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Sasikumar AV, Hariharan SV, Vittal N, Ahuja PM. Management of Speech and Hearing in Low-Income and Middle-Income Countries: Current Conditions, Problems, Future Directions. J Craniofac Surg 2024:00001665-990000000-01783. [PMID: 39078135 DOI: 10.1097/scs.0000000000010391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 05/10/2024] [Indexed: 07/31/2024] Open
Abstract
Management of speech and hearing issues in low-income and middle-income countries (LMICs) has been challenging, considering the population size and availability of resources. There is a need to investigate the depth of these challenges and explore the efficacy of strategies to overcome them. This review aimed to delineate the speech and hearing issues in individuals with cleft lip and palate and how they have been managed in the context of LMICs. Keywords were developed based on the objectives of the study to search for literature published during the period 2010 to 2023. Articles from PubMed, Google Scholar, Science Direct, and ProQuest databases were retrieved using appropriate keyword searches. The titles and abstracts were screened to delete the unsuitable articles. Relevant gray literature and hand-searched articles published were also included. The findings are summarized under the following heads in the context of LMICs: incidence and severity of speech and hearing issues, challenges, and barriers in providing speech and hearing services, methods of developing manpower and training, methods of assessing speech and hearing outcomes, service delivery models employed, and the recent advances relating to management of speech and hearing. A wide range of topics revolving around managing speech and hearing issues in individuals with cleft lip and palate has been researched in the context of LMICs. Scattered and fragmented solutions have been provided to overcome the varied challenges in LMICs. The gaps in the literature and the future directions for research have been identified.
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Affiliation(s)
- Aparna V Sasikumar
- SmileTrain Cleft Leadership Center, Bhagwan Mahaveer Jain Hospital, Bengaluru, Karnataka
| | | | - Namratha Vittal
- SmileTrain Cleft Leadership Center, Bhagwan Mahaveer Jain Hospital, Bengaluru, Karnataka
| | - Payal M Ahuja
- Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Ren Z, Shang F, Zheng Y, Wu N, Ma L, Zhou X. The Role of EGG in Identifying Prevocalic Glottal Stop. J Voice 2024:S0892-1997(24)00020-1. [PMID: 38402112 DOI: 10.1016/j.jvoice.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE The aim of the study is to investigate the use of incidences and characteristics of Prevocalic Electroglottographic Signal (PVES) derived from electroglottography (EGG) in characterizing glottal stops (GS) in cleft palate speech. METHODS Mandarin nonaspirated monosyllabic first-tone words were used for the speech sampling procedure. A total of 1680 utterances (from 83 patients with repaired cleft palates) were divided into three categories based on the results of auditory-perceptual evaluation of recorded speech sounds by three independent reviewers: [Category A (absence of GS agreed by all three reviewers) (n = 1192 tokens), Category B (two out of three reviewers agreed on the presence of a GS) (n = 181 tokens) and Category C (all three reviewers agreed on the presence of a GS) (n = 307 tokens)]. The EGG signals of the 1680 utterances were analyzed using a MATLAB program to automatically mark the instances of PVES (amplitude and time-interval) in the GS utterances. RESULTS The result showed that the incidence of EGG PVES presented good positive correlation with auditory-perceptual evaluation (r = 0.703, P<0.000). Statistical analysis revealed a significant difference in mean PVES amplitude among different groups (P<0.05). There was a significant distinction in the time interval between groups A and B, as well as in groups A and C (P<0.05). CONCLUSIONS The study suggests PVES can be an objective means of identifying GS in cleft palate speech. It also indicates that proportion of amplitude and time interval of PVES tend to be positively correlate with subjective assessment.
