Dual-task speech-in-noise performance in children with unilateral cleft lip and palate and minimal conductive hearing loss.

purposeChildren with cleft lip and palate (CLP) frequently experience middle-ear dysfunction and conductive hearing loss, which may affect functional listening in noise. This study examined speech-in-noise recognition and visual-task latency cost during concurrent auditory-visual task performance in children with unilateral CLP and minimal conductive hearing loss.

methodsTwenty-five children with unilateral CLP and minimal conductive hearing loss and 28 age-matched typically developing controls, aged 7-15 years, completed audiological assessment, a single-task speech-in-noise condition (SIN), a concurrent auditory-visual condition combining speech recognition in noise with a randomized visual saccade task (SIN-WS), and a saccade-only condition. Word recognition accuracy and mean saccadic latency were recorded. Articulation was assessed in the CLP group using a standardized cleft speech assessment.

resultsChildren with CLP showed poorer word recognition accuracy than controls in both SIN and SIN-WS conditions. Model-based analysis showed significant main effects of group and condition, whereas the Group × Condition interaction for word recognition was not significant. Mean saccadic latency increased during the concurrent-task condition in both groups, with a significantly greater increase in the CLP group. Within the CLP group, higher articulation error counts were associated with poorer word recognition accuracy and greater saccadic-latency cost.

conclusionChildren with unilateral CLP and minimal conductive hearing loss showed reduced speech-in-noise recognition and greater visual-task latency cost during concurrent auditory-visual task performance. These findings support the clinical value of assessing functional listening beyond isolated auditory thresholds in children with CLP.