Authors (including presenting author) :
Yiu OY (1)(2), Tso WYW (2), Ip P (2).
Affiliation :
(1) Speech Therapy Unit, Allied Health Department, Hong Kong Children's Hospital. (2) Department of Paediatrics and Adolescent Medicine, The University of Hong Kong.
Introduction :
Effective communication plays a crucial role in an individual's quality of life, particularly for children facing speech sound disorders. Timely speech therapy intervention is vital for these children to improve their communication skills and overall well-being. However, identifying which patients would benefit most from such interventions remains a challenge. Currently, there is no standardized screening tool to effectively triage patients. Additionally, current outcome measures mainly concentrate on speech impairments, neglecting the wider context of quality of life. This highlights the necessity for a more comprehensive approach that integrates both speech assessment and its impact on quality of life, allowing for tailored interventions that address the holistic needs of patients.
Objectives :
This study has two main objectives: first, to identify screening tools that can evaluate speech and quality of life; and second, to investigate the relationship between speech understandability and quality of life within our local community. By establishing this connection, we hope to promote the inclusion of quality of life metrics in the outcome measures for speech therapy, ensuring that interventions not only enhance speech but also contribute positively to the overall well-being of patients.
Methodology :
In this study, 24 patients with cleft lip and palate, along with their parents, participated by completing questionnaires that evaluated quality of life using the Pediatric Quality of Life Inventory (PedsQL 4.0). This inventory includes 23 ordinal response questions categorized into different domains related to physical and psychological health, and it can be completed as both a child self-report and a parent-proxy report. The parents also filled out the Intelligibility Context Scale (ICS), which measures how understandable children's speech is in various situations through seven ordinal response questions. Furthermore, each patient underwent a perceptual speech assessment conducted by a speech therapist, who assigned a 4-point speech understandability rating based on the Cantonese-Cleft Speech Assessment Tool. The study aimed to identify correlations between the speech understandability ratings given by the speech therapist and those reported by parents using the ICS, as well as the relationship between the ICS scores and the quality of life measurements.
Result & Outcome :
The analysis revealed a moderate correlation between the ICS scores and the perceptual speech ratings provided by the speech therapist, assessed using Pearson correlation (r(23) = -0.4016, p=.0521), confirming the ICS's validity as a tool for profiling patients' speech understandability. Additionally, the ICS scores were found to be associated with the quality of life in the parent-proxy report, analyzed with Spearman's rho correlation, and more significantly for psychological health scores (r(23) = .585, p=.003), while no significant correlation was noted with the children's self-reported quality of life.
These findings indicate that the ICS can be an effective screening tool for identifying children who may require speech therapy to improve their understandability. The ICS scores can help triage patients into different waiting times; lower scores indicate a greater need for intervention and are associated with a more significant impact on the child’s quality of life. Additionally, while the current study focused on patients with cleft lip and palate, there is potential for expanding the application of the ICS to other populations with speech sound disorders. Finally, including quality of life as a outcome measure will improve the assessment of intervention effectiveness, ensuring that both speech function and overall quality of life are considered during treatment planning.