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Affiliation(s)
- Zhen Ren
- Department of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Feifei Shang
- Department of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yafeng Zheng
- Department of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Nankai Wu
- Department of Chinese Language and Literature, Jinan University, Guangzhou, China
| | - Lian Ma
- Department of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xia Zhou
- Department of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
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Bschorer F, Hornig L, Schön G, Bschorer R. Speech assessment following microsurgical soft palate repair. J Craniomaxillofac Surg 2023; 51:199-204. [PMID: 36878754 DOI: 10.1016/j.jcms.2023.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 11/01/2022] [Accepted: 01/22/2023] [Indexed: 01/26/2023] Open
Abstract
The aim of this study was to analyze speech intelligibility of children, who had undergone microsurgical soft palate repair according to Sommerlad. Cleft palate patients were treated by closure of the soft palate according to Sommerlad at about 6 months of age. At the age of 11, their speech was evaluated through automatic speech recognition. Word recognition rate (WR) was used as the outcome parameter of automatic speech recognition. To validate automatic speech results, an institute for speech therapy evaluated the speech samples for perceptual intelligibility. The results of this study group were compared to an age-matched control group. A total of 61 children were evaluated in this study, 29 in the study group and 32 in the control group. Study group patients had a lower word recognition rate (mean 43.03, SD 12.31) compared to the control group (mean 49.98, SD 12.54, p = 0.033). The magnitude of the difference was considered small (95% CI of the difference 0.6-13.3). The study group patients received significantly lower scores in the perceptual evaluation (mean 1.82, SD 0.58) compared to the control group mean (mean 1.51, SD 0.48, p = 0.028). Again, the magnitude of the difference was small (95% CI of the difference 0.03-0.57). Within the limitations of the study it seems that microsurgical soft palate repair according to Sommerlad at the age of 6 months might be a relevant alternative to other well established surgical techniques.
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Affiliation(s)
- Frizzi Bschorer
- Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Wismarsche Straße 393-397, 19049, Schwerin, Germany; Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Rostock University Medical Center, Schillingallee 35, 18057, Rostock, Germany.
| | - Lena Hornig
- ISBA University of Cooperative Education, Ziegelseestr. 1, 19055, Schwerin, Germany
| | - Gerhard Schön
- Department of Medical Biometry and Epidemiology, Eppendorf University Hospital, University of Hamburg, Martinistr. 52, D-20246, Hamburg, Germany
| | - Reinhard Bschorer
- Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Wismarsche Straße 393-397, 19049, Schwerin, Germany; MKG-Praxis Am Stadthafen, Schliemannstraße 18, 19055, Schwerin, Germany
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Fan X, Liu W, Nie J, Chen X, Dong Y, Lu Y. Comparison of velopharyngeal morphology of two palatoplasty techniques in patients with hard and soft cleft palate. Front Surg 2023; 9:1080955. [PMID: 36684272 PMCID: PMC9852632 DOI: 10.3389/fsurg.2022.1080955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/21/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose The study aims to compare the velopharyngeal morphology of hard and soft cleft palate (HSCP) patients after Furlow and Sommerlad palatoplasty. Patients and methods A total of 51 patients (20 cases in Furlow palatoplasty group, 16 cases in Sommerlad palatoplasty group and 15 normal children in the control group) were included in our study. Velopharyngeal function and speech outcomes of patients with HSCP who had either Furlow palatoplasty or Sommerlad palatoplasty for cleft palate repair were evaluated by perceptual speech assessment (PSA), lateral cephalometric radiographs and nasopharyngoscopy. To assess velopharyngeal morphology of patients treated with two techqiques, we analyzed measurements such as velar length, pharyngeal depth, and the Adequate ratio (the ratio of velar length to pharyngeal depth). Furthermore, skeletal landmarks including cranial base, cervical vertebrae, posterior nasal spine which were defined as the pharyngeal triangle were measured. Finally, the position of the point U relative to the pharyngeal triangle were compared. Results Velopharyngeal closure (VPC) rate in Furlow palatoplasty group accounted for 90%, while that in Sommerlad palatoplasty group was 81.3%. PSA of the former group was significantly better than that of the latter group (P < 0.05). Velar length, pharyngeal depth and the Adequate ratio (1.37 ± 0.14 vs. 1.41 ± 0.15) were comparable between the Furlow group and control group (P > 0.05), while Sommerlad group had a shorter velar length, deeper pharyngeal depth and a smaller Adequate ratio (1.20 ± 0.18) compared to the above two groups (P < 0.05). Furhermore, the point U of Sommerlad group in the pharyngeal triangle was higher than that of the other two groups. Conclusions In the treatment modality of patients with HSCP, both Furlow palatoplasty and Sommerlad palatoplasty seem to be effective. Furlow palatoplasty appears to have velopharyngeal morphology similar to normal control group., while Sommerlad group shows a shorter velar length, deeper pharyngeal depth and a smaller Adequate ratio.
