Speech Ratings by Speech Clinicians Parents and Children

Abstract

Ratings of speech samples of children with cleft palate were obtained from speech clinicians in a Cleft Palate Clinic, speech clinicians in the public schools, parents of children with clefts, parents of children without clefts, children with clefts and children without clefts. Analyses of the obtained ratings suggest that nasality and articulation ratings obtained from adult groups do not differ appreciably. Correlations between ratings of nasality and articula-tion are interpreted as suggesting that speech clinicians are more likely to differentiate between these two variables than other listener groups. Speech clinicians evaluate speech for the purposes of identifying problems, determining their etiology and selecting appropriate management strategies. In most settings , clinicians who evaluate speech also provide therapy. If their initial evaluations are incomplete) " orvvinaccurate, therapy can be modifiedwith a minimum of harm or inconvenience to the patient. Clinicians who workjwith interdisciplinary diagnostic teams face somewhat different circumstances. Their evaluations may be used to select treatment procedures that will be administered by other professionals, including physicians and dentists, whose ther— apy procedures are not easily modified. Under these circumstances, speech evalua— tions must be as complete and accurate as possible. The Cleft Palate Maxillofacial Clinic at the University of Minnesota consists of an interdisciplinary team that conducts diagnostic evaluations and provides recommen-Address correspondence to: nesota 55455, Tel: (612) 373-4116. dations to patients and the professionals who treat them. In this setting, speech evaluations may strongly influence recommendations to proceed with surgical or dental treatment. The speech evaluations used are based, in part, on information obtained from patients, parents, teachers, speech cli-nicians and other professionals in the Clinic. Speech clinicians who serve on in-terdisciplinary teams are expected to interpret observations made by others and integrate them with their own observations which are made while the patients are in the Clinic. In carrying out these tasks, clinic clini— cians make assumptions regarding the validity and reliability of observations made by themselves and others. Unfortunately, substantiative data relating to these assumptions are limited. Bradford, Brooks and Shelton (1964), Counihan and Culli-nan (1970), and Fletcher (1976) have presented data that question the use of perceptual judgements made by one person for clinical and research purposes. In response to this concern, our Clinic uses observations made by multiple listeners (i.e., three to six speech clinicians) to describe patients' 286