Speech in adults treated for unilateral cleft lip and palate as rated by naive listeners, speech-language pathologists, and patients

Speech may be affected in patients with cleft lip and palate (CLP). Professional listeners, naive listeners, and patients may perceive speech differently. The aim of the study was to assess speech among adults treated for unilateral CLP (UCLP) as rated by naive listeners, speech-language pathologists (SLPs), and self-assessment and to evaluate how well these ratings correlate. All patients with complete UCLP treated at the Uppsala University Hospital, Uppsala, Sweden, in 1960-1987 were invited. A total of 73 of 109 patients (67%) participated, with a mean of 35 years since the initiation of treatment. The noncleft control group consisted of 55 volunteers. All participants answered questionnaires for self-rating of speech, and their speech was audio-recorded digitally. Fourteen naive listeners and four SLPs rated the speech individually from blinded recordings. There were more speech abnormalities among patients compared to controls according to the ratings of naive listeners and SLPs. In controls and patients, there were positive correlations between the speech ratings by naive listeners and SLPs r = 0.44 to 0.71, p < 0.001, Spearman). The patients were less satisfied and rated to have more speech abnormalities than controls (p < 0.001). Although adults treated for UCLP considered their speech as fairly good, they were less satisfied than noncleft controls. The agreement between ratings by naive listeners and SLPs were good, while the agreement between these ratings and self-assessment varied widely. When assessing speech in adults treated for UCLP, differences in perception of speech abnormalities by professionals, laymen, and patients should be considered. (c) 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd.