# Development of Stop Consonants in Children with Repaired Cleft Palate

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $684,095

## Abstract

Cleft palate is the most frequently occurring facial birth defect in the United States. Even following palate
repair, many children will experience delayed speech and language well into the second year of life. Findings
from our current R01 project show that greater than 40% of children with repaired cleft palate do not achieve
emergence of stop consonants by 16 months of age (4 to 6 months following palate repair) and approximately
20% do not by 20 months of age (8 to 10 months following palate repair). By school age, 20% to 30% of
children with repaired cleft palate will require secondary palatal surgery for obligatory symptoms of
velopharyngeal dysfunction and 60% to 70% will require speech therapy for articulation. One of the most
common errors is backed (palatalized) production of alveolar targets. The specific aims of this proposed
renewal are to determine: 1) if a novel aerodynamic measure of velopharyngeal closure for stop consonants at
24 months of age predicts velopharyngeal function at 3, 4, and 5 years of age in children with repaired cleft
palate, 2) age-related changes in obligatory symptoms of velopharyngeal dysfunction – hypernasality and
audible nasal air escape – of children with repaired cleft palate from 5 to 8 years of age, and 3) the effects of
cleft type and hearing status on the development and intelligibility of alveolar stop and fricative targets in
children with repaired cleft palate from 5 to 8 years of age. We will continue to follow three currently enrolled
cohorts of children: 1) with repaired cleft palate (approximately 60), 2) without cleft palate but with history of
early otitis media with effusion (approximately 30), and 3) typically-developing without cleft palate or history of
otitis media with effusion (approximately 30). We will also enroll additional 2 and 5 year-old children to offset
attrition and maintain adequate sample sizes. We will use nasal ram pressure, standard pressure-flow
procedures, perceptual ratings, single-word intelligibility testing, and spectral moment analyses to accomplish
the specific aims. We will evaluate the first specific aim using binomial regression and sensitivity/specificity
analyses. We will evaluate the second and third specific aims using one-way analysis of variance and linear
mixed models with and without cleft type and hearing status as covariates. It is anticipated that the results will
a) further validate a novel and relatively simple procedure to evaluate velopharyngeal function in young
children with repaired cleft palate, b) provide longitudinal data on obligatory symptoms and articulation of older
children with repaired cleft palate, and c) contribute to theories of early speech development of children with
structural anomalies. Such information will be instrumental to optimize the timing of secondary surgeries and
provide evidence-based strategies for behavioral interventions that will improve oral communication and quality
of life.

## Key facts

- **NIH application ID:** 9875452
- **Project number:** 5R01DE022566-07
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** DAVID J ZAJAC
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $684,095
- **Award type:** 5
- **Project period:** 2013-04-04 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9875452

## Citation

> US National Institutes of Health, RePORTER application 9875452, Development of Stop Consonants in Children with Repaired Cleft Palate (5R01DE022566-07). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9875452. Licensed CC0.

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