Outcome of Treatment regarding Articulation, Resonance and Voice in Flemish Adults with Unilateral and Bilateral Cleft Palate

Abstract

The purpose of this study was to evaluate the outcome regarding speech intelligibility, articulation, nasalance, nasality and voice in adult cleft palate patients. An additional objective of this study was to delineate the impact of a unilateral versus bilateral cleft lip and palate on speech outcome and to compare the nasalance and nasality patterns of cleft palate adults with data from non-cleft subjects. Objective (nasalance values obtained by the Nasometer, mirror-fogging test according to Glatzel and the determination of the dysphonia severity index, DSI) and subjective assessment techniques (perceptual evaluation of speech, nasality and voice, the Bzoch tests and the Gutzmann test) were used. All 14 subjects with a complete unilateral or bilateral cleft lip and palate consulted the same craniofacial team, followed an identical surgical protocol, completed the surgical cleft palate treatments and followed speech therapy. Most of the patients had a fairly satisfactory outcome with normal speech intelligibility, but three types of articulation errors seemed to predominate. More than one half of the subjects demonstrated hypernasality. In comparison with the non-cleft normative data, statistically higher nasalance values were obtained in the cleft group. The subjects had a DSI score that corresponds with a normal or slightly impaired voice quality. No significant differences regarding speech outcome were found between subjects with a unilateral or bilateral cleft lip and palate. The results provide important information for speech-language pathologists to evaluate and improve speech outcome in cleft palate patients.

Automatically evaluated degree of intelligibility of children with different cleft type from preschool and elementary school measured by automatic speech recognition

“…The voice quality measured with DSI was normal or just slightly reduced in the CLP children. Our results are in accordance with van Lierde et al's results [34,52,53].…”

“…In contradiction to Karling et al [38], no significant differences between UCLP and BCLP were reported in this study which might be related to the number of tested subjects. In 2003, however, van Lierde et al [52] confirmed their earlier results of 2002 [34] with fewer subjects. According to Hardin-Jones and Jones [61], fewer children with isolated cleft palate of the soft palate show hypernasality than children with combined cleft lip and palate.…”

The impact of mandibular advancement on articulation, resonance and voice characteristics in Flemish speaking adults: a pilot study

“…But no other reports were found who investigated the speech characteristics after BSSO in Flemish speaking adults. From this study and from previous studies in cleft palate patients 24 it seems that in the Flemish language the /r/ is a vulnarable sound for distortions. The / r/ in the Flemish language has a different place of articulation then the /r/ in the English language.…”

Speech Outcome regarding Overall Intelligibility, Articulation, Resonance and Voice in Flemish Children a Year after Pharyngeal Flap Surgery

“…Their nature cannot be explained by this study. Probably the /r/ and the /s/ are vulnerable sounds for dis- [25,26] . Remarkably enough only 1 subject showed 1 year after surgery a compensatory articulation disorder (CAD), specifically a palatal stop.…”