Academia.eduAcademia.edu

Outline

Title
Abstract
Speech Analysis Protocol
Procedures for Data Collection and Analysis
Method Overview
Study 2: Na Samples
Data Analysis
Results
Study 1: Uk/I Samples
Study 2: Na Sample
Discussion
References
All Topics
Medicine and Health Sciences
Speech and Hearing

The Americleft Speech Project: A Training and Reliability Study

Profile image of Kelly CorderoKelly Cordero

2016, The Cleft Palate-Craniofacial Journal

https://doi.org/10.1597/14-027
visibility

…

description

34 pages

link

1 file

Abstract

Objective To describe the results of two reliability studies and to assess the effect of training on interrater reliability scores. Design The first study (1) examined interrater and intrarater reliability scores (weighted and unweighted kappas) and (2) compared interrater reliability scores before and after training on the use of the Cleft Audit Protocol for Speech–Augmented (CAPS-A) with British English-speaking children. The second study examined interrater and intrarater reliability on a modified version of the CAPS-A (CAPS-A Americleft Modification) with American and Canadian English-speaking children. Finally, comparisons were made between the interrater and intrarater reliability scores obtained for Study 1 and Study 2. Participants The participants were speech-language pathologists from the Americleft Speech Project. Results In Study 1, interrater reliability scores improved for 6 of the 13 parameters following training on the CAPS-A protocol. Comparison of the reliability r...

Related papers

Translation and pilot study of the Cleft Hearing Appearance and Speech Questionnaire (CHASQ)
Radmila Dimovska

European Journal of Plastic Surgery, 2019

Background There has been a lack of a standardized protocol for collection of patient reported outcomes (PRO) and detection of and indication for psychological treatment in cleft care. The objectives of this paper was to translate Cleft Hearing Appearance and Speech Questionnaire (CHASQ) into eight European languages, to investigate whether levels of PRO in patients with cleft lip and/or cleft palate (CL/P) were comparable across countries and to investigate clinician experience of the instrument. Methods The PRO measure-CHASQ-was translated into Bulgarian, Estonian, Greek, Latvian, Macedonian, Romanian, Serbian and Swedish and implemented with patients in the respective countries. A focus group discussion was conducted to investigate health care professional experience on the use of CHASQ in their clinics. Data was analysed in accordance with the principles of thematic analysis. Results Analysis showed statistically significant differences between countries and groups of diagnosis in CHASQ scores. CHASQ helped clinicians gain patient information and informed on treatment decisions, broadened the clinicians' role as caregivers and was perceived as short and easy to use. Limited time and resources in clinics were limitations in implementing the instrument. Conclusions Translation and utilization of CHASQ facilitated international comparison and cooperation. Linguistically, valid replicas of CHASQ are now available in many European languages. Results from this study show that CHASQ may be used for collection of PRO on patient satisfaction and to spark conversation between clinicians, patients and families. Level of evidence: Not rateable.

View PDFchevron_right
Assessment and Treatment of Childhood Apraxia of Speech: An Inquiry into Knowledge and Experience of Speech-Language Pathologists
mersede Imani-Shakibayi

Iranian Rehabilitation Journal

Objectives: The present research aims to identify the assessment and treatment processes used by Iranian Speech-Language Pathologists (SLPs) for Childhood Apraxia of Speech (CAS) and investigate the impact of their knowledge level and experience on their choice of assessment and treatment. Methods: This research is a cross-sectional study using a survey design conducted on 260 SLPs with a minimum of a Bachelor’s degree and at least one year of experience of working with preschoolers. The CAS assessment and treatment were measured by a validated questionnaire, which was completed in person or online. Results: The tests of Diadochokinesis (DDK) (66%), single-word speech sampling (58.1%), oral-motor assessment (54.6%), and connected speech sample analysis (53.1%) were the popular tests chosen by the participants. The treatment approaches indicated that Oral Motor Exercises (OMEs) (57.7%) were the only treatment for which over half of the participants voted. The experts chose phonologic...

View PDFchevron_right
Centre-level variation in speech outcome and interventions, and factors associated with poor speech outcomes in 5-year-old children with non-syndromic unilateral cleft lip and palate: The Cleft Care UK study. Part 4
Yvonne Wren

Orthodontics & Craniofacial Research, 2017

Objectives: To investigate centre-level variation in speech intervention and outcome and factors associated with a speech disorder in children in Cleft Care UK (CCUK). Setting and Sample Population: Two hundred and sixty-eight 5-year-old British children with non-syndromic unilateral cleft lip and palate recruited to CCUK. Materials and Methods: Centre-based therapists undertook audio-video recordings. Perceptual analysis was undertaken using the CAPS-A tool. Speech outcomes were based on structural and articulation scores, and intelligibility/distinctiveness. Betweencentre variation in treatment and outcomes were examined using multilevel models. These models were extended to estimate the association between a range of factors (hearing loss, speech intervention, fistula, secondary speech surgery for velopharyngeal insufficiency, socioeconomic status, gender, and parental happiness with speech) and speech outcomes. Results: There was centre-level variation in secondary speech surgery, speech intervention, structure and intelligibility outcomes. Children with a history of speech intervention had a lower odds of poor intelligibility/distinctiveness, 0.1 (95% CI: 0.0-0.4). Parental concern was associated with a higher odds of poor intelligibility/distinctiveness, 13.2 (95% CI: 4.9-35.1). Poor speech outcomes were associated with a fistula, secondary speech surgery and history of hearing loss. Conclusions: Within the centralized service there is centre-level variation in secondary speech surgery, intervention and speech outcomes. These findings support the importance of early management of fistulae, effective management of velopharyngeal insufficiency and hearing impairment, and most importantly speech intervention in the preschool years. Parental concern about speech is a good indicator of speech status.

