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Background:To determine best practices, surgeons who perform cleft palate surgery or surgery for velopharyngeal insufficiency need to be able to compare their outcomes in normalizing the velopharyngeal valve.Methods:We conducted a comprehensive review of articles that reported speech/resonance outcomes following palatoplasty or surgery for velopharyngeal insufficiency. We analyzed protocols that were used and how the results were reported. We found 170 articles, published between 1990 and 2014, that met our inclusion criteria.Results:Most studies (66%) had a sample size of <50 subjects, were retrospective (67%), were not blinded (83%), and did not report the use of reliability (68%). Most studies included 1 evaluator (27%) or 2 evaluators (30%). Only 80% of the articles specified that at least one speech pathologist was an evaluator. Most articles (56%) did not specify the speech samples used, and 65% used an informal test or did not specify the type of test used. Most studies used a perceptual rating scale for articulation (75%) and resonance (83%). Only 39% of the studies included an evaluation of velopharyngeal function. Finally, objective measures were used in only 28% of the studies (9% used aerodynamic measures and 19% used nasometry).Conclusions:Because these articles showed significant variability in how speech/resonance is evaluated and how the outcomes are reported, it is virtually impossible to compare results to determine best surgical procedures. Suggestions are given to standardize outcome measures to improve comparability of data.

<b><i>Purpose:</i></b> The purpose of this study was to investigate the clinical application of the Intelligibility in Context Scale (ICS) instrument in children with velopharyngeal insufficiency (VPI). This study investigated the relationship between clinical speech outcomes and parental reports of speech intelligibility across various communicative partners. <b><i>Methods:</i></b> The ICS was completed by the parents of 20 English-speaking children aged 4–12 years diagnosed with VPI. The parents were asked to rate their children’s speech intelligibility across communication partners using a 5-point scale. Clinical metrics obtained using standard clinical transcription on the Picture-Cued SNAP-R Test were: (1) percentage of consonants correct (PCC), (2) percentage of vowels correct (PVC), and (3) percentage of phonemes correct (PPC). Nasalance from nasometer data was included as an indirect measure of nasality. Intelligibility scores obtained from naive listener’s transcriptions and speech-language pathologists’ (SLP) ratings were compared with the ICS results. <b><i>Result:</i></b> Greater PCC, PPC, PVC, and transcription-based intelligibility values were significantly associated with higher ICS values, respectively (<i>r</i>[20] = 0.84, 0.82, 0.51, and 0.70, respectively; <i>p</i> &#x3c; 0.05 in all cases). There was a negative and significant correlation between ICS mean scores and SLP ratings of intelligibility (<i>r</i> = –0.74; <i>p</i> &#x3c; 0.001). There was no significant correlation between ICS values and nasalance scores (<i>r</i>[20] = –0.28; <i>p</i> = 0.22). <b><i>Conclusion:</i></b> The high correlations obtained between the ICS with PCC and PPC measures indicate that articulation accuracy has had a great impact on parents’ decision-making regarding intelligibility in this population. Significant agreement among ICS scores with naive listener transcriptions and clinical ratings supports use of the ICS in practice.

Objective: There are several risk factors including hearing difficulties, lack of language stimulation, and parents' low level of expectation leading to language disorders in children with cleft palate. Therefore, formal language assessments of children with cleft palate are of great importance in order to prevent further disabilities. The purpose of the present study is to evaluate language parameters in 4- to 7-year old Persian-speaking children with cleft palate. Patients and Methods: 16 children with unilateral and bilateral cleft lip and palate aged between 4 and 7 years participated in the experiment. The Test of Language Development-Primary, third edition (TOLD-P3) was performed to evaluate the language parameters. The results were scored according to the test manual and compared to normative data published with the TOLD-P3. Results:t test analysis showed a significant difference between language parameters in children with cleft lip and palate and the normative data (p < 0.0001). Furthermore, there was a positive correlation between different aspects of language performance. Conclusion: The findings emphasize that speech-language pathologists should also concentrate on early language assessment and treatment for children with cleft lip and palate.

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Velum has a range of positions across different speech segments, with the lowest velum position for nasal consonants, a high (closed) position for obstruent consonants, and a range of positions in the middle for sonorant consonants and vowels varying according to constriction degree. Vowel environment has a considerable influence on the rate of velum closure. Changes in the rates of velar positioning during production of vowels in non-nasal speech (H-words) was studied in seven typically speaking adults with general American dialect and normal oral-nasal resonance. The participants were scoped using a Phantom Miro 310 high-speed video camera (Image acquisition rate of 5000 fps) connected to a flexible scope. Measurements were taken simultaneously with capturing acoustic data. The data suggested that velum tends to have a higher elevation point for vowels with higher degree of constriction in the oral cavity like /i/. Further results will be discussed.