Objective assessment of cleft lip and palate speech intelligibility using articulation and hypernasality measures

Objective. This investigation researched the effectiveness of the PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) method to address compensatory articulation errors in children with cleft palate. Design. Single-subject AB multiple baselines across participants and behaviors. Setting. Pediatric outpatient rehabilitation department in a local hospital in a metropolitan city. Participants. The investigation consisted of 3 participants (ages = 4:4 to 12:8) born with bilateral complete cleft lip and palate. All participants underwent several reconstructive surgeries to repair their lips and palates. Interventions. The PROMPT treatment was provided for 45 minutes 3 times a week for 4 weeks (3 weeks for Participant 2). Main Outcome Measure. Therapy sessions addressed anterior lingual speech motor phonemes across 3 tiers (syllables, words, and phrases). Results. Direct visual observation of data obtained throughout this investigation indicate potential positive effects and significant correlation between improvements in sound production at 3 tiers and the implementation of the PROMPT technique. Speech intelligibility was judged by 3 blinded listeners who were unfamiliar with children with speech disorders or with cleft palate speech. All listeners identified and judged improvement in overall speech intelligibility over the course of this investigation. Listeners examined speech samples selected from sessions 3, 6, 9, and 12. Conclusion. The findings in this investigation provide a potential relationship on the effectiveness of the PROMPT method and attainment of accurate speech productions in children with cleft palate producing compensatory articulation errors, resulting in improvement in overall speech intelligibility.

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Assessing Intelligibility in Speakers with Cleft Palate: A Critical Review of the Literature

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_2002_039_0050_aiiswc_2.0.co_2 ◽

2002 ◽

Vol 39 (1) ◽

pp. 50-58 ◽

Cited By ~ 21

Author(s):

Tara L. Whitehill

Keyword(s):

Literature Review ◽

Speech Intelligibility ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Relevant Literature ◽

Reliability And Validity ◽

Review Of The Literature ◽

Similar Measure ◽

Adequate Definition ◽

Research Questions

Objective A literature review was conducted in order to investigate three research questions: how is speech intelligibility being measured in speakers with cleft lip and palate? Is intelligibility adequately being distinguished from related measures such as acceptability? Has there been an increased understanding of intelligibility deficits in speakers with cleft lip and palate? Fifty-seven relevant articles published between 1960 and 1998 were included in the analysis. Results The results showed an increase in the number of articles that included a measure of intelligibility or a similar measure. Several concerns were raised as a result of the review, including the reliability and validity of measures being employed, adequate definition and differentiation of terms, and the need to determine speech and nonspeech variables contributing to reductions in intelligibility. Relevant literature on intelligibility from fields outside cleft lip and palate is reviewed, and a number of recommendations are made regarding the measurement of intelligibility in speakers with cleft lip and palate.

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Speech intelligibility after repair of cleft lip and palate

Medical Journal of the Islamic Republic of Iran ◽

10.14196/mjiri.31.85 ◽

2017 ◽

Vol 31 (1) ◽

pp. 500-504 ◽

Cited By ~ 1

Author(s):

Azadeh Safaiean ◽

Nahid Jalilevand ◽

Mona Ebrahimipour ◽

Elham Asleshirin ◽

Mehran Hiradfar

Keyword(s):

Speech Intelligibility ◽

Cleft Lip ◽

Cleft Lip And Palate

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Speech Intelligibility of Patients with Cleft Lip and Palate after Placement of Speech Prosthesis

The Cleft Palate-Craniofacial Journal ◽

10.1597/06-061.1 ◽

2007 ◽

Vol 44 (6) ◽

pp. 635-641 ◽

Cited By ~ 29

Author(s):

João Henrique Nogueira Pinto ◽

Giseleda Silva Dalben ◽

Maria Inês Pegoraro-Krook

Keyword(s):

