Objective: The aim of this study was to assess hearing, language, and school performance in children with cleft lip/palate waiting for alveolar and hard palate reconstruction at the age of mixed dentition, compared to age-matched children with no birth anomalies. Methods: Forty-four children aged 8–12 years participated in the study (22 with/22 without cleft). After tympanometry and audiometry, a short in-house questionnaire was administered to their guardians to record data on school performance. Then, assessments were performed on velopharyngeal competency, intelligibility, language, and reading/writing skills. Bivariate and multivariate analyses were performed with p value set at 0.05. Results: Middle ear function, language, and school performance of children with cleft lip/palate were worse than that of children without cleft, particularly on spelling and phoneme-grapheme correspondence. Among children with cleft lip/palate, about half of the variability on the average school notes was related to their results on phonemic synthesis and spelling tests (ANCoVA, R2 = 0.52, p = 0.003), while the spelling results were related to the hearing thresholds (ANCoVA, R2 = 0.39, p = 0.01), regardless if the cleft was unilateral or bilateral. Conclusion: In children with cleft lip/palate, late alveolar and hard palate reconstruction may have an impact on hearing, language development, and performance at school.

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