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Affiliation(s)
- Xiaofen Fan
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Weilong Liu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jiancun Nie
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xiaoxuan Chen
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yingchun Dong
- Department of Oral Anesthesiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China,Correspondence: Yong Lu Yingchun Dong
| | - Yong Lu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China,Correspondence: Yong Lu Yingchun Dong
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Malmenholt A, McAllister A, Lohmander A, Östberg P. Speech feature profiles in Swedish 5-year-olds with speech sound disorder related to suspected childhood apraxia of speech or cleft palate. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 24:156-167. [PMID: 34496681 DOI: 10.1080/17549507.2021.1968951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose: To study the occurrence of speech features commonly associated with Childhood Apraxia of Speech (CAS) in Swedish children with suspected CAS (sCAS) or Speech Sound Disorder (SSD) related to Cleft Palate and/or Lip (CP ± L).Method: Thirty-four children (4.10-5.11) with SSD related to sCAS (n = 15) or repaired CP ± L (n = 19) participated. Consensus judgement of presence/absence of CAS features in single words were based on a checklist with operationalised definitions. Speech sound production measures were based on semi-narrow phonetic transcription. Intra- and inter-transcriber agreement was determined.Result: Twelve participants (ten with sCAS (67%) and two with CP ± L (11%)) shared a CAS profile of phonemic speech inconsistency for consonants and vowels and a set of four features: vowel error, voicing error, difficulty achieving initial articulatory configurations or transitionary movement gestures and stress errors. The most frequent speech difficulties in children with non-CAS CP ± L (n = 17) were consonant distortion (88%) and hypernasal resonance (76%). Prosodic impairment was rare.Conclusion: A distinct CAS speech feature profile was found for children with CAS, differing in number and distribution compared to children with CP ± L and SSD. CAS was found more frequently in CP ± L and SSD compared to reported estimates of clinical prevalence.
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Affiliation(s)
- Ann Malmenholt
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Anita McAllister
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Anette Lohmander
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Per Östberg
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
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Jurado MRB, Cavalheiro MG, de Castro Corrêa C, Whitaker ME, de Vasconcelos Hage SR, Lamônica DAC, Maximino LP. Global and communicative development skills in preschool children with cleft lip and palate. Pediatr Investig 2021; 5:33-37. [PMID: 33778425 PMCID: PMC7984020 DOI: 10.1002/ped4.12250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/04/2020] [Indexed: 11/29/2022] Open
Abstract
IMPORTANCE Cleft lip and palate (CLP) is globally among the most common childhood malformations. This disorder impacts childhood development, including speech and language, and affects children worldwide. OBJECTIVE To analyze child development skills (adaptive fine motor, gross motor, personal-social, and language) in preschool children with isolated CLP compared with children without this malformation. METHODS The participants included an experimental group of 27 children with isolated CLP and a comparison group of 27 children without CLP aged between 48 and 59 months. The groups were evaluated using two instruments: the Denver Developmental Screening Test II (DDST-II) and the Avaliação do Desenvolvimento da Linguagem (ADL-Language Development Assessment). Data were analyzed by descriptive and inductive analyses, using the Student's t-test and the Mann-Whitney test, at a significance level of P ˂ 0.05. RESULTS All children in the comparison group performed within normal standards for their age range in the DDST-II and the ADL. The worst performance in the experimental group was observed in language skills, followed, in declining order, by adaptive fine motor, personal-social, and gross motor as measured by the DDST-II. Children with isolated CLP also performed poorly in receptive, expressive, and global language in the ADL. No statistically significant differences were observed in the experimental group's scores for the ADL and the DDST-II. INTERPRETATION Developmental skill levels were below expectations for children of this age with isolated CLP.
