Facial grimace during speech in cleft lip and palate: a proposal for classification.
Rafaeli Higa Scarmagnani, Ana Paula Fukushiro, Renata Paciello Yamashita
PMID 35019087WHAT IT FOUND
A proposed facial grimace classification did not show a clear agreement gain among raters of speech samples from people with repaired cleft palate.
Grimace ratings were moderately associated with velopharyngeal orifice size.
Key findings
01In 20 people with repaired cleft palate, the new facial grimace criteria produced higher inter-rater agreement than the raters' own criteria, but the difference was not significant.
02Facial grimace ratings correlated moderately and significantly with velopharyngeal orifice area measurement in both rating stages (r=0.550 first stage; r=0.553 second stage).
03Intra-rater agreement after the new criteria ranged from moderate to substantial, and two raters showed lower agreement than before, without significant differences.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The raters were not trained before the first rating stage, so the first ratings reflected their own clinical standards. The agreement gain after the new criteria was not statistically significant. Two raters became less consistent with themselves after using the new criteria, though the changes were not significant. The classification proposal was based on the authors' clinical experience. Subjective perceptual ratings can vary because raters' internal standards and condition affect judgments.
Declared interests
The study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP).
The easy way to misread this
Do not conclude that the new facial grimace classification significantly improved agreement among raters. The inter-rater agreement was higher after the new criteria, but the difference was not significant. Do not treat facial grimace rating as a replacement for instrumental assessment; its correlation with velopharyngeal orifice size was moderate.