View PDFchevron_right
Impact of timing of Palatal repair on Speech Errors in Children with Cleft Lip and Palate (CLP)
Girish K S

Journal of Child Language Acquisition and Development – JCLAD, 2018

Surgery of palate is one of the important rehabilitation for children with cleft lip and palate. In most of the children with cleft lip and palate (CLP), speech errors persist even after surgical repair of the palate. However, the timing of palatal repair plays a vital role. The associated problems in children with cleft lip and palate differ based on the timing of the palatal repair. Resonance and articulation are the crucial measures of disordered speech and they form the important areas of therapeutic interv2ention for children with repaired cleft lip and palate (RCLP). Thus, the present study aims at profiling resonance and consonant production errors (CPEs) in children with RCLP among early intervention group (EIG) and delayed intervention group (DIG). The research design employed was standard group comparison. The participants consisted of eight Kannada speaking children with RCLP (6 to 12 years) in each group (EIG and DIG). They were asked to repeat 10 meaningful bisyllabic words loaded with pressure consonants to assess the resonance and 8 non-meaningful bisyllabic words loaded with stop consonants to check CPEs. The responses were recorded in a sound-treated room and were presented to three Speech Language Pathologists for assessing resonance and CPEs using Henningsson’s protocol. The results revealed a statistically significant reduction in the resonance and few CPEs in EIG than in DIG. ‘Nasalized voiced pressure consonants’ and ‘weak oral pressure’ were found to be significantly lesser in EIG than DIG. The present study concludes that early surgical intervention has a direct impact on reducing hypernasality and CPEs in children with CLP. Children with CLP require early surgical intervention and therapy to establish appropriate oral motor skills that are necessary for normal speech production.

View PDFchevron_right
Telemedicine as a Means of Effective Speech Evaluation for Patients With Cleft Palate
Glendora Tremper

Annals of Plastic Surgery, 2012

Providing long-term multidisciplinary care for cleft lip/palate is a challenge for international humanitarian organizations that perform surgery across borders. The use of telemedicine as a means of evaluating speech in patients with cleft lip/palate has not previously been studied. We looked at determining whether a speech evaluation performed by a Speech-Language Pathologist (SLP) using telemedicine would be equivalent to a speech evaluation performed in-person, in an international setting between Tijuana, Mexico and San Diego, California. Spanish-speaking SLPs developed an informal protocol to evaluate several speech characteristics. Patients were simultaneously evaluated by two SLPs, one in-person in Tijuana and the other over telemedicine videoconference from San Diego, California. Additionally, we obtained data regarding the parents experience with telemedicine through a satisfaction survey. Results showed no statistically significant differences between the two methods of speech evaluation, particularly in oral muscle tone, resonance, lingual lateralization, oral pressure, and dentition. The satisfaction survey showed family satisfaction with the speech evaluation performed using telemedicine. Thus, telemedicine represents an effective medium for conducting speech assessment in patients with cleft lip/palate, allowing for increased access to care for underserved populations.

View PDFchevron_right
Tutorial: Speech assessment for multilingual children who do not speak the same language(s) as the speech-language pathologist
MARTINA OZBIČ

American Journal of Speech-Language Pathology, 2017

Purpose: The aim of this tutorial is to support speech-language pathologists (SLPs) undertaking assessments of multilingual children with suspected speech sound disorders, particularly children who speak languages that are not shared with their SLP. Method: The tutorial was written by the International Expert Panel on Multilingual Children’s Speech, which comprises 46 researchers (SLPs, linguists, phoneticians, and speech scientists) who have worked in 43 countries and used 27 languages in professional practice. Seventeen panel members met for a 1-day workshop to identify key points for inclusion in the tutorial, 26 panel members contributed to writing this tutorial, and 34 members contributed to revising this tutorial online (some members contributed to more than 1 task). Results: This tutorial draws on international research evidence and professional expertise to provide a comprehensive overview of working with multilingual children with suspected speech sound disorders. This over...

View PDFchevron_right

References (104)