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Affiliation(s)
- Mayalle Rocha Bonfim Jurado
- Department of Speech‐Language Pathology and AudiologyBauru School of DentistryUniversity of São PauloBauruSPBrazil
| | | | - Camila de Castro Corrêa
- Plateau University Center of the Federal DistrictUNIPLANBrasiliaDistrito FederalBrazil
- University of BrasíliaUnBBrasiliaDistrito FederalBrazil
| | | | | | | | - Luciana Paula Maximino
- Department of Speech‐Language Pathology and AudiologyBauru School of DentistryUniversity of São PauloBauruSPBrazil
- Hospital for Rehabilitation of Craniofacial AnomaliesUniversity of São PauloBauruSPBrazil
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Seifert M, Davies A, Harding S, McLeod S, Wren Y. Intelligibility in 3-Year-Olds With Cleft Lip and/or Palate Using the Intelligibility in Context Scale: Findings from the Cleft Collective Cohort Study. Cleft Palate Craniofac J 2021; 58:1178-1189. [DOI: 10.1177/1055665620985747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To provide comparison data on the Intelligibility in Context Scale (ICS) for a sample of 3-year-old English-speaking children born with any cleft type. Design: Questionnaire data from the Cleft Collective Cohort Study were used. Descriptive and inferential statistics were carried out to determine difference according to children’s cleft type and syndromic status. Participants: A total of 412 children born with cleft lip and/or palate whose mothers had completed the ICS when their child was 3 years old. Main Outcome Measure(s): Mothers’ rating of their children’s intelligibility using the ICS. Results: The average ICS score for the total sample was 3.75 ( sometimes-usually intelligible; standard deviation [SD] = 0.76, 95% CIs = 3.68-3.83) of a possible score of 5 ( always intelligible). Children’s speech was reported to be most intelligible to their mothers (mean = 4.33, SD = 0.61, 95% CIs = 4.27-4.39) and least intelligible to strangers (mean = 3.36, SD = 1.00, 95% CIs = 3.26-3.45). There was strong evidence ( P < .001) for a difference in intelligibility between children with cleft lip only (n = 104, mean = 4.13, SD = 0.62, 95% CIs = 4.01-4.25) and children with any form of cleft palate (n = 308, mean = 3.63, SD = 0.76, 95% CIs = 3.52-3.71). Children born with cleft palate with or without cleft lip and an identified syndrome were rated as less intelligible (n = 63, mean = 3.28, SD = 0.85, 95% CIs = 3.06-3.49) compared to children who did not have a syndrome (n = 245, mean = 3.72, SD = 0.71, 95% CIs = 3.63-3.81). Conclusions: These results provide preliminary comparative data for clinical services using the outcome measures recommended by the International Consortium for Health Outcomes Measurement.
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Affiliation(s)
- Miriam Seifert
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, United Kingdom
| | - Amy Davies
- University of Bristol, Bristol, United Kingdom
| | - Sam Harding
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
| | - Sharynne McLeod
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Yvonne Wren
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
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Kara M, Calis M, Kara I, Kulak Kayikci ME, Gunaydin RO, Ozgur F. Comparison of speech outcomes using type 2b intravelar veloplasty or furlow double-opposing Z plasty for soft palate repair of patients with unilateral cleft lip and palate. J Craniomaxillofac Surg 2021; 49:215-222. [PMID: 33485752 DOI: 10.1016/j.jcms.2021.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 08/29/2020] [Accepted: 01/02/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The aim of this study is to compare speech outcomes, fistula rates, and rates of secondary speech surgeries after palatoplasty using Furlow palatoplasty or type 2b intravelar veloplasty for soft palate repair. PATIENTS AND METHODS Patients with unilateral cleft lip and palate who had either Furlow palatoplasty or intravelar veloplasty for soft palate repair were retrospectively evaluated for demographic and perioperative variables and speech outcomes. Fistula rate, secondary surgical intervention for improved speech results, and findings of speech assessment were further reviewed for the patients who met the inclusion criteria. RESULTS A total of 76 patients, 36 in the Furlow palatoplasty group and 40 in the intravelar veloplasty group, were included in the study. In the speech assessment, nasalance values were statistically similar between the two groups. Also, there was no statistically significant difference between the groups in velopharyngeal motility (p = 0.103). The total rates of secondary surgeries and fistula were statistically similar between the groups (p = 0.347 and 0.105, respectively). CONCLUSION The similar outcomes of speech and surgical evaluation between the two groups make the surgeon's preference determinant in the selection of the surgical technique for soft palate repair.
