title: Examination of the standard deviation of mean nasalance scores in subjects with cleft palate: implications for clinical use.
abstract: OBJECTIVE
  To evaluate the standard deviation of the nasalance scores in patients having normal and abnormal nasal resonance and to determine its potential value for clinical use. Additionally, the mean nasalance scores were examined across varying degrees of hypernasality.
  
  
  METHODS
  Prospective study design.
  
  
  METHODS
  Pediatric tertiary care hospital.
  
  
  METHODS
  One hundred and forty-eight subjects, ranging in age from 4;0 to 37;0 years, having repaired cleft lip and/or palate and normal resonance, inconsistent, mild, or moderate/severe hypernasality.
  
  
  METHODS
  Oral-nasal acoustic measurements were made using the Nasometer. The standard deviation and mean nasalance scores were calculated for subjects reading three standard passages (Zoo Passage. Rainbow Passage, Nasal Sentences).
  
  
  RESULTS
  The major finding in this study showed that the standard deviation score cannot distinguish speakers beyond a gross normal and abnormal resonance diagnostic category. The values obtained could not be used to distinguish among the varying degrees of hypernasality. A secondary finding was that a mean nasalance score in the high 20 s could be used to differentiate speakers with borderline velopharyngeal function from those who were non-nasal.
  
  
  CONCLUSIONS
  In general, the standard deviation value serves little overall clinical utility; however, it may be of benefit in some specific clinical situations. In support of previous research, the mean nasalance score continues to be the best measure of nasalance. It should serve as a supplement to but not a substitute for clinical judgments.
authors.affiliation: Cleft Lip and Palate Program, Hospital for Sick Children, Toronto, Canada.
authors.forename: L D
authors.initials: LD
authors.lastname: Vallino-Napoli
authors.forename: A A
authors.initials: AA
authors.lastname: Montgomery
mesh_terms: D000162:Acoustics; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000150:complications* / Q000601:surgery; D002972:Cleft Palate / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D009055:Mouth / Q000503:physiopathology; D009666:Nose / Q000503:physiopathology*; D015588:Observer Variation; D010160:Palate, Soft / Q000503:physiopathology; D010614:Pharynx / Q000503:physiopathology; D011446:Prospective Studies; D015203:Reproducibility of Results; D013060:Speech / Q000502:physiology*; D013064:Speech Disorders / Q000145:classification / Q000175:diagnosis* / Q000209:etiology; D013065:Speech Intelligibility / Q000502:physiology; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis / Q000209:etiology