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Purpose: The purpose of this pilot study was to investigate the extent to which a naturalistic communication intervention, enhanced milieu teaching with phonological emphasis (EMT+ PE), improved the language and speech outcomes of toddlers with cleft lip and/or palate (CL/P).
Method: Nineteen children between 15 and 36 months (M = 25 months) with nonsyndromic CL/P and typical cognitive development were randomly assigned to a treatment (EMT+ PE) or nontreatment, business-as-usual (BAU), experimental condition. Participants in the treatment group received forty-eight 30-min sessions, biweekly during a 6-month period. Treatment was delivered in a university clinic by trained speech language pathologists; fidelity of treatment was high across participants.
Results: Children in the treatment group had significantly better receptive language scores and a larger percentage of consonants correct than children in the BAU group at the end of intervention. Children in the treatment group made greater gains than children in the BAU group on most language measures; however, only receptive language, expressive vocabulary (per parent report), and consonants correct were significant.
Conclusions: The results of this preliminary study indicate that EMT+PE is a promising early intervention for young children with CL/P. Replication with a larger sample and long-term follow-up measures are needed.
Clefts of the lip and/or palate (CL/P) occur in approximately 1 of 700 live births in the United States; CL/P is the fourth most commonly occurring birth defect (Cleft Palate Foundation, 2005; Correa & Edmonds, 2002). The population of children with CL/P is heterogeneous, including children whose CL/P is associated with a genetic syndrome and who may have cognitive and other developmental disabilities as well as children who are nonsyndromic and present without other developmental concerns. Two-thirds of children with CL/P have clefting of the lip and/or palate, whereas about one third have cleft palate only. The majority of CL/P cases are unilateral (80%). The primary treatment for children with CL/P is early surgical repair with concurrent multidisciplinary management of related difficulties in feeding, swallowing, speech, and health-related concerns. Children with CL/P typically have primary surgical repairs before 12 months; however, complex instances of CL/P may require multiple surgeries over several years. The presence of CL/P places children at risk for delayed speech and language development. As a result of the identified differences in speech...