Naturalistic intervention in cleft palate children

Aim: 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 a naturalistic intervention. The main purpose was to study whether a naturalistic intervention may reduce the total time of speech therapy necessary for correcting CAD in cleft palate children as compared to a phonologic intervention. Materials and methods: 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 30 patients were selected and were divided randomly into two groups. Fifteen patients were included in the first group (control) and received phonologic SI. The other 15 patients were included in the second group (active) and received naturalistic 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 pathologists every 3 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. Results: Median age in the control group was 54.5 months, and 57.5 months in the active group. A Mann-Whitney rank sum test demonstrated a non-significant difference (P=0.803). The mean total time of SI in the control group was 14.53, and 16.27 in the active group. A student's t-test demonstrated that the total time of SI was not significantly reduced (P=0.331) when a naturalistic intervention was utilized. Conclusions: Naturalistic based SI did not reduce the time necessary for correcting CAD in cleft palate children. (C) 2003 Elsevier Ireland Ltd. All rights reserved.