Impact of Pandemic-Related Social Restrictions on Language and Speech Development in Children with Cleft Lip and/or Palate at 18-24 Months

Objective Determine if early speech and language development in children born with cleft lip and/or palate (CL/P) was impacted by social restrictions during the COVID-19 pandemic. Design Cohort study using data from The Cleft Collective. Participants Children with CL/P whose first 18-24 months were before the pandemic compared to children whose first 18-24 months were impacted by the pandemic. Measures Primary outcome: parental reported Ages and Stages Questionnaire—Third Edition (ASQ-3). Secondary outcomes: 18- to 24-month speech and language therapy (SLT) assessment location; ability to judge velopharyngeal function for speech; SLT judged-expressive language and consonant inventory size for children with a cleft palate. Analyses adjusted for confounders. Results We found no statistical evidence to suggest a difference in ASQ-3 communication (n = 631; OR adjusted 0.96; 95% CIs 0.533, 1.742; P = 0.902), SLT judgements of expressive language (n = 175; OR adjusted 0.66; 95% CIs 0.224, 1.947; P = 0.452), or consonant inventory size at age 18-24 months (n = 186; IRR adjusted 0.98; 95% CIs 0.775, 1.249; P = 0.896) between pre-pandemic and pandemic impacted groups. There was weak statistical evidence of an association between virtual appointments and SLT being unable to rate features of velopharyngeal function for speech (OR adjusted 3.54; 95%CIs 0.849, 14.755; P = 0.083). Conclusions No statistical evidence of an association between exposure to pandemic-related social restrictions and early language development or consonant inventory size at age 18-24 months. Small sample sizes, variation in the pandemic impacted groups, and limitations of the measures should be considered when interpreting the findings. Further work is required to further examine the use of virtual appointments for speech assessment.