Early speech production of children with cleft palate.

Word-initial target phonemes and the production of those phonemes were examined in normal children and children with cleft palate during the period when the children were acquiring their first 50 words. As a group, the children with cleft palate tended to target more words with word-initial nasals, approximants, and vowels ([ +sonorant] phonemes) and fewer words with word-initial stops, fricatives, and affricates ([-sonorant] phonemes). Normal children tended to target more words with initial consonants articulated in the center of the oral tract ([+coronal]) and the children with cleft palate targeted more words with initial phonemes articulated at the periphery of the oral tract ([-coronal]). The same patterns also were observed in production, but individual children with cleft palate did not always follow this pattern. Although the accuracy of the productions of individual children appeared to be related to word choice, factors such as hearing sensitivity, structural adequacy, and the timing of surgical repair also might have affected speech production accuracy.