Longitudinal speech performance in patients with cleft palate: comparisons based on secondary management.

Speech performance of three groups of speakers with cleft palate was analyzed at two-year intervals from age 4 years through age 16 years. The three groups consisted of: Group A--individuals who score below 20 percent correct on the Iowa Pressure Articulation Test (IPAT) at 4 years of age and who received secondary surgery by 8 years of age; Group B--individuals who scored below 20 percent correct on the Iowa Pressure Articulation Test at 4 years of age, but did not receive secondary management by 8 years of age; and Group C--individuals who scored above 20 percent correct on the Iowa Pressure Articulation Test and who did not receive secondary surgery by 8 years of age. The results demonstrated that Group A performed better on several measures of speech performance at 16 years of age than either of the other groups. Also, speech performance appeared to become slightly worse around 12 years of age for Group B. This may be interpreted as evidence that this group may have been negatively affected by the physiologic changes associated with puberty. The other two groups did not appear to show this effect. The results of this study emphasize the need for careful research regarding patients who, in spite of early poor speech performance, are not considered candidates for early secondary management.