Logopedics Phoniatrics Vocology最新文献

Objectives: The present article aims to identify the optimal cutoff score and the diagnostic accuracy for the English version of Speech Handicap Index (SHI) to screen out individuals with and without speech disorders in daily life.

Materials and methods: In this cross-sectional cohort study, a volunteer sample of 104 adult patients after total laryngectomy and 99 healthy controls in the United States completed the English version of SHI online questionnaire. Sensitivity and specificity were computed for a range of cut-off values using the Receiving Operating Characteristics (ROC) analysis to establish an optimal cutoff point for the SHI. Other measures of diagnostic accuracy, such as likelihood ratios (LR), positive predictive values (PPV), and negative predictive values (NPV) were also computed.

Results: Patients after total laryngectomy obtained a higher score than the healthy controls on the mean scores of SHI. According to the ROC analysis, an optimal cutoff score of 17 points determined by Youden index was identified on the head and neck cancer population with a sensitivity of 92.31%, specificity of 92.31%, PPV of 90.60%, NPV of 91.75%, LR + of 9.14, and LR- of 0.09.

Conclusions: The cutoff score of the English version of SHI applied on the English-speaking population in the United States demonstrated promising diagnostic accuracy.

Aim: To longitudinally investigate speech production (consonant proficiency, consonant errors and perceived velopharyngeal competence) in 17 internationally adopted (IA) children with unilateral cleft lip and palate (UCLP) at three time points.

Method: Consonant proficiency (percent consonants correct, consonant inventory) and number and type of consonant errors were calculated based on blind phonetic transcriptions of words from the Swedish Test of Articulation and Nasality (SVANTE). Velopharyngeal competence was perceptually rated by three blinded experienced speech-language pathologists at the ages of 3, 5 and 7-8 years.

Results: A significant positive development of speech production was found, although most children still scored very low for consonant proficiency at the age of 7-8 compared with normative values: the median for percent consonants correct was 79.7 and many children still had persisting cleft-related and developmental consonant errors. At the age of 7-8, almost half of the children were rated as having a competent velopharyngeal function and only three as having an incompetent velopharyngeal function.

Conclusion: Persisting speech difficulties at school age in IA children with UCLP were found in the present study, which is one of the very few longitudinal studies. Our results highlight the need for detailed follow-up of speech production in clinical settings. Speech disorders may have a severe impact on a child's intelligibility and participation with peers, and there is a need for more studies investigating the actual everyday effect of the difficulties found.

Objective: Less attention has been paid to the interaction between voice disorders, stress, and indoor environmental quality for work ability in teachers. Therefore, our aim was to study whether lower work ability associated more strongly when the variables of voice disorders and stress at work were combined as opposed to evaluating these two factors separately.

Methods: We conducted a questionnaire study including validated self-assessment of work ability and a technical assessment of school buildings utilizing a sample of 1198 and a subsample (n = 538) of Finnish teachers.

Results: When combined, voice disorders and stress at work had a stronger association to decreased work ability than when they were evaluated separately. The occurrence of stress was more prevalent in poor and moderate work ability than the occurrence of voice disorders. Nine out of 10 of the teachers who had neither voice disorders nor stress reported good work ability, while four out of 10 of the teachers who suffered from both voice disorders and stress had poor work ability. As regards the background variables, nearly half of the subjects working in the non-problem buildings have neither stress nor voice disorders.

Discussion: We recommend offering support for reducing stress at work to improve teachers' work performance. The findings also support the maintenance of school buildings and keeping them in good condition. Follow-up studies are needed to investigate the possible effects of voice disorders and the associated variables on work ability.

