Previous Speech Therapy Research Articles

Normative nasalance scores in Chilean adults.

The present study is aimed towards determining and comparing normative nasalance scores in Chilean Spanish-speaking adult men and women. 40 women (age range 18 to 35, X = 25.79, SD = 5.83) and 36 men (age range 18 to 35, X = 26.45, SD = 4.08) were invited to participate, all of them without any previous speech therapy, neurological pathologies, intellectual deficits, hearing loss, syndromes, or other diagnosed pathologies that could impact speech production.A study of proper velopharyngeal function was performed, using a perceptual resonance evaluation. Nasalance was determined using a model 6450 Nasometer, during the reading of three standardized speech samples in Spanish: a nasal passage (NP), an oronasal passage (ONP), and an oral passage (OP). Also, the nasalance distance was calculated. Genders were compared using Wilcoxon tests for independent samples. The NP presented the highest percentage of nasalance, with 52.13% (± 4.73), followed by the ONP with 25.38% (± 3.7), and finally the OP, which presented the lowest value of 14.15% (± 5.03). Meanwhile, nasalance distance was 37.98% (± 5.32). Finally, no significant differences were observed when comparing the nasalance between genders (p >0.05). The nasalance values obtained were similar to those observed for other Spanish speakers. Also, male and women showed similar scores. The results of this study are a contribution to the indirect assessment of velopharyngeal function in Chilean adults.

Potential Risk Factors and Prevalence of Voice Symptoms in Students Starting Their Teacher Education

The aim of the present study was to determine prevalence of voice problems and potential risk factors in teacher students at the start of their education. A total of 1494 students from seven teacher education schools participated in the study. The students answered a questionnaire about 11 risk factors, and one with six questions about voice symptoms, Screen6, and 30 statements in the Voice Handicap Index (VHI). Students reporting at least 2 weekly voice symptoms in Screen6 were assigned to the group with voice problems. Significance level was P < 0.05. Results: prevalence of risk factors was about the same in the seven groups of teacher students except the group with highest proportion of women that also showed the highest proportion of voice problems, 38%. Prevalence of voice problems in the total group was 17%. Comparison of students with or without voice problems showed that all factors except one were more prevalent among students with voice problems and women were overrepresented. Mean total VHI score was 22 in students with voice problems and eight in students without voice problems. Multiple regression analyses showed that frequent throat infections, hearing problems, previous speech therapy, or voice training were the potential risk factors that had the strongest association with voice symptoms as well as with total score in VHI. Conclusions: results from this study show that it is common that teacher students experience voice problems already at the start of their education and potential risk factors associated with voice problems are identified. Knowing that teaching is a high-risk profession for developing voice disorders, it is crucial that teacher students should receive compulsory preprofessional voice education including voice ergonomics and voice training.

Maximum phonation times and vital capacity in dysphonic women

ABSTRACT Objective: to verify the correlation between vital capacity and maximum phonation times of /ė/ (unvoiced) and /s/, as well as compare and relate them with the professional voice use and age in women with functional or organic-functional dysphonia. Methods: a retrospective research with 524 records of dysphonic patients from a school clinic, including young adult women with a speech-language diagnosis of functional or organic-functional dysphonia based on medical reports. Neurological and psychiatric alterations, previous speech therapy treatment, symptoms of flu or allergies on the day of evaluation, pulmonary disease, organic dysphonia diagnosis, and hearing loss, were excluded. The sample resulted in 14 women with functional dysphonia and 21 with organic-functional dysphonia. Data on professional voice use, as well as results for vital capacity and maximum phonation times were collected. The data were statistically analyzed at a 5% significance level. Results: There was a positive correlation for both groups of dysphonic patients between the maximum phonation times of /ė/ and of /s/, as well as the maximum phonation times of /ė/, /s/, and vital capacity. Higher values for vital capacity and maximum times of /s/ and /ė/ for voice professionals were seen. The maximum phonation times of /ė/ were lower than those of /s/. Conclusion: as the maximum phonation times of /ė/ increased, the maximum phonation times of /s/ and the vital capacity also augmented in both groups, demonstrating the interrelation among these variables; there was no relation with the other variables studied.