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Affiliation(s)
- Murat Kara
- Hacettepe University Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic Surgery, Cleft Lip and Palate and Craniomaxillofacial Disorders Treatment and Research Center, Ankara, Turkey
| | - Mert Calis
- Hacettepe University Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic Surgery, Cleft Lip and Palate and Craniomaxillofacial Disorders Treatment and Research Center, Ankara, Turkey.
| | - Ilkem Kara
- Hacettepe University Faculty of Health Sciences, Department of Speech and Language Therapy, Cleft Lip and Palate and Craniomaxillofacial Disorders Treatment and Research Center, Ankara, Turkey
| | - Mavis Emel Kulak Kayikci
- Hacettepe University Faculty of Health Sciences, Department of Speech and Language Therapy, Cleft Lip and Palate and Craniomaxillofacial Disorders Treatment and Research Center, Ankara, Turkey
| | - Riza Onder Gunaydin
- Hacettepe University Faculty of Medicine, Department of Otolaryngology, Cleft Lip and Palate and Craniomaxillofacial Disorders Treatment and Research Center, Ankara, Turkey
| | - Figen Ozgur
- Hacettepe University Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic Surgery, Cleft Lip and Palate and Craniomaxillofacial Disorders Treatment and Research Center, Ankara, Turkey
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Prathanee B, Pumnum T, Yoodee P, Makarabhirom K. Speech therapy model for patients with cleft palate in Lao People's Democratic Republic: Lack of speech services. Int J Pediatr Otorhinolaryngol 2020; 138:110366. [PMID: 33152960 DOI: 10.1016/j.ijporl.2020.110366] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND A majority of children with cleft lip and palate (CLP) have persistent speech and language problems after repair. Speech services are critically needed for these children in some developing countries where there is a lack of or no speech services. This includes the Lao People's Democratic Republic (LPDR) where accessibility to speech therapy is not an attainable medical specialty. OBJECTIVE To establish and determine the effectiveness of speech therapy model in reduction of the number of articulation errors for children with CLP in LPDR where these services are lacking. METHODS Speech therapy for children with CLP in LPDR by using the adapted Khon Kaen University Speech Therapy Model based on combining the principles of Community-Based Rehabilitation (CBR), Primary Health Care (PHC) and institutional medical approaches was provided for children with CLP in Bokeo, LPDR. Twelve children with CLP (3.6-16 years) were recruited for this study. Demonstration and teaching services for both speech assistants (SAs), who were local health care providers, and caregivers were performed in 3-day intensive speech camps. Three 1-day follow-up speech camps and 3 site visits were conducted by Thai speech and language pathologists (TSLPs) and their teams. SAs provided speech correction at local health care units based on TSLPs' individual monitoring and supervision. Caregivers practiced assigned exercises at home. Speech Therapy Model in LPDR was undertaken for 1 year. RESULTS The Speech Therapy Model in LPDR was one of the effective models and significantly reduced number of articulatory errors (mean difference = 6.42; 95% confidence interval = 3.01, 9.83).
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Affiliation(s)
- Benjamas Prathanee
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Tawitree Pumnum
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Kalyanee Makarabhirom
- Department of Communication Sciences and Disorders, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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Ren Z, Zhou X, Ma L, Kong J. Comparison Study of Vocal Attack Time in Patients With Cleft Palate With and Without Glottal Stop in Mandarin. J Voice 2018; 33:803.e15-803.e21. [PMID: 30146233 DOI: 10.1016/j.jvoice.2018.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 04/27/2018] [Indexed: 10/28/2022]
Abstract
Glottal stop (GS) is a typical compensatory articulation, which has a great impact on speech intelligibility in patients with cleft palate. It is usually detected by perceptual analysis. The aim of this study is to investigate the utility of vocal attack time (VAT) values in patients with cleft palate with and without GS, when unaspirated monosyllables are articulated in Mandarin, by using electroglottography. Unaspirated monosyllables /pa/ /pi/ /pu/ /ta/ /ti/ /tu/ /ka/ /ki/ /ku/ with tone one were analyzed. A total of 575 tokens were obtained from 42 patients with cleft palate, divided into a GS category (n = 312 tokens) and a nonglottal stop (NGS) category (n = 263 tokens), as assessed perceptually by three judges. Sound pressure and electroglottography recordings were also obtained from these tokens. The time lag of the cross-correlation function was used to gain VAT values. The results showed that the mean VAT values of tokens from the GS category (-0.25 ms) was significantly shorter than that of tokens in the NGS category (3.19 ms) (t = 7.326, P < 0.001). The results also showed that there was no significant difference in VAT values between the different combined monosyllables both in GS and in NGS group. The conclusion that can be drawn from this study is that the VAT value was sensitively decreased in cleft palate Mandarin speakers with GS comparing to those without GS.
