Speech Intervention Via Telepractice for Children With Repaired Cleft Palate

We will check speech accuracy using 16 test words or sounds for each target. To see how much someone improves, we will compare how many they say correctly after therapy to how many they said correctly before therapy. We calculate improvement by subtracting the number correct before therapy from the number correct after therapy, dividing that number by the total number of attempts, and then multiplying by 100 to get a percentage. Finally, we will compare the improvement percentages between the group that receives therapy online (telepractice) and the group that receives therapy in person (face-to-face).

Speech accuracy will be measured using 16 sentences for each target sound or speech goal. To calculate improvement, we will compare the number of sentences said correctly after therapy to the number said correctly before therapy. We subtract the "before" score from the "after" score, divide by the total number of attempts, and multiply by 100 to get a percentage improvement.

Perceptual accuracy (how correctly a child hears specific sounds or words) will be measured using 24 words for the target sound. To calculate improvement, we will compare the number of words correctly identified as correct or incorrect after therapy to the number of words correctly identified before therapy. We subtract the "before" score from the "after" score, divide by the total number of attempts, and multiply by 100 to get a percentage improvement. Each child's overall improvement score will then be calculated by averaging their results across targets.

Functional outcomes (how well a child is understood in everyday situations) will be measured using the Intelligibility in Context Scale (ICS). This is a short questionnaire completed by parents about how easily their child is understood by different people. Improvement will be calculated by comparing the parent ratings after therapy to the ratings before therapy. The difference between these two scores will show how much progress was made. We will compare results between children who received therapy online (telepractice) and those who received therapy in person (face-to-face).

We will measure how clearly children distinguish between the "s" sound (/s/) and the "sh" sound (/ʃ/) in different vowel contexts. To do this, children will repeat made-up words that follow a simple pattern (consonant-vowel-b), such as "soob." These words will include three different vowels: "ee" (i), "ah" (a), and "oo" (u). Each word will be said within a short sentence, such as "It's the soob again," during a repetition task. We will use a sound measurement called an F-ratio to compare the acoustic differences between the "s" and "sh" sounds for each vowel. This ratio is calculated by comparing the median frequency values of the two sounds within each vowel context. The overall F-ratio results for all participants combined will then be compared from before therapy (pre-test) to after therapy (post-test) to see whether the contrast between the sounds improved.