title: Investigating the Effects of Glottal Stop Productions on Voice in Children With Cleft Palate Using Multidimensional Voice Assessment Methods.
abstract: OBJECTIVE
  The aim was to investigate the effects of glottal stop productions (GS) on voice in children with cleft palate using multidimensional voice assessment methods.
  
  
  METHODS
  This is a prospective case-control study.
  
  
  METHODS
  Children with repaired cleft palate (n = 34) who did not have any vocal fold lesions were separated into two groups based on the results of the articulation test. The glottal stop group (GSG) consisted of 17 children who had GS. The control group (CG) consisted of an equal number of age- and gender-matched children who did not have GS. The voice evaluation protocol included acoustic analysis, Pediatric Voice Handicap Index (pVHI), and perceptual analysis (Grade, Roughness, Breathiness, Asthenia, Strain method). The velopharyngeal statuses of the groups were compared using the nasopharyngoscopy and the nasometer.
  
  
  RESULTS
  The total pVHI score and the subscales of the pVHI were found to be significantly higher in the GSG. The F0, jitter, and shimmer were found to be numerically higher in the GSG with the difference being statistically significant in jitter (P < 0.05). Audioperceptual analysis revealed a difference in overall voice quality and roughness between the groups. Greater incidence of significant velopharyngeal insufficiency and higher nasalance scores were found in the GSG (P < 0.05).
  
  
  CONCLUSIONS
  These results may indicate that the vocal quality characteristics of children with GS differ from children who do not have this type of production. It is suggested that children with cleft palate who have GS should receive a comprehensive speech and language pathology intervention including voice therapy techniques.
authors.affiliation: Department of Speech and Language Therapy, Hacettepe University Faculty of Health Sciences, Ankara, Turkey. Electronic address: fesen04@gmail.com.
authors.forename: Fatma Esen
authors.initials: FE
authors.lastname: Aydınlı
authors.affiliation: Department of Speech and Language Therapy, Hacettepe University Faculty of Health Sciences, Ankara, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Özcebe
authors.affiliation: Department of Speech and Language Therapy, Hacettepe University Faculty of Health Sciences, Ankara, Turkey.
authors.forename: Maviş E
authors.initials: ME
authors.lastname: Kulak Kayıkçı
authors.affiliation: Department of Otorhinolaryngology, Hacettepe University Medical Faculty, Ankara, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Yılmaz
authors.affiliation: Hacettepe University Medical Faculty, Ankara, Turkey.
authors.forename: Fatma F
authors.initials: FF
authors.lastname: Özgür
mesh_terms: D000162:Acoustics; D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D004185:Disability Evaluation; D055154:Dysphonia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005931:Glottis / Q000503:physiopathology*; D006801:Humans; D007600:Judgment; D007828:Laryngoscopy; D008297:Male; D011446:Prospective Studies; D013061:Speech Acoustics; D013067:Speech Perception; D013068:Speech Production Measurement; D013070:Speech Therapy; D013066:Speech-Language Pathology / Q000379:methods; D014741:Video Recording; D014833:Voice Quality
keywords: Cleft palate; Dysphonia; Glottal stop; Laryngeal compensation; Velopharyngeal insufficiency