Normative nasalance values across languages.

The Nasometer is an objective computer-based instrument designed to measure the acoustic correlates of resonance and velopharyngeal function. The device has proven to be useful for early identification of persons at risk for velopharyngeal dysfunction. Since its introduction, the Nasometer has been used in craniofacial centers and other clinical settings both in the United States and around the world. The purpose of this paper is to describe the Nasometer and its clinical uses, discuss speaker characteristics that might influence nasalance values, and provide a compilation of published normative nasalance data across English, Spanish, Asian, and European languages. Additionally, languages in need of normative nasalance data are discussed

Louisiana State University nasalance protocol standardization

It was the purpose of this study to obtain nasalance values using the Nasometer and a resonance evaluation created at the Louisiana State University (LSU) Speech and Hearing Clinic. The Nasometer was used to measure the amount of nasal acoustic energy in the speech of 40 normal young adults during sustained vowel production, consonant vowel reduplications, and connected speech using the Rainbow Passage. Means and standard deviations are presented for the individual speech tasks and according to gender. Nasalance values for the sustained vowels were significantly higher for the high front vowel /i/ than any other vowel, and the lowest nasalance value was obtained by the high back vowel /u/. The vowels in order of highest to lowest nasalance values were as follows: /i, ae, a, u/. No significant gender differences were found for sustained vowel production or the Rainbow Passage. Correlation values indicated that three phonemes /u, k, g/ from the resonance protocol were the best predictors of nasalance for the reading passage. The results are discussed with regard to potential reasons why minimal gender differences were found, why the phonemes were found to be the best predictors of nasalance, and how the LSU protocol can be modified to provide a more effective and efficient resonance evaluation

A comparison of nasalance values in tracheoesophageal voice prosthesis and normal laryngeal speakers.

The purpose of this study was to compare nasalance values in tracheoesophageal (TE) voice prosthesis and laryngeal speakers. Nasalance measures were obtained from 10 age-matched male TE speakers and 10 healthy male laryngeal speakers reading the Zoo Passage and Nasal Sentences. All TE speakers were rated as good to excellent in terms of speech proficiency and intelligibility. Nasalance scores were compared across groups. The findings revealed there were no significant differences in average nasalance values between the two groups. Clinical implications and future research needs are discussed

Assessing the Nasalance of Native Mandarin Speakers in Mandarin and English

Objective: To determine whether native Mandarin speakers show a difference in nasalance measurement in their native language compared to English and analyze the effect of predictors on nasalance scores. Design: Participants completed a questionnaire about cultural and linguistic background. All participants recorded three Mandarin sentences and vowels, and three English sentences and vowels, designed to phonetically match Mandarin speech stimuli. Nasalance measurements were taken from the Nasometer II 6450. Participants were randomly selected to repeat recordings for test-retest reliability. Participants and setting: The participants included 45 native Mandarin-speakers (20 males, 25 females) from mainland China between 20 and 54 years of age. All participants were tested in the speech laboratory of East Carolina University. Results: A paired samples t-test revealed a significant difference between mean nasalance scores of English and Mandarin sentences (p < 0.008). Scores for English and Mandarin vowels did not yield significant results. A multiple linear regression model revealed significant gender-based differences (p < 0.05). Age, English language exposure, mean English language preference and dialect did not yield significant results. Conclusions: Native Mandarin speakers yield different nasalance scores in their native language compared to English. This confirms that separate nasalance score norms are needed for the Mandarin language. Gender-based differences should be considered in the collection and analysis of nasalance scores. Reported Nasometer scores can be used for preliminary normative data

Speech characteristics after palatal closure in subjects with isolated clefts : an exploration in Uganda

