Outcome of Speech Intervention in Patients After Cleft Palate Repair

Abstract

Speech resonance disorders in patients with cleft palate are usually due to velopharyngeal insufficiency, which is due to inability to create an oral seal during high pressure sounds pronunciation. We commenced the provision of speech therapy services in our center in 2017. This research is a pilot study to assess the impact of speech intervention on the speech of patients who have had surgical repair of cleft palate, and to ascertain if the timing of the intervention has any impact on the speech of the patients.

Materials and Methods: This is a retrospective review of the medical records of patients who had speech therapy following the surgical repair of cleft lip and palate between July 2018 and July 2019. The video tape recordings of the speech intervention were also retrieved and evaluated. A modified form of Accordi’s speech assessment protocol was utilized to evaluate the outcome of the speech therapy. This protocol uses five key areas of nasality (hypersensitivity or hyponasality), nasal emissions, glottal stays, pharyngeal fricatives and intelligibility. The sum of the single assessment for each evaluated parameter was regarded as the final score and it auges from 0 to 15. These scores were further divided into Class I (I-5), Class II (6-10) and Class III (11-15).

Results: There was a statistically significant difference (p=0.01) in pre-intervention and post-intervention stages of patients showing improvement in speech after speech therapy. There was mild correlation between the age of patients and the Class obtained (correlation coefficient=0.4).

Conclusion: The cleft speech therapy in this study was found to improve speech intelligibility for cleft patients after surgical repair of palatal cleft.