Beliefs and behavioural intentions towards pharmacotherapy for stuttering: A survey of adults who stutter

PurposeAlthough considerable efforts have been made to investigate the effectiveness of pharmacological treatments for stuttering, little is known about how the stuttering community perceives these treatments. This study aimed to assess and quantify beliefs regarding pharmacotherapy for adults who stutter and to establish whether behavioural intentions to undertake treatment were related to these beliefs. MethodAn adapted version of the Beliefs about Medicine Questionnaire was completed by adults who stutter. Participants also reported perceptions of their stuttering including its overall impact, ratings of previous speech therapy, and behavioural intentions to initiate pharmacotherapy and speech therapy in future. ResultsNecessity and concern beliefs were distributed widely across the sample and in a pattern indicating a relatively balanced perception of the benefits and costs of medication prescribed specifically for stuttering. Of the study’s measures, the necessity-concerns differential most strongly predicted the behavioural intention to initiate pharmacotherapy. The overall impact of stuttering predicted intentions to seek both pharmacotherapy and speech therapy. Participants reported the likelihood of pursuing pharmacotherapy and speech therapy in equal measure. ConclusionsThe theoretical model of medication representations appears to be a useful framework for understanding the beliefs of adults who stutter towards the medical treatment of their disorder. The findings of this study may be of interest to clinicians and researchers working in the field of stuttering treatment and to people who stutter considering pharmacotherapy.

Association between the adherence to voice therapy and voice activity profile in patients with behavioral dysphony.

To analyze the association between adherence to voice therapy and voice activity profile in patients with behavioral dysphonia and possible associated factors. The study included eighteen individuals with behavioral dysphonia who were on regular treatment at the institution Hearing and Speech Therapy Service. The participants of this study responded to the Voice Activity and Participation Profile Protocol (VAPP) and URICA-VOICE scale. The associated variables (number of sessions, age, type of behavioral dysphonia, gender and previous speech therapy) were collected through interviews with patients and analysis of their medical records. The data were submitted to inferential statistical analysis. Most patients were in the action stage. There was a statistically significant association between the aspect of the VAPP Effects on Emotion and stages of readiness for adherence to voice therapy, but other VAPP aspects were not associated with the URICA-VOICE scale. Regarding the associated variables, the number of sessions, age and type of behavioral dysphonia were associated with the adherence to voice therapy. There was a statistically significant difference between the type of behavioral dysphonia and VAPP scores. The aspect of VAPP Effects on Emotion and variables such as number of sessions, age and type of dysphonia were associated to the URICA-VOICE scale adherence stage. Individuals with organic dysphonia had greater impact of vocal disorders in their daily activities.

Intervenção fonoaudiológica na esclerose sistêmica: relato de casos

RESUMO A Esclerose Sistêmica é uma doença reumática autoimune do tecido conjuntivo, progressiva, pouco frequente, de etiologia desconhecida e com evolução variável. Atinge órgãos nobres e tecidos periorais, causando limitação na abertura da boca, hipertonia dos órgãos fonoarticulatórios, face com "aparência de máscara", dificuldades na mastigação e deglutição. Com o objetivo de comparar os resultados pré e pós-intervenção fonoaudiológica miofuncional orofacial em sujeitos com esclerose sistêmica, realizou-se estudo clínico exploratório qualiquantitativo no setor de Reumatologia do Hospital Universitário e na Clínica escola de Fonoaudiologia da Universidade Federal de Sergipe, no período de julho/2012 a dezembro/2013. A amostra foi composta por cinco indivíduos, de ambos os gêneros, com faixa etária entre 24 e 60 anos e diagnóstico médico confirmado da referida afecção. Os indivíduos passaram por avaliação por meio do protocolo MBGR e 36 sessões de terapia fonoaudiológica (miofuncional e mioterápica). Ao término, os resultados iniciais e finais foram comparados a partir dos indicadores clínicos trabalhados. Diante da análise dos resultados obtidos, foram observadas melhoras em todos os aspectos trabalhados. A avaliação anterior à fonoterapia revelou restrição na abertura da boca em todos os indivíduos e os resultados finais apresentaram ganhos entre 5.3 e 14.2 mm de abertura (média: 9,26 mm). Com relação à tonicidade, mobilidade dos órgãos fonoarticulatórios e dormência orofacial, observaram-se melhoras e evidências de adequação das funções orais. Pode-se concluir que, apesar de alguns pacientes ainda apresentarem alterações, a reabilitação fonoaudiológica promoveu melhoras significativas no quadro clínico e qualidade de vida dos indivíduos do grupo de estudo.