Cleft lip and/or palate (CL/P) is a congenital craniofacial defect that arises on average in 1.7 per 1000 live births. This anomaly causes atypical facial appearance, hearing problems, malocclusions and speech disorders. Outcomes in terms of speech are influenced by timing of surgical cleft closure. In the Comprehensive Rehabilitation Services in Uganda (CoRSU) hospital, closure of the entire cleft during a single surgery prior to the age of 6 months is preferred in view of reducing default rates for second surgery and decreasing risks for malnutrition and death. However, some patients arrive the first time at the hospital in later childhood, youth or adulthood. No information about satisfaction and speech outcome was yet available for these Ugandan patients. Moreover, only few, if any studies systematically assessed satisfaction and speech following similar surgical timing protocols. Therefore, in view of searching for the optimal surgical treatment for patients with CL/P, the general aim of the current doctoral thesis was to verify satisfaction and speech in Ugandan patients with CL/P repaired in CoRSU by one experienced surgeon using the Sommerlad technique for palatal closure. In view of clinics and further research, normative nasalance values were first obtained in Ugandan English-speaking males and females (age: 2;7 to 13;5 years) without craniofacial anomalies. No significant age and gender differences were observed. Second, parental satisfaction was studied in Ugandan children with unilateral or bilateral cleft lip and palate (CLP) following synchronous lip and palatal closure. Overall high levels of satisfaction were noted for appearance of lip, nose and face, despite lower satisfaction levels for teeth appearance and speech. Comparison with an age- and gender-matched non-cleft control group revealed significant higher parental dissatisfaction for speech and appearance of teeth and nose in Ugandan patients with CLP. Third, articulation and resonance characteristics of Ugandan patients with early synchronous closure of C(L)P (≤ 6 months) were assessed. Comparison with an age- and gender-matched non-cleft control group revealed various deviations from normal speech development. The Ugandan CP group showed significantly smaller consonant inventories as well as significantly more phonetic disorders, phonological processes and nasal emission/turbulence compared to the control group. In addition, Ugandan patients with C(L)P were compared to a Belgian CP group (matched for cleft type, age and gender) who underwent palatal repair after the age of 6 months. A Ugandan and Belgian age- and gender-matched non-cleft control group was included to control for language, culture and other environmental factors. Comparison of the Ugandan and Belgian CP group revealed at least similar articulation and resonance characteristics. No significant group differences were obtained for perceptual evaluation of resonance, mean nasalance values of oral speech samples, consonant inventories and most phonetic errors and phonological processes. However, the Belgian CP group showed significantly more distortions due to higher occurrence frequencies for (inter)dental articulation of apico-alveolar consonants. Finally, articulation and resonance characteristics as well as patients’ satisfaction with speech were verified in Ugandan patients following delayed one-stage soft and hard palatal closure (≥ 8 years). Comparison with an age- and gender-matched non-cleft control group revealed overall low satisfaction with speech and severely disordered articulation and resonance. The patient group showed significantly smaller consonant inventories, more phonetic and phonological disorders, more hypernasality and nasal emission/turbulence as well as higher mean nasalance values for oral and oronasal speech samples compared to the control group. When findings of the current doctoral thesis are placed within a broader framework, early closure of the entire cleft during a single surgery seems to be an appropriate surgical timing protocol for resource-poor countries. However, prior to application in northern countries, more information on maxillofacial growth disturbances is required. Furthermore, when youngsters and adults present with untreated clefts, delayed cleft repair might be of value, although speech outcomes are poor

Effects of Vowel Height and Vocal Intensity on Anticipatory Nasal Airflow in Individuals With Normal Speech

The purpose of this study was to determine the effects of vowel height and vocal intensity on the magnitude of anticipatory nasal airflow in normal speakers when producing vowel-nasal-vowel (VNV) sequences. Measurements of nasal and oral airflow were obtained from 15 men and 12 women with normal speech during production of the VNV sequences /ini/ and /ana/ at low, medium, and high intensity levels. Ratios of nasal to oral-plus-nasal airflow were calculated for the initial vowel of both utterances at each of the intensity levels. Analysis of variance (ANOVA) procedures indicated a significant main effect of intensity level and a significant vowel-by-sex interaction effect (p &lt; .05) on the airflow ratios. Overall, the airflow ratio was reduced at high as compared to low intensity levels, regardless of sex of the speaker or vowel type. Female speakers exhibited greater airflow ratios during production of /ini/ than during productions of /ana/. Their airflow ratios were also greater during production of / ini/ than were those of male speakers. The results suggest that vocal intensity may affect velopharyngeal (VP) function in an assimilative nasal phonetic context. The results further suggest that anticipatory nasal airflow may be determined by the configuration of the oral cavity to a greater extent in women than in men. Theoretical and clinical implications are discussed

