A Comparison and Correlation Analysis of Voice Measures according to the Presence of Compensatory Articulation in Children with Cleft Palate

Objectives: This study aimed to compare voice measurements between children with cleft palate (CP) based on the presence of compensatory articulation (CA), to examine the correlations among acoustic, perceptual, and nasalance scores, and to investigate differences in acoustic measures across vowel contexts. Methods: The study was conducted retrospectively on 22 children aged 4-5 years: 14 children with CP exhibiting CA and 8 children with CP not exhibiting CA. Acoustic measurements, including cepstral peak prominence (CPP), L/H spectral ratio (SR), mean fundamental frequency (F0), F0 range in semitones, and nasalance scores were analyzed, and the GRBAS scale was evaluated. Results: Children with CP exhibiting CA showed significantly higher SR<sub>max</sub>, Mean F0, and nasalance scores; and were perceptually rated higher in the Grade and Rough. Correlations among the measurements revealed that nasalance scores were positively correlated with Grade and Roughness. Breathiness was positively correlated with Grade, Roughness, and mean F0, and SR showed a negative correlation with Breathy and Mean F0. Acoustic measurements for CPP and SR were highest in the low vowel context, followed by the mixed vowel context and the high vowel context. Conclusion: This study suggests that reduced voice quality was perceived in children with CA, and some acoustic measures reflected its characteristics. However, acoustic analysis alone was limited in examining the voice quality of children with CP, emphasizing the need for multidimensional evaluation that considers vowel contexts.