Oral strength in subjects with unilateral cleft lip and palate

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A cleft care workshop for speech and language pathologists in resource-limited countries : the participants' experiences about cleft care in Uganda and satisfaction with the training effect

Objectives: workshops and specialized training programs are often inaccessible for speech and language pathologists (SLPs) based in resource-limited countries given the lack of supply, the long travel distances and the excessive participation fees. To stimulate life-long learning opportunities for all, this study described and measured the effect of a free, two-day cleft care workshop for SLPs in Uganda. The workshop included different topics related to the assessment and treatment of children with a cleft of the palate with or without a cleft of the lip (CP +/- L). Methods: The participants who presented during the two-day course were asked to complete a pre- and postworkshop questionnaire to evaluate their satisfaction. The pre-workshop form also included some questions concerning cleft care in Uganda. Both the pre- and post-workshop forms included three visual analogue scales to investigate the evolution of the participants' estimation of their knowledge regarding speech in patients with a CP +/- L and to assess the changes in their self-confidence in the diagnosis and treatment of this population. Results: seventeen SLPs completed the pre- and post-workshop questionnaires. In general, the participants were highly satisfied with the different themes covered in the program. After the training course, the participants rated their general knowledge about CP +/- L and their self-confidence in the diagnosis and treatment of children with a CP +/- L significantly higher than before the workshop. Conclusion: the vast majority of the SLPs reported that cleft care was not easily accessible in Uganda. The most commonly reported obstacle for cleft care was a lack of knowledge about this matter in the SLPs themselves highlighting the importance of the organization of additional education opportunities. The participants reported a significantly higher level of self-confidence in diagnosing and treating children with a CP +/- L after the workshop. The content of this workshop can form the basis for future learning opportunities for SLPs based in resource-limited countries

Voice symptoms and risk factors for developing voice disorders in future musical actors

Musical theater students follow an intensive program of singing, acting and physical excercises (dancing) and are expected to participate in long rehearsals and full performances. As they are absolutely depending on their vocal quality and vocal capacities for their studies and their future profession, an optimal voice coaching is very important. The purpose of this study was to determine the voice quality, voice symptoms and the risk factors for developing voice problems in future elite vocal performers (musical theater performers). Thirty-one Musical students (7 men and 24 women) with a mean age of 20 years participated to the study. To determine the objective voice quality aerodynamic measurements, voice range profile, acoustic analysis and Dysphonia Severity Index were used. To inventory the voice symptoms and the risk factors for developing voice disorders the Dutch version of the checklists (De Bodt et al. 2008) of Russel et al. (2000) were used. The questionnaires investigate the presence and the frequency (never, daily, weekly, monthly) of voice symptoms and risk factors (vocal abuse, vocal misuse) as reported by the subjects. Psychosocial impact of a voice disorder was investigated using the the Voice Handicap Index and Singing Voice Handicap Index. The mean DSI in male and female Musical theater students was respectively 3.9 and 5.6, both corresponding with an overall good vocal quality. The results of the VHI showed no important psychosocial impact on the speaking voice. Despite the overall good vocal quality, more than 40% experienced voice symptoms on a regular basis. Vocal misuse and abuse was also frequently reported. Videolaryngostroboscopy revealed a high presence of organic and functional voice disorders. Note: The objective vocal quality in this group was presented in a poster at the voice conference in Philadelphia in 2015. This presentation focuses on new data regarding the symptoms and risk factors reported by the subjects

Comparison of motor-phonetic versus phonetic-phonological speech therapy approaches in patients with a cleft (lip and) palate : a study in Uganda

INTRODUCTION : At present, there is growing interest in combined phonetic-phonological approaches to treat active speech errors in children with a cleft (lip and) palate (CP ± L). Unfortunately, evidence for these type of speech interventions in this population is lacking. Therefore, the present study investigated the effectiveness of speech intervention in Ugandan patients with CP ± L. Moreover, a comparison was made between a motor-phonetic and a phonetic-phonological speech intervention. METHODS : Eight patients (median age: 11.26y) with an isolated CP ± L were assigned into a group receiving motor-phonetic treatment (n = 4) or a group receiving combined phonetic-phonological treatment (n = 4). The participants received 6h of individual speech therapy. In both groups, perceptual and instrumental speech evaluations were performed to evaluate the patients' speech before and after the intervention. RESULTS : Speech therapy (irrespective of the used approach) was found to be effective in increasing consonant proficiency and in decreasing the occurrence of non-oral and passive CSCs. No statistically significant differences in outcome variables were found when comparing the two groups pre- and post-treatment. The descriptive results, however, revealed a larger increase in % correctly produced consonants, places and manners after the intervention in the group receiving a combined phonetic-phonological treatment compared to the group receiving a motor-phonetic treatment. CONCLUSION : This study took a first step in providing evidence concerning the effectiveness of different speech therapy approaches in children with CP ± L. The present study holds some important implications for clinical practice suggesting that an additional phonological approach may be beneficial for the patients with CP ± L. Further research including randomized controlled trials with larger sample sizes is necessary to provide further evidence.A PhD grant of the Research Fund Flanders (1120919N).https://www.elsevier.com/locate/ijporl2021-04-01hj2020Speech-Language Pathology and Audiolog