Razumljivost govora kod laringektomiranih bolesnika koji koriste različite oblike govorne komunikacije

Modern methods of speech rehabilitation after a total laryngectomy have come to a great success by giving the patients a possibility to establish an intelligible and functional speech after an adequate rehabilitation treatment. The aim of this paper was to examine speech intelligibility of laryngectomized patients who use different types of vocal communication: esophageal speech, speech with tracheoesophageal prosthesis and speech with electronic laringeal prosthesis. The research was conducted on a sample of 125 laryngectomized patients of both sexes, between 48 and 85 years of age. For the subjective assessment of speech intelligibility, we used the phonetically balanced text. In the paper we used the descriptive statistics methods (the arithmetic mean with standard deviation, as well as minimum and maximum). The differences between the groups were determined by the t-test for independent samples. Pirson's correlation coefficient was used to examine the correlation between the two variables. The examinees are statistically different by the results achieved on the speech intelligibility test. The esophageal patients have the highest scores (1.13±0.86), while the patients with the vocal prosthesis and patients who use electrolarynx have similar scores (0.14±0.35; 0.15±0.36). The differences of the analyzed values were statistically significant (p lt 0.01). The results obtained in this research have shown that the patients who use tracheoesophageal vocal prosthesis have better achievement on the speech intelligibility test comparing to the esophageal patients and patients who use electrolarynx.Primenom savremenih metoda rehabilitacije nakon totalne laringektomije moguće je uspostavljanje razumljivog i funkcionalnog govora. Cilj ovog rada je utvrđivanje razlika u razumljivosti govora kod laringektomiranih bolesnika koji koriste različite oblike govorne komunikacije: ezofagealni govor, govor uz pomoć traheoezofagealne vokalne proteze i govor uz pomoć elektronske laringealne proteze. Istraživanje je izvršeno na uzorku od 125 laringektomiranih bolesnika, starosne dobi od 48 do 85 godina. Za subjektivnu procenu razumljivosti govora korišćen je fonetski izbalansirani tekst. U statističkoj obradi dobijenih podataka korišćene su: mere centralne tendencije, mere varijabilnosti, jednofaktorska analiza varijanse, t-test za nezavisne uzorke i Pirsonov koeficijent korelacije. Utrvrđene su statistički značajne razlike među ispitivanim grupama u postignućima na Testu razumljivosti govora. Ezofagealni pacijenti su ostvarili najviši prosečan skor (1,13±0,86), dok pacijenti iz grupe koja koristi vokalnu protezu imaju približno ista prosečna postignuća kao oni iz grupe koja koristi elektrolarinks (0,14±0,35; 0,15±0,36; p lt 0,01). Dobijeni rezultati su pokazali da pacijenti kojikoriste traheoezofagealne vokalne proteze ostvaruju bolja postignuća na Testu razumljivosti govora od ezofagealnih i pacijenata koji koriste elektrolarinks

