Infants, toddlers and young children with cleft lip and palate (CLP) often present with multiple risk profiles due to the complex interaction between genotypical, phenotypical and environmental risk factors influencing their communication development at different ages. Current research recommends the need for a comprehensive early communication intervention (ECI) approach to the treatment of young children with CLP. The areas of strength and weakness in communication development and the factors influencing children with CLP at specific age-group intervals are under-emphasized. The aim of this study was to identify and describe the age-specific risk factors and assets which could influence the communication development of young children with CLP visiting a university-based ECI clinic, the Clinic for High-Risk Babies (CHRIB). Furthermore, the developmental areas of strength and weakness in the child with CLP at three specific age-group intervals, ranging from 1 month to 48 months were described. A retrospective, descriptive, between-subject developmental design with a correlation approach was employed. Purposive sampling was implemented as a non-randomized sampling method and 227 participants were included in the study. The data was extracted from the CHRIB database and analyzed by means of basic descriptive and advanced inferential statistical methods. Extensive data processing of all the potential factors that could have an influence on the early communication developmental areas of children with CLP was performed. A final analysis of the most important associations was performed in the SPSS. The findings revealed that expressive and receptive language and listening skills presented as the most vulnerable communication areas across all three age-groups. The cumulative effect of the risk factors was the greatest in the *[12;24) months age-group since this age group presented with the highest frequency of delayed communication development. The majority of participants in all three age-groups presented with areas of strength, which include age-appropriate cognitive skills, pragmatic development, gestural development and gross motor development. Low birth weight presented as a persistent phenotypical risk factor which influenced the development of functions related to language use in the [1;12) and [12;24) months age groups, and gross motor development and receptive language in the *[12;24) months age group. The environtypical factors such as education and occupation of the mother, as well as the type of day care, indicated significant associations with listening skill development in the [1;12) months group and with the development of functions relating to language use in the [12;24) months age group. Parent-child interaction showed recurrent significant associations with receptive and expressive language across the three age groups. The findings indicated that young children with CLP have unique communication profiles at different age intervals and that these age-specific risk factors and assets should be recognized to ensure a comprehensive approach to ECI services to these young children and their families.
Dissertation (MCommunication Pathology)--University of Pretoria, 2011.