Vocal characteristics of children with cleft lip/palate and associated velopharyngeal incompetence.

This investigation was designed to evaluate the relationship between aerodynamic measures of velopharyngeal competence and laryngeal function in individuals with repaired cleft palate. Twenty-seven cleft lip and palate or cleft palate individuals, between the ages of 4 and 16 years, were evaluated in an ENT clinic for assessment of vocal function. A commercially available aerodynamic (pressure/flow) system for evaluating velopharyngeal function was used to classify estimated opening of the velopharyngeal port during speech production. Aerodynamic measures of laryngeal function (transglottal pressure and airflow, and laryngeal airway resistance) were also collected. A computerized system for acoustic analyses of voice production was employed to determine vocal characteristics of pitch perturbation (jitter), amplitude perturbation (shimmer) and signal-to-noise ratio (SNR). The results suggested that the cleft speakers showed numerically larger measures of perturbation in the vocal signal, and greater laryngeal airway resistance than their normal controls. Subgroups of cleft palate speakers, based on their vocal dynamics, were proposed. Implications for medical and behavioral management for these subgroups are discussed.