Keywords
Speech rehabilitation
Speech-language intervention
Prevention
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To identify and analyze speech-language pathology strategies used in the prevention and rehabilitation of speech disorders in children with cleft lip and palate, with emphasis on the period after reconstructive surgery. Methods: An integrative literature review was conducted, encompassing children with cleft lip and palate in the post-surgical period and speech-language pathology interventions focused on speech rehabilitation. A search was performed in the BVS, PubMed, Web of Science, and Scopus databases, including full articles published between 2020 and 2025, in Portuguese, English, and Spanish, as well as manuals and normative guidelines. Ten documents were selected and analyzed using thematic analysis. Results: Central themes highlighted included the standardization of protocols, a multidisciplinary approach and longitudinal care, professional training in resource-limited settings, prioritization of intervention quality over the number of sessions, therapeutic personalization with dynamic assessment, and prevention combined with family guidance. The most frequently described interventions include articulatory training, modeling and reinforcement techniques, intraoral pressure stimulation, auditory feedback, and Mediated Learning Experience, favoring the correction of compensatory articulations and the development of speech at the expected level. Final considerations: Standardized protocols, multidisciplinary work, continuous training, and personalized strategies enhance therapeutic results and reduce inequalities in access.
References
ALIGHIERI C, et al. What works for whom? A systematic review on personalized speech intervention in children and adolescents with a cleft palate. International Journal of Pediatric Otorhinolaryngology, 2025; 194: 112401.
ALVES BC, et al. Manual informativo sobre prevenção de alterações de fala em crianças com fissura labiopalatina. HRAC-USP: Bauru-SP, 2020.
ALQIRNAS MQ, et al. Systematic review and meta-analysis of speech outcome among different surgical techniques post cleft palate repair: Furlow against other palatoplasty techniques. Eur J Plast Surg, 2024; 47: 50.
BELCHER RH, et al. Addressing cleft care in low- and middle-income countries beyond cleft lip and palate with improvement of otolaryngology, audiology, and speech services. The Cleft Palate-Craniofacial Journal, 2025.
CLELAND J, et al. Using ultrasound visual biofeedback to treat persistent speech sound disorders in children with cleft palate. International Journal of Language & Communication Disorders, 2015; 50(5): 601-613.
CROWLEY CJ, et al. Impact of an international training on interventionists’ expertise in cleft palate speech: results from Oaxaca, Mexico. American Journal of Speech-Language Pathology, 2024; 33(3): 1456-1470.
CROWLEY CJ. Improving Speech Outcomes in Low- and Middle-Income Countries for Patients Born with Cleft Palate. Plastic and Reconstructive Surgery, 2025; 156(4S-2): 14S-22S.
DERAKHSHANDEH F, et al. Speech characteristics after articulation therapy in children with cleft palate and velopharyngeal dysfunction – a single case experimental design. International Journal of Pediatric Otorhinolaryngology, 2016; 86: 104-113.
KUMMER AW. Cleft Palate Speech and Craniofacial Conditions: A Clinical Guide to Assessment and Treatment. 4. ed. Burlington: Jones & Bartlett Learning, 2018; p630.
LANE H, et al. A systematic review of early speech interventions for children with cleft palate. International
Journal of Language and Communication Disorders, 2022; 57(1): 226-245.
MAAS E, et al. Principles of motor learning in treatment of motor speech disorders. American Journal of Speech-Language Pathology, 2008; 17(3): 277-298.
MAO Q, et al. Pearls and pitfalls in contemporary management of marginal velopharyngeal inadequacy among children with cleft palate. Frontiers in Pediatrics, 2023; 11: 1187224.
MARINO VCC, et al. Articulações compensatórias associadas à fissura labiopalatina: ação terapêutica. Revista CEFAC, São Paulo, 2012; 14(3): 528-543.
MENDES KDS, et al. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm. 2008;17(4):758-764.
MINAS GERAIS. Secretaria de Estado de Saúde. Coordenação de Saúde Bucal. Manual Instrutivo para Atenção à Deformidade Craniofacial-Fissuras Labiopalatinas. 1. ed. Belo Horizonte: SES-MG, 2020. Disponível em: www.saude.mg.gov.br/saudebucal.
NARAN S, et al. What’s new in cleft palate and velopharyngeal dysfunction management? Plastic and Reconstructive Surgery, 2017; 139(6): 1343e-1355e.
OLIVEIRA LF, et al. Manual informativo: materiais complementares e colocação dos fonemas. HRAC-USP: Bauru-SP, 2020.
ONER DA, TASTAN H. Cleft lip and palate: epidemiology and etiology. Otorhinolaryngology-Head and Neck Surgery, 2020; 5.
OUZZANI M, et al. Rayyan – a web and mobile app for systematic reviews. Systematic Reviews, 2016; 5: 210.
PAGE MJ, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 2021; 372: n71.
PARHAM MJ, et al. Updates in cleft care. Seminars in Plastic Surgery, 2023; 37(4): 240-252.
PERSSON C, et al. Longitudinal speech outcome at 5 and 10 years in UCLP: influence of speech therapy and secondary velopharyngeal surgery. Cleft Palate-Craniofacial Journal, 2025; 62(5): 772-785.
PITKANEN VV, et al. Diagnóstico e tratamento da insuficiência velofaríngea em pacientes com fissura palatina após palatoplastia primária. Revista de Cirurgia Craniofacial, 2025; 36(3): 1008-1016.
RUBINS Z, et al. Computers helping people with special needs [electronic resource]. In: MIESENBERGER K, et al. (ed.). Computers helping people with special needs. 14th International Conference, ICCHP 2014, Paris, France, July 9–11, 2014. Proceedings. Part II. Cham: Springer, 2014; p283-286. (Lecture Notes in Computer Science, v. 8548).
RUDNICK EF, SIE KC. Velopharyngeal insufficiency: current concepts in diagnosis and management. Current Opinion in Otolaryngology & Head and Neck Surgery, 2008; 16(6): 530-535.
SOUSA MNA, et al. Trilhando o caminho do conhecimento: o método de revisão integrativa para análise e síntese da literatura científica. Observatorio, 2023.
SOUZA J, et al. Prevalência de fissuras labiopalatais no Brasil e sua notificação no sistema de informação. Revista Brasileira de Cirurgia Plástica, 2024; 39(2).
TRINDADE IEK, et al. Tratado de fissuras labiopalatinas: avanços no diagnóstico e tratamento interdisciplinar. Thieme Revinter: Rio de Janeiro-RJ, 2025; p523.
VENKATRAMAN K, et al. Adaptive insights: dynamic assessment for speech sound intervention in a child with cleft lip and palate. BMJ Case Reports, 2025; 18(1): e262506.
VIEIRA KM, et al. Orofacial clefts in newborns in Brazil: a time series study, 2010–2021. Epidemiologia e Serviços de Saúde, 2025; 34: e20240027.
WITZEL MA, et al. The use of nasopharyngoscopy biofeedback therapy in the correction of inconsistent velopharyngeal closure. International Journal of Pediatric Otorhinolaryngology, 1988; 15(2): 137-142.