关键词: 唇腭裂, 语言发育迟缓, 早期干预, 效果评价, 干预映射理论

Abstract: Objective    To assess the effectiveness of a parent-engaged early intervention program based on intervention mapping theory in promoting speech and language development in children with cleft lip and/or palate，and to provide references for developing speech and language rehabilitation strategies for cleft lip and/or palate in clinical practice. Methods    A retrospective analysis was conducted concerning the clinical records and follow-up data of 108 children who underwent cleft palate repair in the Department of Cleft Palate-Craniofacial Surgery，Hospital of Stomatology，Xi′an Jiaotong University，between July 2017 and December 2018. Age at surgery ranged from 8 to 16 months. Participants were assigned to a control group（n = 42）or an intervention group（n = 66）according to caregivers′ selection of the early intervention program. During hospitalization，both groups received routine health education regarding speech and language development. In addition，the intervention group participated in a parent-engaged early intervention program developed by the research team based on intervention mapping theory，with a total implementation period of approximately 3 months. Speech outcomes were evaluated at approximately 30 months postoperatively. Outcome indexes included stop consonant inventory（SCI），consonant inventory（CI），percentage of correct consonants-high pressure（PCC-H），proportion of normal articulation，proportion of developmental speech characteristics（DSCs），and proportion of cleft speech characteristics（CSCs）which included backed oral productions and other CSCs（compensatory articulation，initial consonant omission，nasalization，and weak-pressure articulation）. Results    The intervention group demonstrated significantly higher SCI and CI，a higher proportion of normal articulations，and a higher proportion of DSCs than the control group，along with a significantly lower proportion of CSCs（all P < 0.05）. Within CSCs subtypes，compensatory articulations，initial consonant omission，and weak-pressure articulation occurred significantly less frequently in the intervention group（all P < 0.05）. No significant differences were observed in backed oral productions or nasalization between the two groups（both P > 0.05）. Conclusion    For children with cleft lip and/or palate aged 8-16 months，implementation of an intervention mapping-based early speech and language intervention following surgery significantly improves speech outcomes compared with routine health education alone. This approach is therefore recommended for broader clinical application.

Key words: cleft lip and/or palate, speech and language development delay, early intervention, effect evaluation, intervention mapping theory