Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 5. Speech outcomes in 5-year-olds - consonant proficiency and errors

Elisabeth Willadsen; Anette Lohmander; Christina Persson; Inger Lundeborg; Suvi Alaluusua; Ragnhild Aukner; Anja Bau; Maria Boers; Melanie Bowden; Julie Davies; Berit Emborg; Christina Havstam; Christine Hayden; Gunilla Henningsson; Anders Holmefjord; Elina Hölttä; Mia Kisling-Møller; Lillian Kjøll; Maria Lundberg; Eilish McAleer; Jill Nyberg; Marjukka Paaso; Nina Helen Pedersen; Therese Rasmussen; Sigvor Reisæter; Helene Søgaard Andersen; Antje Schöps; Inger Beate Tørdal; Gunvor Semb

doi:10.1080/2000656X.2016.1254647

Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 5. Speech outcomes in 5-year-olds - consonant proficiency and errors

Elisabeth Willadsen^*, Anette Lohmander, Christina Persson, Inger Lundeborg, Suvi Alaluusua, Ragnhild Aukner, Anja Bau, Maria Boers, Melanie Bowden, Julie Davies, Berit Emborg, Christina Havstam, Christine Hayden, Gunilla Henningsson, Anders Holmefjord, Elina Hölttä, Mia Kisling-Møller, Lillian Kjøll, Maria Lundberg, Eilish McAleerJill Nyberg, Marjukka Paaso, Nina Helen Pedersen, Therese Rasmussen, Sigvor Reisæter, Helene Søgaard Andersen, Antje Schöps, Inger Beate Tørdal, Gunvor Semb

^*Corresponding author for this work

Department of Nordic Studies and Linguistics

32 Citations (Scopus)

Abstract

Background and aim: Normal articulation before school start is a main objective in cleft palate treatment. The aim was to investigate if differences exist in consonant proficiency at age 5 years between children with unilateral cleft lip and palate (UCLP) randomised to different surgical protocols for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. Design: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Norway, Sweden, and the UK. Methods: Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with non-syndromic UCLP. Speech audio- and video-recordings of 391 children (136 girls and 255 boys) were available and transcribed phonetically. The main outcome measure was Percent Consonants Correct (PCC) from blinded assessments. Results: In Trial 1, arm A showed statistically significant higher PCC scores (82%) than arm B (78%) (p =.045). No significant differences were found between prevalences in Trial 2, A: 79%, C: 82%; or Trial 3, A: 80%, D: 85%. Across all trials, girls achieved better PCC scores, excluding s-errors, than boys (91.0% and 87.5%, respectively) (p =.01). Conclusions: PCC scores were higher in arm A than B in Trial 1, whereas no differences were found between arms in Trials 2 or 3. The burden of care in terms of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed. Trial registration: ISRCTN29932826.

Original language	English
Journal	Journal of Plastic Surgery and Hand Surgery
Volume	51
Issue number	1
Pages (from-to)	38-51
Number of pages	14
ISSN	2000-656X
DOIs	https://doi.org/10.1080/2000656X.2016.1254647
Publication status	Published - 2017

Keywords

cleft speech characteristics
consonant proficiency
Primary palatal repair
randomised clinical trial
unilateral cleft lip and palate

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10.1080/2000656X.2016.1254647

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Willadsen, E., Lohmander, A., Persson, C., Lundeborg, I., Alaluusua, S., Aukner, R., Bau, A., Boers, M., Bowden, M., Davies, J., Emborg, B., Havstam, C., Hayden, C., Henningsson, G., Holmefjord, A., Hölttä, E., Kisling-Møller, M., Kjøll, L., Lundberg, M., ... Semb, G. (2017). Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 5. Speech outcomes in 5-year-olds - consonant proficiency and errors. Journal of Plastic Surgery and Hand Surgery, 51(1), 38-51. https://doi.org/10.1080/2000656X.2016.1254647

Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate : 5. Speech outcomes in 5-year-olds - consonant proficiency and errors. / Willadsen, Elisabeth; Lohmander, Anette; Persson, Christina et al.

In: Journal of Plastic Surgery and Hand Surgery, Vol. 51, No. 1, 2017, p. 38-51.

Research output: Contribution to journal › Journal article › Research › peer-review

Willadsen, E, Lohmander, A, Persson, C, Lundeborg, I, Alaluusua, S, Aukner, R, Bau, A, Boers, M, Bowden, M, Davies, J, Emborg, B, Havstam, C, Hayden, C, Henningsson, G, Holmefjord, A, Hölttä, E, Kisling-Møller, M, Kjøll, L, Lundberg, M, McAleer, E, Nyberg, J, Paaso, M, Pedersen, NH, Rasmussen, T, Reisæter, S, Andersen, HS, Schöps, A, Tørdal, IB & Semb, G 2017, 'Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 5. Speech outcomes in 5-year-olds - consonant proficiency and errors', Journal of Plastic Surgery and Hand Surgery, vol. 51, no. 1, pp. 38-51. https://doi.org/10.1080/2000656X.2016.1254647