Korelacija između akustičkih i perceptivnih parametara glasa kod nastavnica

The aim of the research is to examine the connection between acoustic and perceptual parameters of voice in class female teachers. The survey involved 123 female subjects aged 25 to 59 years. The paper used a computer laboratory for the analysis of acoustic voice parameters, model 4300, "Kay Elemetrics" corporation. A subjective assessment of the quality of the voice was carried out using the Grbas scale. In statistical data processing, the measures of central tendency, variation measures, single-factor analysis of variance, t-test for independent samples and Pirson correlation coefficient were applied. Multidimensional voice analysis is used in the process of diagnostics and voice rehabilitation, which serves us to assess the effectiveness of rehabilitation and to support a subjective assessment of voice testing. Perceptive scales are important in assessing voice quality, determining the degree and severity of voice disorders, and deciding on further clinical procedures. Although the instrumental approach in voice testing is relevant because it provides objectivity, a subjective impression in voice quality assessment is crucial. The results of our research show significant correlations between acoustic and perceptual voice characteristics of the classroom teachers, such as Grbas scales G (degree of hoarseness), R (voice roughness), a (weakness in voice) and S (tension in voice) and most of the respondents acoustic parameters that show variations in frequency and intensity (Jitt, RAP, Shim, APQ , and vAm). Although the changes in the voice quality of the teachers were mild and mild-moderate, they are very important to us because they can indicate the presence of vocal load that can lead to vocal dysfunction and voice disorders.Cilj istraživanja je da se ispita povezanost između akustičkih i perceptivnih parametara glasa kod nastavnica razredne nastave. U istraživanju je učestvovalo 123 ispitanica, starosti od 25 do 59 godina. Korišćena je kompjuterska laboratorija za analizu akustičkih parametara glasa, model 4300, "Kay Elemetrics" korporacije. Subjektivna procena kvaliteta glasa je izvršena primenom Grbas skale. U statističkoj obradi podataka primenjene su mere centralne tendencije, mere varijabilnosti, jednofaktorska analiza varijanse, t-test za nezavisne uzorke i Pirsonov koefcijent korelacije. Multidimenzionalna analiza glasa se koristi u procesu dijagnostike i rehabilitacije glasa, služi za procenu uspešnosti rehabilitacije i kao podrška subjektivnoj proceni ispitivanja glasa. Perceptivne skale su značajne u proceni kvaliteta glasa, određivanju stepena i težine poremećaja glasa, kao i odlučivanju o daljim kliničkim postupcima. Iako je instrumentalni pristup u ispitivanju glasa relevantan jer obezbeđuje objektivnost, subjektivni utisak u proceni kvaliteta glasa je ključan. Rezultati našeg istraživanja pokazuju značajne korelacije između akustičkih i perceptivnih karakteristika glasa kod nastavnica razredne nastave i to između parametara Grbas skale G (stepen promuklosti), R (hrapavost glasa), A (slabost u glasu) i S (napetost u glasu) i većine ispitivanih akustičkih parametara koji pokazuju varijacije u fekvenciji i intenzitetu (Jit, RP, Shim, APQ , i vAm). Iako su promene u kvalitetu glasa kod nastavnica bile blage i blago-umerene, one su veoma značajne za nas jer mogu ukazati na prisustvo vokalnog opterećenja koje može dovesti do vokalne disfunkcije i poremećaja glasa

Multidimensional voice analysis in patients with Broca' s aphasia

The subject of this study is a multidimensional voice analysis in patients with Broca's aphasia. The acoustic tests were done on twelve female patients with Broca's aphasia and twelve female control subjects without speech and language disorders. Each subject was asked to perform maximal vowel 'a' phonation. The several acoustic parameters were analyzed. The Multi-dimensional Voice Program and Computerized Speech Lab were used. The results showed that analyzed acoustic parameters in the Broca's aphasics are significantly different from the acoustic characteristics of voice in control group of subjects. It was pointed out that acoustic analysis of voice could have significance in the evaluation of speech production deficits in Broca's aphasia

The relationship of sensory processing of children with developmental dysphasia with burnout and self-esteem of parents

