Linguistic adaptation and preliminary psychometric evaluation of a Saudi Arabic version of the VELO questionnaire in children with repaired cleft palate

Introduction Velopharyngeal insufficiency (VPI) can affect speech, swallowing, and health-related quality of life (HRQoL) in children with cleft palate. This study reports the linguistic adaptation into Modern Standard Arabic for use in the Saudi context and a preliminary psychometric evaluation of the Velopharyngeal Insufficiency Effects on Life Outcomes (VELO) questionnaire. Methods Two independent bilingual Arabic–English researchers completed the forward translations. A native English-speaking translator fluent in Arabic completed the back-translation. Four speech-language pathologists reviewed the wording for linguistic clarity and appropriateness. Linguistic clarity was evaluated through an eight-item survey completed by ten parents, with feedback reviewed over two rounds. Complete parent-report VELO data were available for 29 children with repaired cleft palate and 40 controls; these participants comprised the primary parent-report sample. Youth analyses were restricted to participants with a verified age of 8–18 years at questionnaire completion (20 participants with cleft palate and 21 controls). Mann–Whitney U tests with Holm adjustment, Cliff's delta, and Cronbach's α were used. Results Parent total VELO scores were lower in the cleft-palate group than in controls (median 79.81 vs. 100.00; Holm-adjusted p < 0.001; Cliff's δ = −0.812); youth total scores were likewise lower (82.61 vs. 100.00; Holm-adjusted p < 0.001; Cliff's δ = −0.850). Parent total internal consistency was α = 0.931 ( n = 29), and youth total internal consistency was α = 0.912 ( n = 20); lower estimates were observed for youth swallowing (α = 0.618) and perception by others (α = 0.539). Discussion These findings provide preliminary evidence of internal consistency and known-groups differences between children with repaired cleft palate and the control group. Further studies in larger, more diverse samples should evaluate test–retest reliability, factor structure, cultural and measurement equivalence, administration-mode equivalence, and associations with objective measures of current VPI severity.