A longitudinal study of speech in 15 children with cleft lip and palate treated by late repair of the hard palate.

Since 1975, children with cleft lip and palate living in the western part of Sweden have been treated according to a regimen of early repair of the soft palate (at the age of 6-8 months) and late hard palate closure (at about 8-9 years of age). The present paper is a longitudinal study of 15 consecutive patients whose speech development was analysed at the mean ages (years:months) of 5:3, 7:0, 8:5, and 9:7 years. Hypernasality gradually decreased over the years whereas nasal escape almost completely ceased after closure of the residual cleft. There was no glottal articulation at any age. Despite the fact that retraction of apicodental consonants decreased in frequency with age and presumably with speech therapy, it was the main problem throughout the observation period. It was presumably caused by the residual cleft in the hard palate compensating for subnormal pressure in front of the opening to the nasal cavity.