Concordance during identification of /k/ and /g/ in cleft lip and palate in different speech stimuli

Abstract

Introduction: Children with cleft lip and palate (CLP) can use compensatory articulation during speech.  The stimuli used for ratings atypical articulatory productions can affect examiners’ agreement during identification of glottal stops. Purposes: To establish the correlation between auditory-perceptual ratings by speech-language-pathologists (SLP) and a golden-standard rating of use of /k/ and /g/ produced by children with operated CP during production of single words, carrier phrases and phrases with recurrence of targets. Method: This prospective study involved ratings of 420 recordings of speech samples produced by six children, three with operated cleft lip and palate or operated cleft palate and three controls. The speech stimuli consisted of single words (SW), carrier phrases (CP) and phrases with recurrence of velar consonants (PR). Five SLPs performed auditory-perceptual ratings to identify if they heard use of glottal stop, omission of target consonants or adequate production.  Agreement between the SLPs and a golden-standard rating was established. Results: The degree of agreement between the SLPs and the golden-standard rating varied according to the speech stimuli (SW = 69%, CP= 79% and PR = 98%, with Kappa statistics ranging from substantial to almost perfect). When taking into account the type of response the agreement was greater for “presence of glottal stop”, particularly for PR. Conclusion: Levels of agreement for perceptual judgments of speech recordings varied according to the stimuli. The use of phrases with recurrence of the target consonant had the best agreement.