This SIG 5 activity includes three articles from a forum aimed at sharing research
conducted in clinical settings around the world. Two research articles analyzed surgical
and parent-led therapy approaches for improved speech and resonance outcomes. A
third tutorial described characteristics needed in an evaluation to analyze clinically
obtained data for research purposes.
The first research article is based in Brazil. It demonstrates positive long-term
outcomes in children with hypernasality/velopharyngeal dysfunction using the
Sommerlad procedure of palatal re-repair to treat residual velopharyngeal insufficiency.
The reported scores were in the categories of: “hypernasality, global impression of
velopharyngeal function, and/or active speech symptoms.” Overall, this study shows
significant improvement in a large percentage of children, with less effect on older
individuals ages 17–22 years.
The second research article includes parents from a previously published twocenter
study in Ireland and the United Kingdom. The aim was to analyze parents’
experiences with parent-led articulation therapy (PLAT) following in-depth training. After
a detailed outline is provided regarding inclusion and teaching of the participants, four
main themes are identified. These include growth of parents, undertaking PLAT,
changes in children, and the future. Ultimately, the majority of parents are in favor of a
parent-led therapy approach with the caveat that in-depth training and direct supervision
from a speech-language pathologist is needed.
The third article, a tutorial, addresses the research–clinical practice gap. A
description is provided of a perceptual speech assessment protocol for cleft palate
speech, to enable clinical data to be used for research purposes. The article provides
detail related to determining the most appropriate standardized assessment tools as well
as the best ways to collect and analyze this data. Further details related to
implementation within the clinical setting are outlined. The data is easily accessible
through networking between cleft teams and Sweden’s national cleft lip and palate
registry, making retrospective research attainable in a clinical setting.
This SIG 5 activity analyzes the relationship between the opioid crisis and cleft lip and palate care across the life span. Two main themes of prevention and treatment after exposure are explained. The articles outline alternatives to opioid use after cleft-related surgeries, impacts on infants and children who were exposed in utero, and velopharyngeal insufficiency treatment after substance abuse.
This Perspectives activity highlights two articles with objective measures for both evaluation and treatment of velopharyngeal dysfunction. The first article discusses the palatal closure efficiency (PaCE) index. This is an aerodynamic tool used to estimate the velopharyngeal opening during certain speech contexts. This is done by measuring a percentage of change between nasal and oral cognates of an individual. The second article describes the nasometer in depth, highlighting its use as an evaluation and treatment tool for decreasing hypernasality. It goes into further detail on the differences between hypernasality and measured nasalance, highlighting both strengths and limitations of the nasalance score.