Medidas orofaciais em nipobrasileiros após crescimento puberal

OBJETIVO: descrever medidas orofaciais em nipobrasileiros após crescimento puberal e verificar diferenças entre medidas de mulheres negras, brancas e nipobrasileiras. MÉTODO: a casuística foi composta de 90 sujeitos japoneses ou descendentes de japoneses, sem histórico de miscigenação, ambos os sexos, entre 20 e 50 anos, sem queixas ou atendimentos fonoaudiológicos atuais ou prévios em motricidade orofacial, sem tratamento ortodôntico atual e sem alteração cognitiva. As medidas avaliadas foram: lábio superior, lábio inferior, filtro, terço superior da face, terço médio da face, terço inferior da face, lados da face, abertura máxima de boca e abertura máxima de boca com a língua na papila. O instrumento utilizado foi o paquímetro eletrônico digital da marca Jomarca. Os dados foram comparados com os achados na literatura referentes às mulheres negras e brancas. RESULTADOS: os dados coletados mostraram homogeneidade entre as medidas; os valores para todas as medidas foram maiores nos homens, com relevância estatística positiva. As diferenças mais significantes entre as negras, brancas e nipobrasileiras foram: terço superior e filtro das nipobrasileiras menor do que de negras e brancas. Para o terço médio não houve diferença estatística significante. O lábio superior das nipobrasileiras é maior do que das brancas e o lábio inferior das nipobrasileiras menor do que das negras. Lados da face sem diferenças estatísticas. CONCLUSÃO: foi possível verificar que as médias das medidas foram sempre maiores nos homens, que houve relações significantes entre algumas medidas orofaciais e que houve diferença estatisticamente significante entre as estruturas das brancas, negras e nipobrasileiras.

Aspectos do sistema estomatognático pré e pós-adenotonsilectomia

To verify the speech therapy aspects of the stomatognathic system, including phonoarticulatory structures (lips, tongue, and soft palate) and swallowing, respiratory, speech, and phonation (vocal quality and resonance) functions, before and after undergoing adenotonsillectomy. The study included 22 children, 17 males and 5 females, aged between 5 and 10 years, suffering from hypertrophy of palatine and adenoid tonsils, with surgical indication for adenotonsillectomy and with no previous speech therapy. The speech-language pathology evaluation was performed before surgery and during the period between 1 and 6 months after adenotonsillectomy. It consisted of an evaluation of structures (lips, tongue, and soft palate) and of swallowing (liquid), respiration (mode), speech, and phonation (voice quality and resonance) functions. To evaluate vocal quality and resonance, 15 participants with the postoperative evaluation carried out in a period from 1 to 2 months were considered. There were differences regarding nasal respiratory mode, lips closed at rest posture, changed tongue tonus, adequate mobility of the soft palate, changed tongue posture during liquid swallowing, and absence of interposition compensatory mechanism of lips in swallowing. Reduction in the frequency of distortion processes was also found. With regard to speech, little improvement in vocal quality and resonance was seen. Following adenotonsillectomy, some structures and functions can spontaneously readapt or improve. However, most children needed to be referred to speech therapy for readapting stomatognathic structures and the assessed functions.

