Abstract
Background: The chosen method of speech assessment, including type of speech material, may affect speech judgement in children with cleft palate.
Aim: To assess the effect of different speech materials on speech judgement in 5-year-old children born with or without cleft palate, as well as the reliability of materials by means of intra- and inter-transcriber agreement of consonant transcriptions.
Methods & Procedures: Altogether 40 children were studied, 20 born with cleft palate, 20 without. The children were audio recorded at 5 years of age. Speech materials used were: single-word naming, sentence repetition (both developed for cleft palate speech assessment), retelling of a narrative and conversational speech. The samples were phonetically transcribed and inter- and intra-transcriber agreement was calculated. Percentage correct consonants (PCC), percentage correct places (PCP), percentage correct manners (PCM), and percentage active cleft speech characteristics (CSC) were assessed. In addition, an analysis of phonological simplification processes (PSP) was performed.
Outcome & Results: The PCC and CSC results were significantly more accurate in word naming than in all other speech materials in the children with cleft palate, who also achieved more accurate PCP results in word naming than in sentence repetition and conversational speech. Regarding PCM and PSP, performance was significantly more accurate in word naming than in conversational speech. Children without cleft palate did better, irrespective of the speech material. The medians of intra- and inter-transcriber agreement were good in both groups and all speech materials. The closest agreement in the cleft palate group was seen in word naming and the weakest in the retelling task.
Conclusion & Implications: The results indicate that word naming is the most reliable speech material when the purpose is to assess the best speech performance of a child with cleft palate. If the purpose is to assess connected speech, sentence repetition is a reliable and also valid speech material, with good transcriber agreement and equally good articulation accuracy as in retelling and conversational speech. For typically developing children without a cleft palate, the chosen speech material appears not to affect speech judgement.
Acknowledgements
The authors are grateful to Speech and Language Pathologist Maria Sporre, who transcribed part of the material. Financial support was received from funds administered by Malmö University Hospital. This study was presented in part at the 11th International Congress on Cleft Lip and Palate and Related Craniofacial Anomalies, in Fortaleza, Brazil, 23 September 2009; and at the 13th Meeting of the International Clinical Linguistics and Phonetics Association, in Oslo, Norway, 25 June 2010. Declaration of interest: The authors report no conflicts of interest and alone are responsible for the content and writing of the paper.