Uvod: Teškoće senzornog procesiranja mogu predstavljati rizik za razvoj jezičkih i govornih poremećaja u najranijem periodu i nužno zahtevaju pomoć stručnjaka i kontinuirano angažovanje roditelja u radu sa detetom, što može dovesti do pojave sagorevanja kod roditelja i pada njihovog samopoštovanja, uz nemogućnost adekvatne pomoći ne samo detetu već i sebi. Cilj: Cilj istraživanja bilo je ispitivanje povezanosti senzorne osetljivosti dece sa razvojnom disfazijom sa karakteristikama roditelja. Metode: Uzorak je činilo 50 roditelja dece uzrasta od tri do šest godina. U istraživanju su korišćeni upitnici za procenu karakteristika senzornog procesiranja: Dečiji senzorni profil 2, Roditeljski inventar sagorevanja, Rozenbergova skala samopoštovanja. U obradi podataka korišćene su mere deskriptivne statistike i Pirsonov koeficijent korelacije. Rezultati: Rezultati istraživanja pokazuju da je nivo roditeljskog sagorevanja relativno nizak – roditelji pokazuju visok stepen lične posvećenosti (M = 4.16, SD = .67), srednji nivo emocionalne iscrpljenosti (M = 2.34, SD = .78) i nizak nivo emocionalnog distanciranja (M = 1.72, SD = .72) – ali i da ih odlikuje niže samopoštovanje (M = 3.11, SD = .34). Takođe, samopoštovanje i sagorevanje nisu međusobno povezani. Na senzornom profilu skale bihevioralnih elemenata veoma visoko međusobno koreliraju, dok intenzitet korelacija u dimenzijama osnovnog sistema procesiranja oscilira i postoji slaba povezanost opšteg samopoštovanja roditelja na dimenzijama procesiranje položaja tela i ponašanje vezano za senzorno procesiranje. Zaključak: Rezultati su razmatrani u kontekstu praktičnih pedagoških implikacija s obzirom na to da ukoliko se teškoće ne otklone u predškolskom periodu, može doći do odgađanja polaska deteta u školu ili dugoročnih teškoća pri učenju i savladavanju školskog gradiva.Introduction. Sensory processing difficulties can pose a risk for the development of language and speech disorders in the earliest period and require professional intervention and intense involvement of parents in homework with children with developmental dysphasia, which might cause parental burnout and lower level of their self-esteem when parents are not able to help, not only the children, but themselves too. Aim. The aim of the research was to examine the relationship between the sensory sensitivity of children with developmental dysphasia and the characteristics of parents. Method. The sample consisted of 50 parents of children aged 3 to 6 years. The following questionnaires were used in the research to assess the characteristics of sensory processing: The Child Sensory Profile 2, Parental Burnout Inventory, and Rosenberg Self-Esteem Scale. Measures of descriptive statistics and Pearson’s correlation coefficient were used in data processing. Results. The results of the research show that the level of parental burnout is relatively low (parents showed a high level of personal accomplishment (M = 4.16, SD = .67), mild level of emotional exhaustion (M = 2.34, SD = .78) and low level of emotional distancing (M = 1.72, SD = .72), but also that they are characterized by lower self-esteem (M = 3.11, SD = .34). Also, self-esteem and burn-out are not related. On the Sensory Profile, subscales of behavior elements are highly correlated, while the intensity of correlations in subscales of the basic system of processing oscillates. There is a weak correlation between the general self-esteem of parents with subscales of body posture and behavior. Conclusion. The obtained results were discussed in the context of practical pedagogical implications, considering that if the difficulties in the child’s functioning are not eliminated in the preschool period, the child’s departure to school may be delayed, or long-term difficulties in learning may appear

Prosodic features of pragmatic abilities in adults with intellectual disabilities

Osobe sa intelektualnom ometenošću imaju snižene socio-komunikacione kompetencije. U odnosu na ostale pragmatske sposobnosti, oblast prozodije, kao segmenta paralingvistike, kod osoba sa intelektualnom ometenošću manje je poznata. Cilj rada je pregled i analiza dostupne literature o paralingvističkim prozodijskim sposobnostima kod odraslih osoba sa intelektualnom ometenošću. Rezultati dobijeni analizom dostupnih istraživanja ukazuju na priličnu konzistentnost nalaza u vezi sa akustičkim i perceptivnim prozodijskim manifestacijama kod osoba sa intelektualnom ometenošću, odnosno o višim vrednostima fundamentalne frekvencije koja je van tipičnog opsega, kao i o smanjenoj modulaciji, nižim vrednostima Jittera i Shimmera, ali i sniženoj energiji. Analizom su uočene i metodološke nekonzistentnosti koje se ponajpre ogledaju u veličini uzorka, starosnoj dobi uzorka, etiologiji intelektualne ometenosti, odabiru analiziranih parametara i tipu foniranja. Sumiranjem istraživačke literature uočavaju se atipične prozodijske karakteristike kod odraslih osoba sa intelektualnom ometenošću u odnosu na odrasle tipičnog razvoja. Proučavanje prozodije u adultnom periodu ima veliki značaj, kako za razumevanje razvojnih faktora u vezi sa ovom sposobnošću, tako i za tretman pragmatskih veština kod osoba sa intelektualnom ometenošću.People with intellectual disabilities (ID) have reduced social communication skills. There is less scientific knowledge about prosody, as a segment of paralinguistics, in people with ID, compared to their other pragmatic abilities. The aim of this paper is to review and analyze the available literature on paralinguistic prosodic abilities in adults with ID. The results obtained from the analysis of available research indicate considerable consistency in findings regarding acoustic and perceptual prosodic characteristics in people with ID, ie higher values of fundamental frequency (F0) which is outside the typical range, as well as reduced modulation, lower values of Jitter and Shimmer, and reduced energy. The analysis also revealed methodological inconsistencies, which are primarily reflected in the sample size, sample age, etiology of ID, selected analyzed parameters and type of phonation. By summarizing the research literature, atypical prosodic characteristics are noticeable in adults with ID in relation to adults of typical development. The study of prosody in the period of adulthood is of great importance, both for understanding the developmental factors related to this ability, but also for the treatment of pragmatic skills in people with ID

