strategies.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656261493294"},"PeriodicalIF":1.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volumetric Assessment of Maxillary Sinus Changes After Le Fort I Osteotomy in Cleft Lip and Palate Patients: A Pilot Study.","authors":"Peterson Rogerio Garcia, Caroline de Paula Oliveira Gringo, Gustavo Ribeiro Ferreira, Isabelle Ferreira de Souza, Amy Stacy Gallegos Soto, Renato Yassutaka Faria Yaedu","doi":"10.1177/10556656251385463","DOIUrl":"10.1177/10556656251385463","url":null,"abstract":"<p><p>ObjectiveTo assess volumetric and morphological changes in the maxillary sinus of patients with cleft lip and palate (CLP) undergoing Le Fort I osteotomy using cone-beam computed tomography (CBCT) and 3D segmentation.DesignRetrospective observational pilot study.SettingA specialized CLP treatment center in the oral and maxillofacial surgery department.Patients/ParticipantsThirty adults with CLP (15 unilateral, 15 bilateral) who underwent Le Fort I osteotomy, with preoperative and ≥12-month postoperative CBCT scans available.MethodsThree-dimensional segmentation of the maxillary sinus was performed using ITK-SNAP software on pre- and postoperative CBCT scans to calculate volumetric changes.Outcome MeasureMaxillary sinus volume (mm³) before and after surgery.ResultsBoth groups exhibited postoperative reductions in sinus volume. In the unilateral group, mean bilateral volume decreased from 12 272 mm³ to 11 433 mm³; in the bilateral group, from 15 082 mm³ to 14 519 mm³. Although the unilateral group showed slightly greater reduction, differences were not statistically significant within or between groups (<i>P</i> > 0.05).ConclusionsLe Fort I osteotomy led to modest postoperative volumetric reduction in the maxillary sinus in both unilateral and bilateral CLP patients. Bilateral CLP cases consistently exhibited larger sinus volumes pre- and postoperatively compared to unilateral cases. These findings suggest cleft morphology influences sinus anatomy and that surgical intervention may alter its structure. Although volumetric changes were not significant, frequent morphological variations highlight the need for ongoing postoperative radiological monitoring.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3225-3231"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catch-Up Growth in Syndromic Robin Sequence: A Systematic Review.","authors":"Sogand Schafer, Jason Yu, John B Mulliken","doi":"10.1177/10556656251392267","DOIUrl":"10.1177/10556656251392267","url":null,"abstract":"<p><p>ObjectiveThe triad of micrognathia, glossoptosis, and airway obstruction defines Robin sequence (RS). Syndromic RS accounts for about 60% of cases, but whether mandibular \"catch-up\" growth occurs in these cases remains unclear. The aim of the systematic review was to assess the current literature for evidence of catch-up growth in syndromic RS.DesignA PRISMA-guided systematic literature review was performed. PubMed was searched for studies describing cases with syndromic RS who underwent conservative (non-surgical) management.Patients, ParticipantsCase reports, case series, and chart reviews containing both the diagnosis of RS and at least one associated syndrome were included. Review articles, non-English publications, and studies lacking sufficient follow-up or clarity on mandibular morphology were excluded.Main Outcome MeasuresThe review assessed micrognathia, mandibular length, catch-up growth, and the necessity of airway enhancement.ResultsThirty-four studies met the criteria for inclusion. These studies included clinical information from a total of 202 cases and addressed 20 different syndromes. RS in the context of Stickler syndrome and 22q11.2 deletion syndrome were most frequently reported, with multiple studies suggesting potential for balanced maxillo-mandibular growth or apparent catch-up growth. However, definitive conclusions were limited by small study population, heterogeneous methodologies, and variable follow-up durations.ConclusionWhile additional data are needed, available literature suggests that certain syndromic RS groups may exhibit spontaneous mandibular growth, potentially reducing the need for invasive procedures such as distraction osteogenesis. Prospective research employing standardized cephalometric measures is necessary to identify which syndromic subpopulations and RS types benefit from conservative versus surgical management.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3258-3270"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymmetric Rapid Maxillary Expansion in a Cleft Lip and Palate Patient With True Unilateral Posterior Crossbite: A Case Report.","authors":"Fenny Tjong, Mentari Tri Iriani, Endah Mardiati, Ida Ayu Evangelina, Avi Laviana, Elih Sayuti","doi":"10.1177/10556656251384159","DOIUrl":"10.1177/10556656251384159","url":null,"abstract":"<p><p>An 18-year-old female with incomplete unilateral cleft lip and palate presented with skeletal class I malocclusion, severe crowding, anterior crossbite, unilateral posterior crossbite, congenitally missing maxillary left lateral incisor, and root dilacerations. The aims of the treatment were to achieve good occlusion and improve psychological well-being. Orthodontic treatment with a preadjusted edgewise MBT 0.022 bracket system and asymmetric Hyrax-type expander achieved proper dental alignment and unilateral transverse expansion without affecting the non-crossbite side. The Rosenberg Self-Esteem Scale increased from 13 to 27, indicating enhanced psychological well-being. The asymmetric Hyrax-type expander was effective for correcting unilateral posterior crossbite.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3512-3524"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Hybrid Telepractice and In-Person Speech Therapy on Speech Outcomes in Persian-Speaking Children with Cleft Palate: A Preliminary Investigation.","authors":"Sogand Zarei, Mohammad-Sadegh Seifpanahi, Kowsar Baghban, Maryam Emadi, Zahra Cheraghi","doi":"10.1177/10556656251387487","DOIUrl":"10.1177/10556656251387487","url":null,"abstract":"<p><p>ObjectiveThis study examined the effects of intensive hybrid telepractice and in-person speech therapy on speech characteristics in Persian-speaking children.DesignSingle-subject experimental design (ABA type).SettingMobasher Speech Therapy Clinic, Hamadan, Iran.ParticipantsFour Persian-speaking children aged 3 to 12 years with CP ± L and at least one active cleft-type characteristic (CTC).InterventionThirty intensive hybrid sessions (three in-person and two telepractice sessions per week) over six weeks.Main Outcome MeasuresPercentage of active oral/nonoral CTCs, percentage of correct consonants (PCC) in sentence imitation, word imitation, and word naming, percentage of stimulable consonants, hypernasality and nasal air emission were evaluated using the cleft audit protocol for speech-augmented protocol. Visual analysis, the two-standard deviation (2SD) test, and effect size indices, percentage of nonoverlapping data (PND) and Improvement Rate Difference (IRD), were used to assess outcomes.ResultsAll participants demonstrated reductions in active CTCs, hypernasality, and nasal air emission, alongside increases in PCC and stimulable consonants. These gains were maintained during the follow-up. PND and IRD indices reached 100% for all participants across all variables, except for hypernasality and nasal air emission. Hypernasality showed moderate treatment effects (PND/IRD = 40-60%), while the PND and IRD values for nasal air emission were 80%. The 2SD test confirmed statistically significant improvements (α = 0.05) in interval-level variables such as PCC and active CTCs, supporting the robustness of treatment effects.ConclusionIntensive hybrid telepractice and in-person therapy can improve multiple speech characteristics in Persian-speaking children with CP ± L, supporting the value of integrated, accessible treatment approaches for this population.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"3232-3246"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}