Influence of Cleft Lip and Palate on Children's Recorder, Flute, and Clarinet Performance

Objective: To evaluate whether having a cleft palate with or without cleft lip (CP ± L) influences the performance of a child on a wind instrument. Design: Cross-sectional. Setting: This study was conducted at Asociación San Lucas (Peru), which has a multidisciplinary care program for children with CP ± L. Free recorder lessons are offered to all patients aged 6–8 years. After that, the children can switch to flute, clarinet, violin, viola, or cello. For a fee, children without CP ± L can also participate in the music program. Participants: All children with and without CP ± L who were participating in the music program and were able to play the recorder, flute, or clarinet (N = 43). Main Outcome Measures: Quantitative and qualitative performance exercises: maximum blowing duration, highest note, lowest note, diminuendo, crescendo, and sound quality. Results: No significant differences in performance were found between children with and without CP ± L. Older children and children with more experience on their instrument demonstrated a significantly longer blowing duration and better sound quality. Within the CP ± L group, those with a satisfactory surgery result had a significantly longer blowing duration than those with a partly satisfactory result (eg, presence of a fistula, palatal surgery revisions, or (need of) pharingoplasty). Furthermore, children with bilateral cleft lip and palate performed diminuendo significantly less smoothly than those with the unilateral type. Conclusion: Children with and without CP ± L demonstrated equally good performances on the recorder, flute, and clarinet. Therefore, families and caregivers should not discourage children with CP ± L from learning to play these wind instruments.