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Oliveira P, Ribeiro VV, Constantini AC, Cavalcante MEDOB, Sousa MDS, da Silva K. Prevalence of Work-Related Voice Disorders in Voice Professionals: Systematic Review and Meta-Analysis. J Voice 2022:S0892-1997(22)00232-6. [PMID: 36057482 DOI: 10.1016/j.jvoice.2022.07.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To analyze the prevalence of work-related voice disorders (WRVD) among the voice professionals. METHODS The study protocol was registered in PROSPERO (CRD42021250121). The search was performed in the Embase, Lilacs, Medline, SCOPUS, and Web of Sciences databases. There were no limitations to the year of publication and the search included observational studies which reported data on the prevalence of dysphonia in voice professionals measured through vocal complaints, vocal self-assessment, the auditory-perceptual judgment of the voice, and laryngoscopy examinations. The critical appraisal instrument for studies reporting prevalence data was used to analyze the risk of bias of the studies. Data analysis was performed using Jamovi and R software with a significance level of 5%. RESULTS The initial search identified 561 articles, 73 of which were finally included and analyzed. The total number of participants was 63,126. Dysphonia was diagnosed in 45,996 participants based on a vocal complaint, 12,843 using vocal self-assessment, 1,254 using the auditory-perceptual judgment, and 1,683 using laryngoscopies. The prevalence of total dysphonia was 44.0 (95% CI 38.47; 49.69). The prevalence of vocal complaints was 43.9% (95% CI 37.37; 50.52), 42.5% (95% CI 28.57; 57.08) for self-assessment, 53.0% (95% CI 29.87; 77.19) for auditory-perceptual judgment, and 36.9% (95% CI 18.62; 57.08) for laryngoscopic examination. In the auditory-perceptual judgment, voice professionals in class 3 (moderate quality, high demand) had a higher prevalence of dysphonia than those in class 4 (moderate quality, moderate demand) (P = 0.04). In the auditory-perceptual judgment (P = 0.04), there was a higher prevalence of dysphonia in teachers than among other voice professionals non-teachers, and in the laryngeal evaluation, no differences were found between professionals (P = 0.8). CONCLUSION There was a high prevalence of dysphonia in voice professionals, especially in the detection by auditory-perceptual judgment. High vocal demand and being a teacher influenced the increase in the prevalence of WRVD.
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Affiliation(s)
- Priscila Oliveira
- Department of Speech Therapy, Universidade Federal da Paraíba - UFPB, João Pessoa, Paraiba, Brazil.
| | - Vanessa Veis Ribeiro
- Speech-Language Pathology Course, Faculdade de Ceilândia, Universidade de Brasília - UnB, Brasília, Federal District, Brazil
| | - Ana Carolina Constantini
- Department of Human Development and Rehabilitation, Speech-Language Pathology Course, Faculdade de Ciências Médicas - FCM, Universidade Estadual de Campinas - Unicamp, Campinas, São Paulo, Brazil
| | | | - Maiara Dos Santos Sousa
- Department of Speech Therapy, Universidade Federal da Paraíba - UFPB, João Pessoa, Paraiba, Brazil
| | - Kelly da Silva
- Speech-Language Pathology Course, Campus Lagarto, Universidade Federal de Sergipe - UFS, Lagarto, Sergipe, Brazil
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Mansouri Y, Naderifar E, Hajiyakhchali A, Moradi N. The Relationship Between Dysphonia Severity Index and Voice-Related Quality of Life in the Elementary School Teachers with Voice Complaint. J Voice 2021; 37:466.e35-466.e39. [PMID: 33858705 DOI: 10.1016/j.jvoice.2021.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 02/06/2021] [Accepted: 02/11/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Teachers are one of the largest groups of professional voice users who are highly dependent on their voice in their working environment using their voice as a primary tool for their profession. Thus, they are at high risk of voice disorders. Since voice disorders are multi-causal in nature, it is necessary to evaluate them systematically and in different ways to determine the exact nature of the disorder. Therefore, in this study, the relationship between Voice-Related Quality of Life (VRQOL) and Dysphonia Severity Index (DSI) was examined from the perspective of teachers with voice complaint. METHOD In this study, 157 primary school teachers with voice complaint (49 males and 108 females) with an average age of 38.54 ± 9.56 years were studied using DSI and VRQOL as a self-assessment. RESULTS The mean of VRQOL was 74.379 ± 18.95 and the mean of DSI was 1.339 ± 1.62. The results of the study showed that there is a significant positive correlation between the overall scores of DSI and VRQOL scales (r = 0.545, P < 0.001). CONCLUSION This study showed that a low dysphonia severity index, reflecting poor laryngeal function, is associated with lower voice-related quality of life. Therefore, accurate and timely assessment of the DSI in teachers can prevent the occurrence and/or progression of voice disorder and, consequently, prevent reducing the voice-related quality of life in teachers.
