Pooling data of speakers of different languages in the same trial and comparing speech outcome across trials seems possible if the assessment of speech concerns consonants and is confined to speech units that are phonetically similar across languages. Agreed conventions and rules are important. A composite variable for perceptual assessment of velopharyngeal function during speech seems usable; whereas, the method for hypernasality evaluation requires further testing.

No abstract

Normative language-based data are important for comparing speech performances of clinical groups. The Swedish Articulation and Nasality Test (SVANTE) was developed to enable a detailed speech assessment. This study's aim was to present normative data on articulation and nasality in Swedish speakers. Single word production, sentence repetition and connected speech were collected using SVANTE in 443 individuals. Mean (SD) and prevalences in the groups of 3-, 5-, 7-, 10-, 16- and 19-year-olds were calculated from phonetic transcriptions or ordinal rating. For the 3- and 5-year-olds, a consonant inventory was also determined. The mean percent of oral consonants correct ranged from 77% at age 3 to 99% at age 19. At age 5, a mean of 96% was already reached, and the consonant inventory was established except for /s/, /r/, /ɕ/. The norms on the SVANTE, also including a short version, will be useful in the interpretation of speech outcomes.

ISRCTN29932826.

The UCLP group performed worse than the comparison group at all ages. A high occurrence of dental plosives as well as a high number of consonant types in babbling and first words seem to be good indicators for better consonant production in later speech. The same prevalence of retracted oral articulation as in previous studies is attributed to the surgical technique.

The majority of articles (76) were published in the Cleft Palate-Craniofacial Journal, with an increase in articles during the 1990s and 2000. Information about measures or variables was clearly given in all articles. However, the review raises several major concerns regarding method for collection and documentation of data and method for measurement. The most distressing findings were the use of a cross-sectional design in studies of few patients with large age ranges and different types of clefts, the use of highly variable speech samples, and the lack of information about listeners and on reliability. It is hoped that ongoing national and international collaborative efforts to standardize procedures for collection and analysis of perceptual data will help to eliminate such concerns and thus make comparison of published results possible in the future.

Care of the patient with cleft lip and/or palate remains complex. Prior attempts at aggregating data to study the effectiveness of specific interventions or overall treatment protocols have been hindered by a lack of data standards. There exists a critical need to better define the outcomes-particularly those that matter most to patients and their families-and to standardize the methods by which these outcomes will be measured. This report summarizes the recommendations of an international, multidisciplinary working group with regard to which outcomes a typical cleft team could track, how those outcomes could be measured and recorded, and what strategies may be employed to sustainably implement a system for prospective data collection. It is only by agreeing on a common, standard set of outcome measures for the comprehensive appraisal of cleft care that intercenter comparisons can become possible. This is important for quality-improvement endeavors, comparative effectiveness research, and value-based health-care reform.

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.