"Can You Understand Me Now?": The Use of Direct Magnitude Estimation Scales in Telepractice Speech Therapy with Clients with Repaired Cleft Palate




Womble, Emma Madison

Journal Title

Journal ISSN

Volume Title



Likert scales require respondents to select a rating based on pre-determined categories. An assumption is made that all respondents view the categories similarly. The Direct Magnitude Estimation Scale (DMES) allows respondents to create their own categories, which leads to increased sensitivity of the measured concept (Meek, Sennott-Miller, & Ferketich, 1992).With the DMES, it is not assumed that everyone shares the same definitions of categories (Meek et al, 1992). With the lack of forced categories there is opportunity for the DMES to detect variation that may not have been detected on a Likert scale (Beltyukova, Stone, & Ellis 2008). Children who have a repaired cleft palate can be difficult to understand. For children with a repaired cleft palate, progress during speech therapy can be slow but steady. With the DMES, people are not forced into categories that might not capture the slow and steady progress of the child. By allowing the clinician working with the child with a repaired cleft palate, the DMES has the potential to document the slow and steady progress more precisely. Student clinicians provided speech therapy to children with a repaired cleft palate under the supervision of a certified bilingual speech-language pathologist. Student clinicians used the DMES to rate each child’s speech after each speech therapy session, as part of a larger study. After the student clinicians rated each child, the DMES for each session were compared to determine if there was evidence of progress by each child. The pilot data suggest that graduate student clinicians can document the progress of their client’s overall intelligibility and target phonemes. The DMES have the potential to be used by other speech language pathologists who may not be familiar with the Likert scale or for who the Likert scale is not culturally appropriate. For example, speech language pathologists or professionals who live in other countries could implement the DMES to track the progress of their clients.



telepractice, speech therapy, direct magnitude, estimation scales, progress, documenting, cleft palate, Honors College


Womble, E. M. (2020). "Can you understand me now?": The use of direct magnitude estimation scales in telepractice speech therapy with clients with repaired cleft palate (Unpublished thesis). Texas State University, San Marcos, Texas.


Rights Holder

Rights License

Rights URI