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Affiliation(s)
- Yousef Mansouri
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ehsan Naderifar
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran; Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alireza Hajiyakhchali
- Associate Professor, Department of Psychology, Faculty of Education and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Negin Moradi
- Musculoskeletal Rehabilitation Research Center, Department of Speech Therapy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Grillo EU. A Nonrandomized Trial for Student Teachers of an In-Person and Telepractice Global Voice Prevention and Therapy Model With Estill Voice Training Assessed by the VoiceEvalU8 App. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:566-583. [PMID: 33524262 PMCID: PMC8740681 DOI: 10.1044/2020_ajslp-20-00200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/03/2020] [Accepted: 11/03/2020] [Indexed: 05/30/2023]
Abstract
Purpose This study investigated the effects of the in-person and telepractice Global Voice Prevention and Therapy Model (GVPTM) treatment conditions and a control condition with vocally healthy student teachers. Method In this single-blinded, nonrandomized trial, 82 participants completed all aspects of the study. Estill Voice Training was used as the stimulability component of the GVPTM to train multiple new voices meeting all the vocal needs of the student teachers. Outcomes were assessed using acoustic, perceptual, and aerodynamic measures captured by the VoiceEvalU8 app at pre and post in fall and during student teaching in spring. Results Significant improvements were achieved for several acoustic and perceptual measures in the treatment conditions, but not in the control condition. The in-person and telepractice conditions produced similar results. The all-voiced phrase and connected speech were more successful in demonstrating voice change for some of the perturbation measures as compared to sustained /a/. Conclusions The treatment conditions were successful in improving the participants' voices for fundamental frequency and some acoustic perturbation measures while maintaining the improvements during student teaching. In addition, the treatment conditions were successful in decreasing the negative impact of voice-related quality of life and vocal fatigue during student teaching. Future research should address the effectiveness of the various components of the GVPTM, the application of the GVPTM with patients with voice disorders, the relevance of defining auditory-perceptual terms by the anatomy and physiology of the voice production system (i.e., Estill Voice Training), and the continued use of the VoiceEvalU8 app for clinical voice investigations. Supplemental Material https://doi.org/10.23641/asha.13626824.
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Affiliation(s)
- Elizabeth U. Grillo
- Department of Communication Sciences and Disorders, West Chester University, PA
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Meier B, Beushausen U. Long-Term Effects of a Voice Training Program to Prevent Voice Disorders in Teachers. J Voice 2021; 35:324.e1-324.e8. [DOI: 10.1016/j.jvoice.2019.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/06/2019] [Accepted: 06/06/2019] [Indexed: 11/29/2022]
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Alves IAV, Paulino VCP, Souza ALR, Barbosa MA, Porto CC. Voice Care from the Student Teachers' Perspective. J Voice 2020; 35:664.e21-664.e26. [PMID: 32224004 DOI: 10.1016/j.jvoice.2019.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 10/18/2019] [Accepted: 12/16/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Voice is an essential working tool in the teaching profession and thus needs to be acknowledged and cared for by student teachers. This study aimed to investigate the presence of vocal symptoms among fourth-year students of teacher education programs and whether students had received voice care advice during their education. METHODS We conducted a descriptive cross-sectional study of 70 students in their final year of 9 teacher education programs at Regional Jataí of Universidade Federal de Goiás, Midwestern Brazil, from January to April 2017. Participants completed a questionnaire on sociodemographic, academic, and work-related characteristics, and were asked to answer an open-ended question on whether they had received any voice care advice during their education (and what type of advice if any). The Screening Index for Voice Disorder was then administered to all participants for self-reported vocal symptoms. RESULTS Of 70 students included in the study, 81.4% were women with a mean age of 30 years. Overall, 62.9% were employed: 47.7% in the field of education and 52.3% in other activities. As for vocal symptoms, 35.7% reported ≥ 5 symptoms, including strained speech (51.4%), dry throat (50.0%), dry cough (48.6%), hoarseness (37.1%), and phlegm (35.7%). Most students (87.14%) did not receive voice care advice during their education. Among those who received advice (12.86%), voice care was limited to lay advice, such as drinking plenty of water, speaking in a lower voice, avoiding straining the voice by shouting, avoiding cold beverages, and drinking ginger tea. CONCLUSION Our findings highlight the need for the introduction of voice training during teacher education in order to promote efficient voice production and prevent occupational voice disorders among future teachers by raising awareness of the importance of voice care and the risk factors that may affect the voice directly or indirectly.
