Speech Intelligibility

Whitehill, TL; Gotzke, Carrie L.; Hodge, Megan

doi:10.1002/9781118785065.ch16

Cited by 14 publications

(19 citation statements)

References 37 publications

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“…This global measure is designed to assist the interpretation of the results of the individual parameters but should never be used as a ‘stand alone’ speech result . However, more recently, intelligibility/understandability and acceptability have been considered as two separate entities . In the CAPS/CAPS‐A scales, these two parameters are collapsed into one scale with doubts on its validity .…”

Section: Discussionmentioning

confidence: 99%

The Cleft Care UK study. Part 4: perceptual speech outcomes

Sell

Mildinhall

Albery³

et al. 2015

Orthod Craniofacial Res

112

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Structured AbstractObjectivesTo describe the perceptual speech outcomes from the Cleft Care UK (CCUK) study and compare them to the 1998 Clinical Standards Advisory Group (CSAG) audit.Setting and sample populationA cross-sectional study of 248 children born with complete unilateral cleft lip and palate, between 1 April 2005 and 31 March 2007 who underwent speech assessment.Materials and methodsCentre-based specialist speech and language therapists (SLT) took speech audio–video recordings according to nationally agreed guidelines. Two independent listeners undertook the perceptual analysis using the CAPS-A Audit tool. Intra- and inter-rater reliability were tested.ResultsFor each speech parameter of intelligibility/distinctiveness, hypernasality, palatal/palatalization, backed to velar/uvular, glottal, weak and nasalized consonants, and nasal realizations, there was strong evidence that speech outcomes were better in the CCUK children compared to CSAG children. The parameters which did not show improvement were nasal emission, nasal turbulence, hyponasality and lateral/lateralization.ConclusionThese results suggest that centralization of cleft care into high volume centres has resulted in improvements in UK speech outcomes in five-year-olds with unilateral cleft lip and palate. This may be associated with the development of a specialized workforce. Nevertheless, there still remains a group of children with significant difficulties at school entry.

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Section: Discussionmentioning

confidence: 99%

The Cleft Care UK study. Part 4: perceptual speech outcomes

Sell

Mildinhall

Albery³

et al. 2015

Orthod Craniofacial Res

112

View full text Add to dashboard Cite

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“…Whitehill et al . () stated that a key objective of all cleft teams is for their patient's speech to be understood and that intelligibility is a measure of how successfully cleft teams have achieved this (Whitehill et al . : 293).…”

Section: Resultsmentioning

confidence: 99%

“…() stated that a key objective of all cleft teams is for their patient's speech to be understood and that intelligibility is a measure of how successfully cleft teams have achieved this (Whitehill et al . : 293). Whilst the SVANTE protocol assesses intelligibility, there are well‐reported challenges in both defining and measuring intelligibility (Whitehill ).…”

Section: Resultsmentioning

confidence: 99%

“…Most studies in the review used ordinal scales to assess intelligibility despite evidence questioning their validity to measure this parameter (Whitehill et al . ). In the context of the International Classification of Functioning, Disability and Health: Children and Youth Version (ICF‐CY; World Health Organization (WHO) ) McLeod et al .…”

Section: Discussionmentioning

confidence: 97%

“…Whilst not a cleft specific outcome measure, a functional approach to assessment at age 3 is important given that many children start attending pre-school education in the UK at this age and thus interact with a wider social group. Most studies in the review used ordinal scales to assess intelligibility despite evidence questioning their validity to measure this parameter (Whitehill et al 2011). In the context of the International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY; World Health Organization (WHO) 2007) McLeod et al (2012: 649) report that intelligibility is influenced by both production factors (body functions) and contextual factors (environmental factors).…”

Section: Discussionmentioning

confidence: 99%

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Assessing speech at three years of age in the cleft palate population: a scoping review of assessment practices

Fitzpatrick

Coad

Sell

et al. 2020

Intl J Lang & Comm Disor

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Background There is no consensus in the UK regarding the types of speech samples or parameters of speech that should be assessed at 3 years of age in children with cleft palate ± cleft lip (CP±L), despite cleft units routinely assessing speech at this age. The standardization of assessment practices would facilitate comparisons of outcomes across UK cleft units; earlier identification of speech impairments—which could support more timely treatments; and more reliable recording of therapy impacts and surgical interventions. Aims To explore assessment practices used to assess speech in 3‐year‐old children with CP±L, including speech parameters, methods of assessment and the nature of the speech sample used. Methods & Procedures A broad examination of the literature was undertaken through the use of a scoping review conducted in accordance with Joanna Briggs Institute guidelines. Search terms were generated from a preliminary search and then used in the main search (Medline, CINAHL, Embase, AMED and PsycINFO). Main Contribution A combination of approaches (medical, linguistic, developmental and functional) is required to assess CP±L speech at age 3. A developmental approach is recommended at this age, considering the complexity of speech profiles at age 3, in which typically developing speech processes may occur alongside cleft speech characteristics. A combined measure for both nasal emission and turbulence, and an overall measure for velopharyngeal function for speech, show potential for assessment at this age. Categorical ordinal scales are frequently used; the use of continuous scales has yet to be fully explored at age 3. Although single‐word assessments, including a subset of words developed for cross‐linguistic comparisons, are frequently used, more than one type of speech sample may be needed to assess speech at this age validly. The lack of consensus regarding speech samples highlights a need for further research into the types of speech samples 3‐year‐olds can complete; the impact of incomplete speech samples on outcome measures (particularly relevant at this age when children may be less able to complete a full sample); the impact of different speech samples on the validity of assessments; and the reliability of listener judgements. Conclusions & Implications Whilst a medical model and linguistic approaches are often central in assessments of age‐3 cleft speech, this review highlights the importance of developmental and functional approaches to assessment. Cross‐linguistic single‐word assessments show potential, and would facilitate the comparison of UK speech outcomes with other countries. Further research should explore the impact of different speech samples and rating scales on assessment validity and listener reliability.

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