Early Speech and Language Development in Children With Nonsyndromic Cleft Lip and/or Palate: A Meta-Analysis.

Unexplained variance in effect sizes suggests other factors like hearing status, socioeconomic status, or velopharyngeal function may influence outcomes but were not consistently reported. Some analyses were underpowered, particularly for speech errors (only 7 studies), limiting confidence in moderator findings. Moderator analyses were exploratory and single-predictor, so interactions between factors like age and assessment type were not controlled. Publication bias was moderate for speech accuracy and expressive language, with trim-and-fill analyses suggesting the true effect sizes may be smaller. Study quality could not be assessed using standard clinical trial checklists because the included studies were descriptive and observational.

The lead author was supported by a National Institutes of Health F32 grant. No other conflicts of interest were reported.

Do not assume a child with NSCL/P has typical language skills if their standardized test scores are in the normal range. This meta-analysis found that receptive language deficits persisted even when scores did not fall below clinical cutoffs, and parent reports showed larger gaps than standardized tests. Relying solely on norm-referenced assessments may miss functional communication problems that affect school and social interaction.