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Affiliation(s)
| | | | - Ana Lúcia Rezende Souza
- Universidade Federal Regional de Jataí, Jatobá Campus, Cidade Universitária, Goiânia, Goiás, Brazil
| | - Maria Alves Barbosa
- Universidade Federal de Goiás (UFG), Setor Leste Universitário, Goiânia, Goiás, Brazil
| | - Celmo Celeno Porto
- School of Medicine, Graduate Program in Health Sciences, Health-Disease Dynamics, Setor Leste Universitário, Goiânia, Goiás, Brazil
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Vocal Dose of Preservice Music Therapists, Preservice Music Teachers, and Other Undergraduate Students. J Voice 2019; 35:328.e1-328.e10. [PMID: 31740101 DOI: 10.1016/j.jvoice.2019.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/18/2019] [Accepted: 09/18/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Researchers have studied various populations with high vocal doses and prevalence of related voice disorders. Teachers, singers, and university students are three such populations that have been examined extensively. No studies to date, however, have examined the voice use of music therapists and compared their voice use to these other populations. OBJECTIVE The purpose of this investigation was to examine voice dosimeter data including phonation duration and percentage, amplitude, frequencies, and distance dose acquired over contiguous 7 day (1 week) periods by preservice music therapists, preservice music teachers, and other university students in concert with daily voice use surveys. STUDY DESIGN This is a quantitative descriptive design. METHODS Eight female students of varied majors (music therapy, music education, vocal performance, elementary education, and "other") in their third year of university study wore a voice dosimeter during all waking hours for 7 days. The dosimeter recorded voicing time, percentage, frequency, and estimated amplitude. Participants also completed surveys related to several parameters of vocal health, the number of hours they slept, and their voice care. RESULTS Participants experienced relatively low vocal doses during the week. Music majors experienced more voice use than nonmusic majors. Some of the highest doses occurred during teaching demonstrations and leading of music therapy practicum sessions. CONCLUSION Preservice music therapists and preservice music teachers may experience extreme increases in vocal load when they enter the field. Absent training protocols, these increases could be detrimental to their vocal health and long-term viability as practitioners.
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Gassull C, Godall P, Polini E, Amador M, Casanova C. Effects of a Voice Training Program on Acoustics, Vocal Use, and Perceptual Voice Parameters in Catalan Teachers. Folia Phoniatr Logop 2019; 72:411-418. [DOI: 10.1159/000502766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 08/14/2019] [Indexed: 11/19/2022] Open
Abstract
<b><i>Objectives:</i></b> To assess the effect of EVES (Education for a Healthy and Efficient Voice), a voice training program aimed at promoting the use of an efficient and healthy voice in teachers. <b><i>Sample and Method:</i></b> Twenty-two teachers in the city of Granollers (Catalonia, Spain) were included in this research. The effect of the EVES program was evaluated focusing on the analysis of physiologic parameters on the one side (stroboscopy analysis), and on perceptual parameters on the other (Q-EVES questionnaire, Voice Handicap Index-10 [VHI-10], and GRBAS [Grade, Roughness, Breathiness, Asthenia, Strain Scale]). <b><i>Results:</i></b> The teachers incorporated the vocal strategies in their professional life and reported that the perception of difficulty in using their voice decreased. We observed a significant improvement in VHI-10 markers, in voice management abilities in the classroom, in perceptive and subjective voice parameters, and in some functional lesions. <b><i>Conclusions:</i></b> The results suggest that the educational intervention model may have a positive effect on teachers’ vocal care.
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Potential Risk Factors and Prevalence of Voice Symptoms in Students Starting Their Teacher Education. J Voice 2019; 35:323.e1-323.e8. [PMID: 31515195 DOI: 10.1016/j.jvoice.2019.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/09/2019] [Indexed: 02/08/2023]
Abstract
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.
