title: Current practice in assessing and reporting speech outcomes of cleft palate and velopharyngeal surgery: a survey of cleft palate/craniofacial professionals.
abstract: OBJECTIVE
  To determine methods by which professionals serving cleft palate/craniofacial teams are evaluating velopharyngeal function and to ascertain what they consider as a successful speech outcome of surgery.
  
  
  METHODS
  A 12-question survey was developed for professionals involved in management of velopharyngeal dysfunction.
  
  
  METHODS
  The survey was distributed through E-mail lists for the American Cleft Palate-Craniofacial Association and Division 5 of the American Speech-Language-Hearing Association. Only speech-language pathologists and surgeons were asked to complete the survey. A total of 126 questionnaires were completed online.
  
  
  RESULTS
  Standard speech evaluations include perceptual evaluation (99.2%), intraoral examination (96.8%), nasopharyngoscopy (59.3%), nasometry (28.9%), videofluoroscopy (19.2%), and aerodynamic measures (4.3%). Significant variation existed in the types and levels of perceptual rating scales. Pharyngeal flap (52.9%) is the most commonly performed procedure for velopharyngeal insufficiency, followed by sphincter pharyngoplasty (27.5%). Criteria for surgical success included normal speech (50.8%), acceptable speech (27.9%), and "improved" speech (8%). However, most respondents felt that success should be defined as normal speech (71.2%). Most respondents believed that surgical success should be determined by the team speech-language pathologist (81.5%); although, some felt success should be determined by the patient/family (17.7%).
  
  
  CONCLUSIONS
  This survey shows considerable variability in the methods for evaluating and reporting speech outcomes following surgery. There is inconsistency in what is considered a successful surgical outcome, making comparison studies impossible. Most respondents thought that success should be defined as normal speech, but this is not happening in current practice.
authors.affiliation: Division of Speech Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA. ann.kummer@cchmc.org
authors.forename: Ann W
authors.initials: AW
authors.lastname: Kummer
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Clark
authors.forename: Erin E
authors.initials: EE
authors.lastname: Redle
authors.forename: Leisa L
authors.initials: LL
authors.lastname: Thomsen
authors.forename: David A
authors.initials: DA
authors.lastname: Billmire
mesh_terms: D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013060:Speech; D011795:Surveys and Questionnaires; D014481:United States; D014681:Velopharyngeal Insufficiency / Q000601:surgery*