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abstract = "Background and aim: Normal articulation before school start is a main objective in cleft palate treatment. The aim was to investigate if differences exist in consonant proficiency at age 5 years between children with unilateral cleft lip and palate (UCLP) randomised to different surgical protocols for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. Design: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Norway, Sweden, and the UK. Methods: Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with non-syndromic UCLP. Speech audio- and video-recordings of 391 children (136 girls and 255 boys) were available and transcribed phonetically. The main outcome measure was Percent Consonants Correct (PCC) from blinded assessments. Results: In Trial 1, arm A showed statistically significant higher PCC scores (82%) than arm B (78%) (p =.045). No significant differences were found between prevalences in Trial 2, A: 79%, C: 82%; or Trial 3, A: 80%, D: 85%. Across all trials, girls achieved better PCC scores, excluding s-errors, than boys (91.0% and 87.5%, respectively) (p =.01). Conclusions: PCC scores were higher in arm A than B in Trial 1, whereas no differences were found between arms in Trials 2 or 3. The burden of care in terms of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed. Trial registration: ISRCTN29932826.",

keywords = "cleft speech characteristics, consonant proficiency, Primary palatal repair, randomised clinical trial, unilateral cleft lip and palate",

author = "Elisabeth Willadsen and Anette Lohmander and Christina Persson and Inger Lundeborg and Suvi Alaluusua and Ragnhild Aukner and Anja Bau and Maria Boers and Melanie Bowden and Julie Davies and Berit Emborg and Christina Havstam and Christine Hayden and Gunilla Henningsson and Anders Holmefjord and Elina H{\"o}ltt{\"a} and Mia Kisling-M{\o}ller and Lillian Kj{\o}ll and Maria Lundberg and Eilish McAleer and Jill Nyberg and Marjukka Paaso and Pedersen, {Nina Helen} and Therese Rasmussen and Sigvor Reis{\ae}ter and Andersen, {Helene S{\o}gaard} and Antje Sch{\"o}ps and T{\o}rdal, {Inger Beate} and Gunvor Semb",

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doi = "10.1080/2000656X.2016.1254647",

language = "English",

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journal = "Journal of Plastic Surgery and Hand Surgery",

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T1 - Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate

T2 - 5. Speech outcomes in 5-year-olds - consonant proficiency and errors

AU - Willadsen, Elisabeth

AU - Lohmander, Anette

AU - Persson, Christina

AU - Lundeborg, Inger

AU - Alaluusua, Suvi

AU - Aukner, Ragnhild

AU - Bau, Anja

AU - Boers, Maria

AU - Bowden, Melanie

AU - Davies, Julie

AU - Emborg, Berit

AU - Havstam, Christina

AU - Hayden, Christine

AU - Henningsson, Gunilla

AU - Holmefjord, Anders

AU - Hölttä, Elina

AU - Kisling-Møller, Mia

AU - Kjøll, Lillian

AU - Lundberg, Maria

AU - McAleer, Eilish

AU - Nyberg, Jill

AU - Paaso, Marjukka

AU - Pedersen, Nina Helen

AU - Rasmussen, Therese

AU - Reisæter, Sigvor

AU - Andersen, Helene Søgaard

AU - Schöps, Antje

AU - Tørdal, Inger Beate

AU - Semb, Gunvor

PY - 2017

Y1 - 2017

N2 - Background and aim: Normal articulation before school start is a main objective in cleft palate treatment. The aim was to investigate if differences exist in consonant proficiency at age 5 years between children with unilateral cleft lip and palate (UCLP) randomised to different surgical protocols for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. Design: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Norway, Sweden, and the UK. Methods: Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with non-syndromic UCLP. Speech audio- and video-recordings of 391 children (136 girls and 255 boys) were available and transcribed phonetically. The main outcome measure was Percent Consonants Correct (PCC) from blinded assessments. Results: In Trial 1, arm A showed statistically significant higher PCC scores (82%) than arm B (78%) (p =.045). No significant differences were found between prevalences in Trial 2, A: 79%, C: 82%; or Trial 3, A: 80%, D: 85%. Across all trials, girls achieved better PCC scores, excluding s-errors, than boys (91.0% and 87.5%, respectively) (p =.01). Conclusions: PCC scores were higher in arm A than B in Trial 1, whereas no differences were found between arms in Trials 2 or 3. The burden of care in terms of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed. Trial registration: ISRCTN29932826.

AB - Background and aim: Normal articulation before school start is a main objective in cleft palate treatment. The aim was to investigate if differences exist in consonant proficiency at age 5 years between children with unilateral cleft lip and palate (UCLP) randomised to different surgical protocols for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. Design: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Norway, Sweden, and the UK. Methods: Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with non-syndromic UCLP. Speech audio- and video-recordings of 391 children (136 girls and 255 boys) were available and transcribed phonetically. The main outcome measure was Percent Consonants Correct (PCC) from blinded assessments. Results: In Trial 1, arm A showed statistically significant higher PCC scores (82%) than arm B (78%) (p =.045). No significant differences were found between prevalences in Trial 2, A: 79%, C: 82%; or Trial 3, A: 80%, D: 85%. Across all trials, girls achieved better PCC scores, excluding s-errors, than boys (91.0% and 87.5%, respectively) (p =.01). Conclusions: PCC scores were higher in arm A than B in Trial 1, whereas no differences were found between arms in Trials 2 or 3. The burden of care in terms of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed. Trial registration: ISRCTN29932826.

KW - cleft speech characteristics

KW - consonant proficiency

KW - Primary palatal repair

KW - randomised clinical trial

KW - unilateral cleft lip and palate

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DO - 10.1080/2000656X.2016.1254647

M3 - Journal article

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AN - SCOPUS:85013414613

SN - 2000-656X

VL - 51

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EP - 51

JO - Journal of Plastic Surgery and Hand Surgery

JF - Journal of Plastic Surgery and Hand Surgery

IS - 1

ER -

Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 5. Speech outcomes in 5-year-olds - consonant proficiency and errors

Abstract

Keywords

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