Modificações faciais em clientes submetidos a tratamento estético fonoaudiológico da face em Clínica-Escola de Fonoaudiologia

OBJETIVO: identificar possíveis modificações faciais em pacientes submetidos à tratamento estético fonoaudiológico da face na Clínica-Escola de Fonoaudiologia e verificar se estas modificações foram percebidas pelo cliente, por terceiros e por fonoaudiólogos, e constatar o grau de satisfação do cliente com o resultado. MÉTODO: participaram do estudo 11 mulheres com idade de 40 a 50 anos (média de idade 44,5 ± 3,6 anos), excluíram-se as com tratamento fonoaudiológico estético ou cirurgia faciais prévios e patologias neurológicas. Submeteram-se a 10 sessões de terapia, com exercícios estáticos e dinâmicos. Responderam questionário sobre modificações percebidas por elas ou referidas por terceiros. Suas fotos pré e pós tratamento foram analisadas por fonoaudiólogos especialistas em motricidade orofacial identificando presença ou ausência de modificações. Em escala análoga visual de 100 mm, marcaram seus graus de satisfação com aparência facial pré e pós tratamento. RESULTADOS: todas (100%) perceberam modificações faciais: diminuição das rugas dos olhos e dos lábios (100%) e diminuição do sulco nasolabial, lábios mais definidos, pele mais viçosa e brilhante e suavização das marcas de expressão (90,91%). Terceiros referiram modificação: diminuição das olheiras pele mais viçosa e brilhante (45,45%). Não se encontrou concordância entre os três especialistas, embora tenham percebido em maior ou menor grau modificações na maioria das variáveis analisadas. O grau médio de satisfação com a aparência facial aumentou de 46,18 para 82,09 (p=0,05). CONCLUSÃO: o tratamento fonoaudiológico proporcionou modificações faciais percebidas pelas clientes, por terceiros e pelos especialistas. Elas mostraram-se mais satisfeitas com o aspecto estético da face após a intervenção fonoaudiológica.

Prevalence of Voice Symptoms and Risk Factors in Teacher Students

Teacher students seem to have low awareness of the vocal demands in their future professions, and students with vocal symptoms are at risk for developing voice disorders during their professional careers. The purpose of the present study was to determine the prevalence of voice problems in teacher students at the very beginning of their education at the university. Of 1636 students approached in the first couple of days, 1250 (76%) answered two questionnaires about voice symptoms, Screen6 and Swedish Voice Handicap Index (Sw-VHI), and one questionnaire about potential risk factors. A majority of the students were women, and their mean age was 23 years (range, 18-52 years). The results showed that 208 of 1250 students (17%) had voice problems, defined as at least two symptoms weekly or more often in Screen6. The proportion of women was larger in the group with voice problems than in the group without voice problems. Significant risk factors for voice problems were vocal fold problems in childhood and adulthood, frequent throat infections, airborne allergy, smoking, hearing problems, previous work as teacher or leader, voice demanding hobbies, and previous speech therapy or voice training. There was a clear association between the number of potential vocal risk factors and the number of voice symptoms. There was also a strong association between the scores of the two questionnaires, the Sw-VHI and the Screen6. Students with voice problems according to Screen6 scored 23.1 (mean Sw-VHI) compared with 7.8 for students without voice problems.