Background: Although dysarthria and respiratory failure are widely described in literature as part of the natural history of Amyotrophic lateral sclerosis (ALS), the specific interaction between them has been little explored.Aim: To investigate the relationship between chronic respiratory failure and the speech of ALS patients.Materials and methods: In this cross-sectional retrospective study we reviewed the medical records of all patients diagnosed with ALS that were accompanied by a tertiary referral center. In order to determine the presence and degree of speech impairment, the Amyotrophic Lateral Sclerosis Functional Rating Scale-revised (ALSFRS-R) speech sub-scale was used. Respiratory function was assessed through spirometry and through venous blood gasometry obtained from a morning peripheral venous sample. To determine whether differences among groups classified by speech function were significant, maximum and mean spirometry values of participants were compared using multivariate analysis of variance (MANOVA) with Tukey's post hoc test.Results: Seventy-five cases were selected, of which 73.3% presented speech impairment and 70.7% respiratory impairment. Respiratory and speech functions were moderately correlated (seated FVC r = 0.64; supine FVC r = 0.60; seated FEV1 r = 0.59 and supine FEV1 r = 0.54, p < .001). Multivariable logistic regression revealed that the following variables were significantly associated with the presence of speech impairment after adjusting for other risk factors: seated FVC (odds ratio [OR] = 0.862) and seated FEV1 (OR = 1.106). The final model was 81.1% predictive of speech impairment. The presence of daytime hypercapnia was not correlated to increasing speech impairment.Conclusion: The restrictive pattern developed by ALS patients negatively influences speech function. Speech is a complex and multifactorial process, and lung volume presents a pivotal role in its function. Thus, we were able to find that lung volumes presented a significant correlation to speech function, especially in those with bulbar onset and respiratory impairment. Neurobiological and physiological aspects of this relationship should be explored in further studies with the ALS population.

Background: Data in national health care quality registries must be valid and reliable in order to enable open comparisons of results.

Aim: To assess the reliability of data on percent consonants correct (PCC) and its associated quality indicator ≥86% correct consonants in the Swedish quality registry for patients born with cleft lip and palate (CLP) registry.

Methods: Six independent speech-language pathologists re-assessed the audio recordings of 96 five-year-olds with PCC data in the CLP registry. Target consonants of a single-word picture-naming test were phonetically transcribed, and PCC was calculated. The reliability of PCC data was assessed with the intraclass correlation coefficient (ICC). The reliability of the quality indicator ≥86% correct consonants was assessed with point-by-point percentage agreement and Cohen's kappa.

Results: Intra- and inter-judge agreement for PCC was excellent with ICCs above 0.9, and so was the agreement of data from the CLP registry and the six judges' re-assessments. The percentage agreement between all judges and the CLP registry for the quality indicator ≥86% correct consonants was poor (67%). However, in 88% of the cases, results from four judges and the CLP registry agreed, corresponding to good agreement. The mean of all kappa values for six judges and the CLP registry corresponded to good agreement (0.72).

Conclusions: The results indicate the PCC data in the CLP registry and the quality indicator ≥86% correct consonants to be reliable. When differences in outcome between treatment centres are detected, the raw data collected should always be re-examined before drawing definitive conclusions.

Purpose: Although numerous patient-reported outcome measures have been developed and validated to quantify the impact of voice problems on different aspects of life, to our knowledge no screening instrument exists that specifically captures voice disorders in a retrospective fashion. The aim of the present study was to examine the psychometric properties and diagnostic validity of a retrospective voice screening method, Screen11, according to the COSMIN framework for health-related, patient-reported outcome measures. The items in Screen11 have been used to establish the prevalence of voice disorders in both general and occupation-specific populations in the Nordic countries. However, the instrument has not been validated.

Methods: The voice patient group (n = 54) in this study comprised of patients from the Turku University Central Hospital phoniatric outpatient clinic seeking help for their voice problems. For these voice patients, we recruited voice-healthy controls (n = 61) who matched in terms of gender, age, and occupation. The participants responded to the Screen11 questionnaire along with the VHI and the VAPP.

Results: The results of the initial exploratory factor analysis showed that all the Screen11 items loaded on a common underlying latent factor. Furthermore, Screen11 had high internal consistency (α = .93) and correlated sufficiently with other voice questionnaires.

Conclusions: The results indicate that Screen11, which screens for possible voice disorders at an early stage, was successfully validated. With respect to its diagnostic validity, the Screen11 sum score is preferable. A threshold of ≥ 15 should be used for differentiating patients with possible voice disorders from those with healthy voices.