  1. Altman, DG. Practical Statistics for Medical Research. London: Chapman and Hall/CRC Press; 1991. p. 404
  2. Anthony, A., Bogle, D., Ingram, TTS., McIsaac, MW. The Edinburgh Articulation Test. Edinburgh: E & S Livingstone; 1971.
  3. Arlt PB, Goodban MT. A comparative study of articulation acquisition as based on a study of 240 normals, aged three to six. Lang Speech Hear Serv Sch. 1976; 7:173-180.
  4. Ball MJ, Rahilly J. Transcribing disordered speech: the segmental and prosodic layers. Clin Linguist Phon. 2002; 16:329-344. [PubMed: 12185981]
  5. Bassich CJ, Ludlow CL. The use of perceptual methods by new clinicians for assessing voice quality. J Speech Hear Disord. 1986; 51:125-133. [PubMed: 3702360]
  6. Baylis AL, Munson B, Moller KT. Perceptions of audible nasal emission in speakers with cleft palate: a comparative study of listener judgments. Cleft Palate Craniofac J. 2011; 48:399-411. [PubMed: 20572776]
  7. Baylis AL, Whitehill TL, Chapman KL. Americleft Speech Group. Validity and reliability of visual analog scaling for assessment of speech outcomes in children with repaired cleft palate. Cleft Palate Craniofac J. 2015; 52:660-670. [PubMed: 25322442]
  8. Bradford LJ, Brooks AR, Shelton RL. Clinical judgment of hypernasality in cleft palate children. Cleft Palate J. 1964; 6:329-335.
  9. Britton L, Albery E, Bowden M, Harding-Bell A, Phippen G, Sell D. A cross-sectional cohort study of speech in 5-year-olds with cleft palate ± lip to support development of national audit standards. Cleft Palate Craniofac J. 2014; 51:431-451. [PubMed: 24635034]
  10. Brunnegård K, Lohmander A. A cross-sectional study of speech in 10-year-old children with cleft palate: results and issues of rater reliability. Cleft Palate Craniofac J. 2007; 44:33-44. [PubMed: 17214536]
  11. Brunnegård K, Lohmander A, van Doorn J. Untrained listeners' ratings of speech disorders in a group with cleft palate: a comparison with speech and language pathologists' ratings. Int J Lang Commun Disord. 2009; 44:656-674. [PubMed: 18821109]
  12. Bunton K, Kent RD, Duffy JR, Rosenbek JC, Kent JF. Listener agreement for auditory-perceptual ratings of dysarthria. J Speech Lang Hear Res. 2007; 50:1481-1495. [PubMed: 18055769]
  13. Byrt T, Bishop J, Carlin JB. Bias, prevalence and kappa. J Clin Epidemiol. 1993; 46:423-429. [PubMed: 8501467]
  14. Chan KMK, Yiu EML. A comparison of two perceptual voice evaluation training programs for naive listeners. J Voice. 2006; 20:229-241. [PubMed: 16139475]
  15. Chan KMK, Yiu EML. The effect of anchors and training on the reliability of perceptual voice evaluation. J Speech Lang Hear Res. 2002; 45:111-126. [PubMed: 14748643]
  16. Chirlian NS, Sharpley CF. Children's articulation development: some regional differences. Aust J Hum Commun Disord. 1982; 10:23-30.
  17. Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960; 20:37-46.
  18. Cordes AK. Individual and consensus judgments of dysfluency types in the speech of persons who stutter. J Speech Lang Hear Res. 2000; 43:951-964. [PubMed: 11386481]
  19. Cordes AK. The reliability of observational data: I. Theories and methods for speech-language pathology. J Speech Lang Hear Res. 1994; 37:264-278.
  20. Cordes AK, Ingham RJ. Effects of time-interval judgment training on real-time measurement of stuttering. J Speech Lang Hear Res. 1999; 42:862-879. [PubMed: 10450907]
  21. Cordes AK, Ingham RJ. The reliability of observational data: II. Issues in the identification and measurement of stuttering events. J Speech Lang Hear Res. 1994; 37:279-294.
  22. Counihan DT, Cullinan DL. Reliability and dispersion of nasality ratings. Cleft Palate J. 1970; 7:261- 270. [PubMed: 5266336]
  23. Cucchiarini C. Assessing transcription agreement: methodological aspects. Clin Linguist Phon. 1996; 10:131-155.
  24. Dalston RM, Marsh JL, Vig KW, Witzel MA, Bumsted RM. Minimal standards for reporting the results of surgery on patients with cleft lip, cleft palate, or both: a proposal. Cleft Palate J. 1988; 25:3-7. [PubMed: 3422597]
  25. Daniel HJ. Nasality ratings of single words, phrases, and running speech samples obtained from cleft palate children. Folia Phoniatr Logop. 1971; 23:41-49.
  26. de Vet HCW, Terwee CB, Know DL, Bouter LM. When to use agreement versus reliability measures. J Clin Epidemiol. 2006; 59:1033-1039. [PubMed: 16980142]
  27. Dodd B, Holm A, Hua Z, Crosbie S. Phonological development: a normative study of British English- speaking children. Clin Linguist Phon. 2003; 17:617-643. [PubMed: 14977026]
  28. Dotevall H, Lohmander-Agerskov A, Ejnell H, Bake B. Perceptual evaluation of speech and velopharyngeal function in children with and without cleft palate and the relationship to nasal airflow patterns. Cleft Palate Craniofac J. 2002; 39:409-424. [PubMed: 12071789]
  29. Eadie TL, Baylor CR. The effect of perceptual training on inexperienced listeners' judgments of dysphonic voice. J Voice. 2006; 20:527-544. [PubMed: 16324823]
  30. Ellis LW, Beltyukova S. Effects of training on naïve listeners' judgments of the speech intelligibility of children with severe-to-profound hearing loss. J Speech Lang Hear Res. 2008; 51:1114-1123. [PubMed: 18664708]
  31. Bronsted K, Grunwell P, Henningsson G, Jansonius K, Karling J, Meijer M, Ording D, Sell D, Vermei- Zieverink E, Wyatt R. Eurocleft Speech Group. A phonetic framework for the cross-linguistic analysis of cleft palate speech. Clin Linguist Phon. 1994; 8:109-125.
  32. Grunwell P, Bronsted K, Henningsson G, Jansonius K, Karling J, Meijer M, Ording D, Wyatt R, Sell D, Vermei-Zieverink E. Eurocleft Speech Group. A six-centre international study of the outcome of treatment in patients with clefts of the lip and palate: the results of a cross-linguistic investigation of cleft palate speech. Scand J Plast Reconstr Surg Hand Surg. 2000; 34:219-229. [PubMed: 11020918]
  33. Fleiss, JL., Levin, B., Pai, MC. Statistical Methods for Rates and Proportions. 3. Hoboken, NJ: John Wiley & Sons; 2003. p. 609
  34. Fujiwara Y, Henningsson G, Ainoda N. A review of Japanese articles on perceptual assessment of speech sounds in individuals with cleft palate. Jpn J Logoped Phoniatr. 2006; 47:252-257.
  35. Gerratt BR, Kreiman J, Antonanzas-Barroso N, Berke GS. Comparing internal and external standards in voice quality judgments. J Speech Lang Hear Res. 1993; 36:14-20.
  36. Gibbon FE, Crampin L. An electropalatographic investigation of middorsum palatal stops in an adult with repaired cleft palate. Cleft Palate Craniofac J. 2001; 38:96-105. [PubMed: 11294548]
