Home Language Environment of Children With Orofacial Clefts as a Target for Intervention : Journal of Craniofacial Surgery

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Home Language Environment of Children With Orofacial Clefts as a Target for Intervention

Gallagher, Emily R. MD, MPH∗,†,‡; Wallace, Erin PhD; Thach, Jenny; Kinter, Sara CCC-SLP†,§; Collett, Brent R. PhD||

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Journal of Craniofacial Surgery 32(2):p 500-504, March/April 2021. | DOI: 10.1097/SCS.0000000000007060



To evaluate the home language environment (HLE) in children with orofacial clefts as a potential modifiable target for language and literacy intervention.


Feasibility study examining longitudinal trends in HLE and responses to parent-focused literacy intervention.


Tertiary care children's hospital.


HLE data were collected for 38 children with orofacial clefts between ages 7 and 23 months. Twenty-seven participants received parent-focused literacy intervention.


Reach Out and Read, a literacy intervention, was introduced during a clinic visit. To assess response, participants were randomized to age at intervention (9, 18, or 24 months).

Main Outcome Measures: 

Primary outcome measures included measurements from recordings in the home language environment of adult word count, child vocalizations, and conversational turns.


Baseline (preintervention) results showed lower adult word count and conversational turns for caregivers and children with cleft lip and palate, as well as for those from lower socioeconomic groups. After the literacy intervention was introduced, this cohort showed increasing measures of child and caregiver vocalizations, particularly when introduced at 18 months.


Although these results are preliminary, findings suggest that HLE characteristics vary as a function of children's cleft type as well as family socioeconomic status. Further, our caregiver-focused literacy intervention was feasible and resulted in short-term improvements in HLE. This is the first study to document HLE as a target for intervention in children with oral clefts. These findings support further research on HLE and caregiver-focused intervention to improve language/literacy outcomes for children with oral clefts.

Copyright © 2020 by Mutaz B. Habal, MD

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