title: Validity of auditory perceptual assessment of velopharyngeal function and dysfunction - the VPC-Sum and the VPC-Rate.
abstract: Overall weighted or composite variables for perceptual auditory estimation of velopharyngeal closure or competence have been used in several studies for evaluation of velopharyngeal function during speech. The aim of the present study was to investigate the validity of a composite score (VPC-Sum) and of auditory perceptual ratings of velopharyngeal competence (VPC-Rate). Available VPC-Sum scores and judgments of associated variables (hypernasality, audible nasal air leakage, weak pressure consonants, and non-oral articulation) from 391 5-year olds with repaired cleft palate (the Scandcleft project) were used to investigate content validity, and 339 of these were compared with an overall judgment of velopharyngeal competence (VPC-Rate) on the same patients by the same listeners. Significant positive correlations were found between the VPC-Sum and each of the associated variables (Cronbachs alpha 0.55-0.87, P < 0.001), and a moderately significant positive correlation between VPC-Sum and VPC-Rate (Rho 0.698, P < 0.01). The latter classified cases well when VPC-Sum was dichotomized with 67% predicted velopharyngeal competence and 90% velopharyngeal incompetence. The validity of the VPC-Sum was good and the VPC-Rate a good predictor, suggesting possible use of both measures depending on the objective.
authors.affiliation: a Division of Speech and Language Pathology , Karolinska Institutet, and Functional Area Speech and Language Pathology, Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Anette
authors.identifier: http://orcid.org/0000-0003-0951-4908
authors.initials: A
authors.lastname: Lohmander
authors.affiliation: a Division of Speech and Language Pathology , Karolinska Institutet, and Functional Area Speech and Language Pathology, Karolinska University Hospital , Stockholm , Sweden.|b Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Emilie
authors.initials: E
authors.lastname: Hagberg
authors.affiliation: c Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, and Division of Speech and Language Pathology , Sahlgrenska University Hospital , Gothenburg , Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Persson
authors.affiliation: d Department of Nordic Studies and Linguistics , University of Copenhagen , Copenhagen , Denmark.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Willadsen
authors.affiliation: e Division of Speech and Language Pathology , Linköping University , Linköping , Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Lundeborg
authors.affiliation: f Greater Manchester Cleft Unit , Royal Manchester Children's Hospital , Manchester , UK.
authors.forename: Julie
authors.initials: J
authors.lastname: Davies
authors.affiliation: g Division of Speech and Language Pathology , Sahlgrenska University Hospital , Gothenburg , Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Havstam
authors.affiliation: h Copenhagen Cleft Palate Center , University Hospital of Copenhagen , Copenhagen , Denmark.
authors.forename: Maria
authors.initials: M
authors.lastname: Boers
authors.affiliation: i Cleft Palate Center , Aarhus , Copenhagen, Denmark.
authors.forename: Mia
authors.initials: M
authors.lastname: Kisling-Møller
authors.affiliation: j Cleft Palate and Craniofacial Center , Helsinki University Central Hospital , Helsinki , Finland.
authors.forename: Suvi
authors.initials: S
authors.lastname: Alaluusua
authors.affiliation: k Statped Sørøst , Oslo , Norway.
authors.forename: Ragnhild
authors.initials: R
authors.lastname: Aukner
authors.affiliation: l Statped Vest , Bergen , Norway.
authors.forename: Nina Helen
authors.initials: NH
authors.lastname: Pedersen
authors.affiliation: j Cleft Palate and Craniofacial Center , Helsinki University Central Hospital , Helsinki , Finland.
authors.forename: Leena
authors.initials: L
authors.lastname: Turunen
authors.affiliation: a Division of Speech and Language Pathology , Karolinska Institutet, and Functional Area Speech and Language Pathology, Karolinska University Hospital , Stockholm , Sweden.|b Stockholm Craniofacial Team , Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Jill
authors.initials: J
authors.lastname: Nyberg
mesh_terms: D001307:Auditory Perception; D002648:Child; D002972:Cleft Palate; D005260:Female; D006801:Humans; D008297:Male; D010614:Pharynx / Q000601:surgery*; D015203:Reproducibility of Results; D013060:Speech; D014681:Velopharyngeal Insufficiency / Q000503:physiopathology*
keywords: Audible nasal emission; VPI symptom; hypernasality; velopharyngeal closure; velopharyngeal competence; velopharyngeal impairment