Issues in perceptual speech analysis in cleft palate and related disorders: a review

Abstract

Background: Perceptual speech assessment is central to the evaluation of speech outcomes associated with cleft palate and velopharyngeal dysfunction. However, the complexity of this process is perhaps sometimes underestimated.

Aims: To draw together the many different strands in the complex process of perceptual speech assessment and analysis, and make recommendations for practice.

Main contribution: This review examines issues such as data sampling, data collection/recording, archiving, the advantages and disadvantages of lay and specialist listeners, approaches to data analysis, reliability, and data interpretation.

Conclusions: The need to capture meaningfully the sound of speech based on detailed phonetic analysis is argued. Also described are some of the differences in measuring speech for clinical, audit and research activities. Blind independent analysis of speech data by specialist therapists is recommended as the gold standard methodological approach when reporting audit and research outcomes. The requirement for ongoing training in listening skills for specialist therapists is advocated. The limitations of an impairment-based-only approach to measurement are also illustrated, indicating the need to develop outcome measures that incorporate more functional issues that affect quality of life.