Adaptations of the speech of children with cleft lip and palate

Introduction: The cleft lip and palate affects the orofacial functions because individual adaptations occur due to the structural condition to accomplish such functions. In these cases, habitual posture of tongue may be altered during rest and speech. Objective: To characterize both the habitual posture of tongue during rest and the speech adaptations in cleft lip and palate individuals. Material and method: Were evaluated 13 children cleft lip and palate repaired(aged from 7 to 11 years-old).The occlusal condition was evaluated by an orthodontist.Three Speech Language Pathologists analyzed the speech through images and the majority opinion was considered. Results: There was a good agreement among the examiners for the habitual posture of tongue (Kappa=0.73) and speech (Kappa=0.85%).The tongue rest position was classified as: not observed(54%), at the mouth floor(39%) and interdental(7%).In the speech production, 92% of the cases displayed some type of alteration in the alveolar and linguodental phonemes, comprising: interdentalization of the tongue(85%), lisp(65%), acoustic distortion(23%) and dorsum palate production(8%).The most altered phonemes were: [l] (80%), [s], [z], [n] (69%), [d] (61%) and [t] (54%); the least altered was [r] (15%). with regards to maxilla-mandible relationship, 7.7% showed vertical alteration; 7.7% vertical and transversal alteration, and 85% presented an association of horizontal, vertical and transversal alteration. There was no significant association among variables. Conclusion: Despite of the altered occlusal condition, there was a balance between the adequate and altered tongue positioning; however, most individuals showed an altered speech due to the interdentalization of the tongue, lisp, acoustic distortion, and dorsum palate production