  37. Gooch JL, Hardin-Jones M, Chapman KL, Trost-Cardamone JE, Sussman J. Reliability of listener transcriptions of compensatory articulations. Cleft Palate Craniofac J. 2001; 38:59-67. [PubMed: 11204684]
  38. Grunwell, P., Sell, D., Harding, A. Describing cleft palate speech. In: Grunwell, P., editor. Analysing Cleft Palate Speech. London: Whurr; 1993.
  39. Hallgren KA. Computing inter-rater reliability for observational data: an overview and tutorial. Tutor Quant Methods Psychol. 2012; 8:23-34. [PubMed: 22833776]
  40. Helou LB, Solomon NP, Henry LR, Coppit GL, Howard RS, Stojadinovic A. The role of listener experience on consensus auditory-perceptual evaluation of voice (CAPE-V): ratings of postthyroidectomy voice. Am J Speech Lang Pathol. 2010; 19:248-258. [PubMed: 20484704]
  41. Henningsson G, Kuehn D, Sell D, Sweeney T, Trost-Cardamone J, Whitehill T. Universal parameters for reporting speech outcomes in individuals with cleft palate. Cleft Palate Craniofac J. 2008; 45:1-17. [PubMed: 18215095]
  42. Hutters B, Henningsson G. Speech outcome following treatment in cross-linguistic cleft palate studies: methodological implications. Cleft Palate Craniofac J. 2004; 41:544-549. [PubMed: 15352862]
  43. Imatomi S. Effects of breathy voice source on ratings of hypernasality. Cleft Palate Craniofac J. 2005; 42:641-648. [PubMed: 16241176]
  44. John A, Sell D, Sweeney T, Harding-Bell A, Williams A. The cleft audit protocol for speech- augmented: a validated and reliable measure for auditing cleft speech. Cleft Palate Craniofac J. 2006; 43:272-288. [PubMed: 16681400]
  45. Kent RD. Hearing and believing: some limits to the auditory-perceptual assessment of speech and voice disorders. Am J Speech Lang Pathol. 1996; 5:7-23.
  46. Keuning KHD, Wieneke GH, Dejonckere PH. The intrajudge reliability of the perceptual rating of cleft palate speech before and after pharyngeal flap surgery: the effect of judges and speech samples. Cleft Palate Craniofac J. 1999; 36:328-333. [PubMed: 10426599]
  47. Kilminster M, Laird E. Articulation development in children aged three to nine years. Aust J Hum Commun Disord. 1978; 6:23-30.
  48. Klinto K, Slameh E, Svensson H, Lohmander A. The impact of speech material on speech judgment in children with and without cleft palate. Int J Lang Commun Disord. 2011; 46:348-360. [PubMed: 21575075]
  49. Kottner J, Audige L, Brorson S, Donner A, Gajewski BJ, Hróbjartsson A, Roberts C, Shoukri M, Steiner DL. Guidelines for reporting reliability and agreement studies (GRRAS) were proposed. Int J Nurs Stud. 2011; 48:661-671. [PubMed: 21514934]
  50. Kreiman J, Gerratt BR. Perceptual assessment of voice quality: past, present and future. SIG3 Perspect Voice Voice Disord. 2010; 22:62-67.
  51. Kreiman J, Gerratt BR, Kempster GB, Erman A, Berke GS. Perceptual evaluation of voice quality: review, tutorial, and a framework for future research. J Speech Lang Hear Res. 1993; 36:21-40.
  52. Kreiman J, Gerratt BR, Precoda K. Listener experience and perception of voice quality. J Speech Lang Hear Res. 1990; 33:103-115.
  53. Kreiman J, Gerratt BR, Precoda K, Berke GS. Individual differences in voice quality perception. J Speech Hear Res. 1992; 35:512-520. [PubMed: 1608242]
  54. Kuehn DP, Moller KT. Speech and language issues in the cleft palate population: the state of the art. Cleft Palate Craniofac J. 2000; 37:348-348. [Accessed March 7, 2012] Available at http:// dx.doi.org/10.1597/1545-1569(2000)037%3C0348:SALIIT%3E2.3.CO;2.
  55. Lee A, Whitehill T, Ciocca V. Effect of listener training on perceptual judgment of hypernasality. Clin Linguist Phon. 2009; 23:319-334. [PubMed: 19399664]
  56. Lewis KE. Reporting observer agreement on stuttering event judgments: a survey and evaluation of current practice. J Fluency Disord. 1994; 19:269-284.
  57. Lewis KE, Watterson TL, Houghton SM. The influence of listener experience and academic training on ratings of nasality. J Commun Disord. 2003; 36:49-58. [PubMed: 12493637]
  58. Lockhart R, McLeod S. Factors that enhance English-speaking speech-language pathologists' transcription of Cantonese-speaking children's consonants. Am J Speech Lang Pathol. 2013; 22:523-539. [PubMed: 23813201]
  59. Lohmander, A. Surgical interventions and speech outcomes in cleft lip and palate. In: Howard, S., Lohmander, A., editors. Cleft Palate Speech: Assessment and Intervention. West Sussex: Wiley- Blackwell; 2011. p. 55-85.
  60. Lohmander, A., Borell, E., Henningsson, G., Havstram, C., Lundeborg, I., Persson, C. SVANTE- Svenskt Artikulations-och Nasalitets Test [manual]. Malmo: Pedogogisk Design; 2005.
  61. Lohmander A, Friede H, Lilja J. Long-term, longitudinal follow-up of individuals with unilateral cleft lip and palate after the Gothenburg primary early veloplasty and delayed hard palate closure protocol: speech outcomes. Cleft Palate Craniofac J. 2012; 49:657-671. [PubMed: 22364610]
  62. Lohmander A, Olsson M. Methodology for perceptual assessment of speech in patients with cleft palate: a critical review of the literature. Cleft Palate Craniofac J. 2004; 41:64-70. [PubMed: 14697067]
  63. Lohmander A, Willadsen E, Persson C, Henningsson M, Bowden B, Hutters B. Methodology for speech assessment in the Scandcleft project-an international randomized clinical trial on palatal surgery: experiences from a pilot study. Cleft Palate Craniofac J. 2009; 46:347-362. [PubMed: 19642772]
  64. Long RE, Hathaway R, Daskalogiannakis J, Mercado A, Russell K, Cohen M, Semb G, Shaw W. The Americleft study: an inter-center study of treatment outcomes for patients with unilateral cleft lip and palate, part 1. Principles and study design. Cleft Palate Craniofac J. 2011; 48:239-243. [PubMed: 21219224]
  65. McNutt JC, Wicki L, Paulsen J. Judgments of phoneme errors under four modes of audio-visual presentation. J Speech Lang Pathol Audiol. 1991; 15:37-42.
  66. McWilliams BJ. Some factors in the intelligibility of cleft-palate speech. J Speech Hear Disord. 1954; 19:524-528. [PubMed: 13222468]
  67. McWilliams, BJ., Morris, HL., Shelton, RL. Cleft Palate Speech. Philadelphia: BC Decker; 1990.
  68. McWilliams, BJ., Philips, BJ. Velopharyngeal Incompetence. Philadelphia: BC Decker; 1990.
  69. McWilliams, BJ., Philips, BJ. Velopharyngeal Incompetence: Audio Seminars in Speech Pathology. Philadelphia: WB Saunders; 1979.