Nasometric Assessment of Bilingual Spanish/English Speakers

The purpose of this study was to examine the effect of native language on speech tasks requiring velopharyngeal closure, particularly the standardized Nasometric assessment of voice resonance. Comparison of ten native-English-speaking adults (N) and ten bilingual Spanish/English speakers (B) indicates that native language did not significantly influence standardized assessment scores, although the effect of gender remains ambiguous, with female participants generally producing higher nasalance scores. Within-subject comparison of the bilingual speakers' individual scores on the English and Spanish stimuli indicated significant differences in the scores obtained on the nasal sentence sets and the oro-nasal paragraphs. Highly fluent bilingual English/Spanish speakers, like the participants of this study, can be accurately assessed using the standardized English nasometry passages. Nevertheless, future researchers and diagnosticians investigating velopharyngeal movement and voice resonance should be aware of the possible gender effect and its potential interaction with native language

Avaliação nasométrica de crianças surdas

Mestrado em Ciências da Fala e da AudiçãoO presente trabalho teve como principal objectivo testar a aplicabilidade clínica do Nasómetro em crianças com surdez. Mais concretamente, foram avaliadas as diferenças entre crianças normo-ouvintes e crianças surdas ao nível da ressonância nasal. Para além disso, foi estudado o efeito da utilização de diferentes tecnologias de apoio (prótese auditiva vs. implante coclear) e de diferentes estímulos de fala (sílabas, palavras e frases) nos valores de nasalância. Tendo em conta as especificidades do Português Europeu, no que respeita à nasalidade, foram criados três sub-testes: repetição de sílabas, nomeação de imagens e leitura de frases. A escolha dos estímulos obedeceu a critérios de ausência ou saturação de segmentos nasais. Foram recolhidos dados de 22 crianças normo-ouvintes e de 14 crianças surdas (7 beneficiárias de prótese auditiva e 7 com implante coclear), usando o Nasómetro. Os resultados evidenciaram diferenças significativas entre o grupo normoouvinte e o grupo com implante coclear para todos os estímulos orais, o que sugere uma tendência para a hipernasalidade. Para além disso, não se verificaram diferenças entre o grupo com prótese auditiva e o grupo normoouvinte em nenhum dos estímulos testados. Os resultados obtidos evidenciaram ainda uma grande variabilidade inter-sujeitos, principalmente no grupo com implante coclear. Relativamente às diferenças entre estímulos, as sílabas, quando comparadas com as frases e as imagens, apresentaram valores de nasalância superiores. Os valores de nasalância obtidos pelo grupo normo-ouvinte seguiram o mesmo padrão de nasalância de outros estudos de nasometria para o português europeu. O Nasómetro poderá ser útil como medida de avaliação nasométrica em crianças normo-ouvintes e surdas, complementando a avaliação auditivoperceptiva da ressonância nasal.This work had as its main goal to test the nasometer clinical application in deaf children. I have ensued an evaluation of the differences on nasal resonance among children with normal hearing and deaf children. Moreover, it was studied the effect of using different support technologies (hearing aid vs cochlear implant) and different speach stimuli (syllable, words and sentences) regarding the nasalance scores. Considering the specificity of the European Portuguese language regarding nasalance three sub-tests were used: syllable repetition, naming images and reading sentences. The stimuli choice complied with criterion of lacking or saturation of nasal segments. The collection of data of 22 normal hearing children and 14 deaf children (7 children with hearing aid and 7 with cochlear implant) by using a nasometer. The results are a clear evidence of the significant differences between the normal hearing children group and the ones with cochlear implants (regarding all oral speech stimuli). This fact suggests a predisposition to hipernasality. Furthermore, there are no other differences between the group using hearing aid and the one with normal hearing. The results achieved are also an indication of a huge intersubject variability, mainly among children with cochlear implants. Regarding the differences between the stimuli used, when syllables are compared to sentences and to images, they offer superior nasalance scores. Nasalance scores obtained from children with normal hearing have followed the same nasalance pattern found in other nasometry studies for the European Portuguese language. The Nasometer can be useful as a measure for nasometric evaluation of deaf children and of children with normal hearing. This will enhance the perceptive auditive results