Velopharyngeal Insufficiency Effects on Life Outcomes -Parent (VELO-P) comparison of children who had secondary surgery and those who did not

Children with cleft lip and/or palate undergo an extensive series of surgical, orthodontic, speech, audiologic, genetic and medical assessments and treatments during their childhood. The purpose of this study was to examine the Velopharyngeal Insufficiency Effects on Life Outcomes – Parent (VELO-P) comparison of children who had surgery and those who did not in children 5 to 7 years old. The VELO is a quality-of-life questionnaire instrument consisting of 6 subscales, speech limitation, swallowing, situational difficulty, emotional impact, perception by others, and caregiver impact. We compared two groups of children with cleft lip and palate, those who had a secondary surgery for speech hypernasality and those who did not have secondary speech for hypernasality. It is predicted that those who had secondary surgery to repair speech hypernasality will be the group that will show a higher quality of life due to the effect the repair would have on improving their speech. The participants included 30 children between the ages of 5 to 7-years-old with cleft lip and/or palate. Ten of which were male and 20 were female. As for the cleft types, 14 had a unilateral cleft lip and palate, 3 had a bilateral cleft lip and palate, and 13 had a cleft palate only. Nineteen of the children did not have surgery for speech hypernasality and eleven did have surgery. The results of study indicated that the two groups differed significantly on total VELO scores (t=.773, p=0.046) indicating that children who did not have surgery had better quality of life than those who experienced speech hypernasality and had secondary surgery. While individual subscales did not show statistical significance, two subscales showed a moderate effect size difference; caregiver impact (d= .46) and emotional impact (d=.54), indicating that having a speech impairment that requires a secondary surgery may not repair the speech impairment to provide the child intelligible speech and therefore a higher quality of life.