Multidimensional voice analysis in patients with Broca' s aphasia

The subject of this study is a multidimensional voice analysis in patients with Broca's aphasia. The acoustic tests were done on twelve female patients with Broca's aphasia and twelve female control subjects without speech and language disorders. Each subject was asked to perform maximal vowel 'a' phonation. The several acoustic parameters were analyzed. The Multi-dimensional Voice Program and Computerized Speech Lab were used. The results showed that analyzed acoustic parameters in the Broca's aphasics are significantly different from the acoustic characteristics of voice in control group of subjects. It was pointed out that acoustic analysis of voice could have significance in the evaluation of speech production deficits in Broca's aphasia

Spectrographic analysis of vowels in laryngectomy patients

Spektrografska analiza govora je pouzdana metoda koja omogućava izdvajanje kvantitativnih parametara glasa. Primenjena je u ovom radu za poređenje različitih oblika komunikacije kod laringektomiranih bolesnika. Cilj istraživanja je da se utvrdi povezanost između parametara spektralne analize i razumljivosti govora kod laringektomiranih bolesnika, kao i uticaj ovih parametara na stepen razumljivosti govora. Uzorkom je obuhvaćeno 125 laringektomiranih pacijenata oba pola, starosti od 48 do 85 godina. Spektrografska analiza sprovedena je primenom kompjuterizovane Laboratorije za ispitivanje glasa i govora “Kay Elemetrics“ korporacije, model 4300. U radu je korišćen „Balansirani tekstˮ za analizu govora i glasa. U statističkoj obradi podataka korišćena je deskriptivna statistika. Razlike su testirane jednofaktorskom analizom varijanse (ANOVA) i t testom za velike nezavisne uzorke, kao i t testom za jedan uzorak. Povezanost je ispitana Pirsonovim koeficijentom korelacije. Univarijantna linearna regresiona analiza korišćena je za utvrđivanje uticaja prediktora na zavisnu varijablu. Utvrđena je samo jedna statistički značajna povezanost parametra IF2 (r = -0,41, p = 0,009) sa ocenom na Testu razumljivosti govora kod ezofagealnih pacijenata i jedna statistički značajna povezanost parametra IF2 (r = 0,35, p = 0,025) sa ocenom na Testu razumljivosti govora kod pacijenata koji koriste elektrolarinks. Rezultati regresione analize su pokazali da je varijabla IF2 statistički značajni prediktor rezultata na Testu razumljivosti kod ezofagealnih pacijenata, objašnjavajuči 14% varijanse (β = -0,41, p = 0,009). U grupi pacijenata koji koriste elektrolarinks varijabla IF2 je statistički značajna u predikciji rezultata na Testu razumljivosti, objašnjavajuči 10% varijanse (β = 0,35, p = 0,025Spectrographic analysis of speech is a reliable method which enables deriving quantitative parameters of voice. In this study, it was used for comparing different forms of communication in laryngectomy patients. The aim of the research was to determine the connection between parameters of spectral analysis and speech understanding in laryngectomy patients, as well as the impact of these parameters on the degree of speech understanding. The study sample included 125 laryngectomy patients of both genders, 48 to 85 years of age. Spectrographic analysis was carried out by implementing the computerized Laboratory for examining voice and speech of “Kay Elemetrics Corporation“, model 4300. The “Balanced text“ for the analysis of speech and voice was used in this study. In statistical data processing, the descriptive statistics was used. The differences were tested by the single factor Analysis of Variance (ANOVA) and by the independent sample t test, and also by a single sample t test. The connection was examined by Pearson correlation coefficient. Univariate linear regression analysis was used for determining the influence of the predictor on the dependent variable. Only one significant connection of the parameter IF2 (r = -0.41, p = 0.009) with speech understanding test assessment was determined in esophageal patients, and one statistically significant connection of the parameter IF2 (r = 0.35, p = 0.025) with the speech understanding test assessment in patients who use electrolarynx. The results of the regression analysis showed that the variable IF2 was a statistically significant predictor of the Understanding test results in esophageal patients, explaining 14% of the variance (Beta = -0.41, p = 0.009). In a group of patients who used electrolarynx, the variable IF2 was statistically significant in the prediction of the Understanding test, explaining 10% of the variance (β = 0.35, p = 0.025)

