Comparing Quality of Life and Perceptual Speech Ratings in Children With Cleft Palate

Abstract

Objective: To delineate the relationship between patient and parent-reported quality of life (QOL) ratings and perceptual characteristics of speech assigned by a speech-language pathologist (SLP) in children with repaired cleft palate. Design: Prospective. Setting: Academic Children’s Hospital. Participants: This population-based sample included children, aged 3 to 18 with a history of repaired cleft palate, and their parents. Intervention: Participants completed the Velopharyngeal Insufficiency Effects on Life Outcomes Questionnaire (VELO). Children’s speech was judged perceptually by an expert SLP using the Pittsburgh Weighted Speech Scale (PWSS). Main Outcome Measure(s): Velopharyngeal Insufficiency Effects on Life Outcomes questionnaire assessed participant and parent perceptions of impact of velopharyngeal function on QOL. Pittsburgh Weighted Speech Scale assessed nasal emissions, facial grimacing, nasality, quality of phonation, and articulation. Results: Enrollment included 48 participant parent dyads. Overall, participants reported high QOL scores within the 95% CI with children reporting slightly better yet not significantly different QOL (86.27 ± 8.96) compared to their parents (81.81 ± 15.2). Children received an average score of 1.38 ± 1.96 on the PWSS corresponding to borderline velopharyngeal competence. A significant moderate negative correlation was found between PWSS total score and parent VELO total score (r = −0.51103, P = .0002). Mild–moderate significant negative correlations were measured between PWSS total and the 5 subscales of the VELO. No significant correlations were measured between PWSS and child VELO total responses or between total scores and subscales. Conclusions: Results suggest that as perceptual analysis of speech improves, overall QOL improves moderately.