A comparative trial of two modalities of speech intervention for compensatory articulation in cleft palate children, phonologic approach versus articulatory approach

Abstract

To compare two modalities of speech intervention (SI) in cleft palate children with compensatory articulation disorder (CAD). The first modality was a phonologic based intervention, the second modality was an articulatory or phonetic intervention. The main purpose is to study whether a phonologic intervention may reduce the total time of speech therapy necessary for correcting CAD in cleft palate children as compared to an articulatory intervention. A prospective, comparative, and randomized trial was carried out. Cleft palate children with velopharyngeal insufficiency and CAD were included in the study group. Only patients with an age ranging from 3 to 7 years were included. A total of 29 patients were selected and were divided randomly into two groups. Fifteen patients were included in the first group (control) and received articulatory SI. Forteen patients were included in the second group (active) and received phonologic SI. The speech pathologist in charge of the SI was the same in all cases. A blind procedure was utilized whereby each patient was evaluated independently by two speech pathologist every three months until both examiners were convinced that CAD had been completely corrected. The mean total time of SI required for the normalization of speech in the two groups of patients was compared. Median age in the control group was 54 months, and 55.50 months in the active group (P > 0.05). The mean total time of SI in the control group was 30.07, and 14.50 in the active group. A Student's t-test demonstrated that the total time of SI was significantly reduced (P < 0.001) when a phonological intervention was utilized. Phonologic based SI significantly reduced the time necessary for correcting CAD in cleft palate children.