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Affiliation(s)
- Zhen Ren
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xia Zhou
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Lian Ma
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Jiangping Kong
- Department of Chinese Language and Literature, Center for Chinese Linguistics, Peking University, Beijing, China.
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Sell D, Southby L, Wren Y, Wills AK, Hall A, Mahmoud O, Waylen A, Sandy JR, Ness AR. Centre-level variation in speech outcome and interventions, and factors associated with poor speech outcomes in 5-year-old children with non-syndromic unilateral cleft lip and palate: The Cleft Care UK study. Part 4. Orthod Craniofac Res 2017; 20 Suppl 2:27-39. [DOI: 10.1111/ocr.12186] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 11/30/2022]
Affiliation(s)
- D. Sell
- North Thames Regional Cleft Service; Speech and Language Therapy Department and Centre for Outcomes and Experience Research in Children's Health; Illness and Disability (ORCHID); Great Ormond Street Hospital NHS Foundation Trust; London UK
| | - L. Southby
- School of Social and Community Medicine; University of Bristol; Clifton Bristol UK
- Cleft.NET.East; Cambridge University Hospitals NHS Foundation Trust; Addenbrooke's Hospital; Cambridge UK
| | - Y. Wren
- Bristol Dental School; University of Bristol; Bristol UK
- Bristol Speech & Language Therapy Research Unit; North Bristol NHS Trust; Southmead Hospital; Bristol UK
| | - A. K. Wills
- Bristol Dental School; University of Bristol; Bristol UK
- National Institute for Health Research (NIHR) Biomedical Research Unit in Nutrition; Diet and Lifestyle at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol; Bristol UK
| | - A. Hall
- Life and Health Sciences; Aston University; Birmingham UK
- Children's Hearing Centre; St Michael's Hospital; Bristol UK
| | - O. Mahmoud
- School of Social and Community Medicine; University of Bristol; Clifton Bristol UK
- Department of Applied Statistics; Helwan University; Cairo Egypt
| | - A. Waylen
- Bristol Dental School; University of Bristol; Bristol UK
| | - J. R. Sandy
- Bristol Dental School; University of Bristol; Bristol UK
| | - A. R. Ness
- Bristol Dental School; University of Bristol; Bristol UK
- National Institute for Health Research (NIHR) Biomedical Research Unit in Nutrition; Diet and Lifestyle at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol; Bristol UK
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Weir-Mayta P, Spencer KA, Eadie TL, Yorkston K, Savaglio S, Woollcott C. Internally Versus Externally Cued Speech in Parkinson's Disease and Cerebellar Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:583-595. [PMID: 28654941 PMCID: PMC5576967 DOI: 10.1044/2017_ajslp-16-0109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/03/2016] [Accepted: 03/15/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE The purpose of this study was to examine the effects of an internally versus externally cued speech task on perceived understandability and naturalness in speakers with Parkinson's disease (PD) and cerebellar disease (CD). METHOD Sentences extracted from a covertly recorded conversation (internally cued) were compared to the same sentences read aloud (externally cued) by speakers with PD and a clinical comparison group of speakers with CD. Experienced listeners rated the speech samples using a visual analog scale for the perceptual dimensions of understandability and naturalness. RESULTS Results suggest that experienced listeners rated the speech of participants with PD as significantly more natural and more understandable during the reading condition. Participants with CD were also rated as significantly more understandable during the reading condition, but ratings of naturalness did not differ between conversation and reading. CONCLUSIONS Speech tasks can have a pronounced impact on perceived speech patterns. For individuals with PD, both understandability and naturalness can improve during reading tasks versus conversational tasks. The speech benefits from reading may be attributed to several mechanisms, including possible improvement from an externally cued speech task. These findings have implications for speech task selection in evaluating individuals with dysarthria.
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Affiliation(s)
- Phil Weir-Mayta
- Department of Communication Sciences and Disorders, California State University, Fullerton
| | - Kristie A. Spencer
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Tanya L. Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Sara Savaglio
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Chris Woollcott
- Department of Speech and Hearing Sciences, University of Washington, Seattle
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