A cleft palate ± a cleft lip is the most prevalent congenital craniofacial defect. The societal burden of
this condition is substantial as it impacts speech, hearing, feeding, oral behavior, dentition, and
satisfaction with appearance. These consequences have a prolonged and adverse influence on social
integration and well-being. The WHO reported considerable financial costs incurred from this defect
in terms of morbidity, health care, emotional issues and social exclusion for patients, their
environments and society. Achieving speech that is understandable and acceptable to others is the
key outcome in cleft treatment. Unfortunately, speech disorders often persist even after successful
surgical closure of the palate. Therefore, speech therapy provided by a speech-language pathologist
(SLP) is necessary. This intervention is traditionally provided twice per week for 30 minutes for
months or even years by first-line SLPs. Unfortunately, this low intensity intervention is based on a
historical context rather than scientific evidence. This means that current speech therapy knows
several shortcomings including poor outcomes, treatment fatigue and high costs related to year-long
therapy. Because of these issues, the use of high intensity speech intervention is proposed. Even
though solid proof-of-concepts exist for this model, it has not yet found its way into clinical practice.
Before this intensity can be implemented and utilized in clinical practice, we must determine the
effect of this novel program on a larger societal scale. We will tackle this issue by conducting a largescale RCT. This project will compare the effect high intensity and low intensity speech intervention in
children with a cleft palate in terms of speech, quality of life, cost-utility, and acceptability as
provided by first-line SLPs. The final goal is to utilize this program in clinical practice and to create
awareness of the benefits for children with a cleft palate among stakeholders.