Spasmodic dysphonia: characteristics and treatment

Spastična disfonija predstavlja oblik poremećaja glasa čiji uzrok još uvek nije poznat. Kod nekih pacijenata nastaje kao primarni poremećaj, a kod drugih se ispoljava udruženo sa određenim oblicima neuropatologije. U cilju bližeg određivanja prirode poremećaja, u radu je dat pregled emprijskih studija koje razmatraju patofizologiju i poreklo spastične disfonije. Istovremeno je pokazan značaj multidimenzionalnog sagledavanja simptoma i prirode poremećaja glasa. Istaknut je značaj kliničke opservacije, primene objektivnih metoda analize glasa i percepcije simptoma oštećene fonacije od strane samog pacijenta. Posebno su opisane postojeće metode terapije, uz isticanje njihovih prednosti i nedostataka u tretmanu pacijenata sa spastičnom disfonijom. Zaključeno je da nijedan do sada opisan metod tretmana ne dovodi do potpunog izlečenja. Istaknut je značaj vokalne terapije kao metode koja izolovano, ili u kombinaicji sa drugim metodama ublažava tegobe kod pacijenata sa spastičnom disfonijom. S obzirom na tekuća shvatanja problema spastične disfonije, buduća naučno-emprijska istraživanja treba usmeriti u pravcu utvrđivanja uzroka poremećaja, standardizacije dijagnostičkih procedura i postupka evaluacije efikasnosti primenjenih metoda tratmana.Spasmodic dysphonia is a voice disorder with no known cause. It occurs as a primary disorder in some patients, while it coexists with other forms of neuropathology in others. The paper reviews empirical studies on pthophysiology and the origin of spasmodic dysphonia, with the aim to define the nature of the disorder. The paper also points out the significance of multidimensional identification of the symptoms and nature of voice disorders. The significance of clinical observation, application of objective methods of analyzing voice and recognizing symptoms of the impaired phonation by the patient are emphasized as well. The paper describes current treatment methods, pointing out their advantages and disadvantages in treating patients with spasmodic dysphonia. It was concluded that none of the treatment methods described so far leads to complete recovery. We pointed out the significance of vocal therapy as a method which separately, or in combination with other methods, reduces the problems of patients with spasmodic dysphonia. With regard to the current views on spasmodic dysphonia problems, future scientific-empirical studies should be directed at determining the cause of the disability, standardizing diagnostic procedures and the process of evaluating the efficacy of the applied treatment methods

Prosodic features of pragmatic abilities in adults with intellectual disabilities