  70. Munson B, Johnson JM, Edwards J. The role of experience in the perception of phonetic detail in children's speech: a comparison between speech-language pathologists and clinically untrained listeners. Am J Speech Lang Pathol. 2012; 21:124-139. [PubMed: 22230182]
  71. Oates J. Auditory-perceptual evaluation of disordered voice quality. Folia Phoniatr Logop. 2009; 61:49-56. [PubMed: 19204393]
  72. Pereira V, Tuomainen J, Sell D. Perceptual outcomes of maxillary osteotomy in patients with cleft lip and palate. Int J Lang Commun Disord. 2013; 48:640-650. [PubMed: 24165361]
  73. Peterson-Falzone SJ. The relationship between timing of cleft palate surgery and speech outcome: what have we learned, and where do we stand in the 1990s? Semin Orthod. 1996; 2:185-191. [PubMed: 9161287]
  74. Prather EM, Hedrick DL, Kern CA. Articulation development in children aged two to four years. J Speech Hear Disord. 1975; 40:179-191. [PubMed: 1234929]
  75. Santelmann H, Sussman J, Chapman K. Perception of middorsum palatal stops from the speech of three children with repaired cleft palate. Cleft Palate Craniofac J. 1999; 36:233-242. [PubMed: 10342611]
  76. Schellinger, SK., Edwards, J., Munson, B., Beckman, MK. The role of listener expectations on judgments of children's /s/ productions. Presented at the Symposium on Research in Child Language Disorders; June 2008; Madison, Wisconsin.
  77. Sell D. Issues in perceptual speech analysis in cleft palate and related disorders: a review. Int J Lang Commun Disord. 2005; 40:103-121. [PubMed: 16101269]
  78. Sell D, Grunwell P, Mildinhall S, Murphy T, Cornish TC, Williams A, Bearn D, Shaw WC, Murray J, Sandy J. Cleft lip and palate care in the United Kingdom-the Clinical Standards Advisory Group (CSAG) study. Part 3: speech outcomes. Cleft Palate Craniofac J. 2001; 38:30-37. [PubMed: 11204679]
  79. Sell D, Harding A, Grunwell P. Revised GOS.SP.ASS (98): speech assessment for children with cleft palate and/or velopharyngeal dysfunction. Int J Lang Commun Disord. 1999; 34:7-33.
  80. Sell D, Harding A, Grunwell P. A screening assessment of cleft palate speech (Great Ormond Street Speech Assessment). Eur J Disord Commun. 1994; 29:1-15. [PubMed: 8032102]
  81. Sell, D., Harding-Bell, A., Sweeney, T., Freeman, J., John, A. CAPS-A Speech Audit Tool Training Programmes-are they necessary?. Presented at the Meeting of the Craniofacial Society of Great Britain and Ireland; April 2010; Liverpool, United Kingdom.
  82. Sell D, John A, Harding-Bell A, Sweeney T, Hegarty F, Freeman J. Cleft Audit Protocol for Speech (CAPS-A): a comprehensive training package for speech analysis. Int J Lang Commun Disord. 2009; 44:529-548. [PubMed: 18821108]
  83. Shriberg LD, Lof GL. Reliability studies in broad and narrow phonetic transcription. Clin Linguist Phon. 1991; 5:225-279.
  84. Shriberg LD, McSweeny JL, Anderson BE, Campbell TF, Chial MR, Green JR, Hauner KK, Moore CA, Rusiewicz HL, Wilson DL. Transitioning from analog to digital audio recording in childhood speech sound disorders. Clin Linguist Phon. 2005; 19:335-359. [PubMed: 16019779]
  85. Shrivastav R, Sapienza CM, Nandur V. Application of psychometric theory to the measurement of voice quality using rating scales. J Speech Lang Hear Res. 2005; 48:323-335. [PubMed: 15989395]
  86. Smit AB. Phonologic error distributions in the Iowa-Nebraska Articulation Norms. J Speech Lang Hear Res. 1993; 36:533-537.
  87. Smit AB, Hand L, Freilinger JJ, Bernthal JE, Bird A. The Iowa articulation norms project and its Nebraska replication. J Speech Hear Disord. 1990; 55:779-798. [PubMed: 2232757]
  88. Spriestersbach DC, Powers GR. Nasality in isolated vowels and connected speech of cleft palate speakers. J Speech Hear Res. 1959; 2:40-45. [PubMed: 13655290]
  89. Stevens I, Daniloff RG. Trouble with /s/: a methodological study of factors affecting the judgment of misarticulated /s/. J Commun Disord. 1977; 10:207-220. [PubMed: 903406]
  90. Stoddard, GJ. Biostatistics and Epidemiology Using Stata: A Course Manual. Salt Lake City, UT: University of Utah School of Medicine; Available at http://www.ccts.utah.edu/biostats/? pageId=5385 [Accessed February 20, 2012]
  91. Streiner, DL., Norman, GR. Health Measurement Scales: A Practical Guide to Their Development and Use. New York: Oxford University Press; 1995. p. 118
  92. Sussman, J., Chapman, KL. Acoustic analysis of mid-dorsum, alveolar, and velar stop consonants. Presented at the American Speech-Language-Hearing Association Convention; November 2000; Washington, DC.
  93. Sweeney, T. Nasality-assessment and intervention. In: Howard, S., Lohmander, A., editors. Cleft Palate Speech Assessment and Intervention. Oxford: Wiley and Blackwell; 2011. p. 199-216.
  94. Templin, MC. Certain Language Skills in Children [monograph]. Minneapolis: University of Minnesota Press; 1957.
  95. Tönz M, Schmid I, Graf M, Mischler-Heeb R, Weissen J, Kaiser G. Blinded speech evaluation following pharyngeal flap surgery by speech pathologists and lay people in children with cleft palate. Folia Phoniatr Logop. 2002; 54:228-295.
  96. Trost-Cardamone, JE. American English Sentence Sample: a controlled sample for assessing cleft palate speech outcome. Presented at the Meeting of the American Cleft Palate-Craniofacial Association; April 2012; San Jose, California.
  97. Van Hattum RJ. Articulation and nasality in cleft palate speakers. J Speech Hear Disord. 1958; 1:383- 387. [PubMed: 13599159]
  98. Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med. 2005; 37:360-363. [PubMed: 15883903]
  99. Watterson T, Lewis K, Allord M, Sulprizio S, O'Neill P. Effect of vowel type on reliability of nasality ratings. J Commun Disord. 2007; 40:503-512. [PubMed: 17391692]
  100. Whitehill TL, Lee ASY, Chun JC. Direct magnitude estimation and interval scaling of hypernasality. J Speech Lang Hear Res. 2002; 45:80-88. [PubMed: 14748640]
  101. Wolfe V, Martin D, Borton D, Youngblood HC. The effect of clinical experience on cue trading for the /r-w/ contrast. Am J Speech Lang Pathol. 2003; 12:221-228. [PubMed: 12828535]
  102. Yeung, AC. Dissertation. Pokfulam, Hong Kong: University of Hong Kong; 2010. Effects of Listening Conditions on Perceptual Ratings of Hypernasal Speech.
  103. Young, MA. Identification of stuttering and stutterers. In: Curlee, RF., Perkins, WH., editors. Nature and Treatment of Stuttering: New Directions. San Diego: College-Hill; 1984. p. 13-30.
  104. Zraick RI, Liss JM. A comparison of equal-appearing interval scaling and direct magnitude estimation of nasal voice quality. J Speech Lang Hear Res. 2000; 43:979-988. [PubMed: 11386483]

