The cleft audit protocol for speech-augmented: A validated and reliable measure for auditing cleft speech

Area of Science:

• Speech-language pathology
• Craniofacial anomalies
• Clinical assessment tools

Background:

• Cleft speech assessment requires standardized tools for reliable intercenter audits.
• Existing measures may not capture all essential speech outcomes.
• A systematic approach is needed to indicate treatment needs and ongoing care burden.

Purpose of the Study:

• To develop and validate the Cleft Audit Protocol for Speech-Augmented (CAPS-A).
• To assess the acceptability, validity, and reliability of CAPS-A for cleft speech audits.
• To establish a tool for systematic recording and reporting of speech outcomes.

Main Methods:

• Development of CAPS-A by cleft speech experts, incorporating key features from existing measures.
• Criterion validity assessed by comparing CAPS-A outcomes with clinical assessments in 20 cases.
• Intra- and interrater reliability tested with specialist speech and language therapists assessing 10 cases.

Main Results:

• Criterion validity showed high agreement (mean 87%, range 70-100%).
• Intra- and interexaminer reliability were good/very good (Kappa 0.61-1.00) for most sections, moderate (Kappa 0.41-0.60) for others.
• The CAPS-A tool was reported as acceptable and easy to use post-training.

Conclusions:

• The developed CAPS-A is an acceptable, valid, and reliable tool for cleft speech audits.
• CAPS-A is recommended for intercenter studies in the UK and Ireland, with potential use in other English-speaking regions.
• The tool has broader applicability for reporting speech outcomes post-surgery.