The Influences of Child Intelligibility and Rate on Caregiver Responses to Toddlers With and Without Cleft Palate.

Objective: The purpose of this study was to investigate the influences of child speech intelligibility and rate on caregivers' linguistic responses. Design: This study compared the language use of children with cleft palate with or without cleft lip (CP +/- L) and their caregivers' responses. Descriptive analyses of children's language and caregivers' responses and a multilevel analysis of caregiver responsivity were conducted to determine whether there were differences in children's productive language and caregivers' responses to different types of child utterances. Setting: Play-based caregiver-child interactions were video recorded in a clinic setting. Participants: Thirty-eight children (19 toddlers with nonsyndromic repaired CP +/- L and 19 toddlers with typical language development) between 17 and 37 months old and their primary caregivers participated. Main Outcome Measures: Child and caregiver measures were obtained from transcribed and coded video recordings and included the rate, total number of words, and number of different words spoken by children and their caregivers, intelligibility of child utterances, and form of caregiver responses. Results: Findings from this study suggest caregivers are highly responsive to toddlers' communication attempts, regardless of the intelligibility of those utterances. However, opportunities to respond were fewer for children with CP +/- L. Significant differences were observed in children's intelligibility and productive language and in caregivers' use of questions in response to unintelligible utterances of children with and without CP +/- L. Conclusions: This study provides information about differences in children with CP +/- L's language use and caregivers' responses to spoken language of toddlers with and without CP +/- L.