Related papers

Problems With Reliability of Speech Variables for Use in Quality Registries for Cleft Lip and Palate—Experiences From the Swedish Cleft Lip and Palate Registry
Kristina Klintö

The Cleft Palate-Craniofacial Journal, 2018

Objective: To test the reliability of the speech data in the Swedish quality registry for cleft lip and palate. Design: Retrospective study. Setting: Primary care university hospital. Participants: Ninety-four children born with cleft palate with or without cleft lip between 2005 and 2009 who had been assessed and registered in the quality registry at the age of 5 years. Main Outcome Measures: Data in the registry on percent oral consonants correct, percent oral errors, percent nonoral errors, perceived velopharyngeal function (PVPF), and intelligibility were compared with results based on reassessments by 3 independent raters from audio recordings. Agreement was calculated by the intraclass correlation coefficient (ICC), quadratic weighted kappa, and percentage agreement. Results: Absolute agreement calculated by average measures ICC for percent oral consonants correct, percent oral errors, and percent nonoral errors was above >0.90. Single measures ICC for percent oral consonan...

View PDFchevron_right
Speech services by speech volunteers for children with cleft lip and palate in professional lacking area: Pilot study
benjamas prathanee

JOURNAL OF ASSOCIATED MEDICAL SCIENCES (Online), 2024

Background: Cleft lip and cleft palate are the most common birth defects. Children with cleft lip with or without cleft palate (CP±L) face a vary of challenges, depending on the type and severity of the cleft including speech difficulty, dental problems, feeding difficulty, ear infections and hearing loss. Articulation error is the most common residual defect in children with cleft palate with or without cleft lip. Objective: To compare the numbers of pre-and post-articulation errors after using the Model of Speech Therapy by Volunteers (STV) for children with CP±L. Materials and methods: 9 children, aged range 6; 4-14; 2 years old, were included in this study and completely participated in the study. Pre-and post-articulation tests by Myanmar Articulation, Resonation, Nasal Emission and Nasal Turbulence Test were assessed at Mahamuni Monastery, and Thiriyadana Guha Pone Htoon Shan Monastery, Tachileik, Myanmar. STV is composed of a 3-day speech camp (1 st month), 3 times 1-day site visits for complicated cases (2 nd , 6 th , and 10 th months) and 3 times of 1-day follow-up speech camps (4 th , 8 th , and 12 th months), Phonological approaches, traditional strategies, and specific techniques for speech correction in children with CP±L were taught to speech volunteers (SVs) and caregivers. Homework was assigned to SVs and caregivers. SVs provided a session of 45-minute speech correction every week. Caregivers practiced 5 sessions of 30 minutes in speech exercises /weeks at home. STV revealed significant reductions in the numbers of articulation errors including articulation screening test [median difference: MD=6 (95% confident interval: CI=5.2-9.2)], and Myanmar articulation standard test at both word and sentence levels; [MD=8 (95% CI=6.5-10.8) and MD=5 (95% CI=4.2-8.3), respectively]. STV significantly decreased a number of articulation errors in children with CP±L of Myanmar, a professional lacking area, and could be applied in any area that has a similar situation. The result was a primary study, the further research should enroll more participants for generalization.

