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Hypernasality is one of the major speech errors in children with cleft lip and palate even after surgical correction. Hypernasality can be evaluated subjectively as well as objectively. Rating hypernasality perceptually is universally acknowledged as one of the difficult task which requires considerable amount experience in the field of cleft lip and palate. However, this method carries inherent limitations that the finer degrees of speech variation are difficult to assess subjectively and both speaker as well as listener variables have the potential to influence the speech ratings. Objective assessments supplement subjective assessments and play a major role in the evaluation of articulation errors in children with CLP. Nasometer (Kay Elemetrics) is a largely used microphone-computer based system used for the registration of the nasalance values. In places which do not have the access of using a nasometer, it becomes difficult in evaluating the subjects with cleft lip and palate thus hampering the intervention program Thus it is required to know if the values obtained via subjective evaluation is similar to that obtained through the objective means of collecting data. Hence the present study explored the subjective and objective correlation of hypernasality in children with RCLP by comparing the perceptual rating of hypernasality with overall nasalance values of Nasometry. The present study also compared different degrees of severity of perceptually rated hypernasality with Nasometry scores obtained from different stimuli. The evaluation included 23 Kannada speaking children with repaired cleft lip and palate in the age range of six to twelve years. The hypernasality of all the children (10 mild, 10 moderate and 3 severe hypernasality) were perceptually rating using Henningsson's rating scale by three experienced speech-language pathologists. Nasometry recording was also done for the same subjects for (i)Vowels (ii) Words and (iii)Sentences. The final rating of overall hypernasality for each child is based on the consensus among the three judges. The Nasometry stimuli considered were vowels (3), words (20) and sentences (15). Spearman’s correlation was computed and revealed a high positive correlation (0.80) between the subjective and objective assessment. The different degrees of perceptually rated hypernasality were in a positive correlation with Nasometry scores of vowels (0.784), words (0.730), and sentences (0.684). Hence the present study concludes that the perceptual still hold good to be the gold standard for evaluation and also in places with remote access to instruments the investigator can bank on perceptual values but the requirement for objective assessment is also required which would allow us to quantify the data and keep track of the progress of the case during therapeutic management.
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