Methodology for speech assessment in the Scandcleft project--an international randomized clinical trial on palatal surgery: experiences from a pilot study.

OBJECTIVE: To present the methodology for speech assessment in the Scandcleft project and discuss issues from a pilot study. DESIGN: Description of methodology and blinded test for speech assessment. Speech samples and instructions for data collection and analysis for comparisons of speech outcomes across five included languages were developed and tested. PARTICIPANTS AND MATERIALS: Randomly selected video recordings of 10 5-year-old children from each language (n = 50) were included in the project. Speech material consisted of test consonants in single words, connected speech, and syllable chains with nasal consonants. Five experienced speech and language pathologists participated as observers. MAIN OUTCOME MEASURES: Narrow phonetic transcription of test consonants translated into cleft speech characteristics, ordinal scale rating of resonance, and perceived velopharyngeal closure (VPC). A velopharyngeal composite score (VPC-sum) was extrapolated from raw data. Intra-agreement comparisons were performed. RESULTS: Range for intra-agreement for consonant analysis was 53% to 89%, for hypernasality on high vowels in single words the range was 20% to 80%, and the agreement between the VPC-sum and the overall rating of VPC was 78%. CONCLUSIONS: Pooling data of speakers of different languages in the same trial and comparing speech outcome across trials seems possible if the assessment of speech concerns consonants and is confined to speech units that are phonetically similar across languages. Agreed conventions and rules are important. A composite variable for perceptual assessment of velopharyngeal function during speech seems usable; whereas, the method for hypernasality evaluation requires further testing.

A longitudinal group study of speech development in Danish children born with and without cleft lip and palate.

The present study focuses on contoid vocalization by Danish 1-year-old unrepaired toddlers born with cleft lip and palate, and how they differ from their non-cleft peers. Furthermore, we focus on how the same children master Danish consonants at 3 years of age compared with their non-cleft peers in terms of their ability to produce consonants in accordance with adult target. Also, with the 3 year olds, we look at cleft speech characteristics as well as developmental speech characteristics found in both groups of children. Based on phonetic transcription, it was found that Danish unoperated cleft palate children at 1 year of age produced few types of contoids and preferably contoids that did not require closure of the velopharyngeal port in their prespeech. In addition, the data suggest that consonants produced by cleft children who are treated with one-stage surgery after speech onset, at 3 years of age differ from speech produced by non-cleft children, not only as regards cleft speech characteristics, but also as regards developmental speech characteristics.

A simple nasal anemometer for clinical purposes.

There is a need for clinical methods which give more direct information about the behaviour of the velopharyngeal mechanism in natural speech than do the examination methods normally applied to patients suffering from velopharyngeal insufficiency. One possibility is the recording of nasal airflow in order to detect nasal emission of air. The purpose of the present study is to examine the qualities and the characteristics of a simple and cheap nasal anemometer. As this type of flowmeter is considered less reliable than most other flowmeters, its limitations must be clearly understood and accounted for in drawing conclusions. Therefore, nasal airflow in speech obtained with this flowmeter is discussed in relation to nasal airflow obtained by the more reliable pneumotachograph and in relation to nasal airflow data found in the literature. The tests made here suggest that, at least for the type of speech material and measurements used in the present study, reliable nasal airflow data can be obtained by the anemometer.

Strategies in cleft palate speech--with special reference to Danish.

In the first part of this paper speech problems as a consequence of cleft palate are described in the light of three strategies: one passive and two active. In the passive strategy, the speaker does not attempt to reduce the inevitable consequences of insufficient velopharyngeal closure. In the active strategies, the speaker attempts to reduce these consequences by compensation or by camouflage. In the second part of the article the strategies are applied to classify the persisting speech problems in five Danish children with cleft palate (4 to 5 years of age) based on a phonetic transcription of their consonant production.

Vocal fold adjustments in aspirated and unaspirated stops in Danish.

Vocal fold adjustments in Danish aspirated and unaspirated stops were investigated by electromyography, photo-electric glottography, and fiberoptic stills. The results show that these two stop types are produced primarily by different types of glottal gesture, rather than by a different timing of the glottal and supraglottal articulations. Other, more general aspects of glottal behaviour in relation to aspiration and devoicing in stops are also discussed.