View in EDS

Rethinking Speech Sound Disorder (SSD) in Non-Syndromic Cleft Lip and Palate: The Importance of Recognizing Phonological and Language Difficulties

Saved in:
Bibliographic Details
Title: Rethinking Speech Sound Disorder (SSD) in Non-Syndromic Cleft Lip and Palate: The Importance of Recognizing Phonological and Language Difficulties
Language: English
Authors: Stephanie van Eeden (ORCID 0000-0002-0902-0564), Cristina McKean (ORCID 0000-0001-9058-9813), Helen Stringer (ORCID 0000-0002-7470-2166)
Source: International Journal of Language & Communication Disorders. 2025 60(1).
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 22
Publication Date: 2025
Document Type: Journal Articles
Reports - Research
Descriptors: Foreign Countries, Congenital Impairments, Speech Impairments, Articulation Impairments, Phonology, Speech, Language Tests, Language Impairments, Children, Language Skills, Language Acquisition, Speech Evaluation
Geographic Terms: United Kingdom
Assessment and Survey Identifiers: Clinical Evaluation of Language Fundamentals
DOI: 10.1111/1460-6984.13151
ISSN: 1368-2822
1460-6984
Abstract: Background: Children born with cleft palate ± lip (CP ± L) are at risk of speech sound disorder (SSD). Up to 40% continue to have SSD at age 5-6 years. These difficulties are typically described as articulatory in nature and often include cleft speech characteristics (CSC) hypothesized to result from structural differences. In non-CP ± L SSD comorbidity with language difficulties is often reported. There is growing evidence of concomitant language difficulties in children with CP ± L and of a higher prevalence of developmental speech errors in children compared with non-CP ± L peers. The impact of underlying phonological and language skills on speech production in children with CP ± L is poorly understood. Aims: To investigate language outcomes in children with CP ± L and the relationship to speech production, by answering the following research questions: (1) Does the profile of language skills in children with CP ± L differ from normative samples? (2) Do children with CP ± L and SSD have poorer language skills than those with typically developing speech? (3) Is there an association between language skills and speech profile in children with CP ± L at age 5--8 years? Methods & Procedures: In this prospective cross-sectional, observational study, 95 participants were recruited from regional cleft lip and palate services in the UK. They were aged 5;0--7;11 with non-syndromic CP ± L. Those with a syndromic diagnosis, global learning disability, sensorineural hearing loss and first language other than English were excluded. Assessments of speech (Diagnostic Evaluation of Articulation and Phonology--DEAP) and language (Clinical Evaluation of Language Fundamentals--5th UK edition--CELF) were completed. Language outcomes were analysed and compared with normative samples and according to speech error analysis. Outcomes & Results: Average language scores were within the expected range. For those presenting with SSD, language scores were significantly lower than those with typically developing speech. Analysis of speech errors showed four distinct speech profiles: typical speech, CSC only, developmental speech characteristics (DSC), and combined CSC + DSC. Language scores were lower for participants with DSC (±CSC). A significant association was found between the presence of CSC + DSC and expressive language outcomes (odds ratio (OR) = 10.82; 95% confidence interval (CI) = 2.42, 48.32, p = 0.002). Conclusions & Implications: An association between language skills and speech production was observed. The distribution of speech errors in children with CP ± L varied with a high level of DSC as well as CSC. Those with CSC + DSC had significantly lower language scores than those with typically developing speech or CSC only. Speech and language therapists working with this caseload should be alerted to potential ongoing phonological and language difficulties in children presenting with this profile.
Abstractor: As Provided
Entry Date: 2025
Accession Number: EJ1458734
Database: ERIC
FullText Text:
  Availability: 0
Header DbId: eric
DbLabel: ERIC
An: EJ1458734
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Rethinking Speech Sound Disorder (SSD) in Non-Syndromic Cleft Lip and Palate: The Importance of Recognizing Phonological and Language Difficulties
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Stephanie+van+Eeden%22">Stephanie van Eeden</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-0902-0564">0000-0002-0902-0564</externalLink>)<br /><searchLink fieldCode="AR" term="%22Cristina+McKean%22">Cristina McKean</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-9058-9813">0000-0001-9058-9813</externalLink>)<br /><searchLink fieldCode="AR" term="%22Helen+Stringer%22">Helen Stringer</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-7470-2166">0000-0002-7470-2166</externalLink>)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22International+Journal+of+Language+%26+Communication+Disorders%22"><i>International Journal of Language & Communication Disorders</i></searchLink>. 2025 60(1).
