# Presentation: 114542

## Evaluation

- Workshop on Universal Reporting Parameters for the Speech
- of Individuals with Cleft Palate
*Washington DC, April/May 2004*
- Triona Sweeney, Dublin & Tara Whitehill, Hong Kong

## Introduction

- Original premise of project was to map information from current practice, without any/much modification in practice.
- Need to be aware of range of current practice in evaluation
- ? Flexibility vs. conformity

## 14 variables in evaluation (at least!)

- Context
- Who
- Frequency
- When
- Purpose
- Duration
- Protocol
- Recording

- Reliability
- Speech materials
- Parameters
- Language specificity
- Developed vs. developing countries
- Diagnosis

## Context

- Assumption: Speech evaluation done by an individual working within part of a cleft team
- “Screening” during team visit
- 			       Vs
- Lengthier evaluation as a “one-off”
- (Other)

## Who 

- Speech-language therapist (/SLP/equivalent) with experience/expertise in cleft palate
- Full-time dedicated to cleft vs. not
- ‘Generalist’ SLP
- Other professional (dedicated to cleft)
- With or without specialist training
- With or without ‘expertise’ in cleft
- See #12
- (Other)
- (Levels of Input)

## Frequency

- How frequently is child seen for speech screening/evaluation?
- E.g., once a year, every 2-3 years, every 6 months
- (Other)

## When is data collected

- ? Full records at specific ages
- 	eg 	- 5 years
- 		  10 years
- 		  15 years

## Purpose

- Clinical/Service
- Research
- Clinical audit
- (Combination)
- (Other)

## Duration

- For example,
- 5-10 minute screening
- 1 hr. or more speech-language evaluation
- (in between)
- (other)

## Protocol

- Is the speech evaluation protocol individual to the centre/unit/hospital
- 		                 vs
- An agreed protocol used in the district/
-    country/region
- (Something between)

## Recording

- “live” - written record only
- Audiorecording
- analogue
- digital
- Videorecording
- analogue
- digital
- (Combination)
- (Other)

## Reliability

- No prospect for assessing (e.g. live)
- Prospect (recordings) but not routinely done
- Routinely assess intrajudge reliability
- 			        and/or
- Routinely assess interjudge reliability
- ‘blind”/randomized evaluation
- (Other)

## Speech materials

- What speech materials are used in evaluating speech? (usually combination)
- For example,
- Sustained vowels
- Single words
- Articulation/phonology test (single words and/or sentences)
- Sentences
- Connected speech
- Conversation
- For each: Elicited, repetition, reading, spontaneous
- (Other)

## Parameters

- What parameters are routinely covered in the speech evaluation
- For example,
- Speech - resonance
- 		           - nasal emission/nasal turbulence
- 		           - articulation/phonology
- Voice
- Language
- (Hearing)
- (Other)

## Resonance assessments

- Equal Appearing Interval Scales (EAI)
- Visual Analogue Scales (VA)
- Descriptive Scales
- Classification - mild/mod/severe
- Numerical Scales  - varying points (0 - 4; 1-5; 1 - 7)
- Other

- Parameters, continued

## Nasal Emission

- Nasal emission
- 		‘vs’
- Nasal turbulence

- Parameters, continued

## Nasal emission/nasal turbulence assessments

- Present/absent
- EAI
- VA
- Numerical Scales
- Classification - mild/mod/severe
- Descriptive - severity/ frequency/ consistency
- Other

- Parameters, continued

## Assessment of Consonant Production

- Cleft Type Characteristics
- Compensatory Articulations
- Cleft related articulations
- ?Phonological implications
- Other

- Parameters, continued

## Language Specific Factors

- Debate regarding the extent to which we can compare results across languages
- Several cross-language initiatives - focusing on phonemes/aspects shared between languages

## Developed vs. Developing Countries

- Or, countries with well-established speech/language profession and/or specialization in cleft vs. those without
- System can/should only be used by qualified SLP/equivalent with specialization in cleft?
- What about a context, for example, where individual focuses primarily on speech, and may have many years experience with cleft, but without formal education/training
- (Other combinations/situations)

## Diagnosis

- Which diagnoses are made by the SLP/equivalent carrying out the evaluation, and which by other members of the team:
- Cleft diagnosis
- Occlusion
- Fistula

## Conclusion

- To what extent is consistency in evaluation materials/procedures necessary, and to what extent might the system allow for flexibility in evaluation materials/procedures?