title: The Americleft Speech Project: A Training and Reliability Study.
abstract: To describe the results of two reliability studies and to assess the effect of training on interrater reliability scores.
  
  
  
  The first study (1) examined interrater and intrarater reliability scores (weighted and unweighted kappas) and (2) compared interrater reliability scores before and after training on the use of the Cleft Audit Protocol for Speech-Augmented (CAPS-A) with British English-speaking children. The second study examined interrater and intrarater reliability on a modified version of the CAPS-A (CAPS-A Americleft Modification) with American and Canadian English-speaking children. Finally, comparisons were made between the interrater and intrarater reliability scores obtained for Study 1 and Study 2.
  
  
  
  The participants were speech-language pathologists from the Americleft Speech Project.
  
  
  
  In Study 1, interrater reliability scores improved for 6 of the 13 parameters following training on the CAPS-A protocol. Comparison of the reliability results for the two studies indicated lower scores for Study 2 compared with Study 1. However, this appeared to be an artifact of the kappa statistic that occurred due to insufficient variability in the reliability samples for Study 2. When percent agreement scores were also calculated, the ratings appeared similar across Study 1 and Study 2.
  
  
  
  The findings of this study suggested that improvements in interrater reliability could be obtained following a program of systematic training. However, improvements were not uniform across all parameters. Acceptable levels of reliability were achieved for those parameters most important for evaluation of velopharyngeal function.
authors.forename: Kathy L
authors.initials: KL
authors.lastname: Chapman
authors.forename: Adriane
authors.initials: A
authors.lastname: Baylis
authors.forename: Judith
authors.initials: J
authors.lastname: Trost-Cardamone
authors.forename: Kelly Nett
authors.initials: KN
authors.lastname: Cordero
authors.forename: Angela
authors.initials: A
authors.lastname: Dixon
authors.forename: Cindy
authors.initials: C
authors.lastname: Dobbelsteyn
authors.forename: Anna
authors.initials: A
authors.lastname: Thurmes
authors.forename: Kristina
authors.initials: K
authors.lastname: Wilson
authors.forename: Anne
authors.initials: A
authors.lastname: Harding-Bell
authors.forename: Triona
authors.initials: T
authors.lastname: Sweeney
authors.forename: Gregory
authors.initials: G
authors.lastname: Stoddard
authors.forename: Debbie
authors.initials: D
authors.lastname: Sell
mesh_terms: D002972:Cleft Palate / Q000150:complications*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D010700:Phonetics; D015203:Reproducibility of Results; D013064:Speech Disorders / Q000175:diagnosis* / Q000628:therapy*; D013068:Speech Production Measurement; D013066:Speech-Language Pathology / Q000193:education*
keywords: Americleft; cleft palate; listener agreement; listener reliability; perceptual ratings; speech outcome; training