ABSTRACT
OBJECTIVE: Even after adequate surgical and nonsurgical treatment, combined or isolated clefts often cause functional disorders, such as speech disorders. Speech disorders vary widely in extent and can take the form, for example, of specific features of articulation, with altered nasal emission and shifted articulation, leading to reduced speech intelligibility. So far it has not been possible to describe the relationship between cleft type and intelligibility except subjective, categorical evaluation. METHODS: Intelligibility of the speech as influenced by cleft palate in 58 children aged 9+/-2 was quantified objectively and numerically by means of automatic speech recognition technology in speech recordings for the PLAKSS test [test for psycholinguistic analysis of childhood speech impairments]. It was found that 33 children had a unilateral cleft lip and palate (CLP), 9, bilateral CLP, 10, isolated cleft palate, and 6, submucosal cleft palate. As a control group, 84 children aged 9+/-1 years and with physiological articulation were recruited from a mainstream school. Speech intelligibility is expressed as word accuracy, which means the percentage of correctly recognized words in a word sequence. RESULTS: Word accuracy levels in the control group were between 39% and 84% (mean 62%+/-10%), while the children with clefts achieved values between 0% and 73% (mean 42%+/-17%). There was no difference in intelligibility between children with isolated cleft palate and those with combined cleft type. Differences were, however, found between each group and the control group (p<0.01). CONCLUSION: Speech intelligibility of children with isolated cleft palate does not significantly differ from that of children with combined cleft type including the palate, as has been objectively quantified for the first time by objective methods. In the presence of speech disorders, the need for diagnosis and therapy is just as great in children with isolated cleft palate as in children with combined cleft types.
