PURPOSE The purpose of this study was to examine the influence of socioeconomic deprivation on language and developmental outcomes in toddlers with cleft palate with or without cleft lip (CP ± L). Other factors known to influence language outcomes were also considered, including home language history, history of hearing problems, syndromic diagnoses, and sex. METHOD A multicenter, cross-sectional study design was conducted. Data for 566 16-month-old toddlers with CP ± L were collected from 17 outpatient cleft palate clinics located throughout the United States. Outcome measures included the MacArthur-Bates Communicative Development Inventories, LENA Developmental Snapshot, age at first word as reported by the caregiver, and the Ages and Stages Questionnaires-Third Edition (ASQ-3). Multivariable linear or logistic regression was used to determine the influence of socioeconomic deprivation, as measured by the Area Deprivation Index, on language and developmental outcomes. RESULTS Greater socioeconomic deprivation significantly predicted poorer language outcomes in toddlers with CP ± L, including receptive vocabulary words (p = .02), expressive vocabulary words (p = .02), and late-developing gestures (p = .02). Additionally, toddlers from less affluent neighborhoods produced their first words significantly later than their counterparts living in more affluent areas (p < .01). Lower maternal education levels predicted significantly increased risk for problem solving delays (p < .01), and patients with subsidized insurance were at significantly increased risk for personal-social delays on the ASQ-3 (p < .01). CONCLUSIONS Children with CP ± L are susceptible to developmental delays associated with socioeconomic deprivation. These findings have implications for identifying a child's individual risk factors for developmental language disorders when conducting speech-language assessments. Future study should examine how inequities in care can be mitigated and addressed.

中文翻译：

---

社会经济剥夺会对腭裂幼儿的语言能力产生不利影响。


目的本研究的目的是探讨社会经济剥夺对伴有或不伴有唇裂（CP±L）的腭裂幼儿语言和发育结果的影响。还考虑了其​​他已知影响语言结果的因素，包括家庭语言史、听力问题史、综合征诊断和性别。方法 进行了多中心、横断面研究设计。从美国各地 17 个腭裂门诊收集了 566 名患有 CP ± L 的 16 个月大幼儿的数据。结果测量包括麦克阿瑟-贝茨沟通发展量表、LENA 发展快照、看护者报告的第一句话年龄以及年龄和阶段问卷第三版 (ASQ-3)。使用多变量线性或逻辑回归来确定社会经济剥夺（通过区域剥夺指数衡量）对语言和发展结果的影响。结果 更大的社会经济剥夺显着预测 CP ± L 幼儿的语言结果较差，包括接受性词汇 (p = .02)、表达性词汇 (p = .02) 和发育迟缓的手势 (p = .02)。此外，来自不太富裕社区的幼儿比生活在较富裕地区的幼儿显着晚说出第一个单词（p < .01）。较低的母亲教育水平预示着问题解决延迟的风险显着增加 (p < .01)，而拥有补贴保险的患者在 ASQ-3 上的个人社交延迟风险显着增加 (p < .01)。结论 患有 CP ± L 的儿童容易受到与社会经济剥夺相关的发育迟缓的影响。 这些发现对于在进行言语评估时识别儿童发展性语言障碍的个体风险因素具有重要意义。未来的研究应该探讨如何减轻和解决护理方面的不平等问题。