A Scoping Review of Assessment Protocols of Cleft Palate Speech: Implications for Developing Language-Specific Protocols

Abstract

Objective

This scoping review has three aims: (1) to identify the most common and less frequently included features of existing cleft palate speech assessment protocols; (2) to examine the strengths and limitations of these protocols; and (3) to propose key considerations for developing language-specific cleft palate speech assessment protocols in regions where a standardized assessment protocol has not yet been established.

Design

A comprehensive search was conducted for cleft palate speech assessment protocols using published textbooks and five electronic databases: PubMed, CINAHL Ultimate, Scopus, PsycINFO, and Cochrane. After screening the abstract and full-texts, the reference list was also reviewed. Protocols were identified if they: (1) assessed cleft palate speech, (2) were published in a peer-reviewed journal or textbook, and (3) were available in English.

Main Outcome

Seventeen protocols were identified, comprising of 16 distinct assessment components. They were classified into three categories: core, peripheral, and low-frequency components. Core components, included in the majority of protocols, were resonance, nasal airflow, cleft-specific speech characteristics, articulation, and voice. Peripheral components, such as intelligibility, facial grimace, and language, appeared in more than half of the protocols. Low-frequency components, including hearing, were identified in only a few protocols.

Conclusion

Standard cleft speech assessment protocols should consistently include five core features. However, when developing language-specific protocols, it is essential to account for phonological, prosodic, phonotactic, and cultural characteristics of the target language. Doing so will enable more culturally and linguistically responsive assessment, improve diagnostic accuracy, and support better outcomes for children with cleft palate.