title: Conversational skills of children with cleft lip and palate: a replication and extension.
abstract: OBJECTIVE
  To replicate and to extend a previous study examining the conversational skills of children with cleft lip and palate.
  
  
  METHODS
  Thirty-four children (33 to 44 months) participated: 17 children with cleft lip and palate and 17 noncleft children.
  
  
  METHODS
  The children were observed during an interaction with caregivers in their homes. Samples of caregiver-child interactions were coded as assertive or responsive, for type of conversational act, and for discourse level categories. Profiles of conversational activity were determined for each child based on the coding. Correlations were performed to examine the relationship between assertiveness and speech variables (articulation and resonance) for the children with cleft lip and palate.
  
  
  RESULTS
  Group comparisons revealed that the children with cleft lip and palate produced fewer assertive utterances, were less likely to respond adequately to comments by caregivers, and produced more topic maintaining and fewer topic extending utterances than did their noncleft peers during conversational interactions. Examination of individual child data indicated that 35% of the children with cleft lip and palate exhibited conversational profiles characterized by either low assertiveness or low responsiveness. Finally, a significant positive correlation was noted between conversational assertiveness and speech production skills.
  
  
  CONCLUSIONS
  These findings suggested that the children with cleft lip and palate were less conversationally assertive than their noncleft peers. Further, there appeared to be a relationship between speech production skills and conversational skills, suggesting that poor speech may be impacting language performance for these children.
authors.affiliation: HealthSouth Rehabilitation Hospital of Utah, and Department of Communication Sciences and Disorders, The University of Utah, 390 S. 1530 E., Rm. 1201, Salt Lake City, UT 84112-0252, USA.
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Frederickson
authors.forename: Kathy L
authors.initials: KL
authors.lastname: Chapman
authors.forename: Mary
authors.initials: M
authors.lastname: Hardin-Jones
mesh_terms: D001242:Assertiveness; D002675:Child, Preschool; D002971:Cleft Lip / Q000523:psychology*; D002972:Cleft Palate / Q000523:psychology*; D005260:Female; D006801:Humans; D007802:Language; D007805:Language Development Disorders / Q000209:etiology; D008297:Male; D015588:Observer Variation; D013060:Speech; D018709:Statistics, Nonparametric