The impact of enhanced Milieu teaching with phonological emphasis (EMT + PE) on the speech and language outcomes for toddlers with cleft palate in Brazil and the United States of America

The purpose of this study was to compare the speech and language outcomes of children with cleft palate with or without cleft lip (CP+/-L) in the USA to children with CP+/-L in Brazil who underwent intervention with enhanced Milieu teaching with phonological emphasis (EMT + PE), as there are few cross-country intervention comparisons for children with CP+/-L. This is a retrospective analysis of 29 participants from the USA and 24 participants from Brazil who were matched on age. The US participants were between the ages of 13–35 months (<i>M</i> = 23.76), spoke Standard American English in the home, and were recruited from East Tennessee State University and Vanderbilt University. The Brazilian participants were between the ages of 20–34 months (<i>M</i> = 25.04), spoke Brazilian Portuguese in the home, and were recruited from the <i>Hospital de Reabilitação de Anomalias Craniofaciais–Universidade de São Paulo</i>. All treatment participants received EMT + PE from trained speech-language pathologists in hospital-university clinics. The treatment groups demonstrated greater gains than comparison groups in percent consonants correct, number of different words, and expressive/receptive vocabulary. There was no main effect nor interaction by country. The application of EMT + PE in a second culture and language is a viable early intervention option for participants with CP+/-L.