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Orthod Craniofac Res. 2015 Nov;18 Suppl 2:36-46. doi: 10.1111/ocr.12112.

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

Author information

1
Speech and Language Therapy Department and Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital NHS Foundation Trust, London, UK.
2
Previously South Thames Cleft Service, Guys and St Thomas' NHS Foundation Trust Hospital, London, UK.
3
University Hospitals Bristol NHS Trust, Cleft Lip and Palate Team, Bristol, UK.
4
School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
5
National Institute for Health Research (NIHR) Biomedical Research Unit in Nutrition, Diet and Lifestyle at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.

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

PMID:
26567854
PMCID:
PMC4670716
DOI:
10.1111/ocr.12112
[Indexed for MEDLINE]
Free PMC Article

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