Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Nov;18 Suppl 2(Suppl 2):36-46.
doi: 10.1111/ocr.12112.

The Cleft Care UK study. Part 4: perceptual speech outcomes

D Sell  1 , S Mildinhall  2 , L Albery  3 , A K Wills  4 , J R Sandy  4 , A R Ness  4   5
Affiliations

The Cleft Care UK study. Part 4: perceptual speech outcomes

D Sell et al. Orthod Craniofac Res. 2015 Nov.

Abstract

Objectives: To describe the perceptual speech outcomes from the Cleft Care UK (CCUK) study and compare them to the 1998 Clinical Standards Advisory Group (CSAG) audit.

Setting and sample population: A cross-sectional study of 248 children born with complete unilateral cleft lip and palate, between 1 April 2005 and 31 March 2007 who underwent speech assessment.

Materials and methods: Centre-based specialist speech and language therapists (SLT) took speech audio-video recordings according to nationally agreed guidelines. Two independent listeners undertook the perceptual analysis using the CAPS-A Audit tool. Intra- and inter-rater reliability were tested.

Results: For each speech parameter of intelligibility/distinctiveness, hypernasality, palatal/palatalization, backed to velar/uvular, glottal, weak and nasalized consonants, and nasal realizations, there was strong evidence that speech outcomes were better in the CCUK children compared to CSAG children. The parameters which did not show improvement were nasal emission, nasal turbulence, hyponasality and lateral/lateralization.

Conclusion: These results suggest that centralization of cleft care into high volume centres has resulted in improvements in UK speech outcomes in five-year-olds with unilateral cleft lip and palate. This may be associated with the development of a specialized workforce. Nevertheless, there still remains a group of children with significant difficulties at school entry.

Keywords: cleft lip; cleft palate; speech; treatment outcome.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of intelligibility scores among five-year-old children in the CCUK (N = 238) and CSAG study (N = 235).
Figure 2
Figure 2
Summary of 34 studies where recordings of children with cleft palate were reviewed [median and range shown 38,39]. The horizontal bar is the median, and the vertical bar is the range of estimates across studies. The data from the CSAG (white bars) and CCUK studies (black bars) are also presented thus enabling comparison with previously reported values in the literature.
See this image and copyright information in PMC

References

    1. Semb G, Brattström V, Mǿlsted K, Prahl-Anderson B, Shaw W. The Eurocleft Study: intercentre Study of treatment outcomes in patients with complete cleft lip and palate. Cleft Palate Craniofac J. 2005;42:64–8. - PubMed
    1. Sandy J, Williams A, Bearn D, Mildinhall S, Murphy T, Sell D, et al. Cleft Lip and Palate Care in the United Kingdom – The Clinical Standards Advisory Report (CSAG) Study. Part 1 Background and methodology. Cleft Palate Craniofac J. 2001;38:20–3. - PubMed
    1. Williams A, Bearn D, Mildinhall S, Murphy T, Sell D, Shaw W, et al. Cleft Lip and Palate Care in the United Kingdom – The Clinical Standards Advisory Report (CSAG) Study. Part 2: dentofacial outcomes and patient satisfaction. Cleft Palate Craniofac J. 2001;38:24–9. - PubMed
    1. Sell D, Grunwell P, Mildinhall S, Murphy T, Tremaine A, Cornish O, et al. Cleft Lip and Palate care in the United Kingdom – The Clinical Standards Advisory Report (CSAG) Study. Part 3 Speech outcomes. Cleft Palate Craniofac J. 2001;38:30–7. - PubMed
    1. Bearn D, Mildinhall S, Murphy T, Murray J, Sell D, Shaw W, et al. Cleft Lip and Palate Care in the United Kingdom – The Clinical Standards Advisory Report (CSAG) Study 2001; Part 4: outcome, comparisons, training and conclusions. Cleft Palate Craniofac J. 2001;38:38–43. - PubMed

Publication types