Tempos máximos de fonação de vogais em mulheres adultas com nódulos vocais

Maximum phonation times (MPT) of vowels in adult women with vocal nodules. To verify and to correlate the values of MPT of vowels in young and middle-aged adult women with vocal nodules. Database records from a speech therapy school-clinic were used, making up a total of 38 subjects. female adults, aged between 20 and 53 years, with otorhinolaryngology diagnosis of vocal nodules. to present a laryngeal pathology other than vocal nodules; hearing loss ; oral breathing; history of neurological, psychiatric, endocrine or gastric disorders; flu or allergy history; drinking and/or smoking habits; previous speech therapy and/or otorhinolaryngology treatments. Anamnesis data, the otorhinolaryngology diagnosis, and the MPT measurements of vowels /a, i, u/ were verified for each subject. MPT evaluation consisted of the duration measurement of three emissions of the vowels, using habitual tone and intensity, until the end of exhalation, with the patient in a standing position, considering the highest value of each vowel. The results were statistically analyzed with a significance level of 5%. Representative age range; less representative MPT and mean, below normality and with a strong positive and meaningful correlation; moderate, positive and significant correlation between MPTs and their means. For the group of adult women with vocal nodules, the MPT values were reduced and positively correlated; the MPT of vowel /a/ presented a lower value when compared to the other investigated vowels.

Harnessing language awareness in a communicative context: a group study of the efficacy of Metaphon

ABSTRACT Metaphon is a two‐phase therapy procedure for children with disordered phonology. It seeks to influence phonological production by targeting aspects of linguistic awareness within an interactive learning framework. An earlier investigation of this procedure, involving 13 children treated by a single therapist, showed a significant decrease in the occurrence of simplifying processes post‐therapy for most subjects (Howell &amp; Dean, 1994). The investigation reported in this paper sought to test the effectiveness of Metaphon therapy further by studying a larger number of children. In addition, the study was designed to determine the relative contribution to phonological change of the two phases of Metaphon therapy; Phase I which aims to harness awareness of phonological contrasts and Phase II which aims to enhance communicative competence. Fifty children aged between 3;6‐5;6 participated in the investigation. They were treated by 12 speech and language therapists. The criteria used for subject selection ensure that the children had received no previous speech therapy and that their communication difficulties were specific to the speech sound system. They were all monolingual speakers and came from a variety of social backgrounds. The subjects were assigned to four different experimental conditions: Group 1 — Phase I treatment only (six treatment sessions); Group 2 — both phases I and II treatment (10 treatment sessions); Groups 3 and 4 — no treatment (control groups, one for each of the two treatment conditions). (All the children in the control groups received therapy immediately following the experimental period.) A variety of cognitive and linguistic assessments were given to all subjects before and after their respective periods of therapy/no therapy. A comparison of mean error scores on a measure of phonological production before and after the period of therapy/no therapy showed a reduction in error occurrence for all four groups, with the greater change occurring in Group 2, the subjects receiving the complete Metaphon programme. Analysis of covariance revealed a significant interaction between treatment group (control/experimental) and inter‐test interval. The results suggest that Metaphon therapy does have a positive effect on phonological change, with both phases of Metaphon required for maximum effectiveness for most subjects. The implications for clinical practice from this investigation include the following. Firstly, that enhancing awareness of the phonological and communicative aspects of language appears to be an effective way of bringing about phonological change. Secondly, the finding that phonological change occurred in both the treated and non‐treated groups over a relatively short timespan suggests that the potential influence of maturation should be considered when appraising the effectiveness of any therapeutic programme used with this client group.

Articulatory disorders in speech among Finnish-speaking students according to age, sex, and speech therapy

A group of Finnish-speaking students ( n=451) was examined clinically to study occurence of articulatory disorders in speech, controlling for the possible effects of age, sex, and previous speech therapy. Distortions of the /s/ sound were found in 16%, of the /r/ sound in 3%, and of the /l/, /n/, or /d/ sounds in about 1% of the subjects; the rarest faultily produced sounds were usually combined with other articulatory disorders. According to fitted loglinear functions, age and sex were not related to prevalence of articulatory disorders in speech among young adults, while there was a tendency for subjects with previous speech therapy to have higher frequencies of articulatory disorders of /s/ and /r/ sounds than subjects with no such treatment, suggesting that exclusion of the treated subjects would have resulted in too low a prevalence of articulatory disorders in the sample.