Osobe sa intelektualnom ometenošću imaju snižene socio-komunikacione kompetencije. U odnosu na ostale pragmatske sposobnosti, oblast prozodije, kao segmenta paralingvistike, kod osoba sa intelektualnom ometenošću manje je poznata. Cilj rada je pregled i analiza dostupne literature o paralingvističkim prozodijskim sposobnostima kod odraslih osoba sa intelektualnom ometenošću. Rezultati dobijeni analizom dostupnih istraživanja ukazuju na priličnu konzistentnost nalaza u vezi sa akustičkim i perceptivnim prozodijskim manifestacijama kod osoba sa intelektualnom ometenošću, odnosno o višim vrednostima fundamentalne frekvencije koja je van tipičnog opsega, kao i o smanjenoj modulaciji, nižim vrednostima Jittera i Shimmera, ali i sniženoj energiji. Analizom su uočene i metodološke nekonzistentnosti koje se ponajpre ogledaju u veličini uzorka, starosnoj dobi uzorka, etiologiji intelektualne ometenosti, odabiru analiziranih parametara i tipu foniranja. Sumiranjem istraživačke literature uočavaju se atipične prozodijske karakteristike kod odraslih osoba sa intelektualnom ometenošću u odnosu na odrasle tipičnog razvoja. Proučavanje prozodije u adultnom periodu ima veliki značaj, kako za razumevanje razvojnih faktora u vezi sa ovom sposobnošću, tako i za tretman pragmatskih veština kod osoba sa intelektualnom ometenošću.People with intellectual disabilities (ID) have reduced social communication skills. There is less scientific knowledge about prosody, as a segment of paralinguistics, in people with ID, compared to their other pragmatic abilities. The aim of this paper is to review and analyze the available literature on paralinguistic prosodic abilities in adults with ID. The results obtained from the analysis of available research indicate considerable consistency in findings regarding acoustic and perceptual prosodic characteristics in people with ID, ie higher values of fundamental frequency (F0) which is outside the typical range, as well as reduced modulation, lower values of Jitter and Shimmer, and reduced energy. The analysis also revealed methodological inconsistencies, which are primarily reflected in the sample size, sample age, etiology of ID, selected analyzed parameters and type of phonation. By summarizing the research literature, atypical prosodic characteristics are noticeable in adults with ID in relation to adults of typical development. The study of prosody in the period of adulthood is of great importance, both for understanding the developmental factors related to this ability, but also for the treatment of pragmatic skills in people with ID

Spasmodic dysphonia: characteristics and treatment

Spastična disfonija predstavlja oblik poremećaja glasa čiji uzrok još uvek nije poznat. Kod nekih pacijenata nastaje kao primarni poremećaj, a kod drugih se ispoljava udruženo sa određenim oblicima neuropatologije. U cilju bližeg određivanja prirode poremećaja, u radu je dat pregled emprijskih studija koje razmatraju patofizologiju i poreklo spastične disfonije. Istovremeno je pokazan značaj multidimenzionalnog sagledavanja simptoma i prirode poremećaja glasa. Istaknut je značaj kliničke opservacije, primene objektivnih metoda analize glasa i percepcije simptoma oštećene fonacije od strane samog pacijenta. Posebno su opisane postojeće metode terapije, uz isticanje njihovih prednosti i nedostataka u tretmanu pacijenata sa spastičnom disfonijom. Zaključeno je da nijedan do sada opisan metod tretmana ne dovodi do potpunog izlečenja. Istaknut je značaj vokalne terapije kao metode koja izolovano, ili u kombinaicji sa drugim metodama ublažava tegobe kod pacijenata sa spastičnom disfonijom. S obzirom na tekuća shvatanja problema spastične disfonije, buduća naučno-emprijska istraživanja treba usmeriti u pravcu utvrđivanja uzroka poremećaja, standardizacije dijagnostičkih procedura i postupka evaluacije efikasnosti primenjenih metoda tratmana.Spasmodic dysphonia is a voice disorder with no known cause. It occurs as a primary disorder in some patients, while it coexists with other forms of neuropathology in others. The paper reviews empirical studies on pthophysiology and the origin of spasmodic dysphonia, with the aim to define the nature of the disorder. The paper also points out the significance of multidimensional identification of the symptoms and nature of voice disorders. The significance of clinical observation, application of objective methods of analyzing voice and recognizing symptoms of the impaired phonation by the patient are emphasized as well. The paper describes current treatment methods, pointing out their advantages and disadvantages in treating patients with spasmodic dysphonia. It was concluded that none of the treatment methods described so far leads to complete recovery. We pointed out the significance of vocal therapy as a method which separately, or in combination with other methods, reduces the problems of patients with spasmodic dysphonia. With regard to the current views on spasmodic dysphonia problems, future scientific-empirical studies should be directed at determining the cause of the disability, standardizing diagnostic procedures and the process of evaluating the efficacy of the applied treatment methods