Age-Related Changes in Perceived Nasal Resonance of Young Children With Repaired Cleft Palate: A Paired-Comparison Study

Objective: The primary objective was to determine age-related changes in perceived nasal resonance of young children with repaired cleft palate with or without cleft lip (CP ± L). A secondary objective was to explore associated changes in vowel segment duration, speaking rate, and fundamental frequency (F0) of the children. Design: Prospective, longitudinal observational. Setting and Participants: Twenty children with non-syndromic CP ± L followed at 3 facilities. Materials and Methods: All participants were audio recorded repeating identical speech samples at 3 time points corresponding to mean ages of 6, 7, and 8 years. Sixty audio files were created with counterbalanced pairs of recordings from the 3 time points. Five blinded speech-language pathologists judged which sample of a pair sounded more nasal. Main Outcome Measures: Paired-comparison judgments of nasality at each age; vowel duration, speaking rate, and F0 at each age derived from acoustic analysis. Results: Speech samples from the youngest age were judged as more nasal more often than samples from the older ages ( P < .001). There were decreases in vowel duration ( P = .021) and F0 ( P = .006) along with an increase in speaking rate ( P < .001) as function of age. Conclusions: Children with repaired CP ± L are perceived to be more nasal at younger ages during production of phonetically identical speech samples. Clinicians need to be cognizant of age-related changes in other aspects of speech production that may influence judgments of nasal resonance.