View PDFchevron_right
Research Paper Assessment and Treatment of Childhood Apraxia of Speech: An Inquiry into Knowledge and Experience of Speech-Language Pathologists
Iranian Rehabilitation Journal (IRJ)

Iranian Rehabilitation Journal, 2022

The present research aims to identify the assessment and treatment processes used by Iranian Speech-Language Pathologists (SLPs) for Childhood Apraxia of Speech (CAS) and investigate the impact of their knowledge level and experience on their choice of assessment and treatment. Methods: This research is a cross-sectional study using a survey design conducted on 260 SLPs with a minimum of a Bachelor's degree and at least one year of experience of working with preschoolers. The CAS assessment and treatment were measured by a validated questionnaire, which was completed in person or online. Results: The tests of Diadochokinesis (DDK) (66%), single-word speech sampling (58.1%), oral-motor assessment (54.6%), and connected speech sample analysis (53.1%) were the popular tests chosen by the participants. The treatment approaches indicated that Oral Motor Exercises (OMEs) (57.7%) were the only treatment for which over half of the participants voted. The experts chose phonologically-based treatments and Integrated Phonological Awareness (IPA), but the less-experienced participants were more interested in PROMPT (prompts for restructuring oral muscular phonetic targets). The majority of the participants (70.8%) believed that children with CAS make very slow progress and 21.9% declared that speech problems of such children persist through the school years. Discussion: The participants' choice of assessment tasks is in line with the results of recent studies. However, opting for outdated treatments such as OME indicates a gap between the clinicians' knowledge and experience in using evidence-based treatments.

View PDFchevron_right
Telepractice Parent Training of Enhanced Milieu Teaching With Phonological Emphasis (EMT+PE) For Persian-Speaking Toddlers With Nonsyndromic Cleft Palate: Protocol for a Randomized Controlled Trial
Talieh Zarifian

JMIR research protocols, 2024

Background: Children born with a cleft palate with or without a cleft lip (CP/L) are at increased risk for delayed language development and speech sound disorders. Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) is a recommended naturalistic intervention for toddlers with CP/L. The parents' role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Telepractice is an appropriate method for training parents and children with various speech-related disorders. Objective: This study aims to determine and compare the effectiveness of telepractice and the parent-implemented EMT+PE intervention on language and speech measures in toddlers with CP/L with usual interventions and determine the effectiveness maintenance of the intervention. A randomized controlled trial (RCT) will assess the efficacy of telepractice and the parent-implemented EMT+PE intervention in enhancing speech and language measures in toddlers with CP/L. Eligible participants will be randomly assigned to one of 2 groups: the conventional intervention group and the EMT+PE intervention group. Participants' speech and language measures will be evaluated remotely by trained raters before and after the intervention and 2 months after the intervention. Parents of participants in the intervention group will receive 3 months of training in speech and language supportive strategies from trained therapists using telehealth fidelity scales. Parents of participants in the control group will receive the conventional speech and language intervention by cleft team therapists. Study outcomes will include language variables (mean length of utterance) and speech production variables (percent correct consonants). The protocol was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences in February 2022. The selection process of participants, as well as training therapists and raters, commenced in January 2022, the therapy and follow-up period ended in June 2023, and pre-and postintervention assessments have been conducted. Data analysis is ongoing, and we expect to publish our results by the summer of 2024. Funding is yet to be received. The results of this study may help us develop a speech and language intervention with a different delivery model for toddlers with CP/L, and the cleft team care can use these results in service delivery. Consistent with our hypothesis, speech and language measures are expected to improve.

View PDFchevron_right
Effects of a naturalistic intervention on the speech outcomes of young children with cleft palate
Nancy Scherer

International Journal of Speech-Language Pathology, 2020

Purpose: The purpose of this study was to investigate the extent to which a naturalistic communication intervention, Enhanced Milieu Teaching with Phonological Emphasis (EMT þ PE) improved the speech outcomes of toddlers with cleft palate with or without cleft lip (CP ± L) Method: This study was a stratified randomised controlled trial. Setting: Treatment was delivered in a university clinic by a trained speech-language pathologist. Participants: Thirty children aged between 15 and 36 months (M ¼ 25) with nonsyndromic CP ± CL and typical cognitive development were randomly assigned to a treatment (EMT þ PE) or business as usual comparison condition. Interventions: Participants in the EMT þ PE treatment group received 48, 30-min sessions, over a 6-month period. Fidelity of treatment was high across participants. Main outcome measures: The primary outcome measures were percent consonants correct (PCC), consonant inventory, compensatory articulation errors, and nasal emission. Results: Regression analyses controlling for pre-intervention child characteristics were conducted for PCC and consonant inventory. Intervention was not a significant predictor of post-intervention outcome. Words per minute differentiated the children who benefitted from the intervention from those who did not. Reduction in compensatory errors and nasal emission occurred in both groups but to a greater degree in the EMT þ PE group. Conclusion: EMT þ PE is a promising early speech intervention for young children with CP ± L, especially for children with higher rates of word use.

