Applying principles of motor learning to speech intervention for children with cleft palate: is it effective?

Abstract

Cleft palate with/without cleft lip (CP+/-L) is a common congenital defect and it is known to impact speech development. Minimising speech and resonance difficulties is a primary aim of CP+/-L repair. However, it is estimated that between 50-70 percent of children with CP+/-L will require speech pathology intervention, even after surgical repair. There is currently a paucity of evidence to support any speech intervention approach with children with CP+/-L, making it difficult for clinicians to choose an evidence-based intervention approach. Principles of motor learning (PML) provide clinicians with advice on the structure and frequency of practice and how to provide feedback that best facilitates learning, retention, and transfer of skill. However, despite the growing body of literature to support the principles of motor learning in the treatment of motor speech disorders in children, little is known about the effectiveness of using PML with children with CP+/-L. This research aimed to determine the effectiveness of speech interventions that apply PML, both clinician-led and parent-led app-based, in improving speech outcomes at word level for children with CP+/-L. Both clinician-led and parent-led app-based speech interventions were effective for children with cleft related speech errors. Nine of the eleven children experienced improvement for all phases of treatment completed, and the remaining two children made improvements in one of the two phases completed.