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 22
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2025
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Congenital+Impairments%22">Congenital Impairments</searchLink><br /><searchLink fieldCode="DE" term="%22Speech+Impairments%22">Speech Impairments</searchLink><br /><searchLink fieldCode="DE" term="%22Articulation+Impairments%22">Articulation Impairments</searchLink><br /><searchLink fieldCode="DE" term="%22Phonology%22">Phonology</searchLink><br /><searchLink fieldCode="DE" term="%22Speech%22">Speech</searchLink><br /><searchLink fieldCode="DE" term="%22Language+Tests%22">Language Tests</searchLink><br /><searchLink fieldCode="DE" term="%22Language+Impairments%22">Language Impairments</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Language+Skills%22">Language Skills</searchLink><br /><searchLink fieldCode="DE" term="%22Language+Acquisition%22">Language Acquisition</searchLink><br /><searchLink fieldCode="DE" term="%22Speech+Evaluation%22">Speech Evaluation</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22United+Kingdom%22">United Kingdom</searchLink>
– Name: SubjectThesaurus
  Label: Assessment and Survey Identifiers
  Group: Su
  Data: <searchLink fieldCode="SU" term="%22Clinical+Evaluation+of+Language+Fundamentals%22">Clinical Evaluation of Language Fundamentals</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1111/1460-6984.13151
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1368-2822<br />1460-6984
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Children born with cleft palate ± lip (CP ± L) are at risk of speech sound disorder (SSD). Up to 40% continue to have SSD at age 5-6 years. These difficulties are typically described as articulatory in nature and often include cleft speech characteristics (CSC) hypothesized to result from structural differences. In non-CP ± L SSD comorbidity with language difficulties is often reported. There is growing evidence of concomitant language difficulties in children with CP ± L and of a higher prevalence of developmental speech errors in children compared with non-CP ± L peers. The impact of underlying phonological and language skills on speech production in children with CP ± L is poorly understood. Aims: To investigate language outcomes in children with CP ± L and the relationship to speech production, by answering the following research questions: (1) Does the profile of language skills in children with CP ± L differ from normative samples? (2) Do children with CP ± L and SSD have poorer language skills than those with typically developing speech? (3) Is there an association between language skills and speech profile in children with CP ± L at age 5--8 years? Methods & Procedures: In this prospective cross-sectional, observational study, 95 participants were recruited from regional cleft lip and palate services in the UK. They were aged 5;0--7;11 with non-syndromic CP ± L. Those with a syndromic diagnosis, global learning disability, sensorineural hearing loss and first language other than English were excluded. Assessments of speech (Diagnostic Evaluation of Articulation and Phonology--DEAP) and language (Clinical Evaluation of Language Fundamentals--5th UK edition--CELF) were completed. Language outcomes were analysed and compared with normative samples and according to speech error analysis. Outcomes & Results: Average language scores were within the expected range. For those presenting with SSD, language scores were significantly lower than those with typically developing speech. Analysis of speech errors showed four distinct speech profiles: typical speech, CSC only, developmental speech characteristics (DSC), and combined CSC + DSC. Language scores were lower for participants with DSC (±CSC). A significant association was found between the presence of CSC + DSC and expressive language outcomes (odds ratio (OR) = 10.82; 95% confidence interval (CI) = 2.42, 48.32, p = 0.002). Conclusions & Implications: An association between language skills and speech production was observed. The distribution of speech errors in children with CP ± L varied with a high level of DSC as well as CSC. Those with CSC + DSC had significantly lower language scores than those with typically developing speech or CSC only. Speech and language therapists working with this caseload should be alerted to potential ongoing phonological and language difficulties in children presenting with this profile.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2025
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1458734
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1458734
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/1460-6984.13151
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 22
    Subjects:
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Congenital Impairments
        Type: general
      – SubjectFull: Speech Impairments
        Type: general
      – SubjectFull: Articulation Impairments
        Type: general
      – SubjectFull: Phonology
        Type: general
      – SubjectFull: Speech
        Type: general
      – SubjectFull: Language Tests
        Type: general
      – SubjectFull: Language Impairments
        Type: general
      – SubjectFull: Children
        Type: general
      – SubjectFull: Language Skills
        Type: general
      – SubjectFull: Language Acquisition
        Type: general
      – SubjectFull: Speech Evaluation
        Type: general
      – SubjectFull: United Kingdom
        Type: general
      – SubjectFull: Clinical Evaluation of Language Fundamentals
        Type: general
    Titles:
      – TitleFull: Rethinking Speech Sound Disorder (SSD) in Non-Syndromic Cleft Lip and Palate: The Importance of Recognizing Phonological and Language Difficulties
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Stephanie van Eeden
      – PersonEntity:
          Name:
            NameFull: Cristina McKean
      – PersonEntity:
          Name:
            NameFull: Helen Stringer
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2025
          Identifiers:
            – Type: issn-print
              Value: 1368-2822
            – Type: issn-electronic
              Value: 1460-6984
          Numbering:
            – Type: volume
              Value: 60
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: International Journal of Language & Communication Disorders
              Type: main
ResultId 1