Cleft Palate ◽

Speech Intelligibility ◽

Cleft Lip ◽

Speech Therapy ◽

Cleft Lip And Palate ◽

Velopharyngeal Insufficiency ◽

Cross Sectional ◽

Before And After ◽

Dental Needs

Objective: To evaluate the speech intelligibility of patients with clefts before and after placement of a speech prosthesis. Design: Cross-sectional. Setting: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Bauru, Brazil. Patients: Twenty-seven patients with unoperated cleft palate or operated cleft palate presenting with velopharyngeal insufficiency (VPI) after primary palatoplasty, treated with speech prosthesis, aged 8 to 63 years. Interventions: Patients were fitted with palatopharyngeal obturators or pharyngeal bulbs, suitable to their dental needs. Five speech-language pathologists blindly evaluated speech samples of the patients with and without the prosthesis. Main Outcome Measures: Classification of speech samples according to a scoring system developed for speech intelligibility problems: 1 (normal), 2 (mild), 3 (mild to moderate), 4 (moderate), 5 (moderate to severe), and 6 (severe). Results were evaluated by the calculation of means of all judges for each patient in both situations. Results: The judges presented significant agreement (W = .789, p < .01). Speech intelligibility was significantly better after placement of the prosthesis for both unoperated patients (Z = 1.93, p = .02) and operated patients with VPI after primary palatoplasty (Z = 1.78, p = .03). Conclusions: Speech intelligibility may be improved by rehabilitation of patients with cleft palate using a speech prosthesis. Speech therapy is needed to eliminate any compensatory articulation productions developed prior to prosthetic management.

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Objective Assessment of the Nasal Airway in Unilateral Cleft Lip and Palate—A Long-Term Study

The Cleft Palate-Craniofacial Journal ◽

10.1597/09-057.1 ◽

2010 ◽

Vol 47 (3) ◽

pp. 217-224 ◽

Cited By ~ 21

Author(s):

Maria Mani ◽

Staffan Morén ◽

Ornolfur Thorvardsson ◽

Olafur Jakobsson ◽

Valdemar Skoog ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Objective Assessment ◽

Nasal Airway ◽

Term Study ◽

Long Term Study

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Effect of the Visual Presentation of a Craniofacial Syndrome on Speech Intelligibility in Noise

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665618825403 ◽

2019 ◽

Vol 56 (8) ◽

pp. 1038-1043

Author(s):

Tim Bressmann ◽

Tamara Eick ◽

Jennifer Pardo

Keyword(s):

Speech Intelligibility ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Visual Presentation ◽

Future Research ◽

Previous Knowledge ◽

Facial Motion ◽

Speech Stimuli ◽

Craniofacial Syndrome ◽

Intelligibility Ratings

Objective: Research has argued that a speaker’s facial appearance can result in an “intelligibility cost” for the listener. The study investigated whether such an intelligibility cost exists for a visible repaired cleft lip and nasal asymmetry. Setting: University department. Participants: Eight typical speakers provided speech samples. Twenty-eight naive listeners participated in a speech in noise experiment. Interventions: Listeners transcribed sentences in noise that were paired with faces of individuals with repaired cleft lip and nasal asymmetry or typical faces. They also rated speaker intelligibility and answered a questionnaire about their previous knowledge about cleft lip and palate. Main Outcome Measures: Percentage of words transcribed correctly and intelligibility ratings, compared by experimental condition (photo of typical face or face with repaired cleft lip and nasal asymmetry) and speaker gender. Results: There were no statistically significant differences between speech stimuli that were presented with faces with repaired cleft lip and nasal asymmetry or typical faces. The percentage of words transcribed correctly by the listeners was lower for female speakers ( F = 12.7, df = 1; P < .01). Speech intelligibility of female speakers was rated more poorly ( F = 10.5, df = 1; P < .01). Conclusions: Presence of a repaired cleft lip and nasal asymmetry did not result in an intelligibility cost for naive listeners. Future research should investigate possible effects of facial motion or previous knowledge.

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