Comparison of motor-phonetic versus phonetic-phonological speech therapy approaches in patients with a cleft (lip and) palate: a study in Uganda

Introduction: At present, there is growing interest in combined phonetic-phonological approaches to treat active speech errors in children with a cleft (lip and) palate (CP +/- L). Unfortunately, evidence for these type of speech interventions in this population is lacking. Therefore, the present study investigated the effectiveness of speech intervention in Ugandan patients with CP +/- L. Moreover, a comparison was made between a motor-phonetic and a phonetic-phonological speech intervention. Methods: Eight patients (median age: 11.26y) with an isolated CP +/- L were assigned into a group receiving motor-phonetic treatment (n = 4) or a group receiving combined phonetic-phonological treatment (n = 4). The participants received 6h of individual speech therapy. In both groups, perceptual and instrumental speech evaluations were performed to evaluate the patients' speech before and after the intervention. Results: Speech therapy (irrespective of the used approach) was found to be effective in increasing consonant proficiency and in decreasing the occurrence of non-oral and passive CSCs. No statistically significant differences in outcome variables were found when comparing the two groups pre- and post-treatment. The descriptive results, however, revealed a larger increase in % correctly produced consonants, places and manners after the intervention in the group receiving a combined phonetic-phonological treatment compared to the group receiving a motor-phonetic treatment. Conclusion: This study took a first step in providing evidence concerning the effectiveness of different speech therapy approaches in children with CP +/- L. The present study holds some important implications for clinical practice suggesting that an additional phonological approach may be beneficial for the patients with CP +/- L. Further research including randomized controlled trials with larger sample sizes is necessary to provide further evidence.