Relationship between Intelligibility in Context Scale and Cleft-Related Speech Sound Errors in 3-year-olds with Nonsyndromic Cleft (Lip and) Palate

Cassandra Alighieri*, Yvonne E Wren, Kristiana Van Lierde

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Purpose:
Cleft-related speech sound errors can negatively affect speech intelligibility in children with a cleft palate with or without a cleft lip (CP±L), though the extent of this impact has been unclear. Understanding this relationship could facilitate intervention planning. Therefore, this study investigated the association between different types of cleft-related speech sound errors and scores on the seven items of the Intelligibility in Context Scale (ICS).

Methods:
Data from the Cleft Collective Cohort Study were used. A total of 157 children with nonsyndromic CP±L, whose mothers had completed the ICS (7-item questionnaire rating the degree to which children's speech is understood by different communication partners) and whose speech and language therapist had completed the Cleft Collective speech and language assessment form at 3 years of age, were included in this study. To verify whether the presence of cleft-related speech sound errors influenced scores on the seven items of the ICS, one-way multivariate analysis of variances (MANOVAs) were carried out. Effect size measures were calculated using the Partial Eta Squared value.

Results:
The presence of at least one anterior oral error or at least one passive error had an effect on intelligibility by immediate and extended family members, acquaintances, the child’s friends, strangers, and average ICS scores. This effect was small to medium strong. Evidence was also found to suggest a difference in speech intelligibility by immediate family members, extended family members, the child’s friends, acquaintances, strangers, and the average ICS score between children who presented with dentalisation (anterior oral error) or glottal articulation (non-oral error) and children who did not. The effect was medium strong. Surprisingly, speech intelligibility by teachers or carers was not impacted by any type of cleft-related speech sound error.

Conclusion:
The presence of anterior oral errors and passive errors reduced speech intelligibility across different communication partners. Non-oral errors did not show as strong an impact, although specific subtypes like glottal articulation did reduce ICS scores. These findings suggest the importance of individualized treatment strategies, with increased attention to specific subtypes of cleft-related speech sound errors.
Original languageEnglish
JournalJournal of Speech, Language, and Hearing Research
Publication statusAccepted/In press - 5 Mar 2025

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