Articulatory competence in young adults with repaired cleft lip and palate

Abstract Background Cleft Lip and Palate (CLP) is a congenital condition often linked with hypernasality and compensatory articulation. Perceptual speech rating, such as Universal Parameters for Reporting Speech Outcomes in Individuals with Cleft Palate, is the gold standard but lacks quantification of errors. Due to India’s diverse linguistic context and a shortage of trained professionals, using these scales can be challenging. Therefore, reliable speech evaluation methods are crucial. Articulatory competence matrix (ACM), which is a broader, conceptual framework that includes the percentage of vowels correct (PVC), percentage of consonants correct (PCC), relative distortion index (RDI), and articulation competence index (ACI)—provides a comprehensive, quantitative assessment of articulation. This study investigates whether ACM and its components can effectively quantify articulatory skills in individuals with CLP. Methods Sixty native Indian language speakers aged 18–25 were divided into two groups: RCLP-YA (Young Adults with Repaired Cleft Lip and Palate) and T-YA (Typical Young Adults). Speech samples from articulation tests and narration tasks were recorded, transcribed, and analyzed for PCC, PVC, RDI, ACI, and Speech Understandability (SU). Inter-rater reliability and statistical analyses were conducted. Results Significant differences were observed between RCLP-YA and T-YA groups across all components of ACM, with median scores for PCC, PVC, ACI, and RDI differing significantly from control values. Inter-rater reliability was high (ICC range = 0.78–1.00). A strong negative correlation was found between SU and PCC ( ρ = − 0.93), PVC ( ρ = − 0.75), and ACI ( ρ = − 0.96), while RDI showed no significant correlation ( ρ = − 0.24, p = 0.18). A significant association was also found between ACM components and SU ( χ 2 = 42.85, p < 0.001). Conclusion ACM metrics effectively quantify articulatory skills in individuals with CLP. Unlike perceptual scales, ACM offers a quantitative baseline for monitoring progress and evaluating treatment efficacy, providing a robust framework for assessing CLP-related speech disorders.