A Cross-Sectional Study of Speech in 10-Year-Old Children with Cleft Palate: Results and Issues of Rater Reliability

• Published in: The Cleft palate-craniofacial journal Vol. 44; no. 1; pp. 33 - 44
• Main Authors: Brunnegård, Karin, Lohmander, Anette
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2007; American Cleft Palate-Craniofacial Association; SAGE PUBLICATIONS, INC
• Subjects: Articulation Disorders; Articulation Disorders - classification; Biological and medical sciences; Child; Children & youth; classification; Cleft Lip; Cleft Lip - physiopathology; Cleft Lip - surgery; Cleft Palate; Cleft Palate - physiopathology; Cleft Palate - rehabilitation; Cleft Palate - surgery; Cross-Sectional Studies; Deformities; Diagnosis; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Follow-Up Studies; Humans; Male; Medical and Health Sciences; Medical disorders; Medical sciences; Medicin och hälsovetenskap; Non tumoral diseases; Otorhinolaryngology. Stomatology; Phonetics; physiology; physiopathology; Pressure; Rating Scales; rehabilitation; Reliability; Reproducibility of Results; Retrospective Studies; Speech; Speech - physiology; Speech Pathology; Speech Perception; Speech Perception - physiology; Speech Therapy; Speech-Language Pathology; Speech-Language Pathology - standards; Speech/Language Therapists; surgery; Test Validity and Reliability; Voice Disorders; Voice Disorders - classification; Voice Quality; Voice Quality - physiology; cleft palate; cleft lip and palate; speech; two-stage palatal repair; reliability; Human; Cleft palate; Cleft lip; Stomatology; Congenital cleft; Congenital disease; Malformation; Cross sectional study; Speech; Oral cavity disease; Palate; Reliability; Repair; Child
• ISSN: 1055-6656; 1545-1569
• DOI: 10.1597/05-164

Objectives: To describe speech based on perceptual evaluation in a group of 10-year-old children with cleft palate. A secondary aim was to investigate the reliability of speech-language pathologists’ perceptual assessment of cleft palate speech. Design: Retrospective cross-sectional study in children with cleft palate. External raters made assessments from randomized speech recordings. Subjects: Thirty-eight children with unilateral cleft lip and palate (UCLP) or cleft palate only (CPO) and 10 children in a comparison group. Main Outcome Measures: Ratings of hypernasality, hyponasality, audible nasal air leakage, weak pressure consonants, and articulation. Exact agreement and weighted kappa values were used for reliability. Results: Hypernasality was found in 25% of children with a cleft of the soft palate (CSP), 33% of children with a cleft of the hard and soft palate (CHSP), and 67% of children with a UCLP. Similar results were found for audible nasal air leakage. Articulation errors were found in 6% of the CHSP group and 25% of the UCLP group, whereas no child in the CSP group had articulation errors. The reliability was moderate to good for different variables, with lowest values for hypernasality. Conclusions: Speech results in this series seem less satisfactory than those reported in other published international studies, but it is difficult to draw any certain conclusions about speech results because of large methodological differences. Further developments to ensure high reliability of perceptual ratings of speech are called for.