A Perceptual Outcome Measure of Velopharyngeal Function Based on the Cleft Audit Protocol for Speech--Augmented (CAPS-A VPC-Sum): Validation through a Speech Osteotomy Study

Autor/inn/en	Pereira, Valerie J.; Tuomainen, Jyrki; Lee, Kathy Y. S.; Tong, Michael C. F.; Sell, Debbie A.
Titel	A Perceptual Outcome Measure of Velopharyngeal Function Based on the Cleft Audit Protocol for Speech--Augmented (CAPS-A VPC-Sum): Validation through a Speech Osteotomy Study
Quelle	In: International Journal of Language & Communication Disorders, 56 (2021) 4, S.754-767 (14 Seiten) PDF als Volltext Verfügbarkeit
Zusatzinformation	ORCID (Pereira, Valerie J.)
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1368-2822
DOI	10.1111/1460-6984.12625
Schlagwörter	Congenital Impairments; Speech Tests; Outcome Measures; Test Validity; Scores; Surgery; Interrater Reliability; Test Reliability + Suchen Sie Ihr Suchwort? Sprechtest; Testvalidität; Chirurgie; Interrater-Reliabilität; Testreliabilität
Abstract	Background: The status of the velopharyngeal mechanism can be inferred from perceptual ratings of specified speech parameters. Several studies have proposed the measure of an overall velopharyngeal composite score based on these perceptual ratings and have reported good validity. The Cleft Audit Protocol for Speech--Augmented (CAPS-A) is a validated and reliable perceptual framework for the assessment of cleft speech and velopharyngeal function used by all Regional Cleft Services in the UK and Ireland. An overall velopharyngeal composite summary score based on the CAPS-A would serve as an important surgical outcome measure of speech. Aims: To develop and validate a velopharyngeal composite summary score based on perceptual ratings made on the CAPS-A (CAPS-A VPC-Sum) using data from a maxillary osteotomy (MO) study. Methods & Procedures: There were two surgical groups--a cleft lip and palate (CLP) (N = 20) group and a non-CLP group (N = 10), and a normal control group (N = 20). Participants in groups 1 and 2 were seen for perceptual and instrumental assessments of speech and velopharyngeal function preoperatively (T1), 3 months (T2) and 12 months (T3) postoperatively. Perceptual speech data were collected and rated by independent listeners using CAPS-A. Outcomes & Results: Moderate to strong interrater reliability for perceptual data (r[subscript s] = 0.503-1.000, all p < 0.01) and strong to very strong reliability for videofluoroscopic measurements (r[subscript s] = 0.746-0.947) were found. Construct validity of the CAPS-A VPC-Sum was shown by an increase in postoperative scores for the CLP group only [kappa][superscript 2](2) = 9.769, p = 0.008 and significant differences between the CLP and the other two groups at T2 and T3 using independent "t"-tests. Convergent and divergent validity was indicated by a positive moderate correlation with related parameters (e.g., hypernasality r[subscript s] = 0.869, p < 0.01) and a weak correlation with unrelated parameters (e.g., amount of forward advancement r[subscript s] = 0.160, p = 0.526). Criterion validity was found by a moderate correlation between closure ratio r[subscript s] = -0.541, p = 0.020 and CAPS-A VPC-Sum. Conclusions & Implications: A velopharyngeal composite score based on perceptually rated parameters serves as an important surgical speech outcome measure. The CAPS-A VPC-Sum is a useful, reliable and valid outcome measure of velopharyngeal function. There are added positive implications for other clinicians using geographically and language-specific adapted versions of the CAPS-A internationally. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2024/1/01