Investigating the Effects of Glottal Stop Productions on Voice in Children With Cleft Palate Using Multidimensional Voice Assessment Methods

J Voice. 2016 Nov;30(6):763.e9-763.e15. doi: 10.1016/j.jvoice.2015.10.007. Epub 2015 Dec 28.

Abstract

Objectives: The aim was to investigate the effects of glottal stop productions (GS) on voice in children with cleft palate using multidimensional voice assessment methods.

Study design: This is a prospective case-control study.

Methods: Children with repaired cleft palate (n = 34) who did not have any vocal fold lesions were separated into two groups based on the results of the articulation test. The glottal stop group (GSG) consisted of 17 children who had GS. The control group (CG) consisted of an equal number of age- and gender-matched children who did not have GS. The voice evaluation protocol included acoustic analysis, Pediatric Voice Handicap Index (pVHI), and perceptual analysis (Grade, Roughness, Breathiness, Asthenia, Strain method). The velopharyngeal statuses of the groups were compared using the nasopharyngoscopy and the nasometer.

Results: The total pVHI score and the subscales of the pVHI were found to be significantly higher in the GSG. The F0, jitter, and shimmer were found to be numerically higher in the GSG with the difference being statistically significant in jitter (P < 0.05). Audioperceptual analysis revealed a difference in overall voice quality and roughness between the groups. Greater incidence of significant velopharyngeal insufficiency and higher nasalance scores were found in the GSG (P < 0.05).

Conclusions: These results may indicate that the vocal quality characteristics of children with GS differ from children who do not have this type of production. It is suggested that children with cleft palate who have GS should receive a comprehensive speech and language pathology intervention including voice therapy techniques.

Keywords: Cleft palate; Dysphonia; Glottal stop; Laryngeal compensation; Velopharyngeal insufficiency.

MeSH terms

  • Acoustics
  • Age Factors
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cleft Palate / complications*
  • Cleft Palate / diagnosis
  • Cleft Palate / physiopathology
  • Cleft Palate / surgery
  • Disability Evaluation
  • Dysphonia / diagnosis
  • Dysphonia / etiology*
  • Dysphonia / physiopathology
  • Female
  • Glottis / physiopathology*
  • Humans
  • Judgment
  • Laryngoscopy
  • Male
  • Prospective Studies
  • Speech Acoustics*
  • Speech Perception
  • Speech Production Measurement
  • Speech Therapy
  • Speech-Language Pathology / methods
  • Video Recording
  • Voice Quality*