Study participation is not expected to take more than 35 minutes maximum.

Data collection will be completed during routine speech evaluations if possible. If not possible, participants will be asked to visit our lab for data collection. Assessments completed for clinic will not be replicated for this study. The following procedures will be completed…

Laryngeal Aerodynamic Assessment: These assessments are routinely carried out in ENT clinics and take under 10 minutes. Participants will be asked to repeat strings of the sound /pa/ (i.e., /pa pa pa pa pa/) into a small portable mask, which will record airflow and pressure as children phonate. They will be asked to produce this stimuli until 5 correct productions have been recorded. They will be asked to produce these stimuli at normal vocal loudness and will hear examples of correct productions. They will also be asked to produce similar strings of the sounds /pi/ at the softest vocal intensity possible without whispering. Again, 5 correct productions will be recorded. Participants will be asked to wear temporary nose plugs during the task.

Acoustics: Participants may also be asked to repeat several short sentences and prolonged vowels into a microphone for audio recordings. These will be recorded via microphone for audio only. This procedure is often completed as part of standard evaluations but will be recorded at higher quality for study purposes. This takes around 5 minutes.

Respiratory Kinematics: Children will be asked to breathe in and out, as well as speak sentences, with respiratory bands around their chest and abdomen. This takes around 10 minutes.

Resonance: Participants may be asked to repeat several short sentences into a microphone attached to a small plate. This will take under 5 minutes.

Voice effects on Life: Participants will be asked to complete several previously validated questionnaires. For children, <8 these will be completed by caregivers - and all children will have this option if needed. Questionnaires can also be read to participants if needed. These may be completed online or on paper copies.

Survey: Children with cleft palate only will be asked to complete a survey about their voice. If 13 to 17, they will complete this for themselves. If 12 or younger, they will have a caregiver complete it for them. The survey can be completed on site or later at home.

Information taken from routine speech evaluations (only for patients seen in clinic, not for controls): The following assessments are a routine part of care in speech evaluations for children with cleft palate or velopharyngeal insufficiency. Data from assessments performed as part of the child’s routine care will be gathered. These assessments include articulation testing, intelligibility ratings, Nasometer testing, and auditory-perceptual ratings of resonance. These assessments will not be performed solely for research purchases, but as part of clinical care. Basic patient demographics such as age, sex, and voice or cleft related diagnosis will also be gathered.

Study procedures will be similar across patients and controls except that controls will not have their medical records accessed. Additionally, only children with cleft palate will have their parents surveyed.