What works for whom? A systematic review on personalized speech intervention in children and adolescents with a cleft palate

Objective

Personalized health care involves intervention that is tailored to the unique characteristics of the individual. Even though personalized interventions have gained more attention in the past decades, this topic has not yet been systematically studied in the area of speech and language intervention in children with a cleft (lip and) palate (CP ± L). The aim of this systematic review is to summarize the evidence of the effects of personalized speech intervention in children with a CP ± L, aged 3–18 years, with a narrow focus on anterior oral, posterior oral, and non-oral cleft speech characteristics.

Methods

This systematic literature review was developed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), and Embase were searched and the grey literature was checked. The search strategy was based on three concepts: cleft palate, speech intervention, and children. Two raters independently determined the eligibility and extracted all relevant data from the included studies. The methodological quality of the included study was also assessed using the QualSyst tool.

Results

Four studies were included in this review. The overall quality of the included studies was good. Children with severe, non-oral cleft speech characteristics were found to benefit from motor-phonetic based intervention strategies. Linguistic-phonological strategies, in contrast, were more effective in improving speech and health-related quality of life in children with less severe, anterior oral or posterior oral cleft speech characteristics.

Conclusion

There is some evidence that personalized speech intervention yields better outcomes than a “one-size-fits-all” approach. Further research, especially randomized (sham-)controlled trials, is necessary to confirm these results.