The early intervention Språkstart Halland targets children aged 0-3 years. During home visits at 6 and 11 months, library staff deliver gift-packs containing books, toys, songs, and rhymes to promote early language stimulation. Parents are encouraged to engage in 'talk, play, sing, read' activities to support language development. The aim of the present study was to examine parents' experiences of the 6- and 11-month visits and develop an understanding of their general impressions and thoughts regarding the perceived impact of the visits. Parents (n = 15) were interviewed in four focus groups and two one-on-one interviews. Data was analysed using qualitative content analysis. The findings show that the intervention changed the parents' mindset and increased their knowledge regarding early language stimulation. Tools and strategies benefitting the parent-child interaction were gained. A positive experience and personal guidance created motivation for the parents to carry out the language stimulating activities after the visit. Social gains were described. The findings imply usefulness of the intervention in supporting children's language and literacy development.

Understanding the impact of listening effort (LE) and fatigue has become increasingly crucial in optimizing the learning experience with the growing prevalence of online classrooms as a mode of instruction. The purpose of this study was to investigate the LE, fatigue, and voice quality experienced by students during online and face-to-face class sessions. A total of 110 participants with an average age of 20.76 (range 18-28) comprising first year undergraduate students in Speech and Language Therapy and Audiology programs in Turkey, rated their LE during the 2022-2023 spring semester using the Listening Effort Screening Questionnaire (LESQ) and assessed their fatigue with the Multidimensional Fatigue Inventory (MFI-20). Voice quality of lecturers was assessed using smoothed cepstral peak prominence (CPPS) measurements. Data were collected from both online and face-to-face sessions. The results revealed that participants reported increased LE and fatigue during online sessions compared to face-to-face sessions and the differences were statistically significant. Correlation analysis showed significant relationships (p < 0.05) between audio-video streaming quality and LE-related items in the LESQ, as well as MFI sub-scales and total scores. The findings revealed a relationship between an increased preference for face-to-face classrooms and higher levels of LE and fatigue, emphasizing the significance of these factors in shaping the learning experience. CPPS measurements indicated a dysphonic voice quality during online classroom audio streaming. These findings highlight the challenges of online classes in terms of increased LE, fatigue, and voice quality issues. Understanding these factors is crucial for improving online instruction and student experience.

Swallowing disorder is prevalent in children with cerebral palsy (CP), and previous studies have shown that motor-based programs benefit children with CP by facilitating motor learning. We hypothesized that action observation training (AOT) could enhance motor learning and improve the oral phase of swallowing in children. In this two-group parallel double-blind randomized controlled trial, the intervention group received AOT and sensorimotor therapy, while the control group received a sham and sensorimotor therapy. The function of the oral phase of swallowing, as the primary outcome, was measured pre-intervention, post-intervention, and at one month of follow-up. Secondary outcomes included reported symptoms of feeding problems and the impact of the child's swallowing disorder on the main caregiver, which were measured pre-intervention and post-intervention. The result of the Mann-Whitney U test showed a significant difference between the two groups in the function of the oral phase of swallowing after the intervention. Additionally, the intervention had a large effect size. However, no significant difference was found in the parent-reported scores of the feeding/swallowing impact survey and symptoms of feeding problems between the two groups. In conclusion, this pilot study provides preliminary evidence of the clinical efficacy of AOT as a safe neurorehabilitation method to improve the oral phase of swallowing in children with CP. However more studies are needed in the future.

Objective: The present study aims at investigating the immediate effects of the Semi-Occluded Bubble Mask Technique (SOBM) performed with the device VocalFeel® as a vocal warm-up in a group of professional singers.

Study design: A randomized controlled study was carried out.

Methods: Forty-four vocally healthy professional singers were randomly divided into two groups on recruitment: an experimental group and a control group. The same vocal warm-up exercise was performed by the experimental group with the SOMB technique and by the control group without semi-occlusion. Self assessments, acoustic analysis and aerodynamic analysis of Peak Nasal Inspiratory Flows (PNIF) and Peak Oral Inspiratory Flows (POIF) were performed.

Results: Significant improvements after the SOBM technique were detected in the experimental group concerning some acoustic parameters (Jitt%; Shimm%) and aerodynamic measures (PNIF and POIF). No significant improvements after the warm-up exercise were observed in the control group. Significant differences between the experimental and the control group were found for ΔJitt%, ΔShimm%, ΔNHR, ΔPOIF and self assessments.

Conclusions: The results of the present study support the efficacy of a vocal warm-up performed with the SOBM technique using VocalFeel® device in terms of acoustic quality, aerodynamic measures and perceived phonatory comfort in professional singers.