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Greve K, Bryn EK, Simberg S. Voice Disorders and Impact of Voice Handicap in Norwegian Student Teachers. J Voice 2019; 33:445-452. [DOI: 10.1016/j.jvoice.2018.01.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 01/23/2018] [Indexed: 11/27/2022]
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Ohlsson AC, Dotevall H, Gustavsson I, Hofling K, Wahle U, Österlind C. Voice Therapy Outcome-A Randomized Clinical Trial Comparing Individual Voice Therapy, Therapy in Group, and Controls Without Therapy. J Voice 2018; 34:303.e17-303.e26. [PMID: 30344071 DOI: 10.1016/j.jvoice.2018.08.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 07/24/2018] [Accepted: 08/31/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE A stumbling-block in voice therapy is how the patient will be able to apply the new voice technique in everyday life. Possibly this generalization process could be facilitated by giving voice therapy in group because of the natural forum for training voice-to-speech early in communication between the patients in a group setting. The aim of the study was to compare treatment results from individual voice therapy and voice therapy in group, at several time points and in comparison to patients with no voice therapy. METHODS A randomized treatment study was performed with 77 consecutive patients diagnosed with a functional voice disorder. Thirty-one patients were randomized to individual and group therapy, respectively, and 15 patients to no therapy. The assessments included standardized voice recording and registration of voice range profile (VRP), answering Voice handicap index (VHI) and visual analogue scales for self-hoarseness and self-vocal fatigue, and perceptual voice evaluation by speech-language pathologist. The assessments were performed before, direct after therapy, and three months later in all groups. The 2 therapy groups were also assessed 12 months after therapy. RESULTS All VHI scores as well as the self-ratings of hoarseness and vocal fatigue, and the perceptual evaluation of voice quality and maximum VRP improved significantly in both therapy groups 3 months after treatment and at 12 months follow-up. There were no significant changes in the control group, with the exception of decreased self-rated hoarseness and increased maximum VRP. Comparisons between treatment groups showed significant larger improvement after group therapy for VHI physical subscale at 12 months, as well as significant lower VHI total score at all measurement sessions and lower subscale scores at 12 months. There were no differences between treatment groups in self-hoarseness or self-vocal fatigue and no difference in perceptual voice quality or VRP. Comparison between controls and treatment groups showed significant larger change in treatment groups from baseline to three months in VHI total and to end of therapy in functional subscale. Treatment groups also showed significant lower scores than controls at each measurement session, for VHI total and physical subscale as well as lower degree of perceptual aberration of voice quality and vocal fatigue, at three months follow-up. CONCLUSIONS This study shows long-term improvement from behavioral voice therapy, particularly in a group setting. The results indicate the importance of early transfer-to-speech and late posttherapy test to capture whether the goal of voice therapy was fulfilled or not for the patients.
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Affiliation(s)
- Ann-Christine Ohlsson
- Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Hans Dotevall
- Department of Logopedics and Phoniatrics, ENT Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inger Gustavsson
- Department of Speech Language Pathology, ENT Clinic, Hospital of South of Älvsborg, Borås, Sweden
| | - Kerstin Hofling
- Department of Speech Language Pathology, Hospital of Lidköping, Lidköping, Sweden
| | - Ulrika Wahle
- Department of Logopedics and Phoniatrics, ENT Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Claes Österlind
- Department of Speech Language Pathology, NU- Healthcare, Trollhättan, Sweden
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Holmqvist-Jämsén S, Johansson A, Santtila P, Westberg L, von der Pahlen B, Simberg S. Investigating the Role of Salivary Cortisol on Vocal Symptoms. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:2781-2791. [PMID: 28915296 DOI: 10.1044/2017_jslhr-s-16-0058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 04/19/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE We investigated whether participants who reported more often occurring vocal symptoms showed higher salivary cortisol levels and if such possible associations were different for men and women. METHOD The participants (N = 170; men n = 49, women n = 121) consisted of a population-based sample of Finnish twins born between 1961 and 1989. The participants submitted saliva samples for hormone analysis and completed a web questionnaire including questions regarding the occurrence of 6 vocal symptoms during the past 12 months. The data were analyzed using the generalized estimated equations method. RESULTS A composite variable of the vocal symptoms showed a significant positive association with salivary cortisol levels (p < .001). Three of the 6 vocal symptoms were significantly associated with the level of cortisol when analyzed separately (p values less than .05). The results showed no gender difference regarding the effect of salivary cortisol on vocal symptoms. CONCLUSIONS There was a positive association between the occurrence of vocal symptoms and salivary cortisol levels. Participants with higher cortisol levels reported more often occurring vocal symptoms. This could have a connection to the influence of stress on vocal symptoms because stress is a known risk factor of vocal symptoms and salivary cortisol can be seen as a biomarker for stress.
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Affiliation(s)
| | - Ada Johansson
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
- Department of Psychology and Speech-Language Pathology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | - Pekka Santtila
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | - Lars Westberg
- Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - Susanna Simberg
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
- Department of Special Needs Education, Faculty of Educational Sciences, University of Oslo, Norway
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