Electronic Thesis and Dissertation Repository


Doctor of Philosophy


Health and Rehabilitation Sciences


Drs. Philip C. Doyle

2nd Supervisor

Elizabeth Skarakis-Doyle

Joint Supervisor


Myriad findings on children with velopharyngeal insufficiency (VPI) indicate the potential for this population of children to experience feelings of apprehension specific to communication and the potential for other psychological and social difficulties. The purpose of the present investigation was to explore the construct of communication apprehension (CA) and its potential relationship to social and communicative functioning in a diverse group of children with VPI. Potential linkages between CA and multiple socio-communicative constructs including attitude, speech satisfaction, speech and language skill, social competence, and speech severity were explored in a cohort of children with and without VPI, followed by an in-depth exploration of these interrelationships within the VPI group.

Two groups of children between the ages of 7 and 14 years participated in this prospective comparative study; 20 children who presented with VPI and 20 typically developing children without VPI. Children completed a battery of questionnaires: The Measure of Elementary Communication Apprehension (Revised) (MECA-R), the Communication Attitude Test (CAT), and the Speech Satisfaction measure (SS). In addition, parents of study participants completed the Social Competence Scale (SC) of the Home and Communication Social Behavior Scales (HCSBS), and (for parents of children with VPI), the Children’s Communication Checklist-Second Edition (CCC-2). Finally, perceptual evaluations of the speech characteristics of children with VPI were also gathered.

Children with VPI reported higher CA than did the typically developing children. Correlational analyses revealed expected relationships between CA and social and communicative functioning for the combined cohort of children, but not so for the VPI group alone. However, significant relationships between communication attitude and social-communicative constructs were identified for both the combined cohort data and the VPI group only data. Unexpectedly, results of the present study found that communication attitude, rather than CA, was more strongly related to the functional abilities examined for both the combined cohort of children and children with VPI alone. Results of the present study suggest the presence of great variability in the social and communicative functioning of children with VPI. As such, comprehensive, yet individualized clinical assessments of social and communicative profiles of children with VPI should be sought in this clinical population.