Perception of Postpalatoplasty Speech Differences in School-Age Children by Parents, Teachers, and Professional Speech Pathologists

Abstract

The aims of this study were twofold: (1) to test the ability of parents and teachers to discriminate the speech of children with repaired cleft palate from that of their unaffected peers and (2) to compare these lay assessments of speech acceptability with the critical perceptual assessments of expert clinicians. The subjects for this study were 20 children of school age (age range, 8 to 12 years) who were drawn from a large population (n = 1282) of patients. All subjects had been referred for palatoplasty to the same tertiary cleft center between 1978 and 1991. There were 16 matched controls. The listening team included parents of subjects (n = 32) and teachers of age-matched school children (n = 12). Randomized master audiotape recordings of the study group were presented in blinded fashion to both groups of the adult raters, who were inexperienced in the evaluation of patients with speech dysfunction. An experienced panel of three extramural speech pathologists evaluated the same recordings. In all parameters rated, both parents and teachers showed a consistent tendency to give the subject children more negative ratings than the control children. Expert raters were sensitive to differences in resonance and intelligibility in the control and cleft palate groups. Results of this study differ from similar previous research, indicating that naive peer raters (similar-age children) were insensitive to speech differences in the cleft palate and control groups.

Blinded Speech Evaluation following Pharyngeal Flap Surgery by Speech Pathologists and Lay People in Children with Cleft Palate

“…Glottal stops were assessed on the binary scale only. [3], but translated into German. In addition, those who were given a 'yes' rating on the binary scale were further rated using the '1-5' scale were 1 representing 'very inaccurate description', and 5 representing 'very accurate description'.…”

“…Nevertheless, there is some evidence that the reliability of discerning differences in voice quality and misarticulations is poor per se [16]. The relevance of these speech parameters to daily life have, however, already before been called into consideration [3,17]. Therefore, the same audiotapes were also analyzed by adult lay people.…”

Speech intelligibility of children with unilateral cleft lip and palate (Dutch cleft) following a one-stage Wardill–Kilner palatoplasty, as judged by their parents

“…The majority of studies used listeners who were qualified speech language pathologists or graduate students. To the best of the authors' knowledge only three studies 16,17,20 used parent groups to judge the overall speech intelligibility of children with cleft palate. In the study of STARR et al 16 12 parents of children with cleft palate, 12 parents of children without cleft palate and several clinic/school clinicians rated the speech samples of 15 children (aged 8-21 years) with cleft palate using an equal-appearing interval and category scales.…”

“…Parents and children expressed increased satisfaction with speech as the children's age increased. In the study of WITT et al 20 a parent group (32 parents of cleft palate subjects) rated the speech intelligibility of 20 children with cleft palate (mean age 10.6 years) using a 12-item rating scale with speech descriptors ranked on a binary (yes/no) scale. The results of this study show that parents of children with cleft palate may effectively screen for impaired speech in the cleft palate population.…”

“…Parents are more familiar with their child's phonetic repertoire and behavior, involvement may improve the parent's knowledge of the child's development and subsequent participation in intervention programs, parental assessment may save time and early identification of speech abnormalities may be encouraged as an attempt to prevent or minimize disabilities through appropriate interventions 12,20 .…”