An inter-center comparison of speech outcomes: The Americleft project

描述（由申请人提供）：腭裂影响儿童的言语，语言和听力;外观;闭塞和心理社会功能。尽管多年的研究试图确定最好的治疗方案，为儿童与裂缝，仍然有很多争论，哪些治疗产生最好的结果。为了提高治疗腭裂伴或不伴唇裂（CP+L）儿童的证据质量，许多来源表明，中心间研究提供了一种判断单个中心治疗方案总体结果的方法。在欧洲进行了许多非常成功的中心间研究（例如，EUROCLEFT; SCANCLEFT），导致治疗方案发生重大变化。最近，一群心理学家发表了一系列北美中心的中心间比较：美国左派研究。拟议的前瞻性研究的目的是比较美国三个不同的腭裂/颅面中心之间的语音结果，试图确定与更好的语音结果相关的治疗方案。180名5岁和6岁CP+L儿童（每个研究中心60名）和60名健康、典型发育的无CP+L儿童将参加本研究。所有在2006年8月1日至2010年6月31日期间出生并在三个中心之一接受腭部手术的儿童都将被要求参加。作为每年团队访问的一部分，将使用为此目的制定的标准协议对儿童进行评估。视频记录的样本将被发送到一个中央位置进行编辑，并张贴在一个安全的网站上进行评级。将由经过培训的言语-语言病理学家（SLP）对可接受性、鼻音过重和言语产生进行盲态评级。将要求评定者判断是否需要额外的咽功能评估或言语干预。将在三个中心之间以及三组CP+L儿童和非CP+L儿童之间进行比较。该项目还将提供成功率的基准，中心可以用来判断他们的结果。本研究的发现有可能减轻腭裂对腭裂儿童生活质量、言语和心理社会功能的影响。

DESCRIPTION (provided by applicant): Palatal clefting impacts a child's speech, language, and hearing; appearance; occlusion, and psychosocial functioning. Despite years of research attempting to identify the best treatment protocols for children with clefts, there is still much debate about which treatments yield the best outcomes. In an attempt to improve the quality of evidence available for treatments for children with cleft palate with or without cleft lip (CP+L), number of sources have suggested that inter-center studies provide a way to judge the overall outcome of an individual center's treatment protocol. A number of very successful inter-center studies have been conducted in Europe (e.g., EUROCLEFT; SCANCLEFT), resulting in significant changes to treatment protocols. More recently, a group of orthodontists published a series of inter-center comparisons of North American centers: The Americleft Study. The aim of the proposed prospective study is to compare speech outcomes among three different Cleft Palate/Craniofacial Centers in the US in an attempt to identify treatment protocols that are associated with better speech outcomes. One-hundred eighty 5- and 6- year-old children with CP+L (60 per site) and 60 healthy, typically-developing children without CP+L will participate in the study. All children born between 8/1/06 and 6/31/10 who received palatal surgery at one of the three centers will be asked to participate. The children will be evaluated as part of their yearly team visits using a standard protocol developed for this purpose. The video recorded samples will be sent to a central location for editing and posting on a secure website for rating. Blinded ratings will be conducted by trained Speech-Language Pathologists (SLPs) acceptability, hypernasality, and speech production. The raters will be asked to judge whether additional evaluation of velopharyngeal function or speech intervention is needed. Comparisons will be made between the three centers and between each of the three groups of children with CP+L and children without CP+L. This project will also provide benchmarks for success rates that centers can use to judge their outcomes. The findings of this study have the potential to lessen the effects of clefting on quality of life, speech, and psychosocial functioning for childre with cleft palate.