View PDFchevron_right

Related topics

  • Psychology
  • Speech Language Pathology
  • Dentistry
  • Phonetics
  • Cleft Palate
  • Speech Disorders
  • Medicine
  • Reproducibility of Results
  • Disability Evaluation

    • Cited by

    Influência de estímulos de fala na identificação perceptivo-auditiva da hipernasalidade em indivíduos com fissura labiopalatina
    Maria Pegoraro-Krook

    CoDAS

    RESUMO Objetivo Investigar a influência de estímulos de fala distintos na identificação perceptivo-auditiva da hipernasalidade em indivíduos com fissura labiopalatina operada (FLP). Método Foram editadas amostras de fala gravadas em áudio de 80 indivíduos com FLP unilateral operada, de ambos os sexos, com idades entre 9 e 17 anos (média=12 anos e 7 meses). As amostras foram gravadas durante a produção de 9 estímulos de fala distintos: contagem de números e conjuntos de frase orais, sendo 1 constituído por consoantes de baixa pressão e 7 constituídos por consoantes de alta pressão. Três fonoaudiólogas identificaram a presença ou ausência da hipernasalidade ao analisarem 864 gravações (80 indivíduos X 9 estímulos + 144 gravações repetidas para análise de concordância intra-avaliador). Os índices de concordância intra e interavaliadores foram estabelecidos para todos os 9 estímulos de fala e comparados entre si por meio do Teste Z, com nível de significância de 5%, com maiores índices ...

    View PDFchevron_right
    Management of Velopharyngeal Insufficiency in Cleft Patients With and Without Multidisciplinary Team Care
    Sarah Pollard

    The Cleft Palate-Craniofacial Journal

    Objective: To evaluate the effect of an American Cleft Palate-Craniofacial Association (ACPA)–approved multidisciplinary team on velopharyngeal insufficiency (VPI) diagnosis and treatment. Design: Retrospective cohort setting; tertiary children’s hospital patients; children with cleft palate repair identified through procedure codes. Main Outcome Measures: Velopharyngeal insufficiency diagnosis was assigned based on surgeon or team assessment. Age at diagnosis and surgery was recorded. Difference in age and rate of VPI diagnosis and surgery was analyzed with t test. Multivariate linear and logistic regression adjusted for confounding variables. Results: Nine hundred forty patients were included with 71.5% cared for by an ACPA-approved multidisciplinary team. More (38.8% ) team care patients were found to have a diagnosis of VPI in comparison to 10% in independent care ( P < .001). Team care was associated with an almost 6-fold increase in VPI diagnosis ( P < .001). Team care w...

    View PDFchevron_right
    Speech in 5-year-olds born with unilateral cleft lip and palate: a Prospective Swedish Intercenter Study
    Christina Havstam

    Journal of Plastic Surgery and Hand Surgery

    Studies on the impact of cleft palate surgery on speech with stringent methodology are called for, since we still do not know the best timing or the best method for surgery. The purpose was to report on speech outcome for all Swedish-speaking 5-year-olds born with a non-syndromic unilateral cleft lip and palate (UCLP), in 2008-2010, treated at Sweden's six cleft palate centres, and to compare speech outcomes between centres. Speech was assessed in 57 children with percent consonants correct adjusted for age (PCC-A), based on phonetic transcriptions from audio recordings by five independent judges. Also, hypernasality and perceived velopharyngeal function were assessed. The median PCC-A for all children was 93.9, and medians in the different groups varied from 89.9 to 96.8. In the total group, 9 children (16%) had more than mild hypernasality. Twenty-two children (38.5%) were perceived as having competent/sufficient velopharyngeal function, 25 (44%) as having marginally incompetent/insufficient velopharyngeal function, and 10 children (17.5%) as having incompetent/insufficient velopharyngeal function. Ten children were treated with secondary speech improving surgery and/or fistula surgery. No significant differences among the six groups, with eight to ten children in each group, were found. The results were similar to those in other studies on speech of children with UCLP, but poorer than results in normative data of Swedish-speaking 5-year-olds without UCLP. Indications of differences in frequency of surgical treatment and speech treatment between centres were observed.

    View PDFchevron_right
    The Language Profile of Preschool Children With 22q11.2 Deletion Syndrome and the Relationship With Speech Intelligibility
    Ellen Gerrits

    American Journal of Speech-Language Pathology

    Purpose: Young children with 22q11.2 deletion syndrome (22q11DS) often have impaired language development and poor speech intelligibility. Here, we report a comprehensive overview of standardized language assessment in a relatively large sample of preschool-aged children with 22q11DS. We furthermore explored whether speech ability explained variability in language skills. Method: Forty-four monolingual Dutch preschoolers (3–6 years) with a confirmed genetic 22q11DS diagnosis participated in this prospective cohort study. Standardized tests (Clinical Evaluation of Language Fundamentals Preschool-2-NL and Peabody Picture Vocabulary Test-III-NL) were administered. Speech intelligibility was rated by two expert speech and language therapists using a standardized procedure. Results: Most children had impaired language skills across all tested domains. The composite score for expressive language was significantly lower than that for receptive language, but the two were strongly correlated...

    View PDFchevron_right
    Problems With Reliability of Speech Variables for Use in Quality Registries for Cleft Lip and Palate—Experiences From the Swedish Cleft Lip and Palate Registry
    Kristina Klintö

    The Cleft Palate-Craniofacial Journal, 2018

    Objective: To test the reliability of the speech data in the Swedish quality registry for cleft lip and palate. Design: Retrospective study. Setting: Primary care university hospital. Participants: Ninety-four children born with cleft palate with or without cleft lip between 2005 and 2009 who had been assessed and registered in the quality registry at the age of 5 years. Main Outcome Measures: Data in the registry on percent oral consonants correct, percent oral errors, percent nonoral errors, perceived velopharyngeal function (PVPF), and intelligibility were compared with results based on reassessments by 3 independent raters from audio recordings. Agreement was calculated by the intraclass correlation coefficient (ICC), quadratic weighted kappa, and percentage agreement. Results: Absolute agreement calculated by average measures ICC for percent oral consonants correct, percent oral errors, and percent nonoral errors was above >0.90. Single measures ICC for percent oral consonan...

    View PDFchevron_right
    580 California St., Suite 400
    San Francisco, CA, 94104
    © 2025 Academia. All rights reserved