Prediction of Velopharyngeal Competancy

Abstract

Although there are various diagnostic tools for assessment of velo-pharyngeal competency such as lateral x-rays, einefluorography, ma— nometers, nasal air flow and articulation tests (I, 3, 4, 6, 7, 8, 1]), it is ex— tremely difficult for the speech clinician to predict which individuals with clefts will need secondary palatal management. In fact, quite often the clinician will conduct a trial therapy period to see if progress is made before referral for consideration of secondary management (6). Therefore, the question asked in this study was: Are there measures which are predictive of the need for further palatal management? Procedure SUBJECTS. One hundred eight subjects with cleft palate were selected for comparative purposes with a previous report (9). They were selected on the basis that an articulation test was available within the age—test period of 79 to 90 months. In addition, clinical ratings of velopharyngeal competency and lateral X—rays were available. Subjects who at the time of test had 0b— turation, a pharyngeal flap or did not continue on the research project for at least one year after the base test were excluded from the study. A total of 75 subjects qualified. The subjects had a mean age of 84 months (range 79 to 90) at the initial test period and 162 months (range 103 to 242) at the time of preparation of this report. Therefore, the average intervening time period was 61/2 years. PREDICTIVE MEASURES. Three measures were evaluated for their prog— nostic value. One measure was the Iowa Pressure Articulation Test ('7). This test was originally constructed to help discriminate between speakers possessing velopharyngeal competency and those who do not. On this test, scores were determined on a correct/incorrect basis. Three categories were arbitrarily defined: (1) articulation scores above 50%, (2) articulation scores between 50% and 34%, and (3) articulation scores below 34%. The second measure was judgment of velopharyngeal competency made by the The authors are affiliated with the