gms | German Medical Science

Background/research question: Even in 2022, the evidence of duration, intensity and type of speech therapy for cleft palate cleft lip (CP+/L) remains unclear. The objective of the present study was (1) to investigate effectiveness of phonological and/or phonetic therapy for children and adolescents (1;0-19;11 yrs.) with CP+/L and cleft type characteristics (CTCs) and (2) to identify different types of interventions assessed.

Methods: A systematic review of journal publications was conducted in January 2022 by an extensive electronic search and analysis of the databases of Cochrane Library, PubMed, ISI Web of Science, APA PsycINFO and The Health Technology Assessment Database. The search strategy was amended by a manual search of published articles and by checking reference lists of identified publications. There was no limitation in publication year or language. Inclusion criteria for studies were: phonological or phonetic therapy without any technical instruments, experimental group ≥90% of children with CP+/L and CTCs, therapy by SLT/SLP, reported outcome measures for speech-language assessment.

Results: The searches identified 637 references. After screening for title and abstract 558 papers had to be excluded, while another 55 publications dropped out by full text analyses regarding missing inclusion criteria. Finally, a total of 24 studies could be included in the analysis. Seven studies were conducted prior 2000, 6 were conducted between 2000 and 2015, and the remaining 11 studies took place after 2015. The publications reflect different study designs with various levels of evidence. In terms of intervention approaches, 12 studies evaluated phonological approaches, 6 evaluated phonetic approaches and 6 a mixture of both.

Conclusion: The analyses of the studies show significant improvements by all three approaches, with an advantage in phonological intervention. Risk of bias in studies was moderate.

Competing interests: Keine