Shima SOBHANI, Gholamreza BAYAZIAN, Nahid JALILEVAND, Arezoo SAFFARIAN, Leila GHELICHI
Turkish Journal of Plastic Surgery - 2026;34(4):152-159
Background: Velopharyngeal insufficiency (VPI) in patients with repaired cleft palate can result in resonance and speech disorders. Identifying and managing VPI requires a multidisciplinary team with an experienced speech and language pathologist (SLP) specializing in cleft palate, playing a crucial role in recognizing VPI and associated speech problems through perceptual assessment. This study aimed to develop a tool for documenting and scoring factors that contribute to evaluating VPI as well as assessing its validity and reliability. Materials and Methods: To identify the items for assessment through a perceptual assessment, a literature review was conducted. In addition, speech materials were created using simple sentences that included Persian consonants and vowels. Five experienced speech therapists specializing in cleft palate commented on 24 sentences and 7 items. The content validity ratio (CVR) and content validity index (CVI) of the sentences and items were calculated. Ninety individuals participated in the study, with 45 patients with cleft lip and palate (CLP) and 45 normal peers matched by age and gender. The Cronbach alpha was used to examine the internal consistency of the tool, while the kappa correlation coefficient was used to assess interrater reliability. The Mann-Whitney U-test was used for comparing groups. Differences with a P < 0.05 were deemed significant. Results: The CVR and CVI values for each sentence that was used in speech perceptual assessment were 1 and above 0.8, respectively, and all 7 items had a CVR of 1. The mean age of participants with CLP and normal individuals was 12.44 +/- 8.94 and 12.13 +/- 9.76 years, respectively. Furthermore, the Cronbach alpha coefficient was 0.756. The kappa coefficients for interrater agreement were between 0.887 and 1. Conclusions: The validity and reliability of the VPI assessment scale were in acceptable ranges.
