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Mangal M, Kumar P, Munjal S, Sharma RK. Endoscopic evaluation of velopharyngeal function in cleft lip palate patients - A correlation with speech analysis. J Plast Reconstr Aesthet Surg 2023; 77:170-176. [PMID: 36571963 DOI: 10.1016/j.bjps.2022.10.041] [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: 06/04/2021] [Revised: 07/13/2022] [Accepted: 10/11/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Speech abnormalities due to velopharyngeal insufficiency (VPI) significantly affect communication skills, self-esteem, and scholastic performance. It leads to a poor social, emotional, educational, and behavioral development and a poor quality of life overall in cleft lip palate (CLP) patients. Its early diagnosis and severity assessment using video-nasoendoscopy and speech assessment can significantly contribute to management. The present study evaluated VPI in CLP patients using both tools. METHODS A total of 48 patients with repaired cleft palate were subjected to speech and video-nasoendoscopic assessment. Speech assessment measured severity of hypernasality, speech intelligibility, and voice quality. Video-nasoendoscopy evaluated velopharyngeal port closure to grade the severity of VPI. The speech assessment and video-nasoendoscopy findings were analyzed and correlated. RESULTS There was a moderately strong statistically significant negative correlation between the grade of VPI and hypernasality (r = -0.542, p = 0.000). There was a stronger statistically significant negative correlation of grade of velopharyngeal port insufficiency with speech intelligibility (r = -0.634, p = 0.000). About 72% of the patients had abnormal voice quality. CONCLUSION This study is the first attempt at diagnosing and grading VPI on a quantitative scoring based on a ratio scale for the motion of soft palate and pharyngeal walls. The strong correlation between endoscopic grading and speech analysis findings warrants further evaluation of nasoendoscopic grading of VPI in more studies.
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Affiliation(s)
- Mayank Mangal
- Department of Plastic Surgery, PGIMER, Chandigarh, India
| | - Parmod Kumar
- Department of Plastic Surgery, PGIMER, Chandigarh, India.
| | - Sanjay Munjal
- Department of Otolaryngology, PGIMER, Chandigarh, India
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Hanley L, Ballard KJ, Dickson A, Purcell A. Speech Intervention for Children With Cleft Palate Using Principles of Motor Learning. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:169-189. [PMID: 36475751 DOI: 10.1044/2022_ajslp-22-00007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE This is a pilot study to apply an articulatory kinematic speech intervention that uses the principles of motor learning (PML) to improve speech and resonance outcomes for children with cleft palate. It is hypothesized that (a) treatment that applies select PML during practice will improve production of treated phonemes, representing both active and inconsistent passive errors, at word level in children with cleft palate; (b) effects of practice on phonemes with active or inconsistent passive errors will generalize to untreated exemplars of treated phonemes; and (c) learning will be retained for at least 1-month posttreatment. METHOD A multiple-baseline design across participants combined with a crossover single-case experimental model was used. Participants attended two 8-week blocks of twice-weekly face-to-face speech therapy (40-50 min/treatment) to treat active and inconsistent passive cleft speech errors using articulatory kinematic speech intervention that applied PML. The participants were four children with cleft-type speech errors. The primary dependent variable measured was percentage of words correct across treatment items, generalization items, and control items. Perceptual accuracy of target words was scored. Effect sizes were calculated to quantify the magnitude of treatment effect. RESULTS For three children with active and inconsistent passive cleft speech errors and one child with active cleft speech errors and developmental phonological speech errors, this approach resulted in improvements to their treated items and generalization to their untreated items. Inconsistent passive cleft speech errors were particularly responsive to the treatment in the three children who presented with these errors. CONCLUSION This Phase I study has shown that articulatory kinematic speech intervention that applies the PML is effective in improving the speech outcomes for children with cleft palate and that there is validity in pursuing further research into this approach. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21644831.
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Affiliation(s)
- Leah Hanley
- Faculty of Medicine & Health, University of Sydney, New South Wales, Australia
| | - Kirrie J Ballard
- Faculty of Medicine & Health, University of Sydney, New South Wales, Australia
| | | | - Alison Purcell
- Faculty of Medicine & Health, University of Sydney, New South Wales, Australia
- Speech Pathology, School of Health Sciences, Western Sydney University, New South Wales, Australia
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Inostroza-Allende F, Palomares-Aguilera M, Jara MG, Gaponov CQ, Villarroel CG, Pegoraro-Krook MI. Normative nasalance scores in Chilean adults. Codas 2022; 34:e20210152. [PMID: 35352792 PMCID: PMC9886296 DOI: 10.1590/2317-1782/20212021152] [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: 07/05/2021] [Accepted: 12/08/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The present study is aimed towards determining and comparing normative nasalance scores in Chilean Spanish-speaking adult men and women. METHODS 40 women (age range 18 to 35, X = 25.79, SD = 5.83) and 36 men (age range 18 to 35, X = 26.45, SD = 4.08) were invited to participate, all of them without any previous speech therapy, neurological pathologies, intellectual deficits, hearing loss, syndromes, or other diagnosed pathologies that could impact speech production.A study of proper velopharyngeal function was performed, using a perceptual resonance evaluation. Nasalance was determined using a model 6450 Nasometer, during the reading of three standardized speech samples in Spanish: a nasal passage (NP), an oronasal passage (ONP), and an oral passage (OP). Also, the nasalance distance was calculated. Genders were compared using Wilcoxon tests for independent samples. RESULTS The NP presented the highest percentage of nasalance, with 52.13% (± 4.73), followed by the ONP with 25.38% (± 3.7), and finally the OP, which presented the lowest value of 14.15% (± 5.03). Meanwhile, nasalance distance was 37.98% (± 5.32). Finally, no significant differences were observed when comparing the nasalance between genders (p >0.05). CONCLUSION The nasalance values obtained were similar to those observed for other Spanish speakers. Also, male and women showed similar scores. The results of this study are a contribution to the indirect assessment of velopharyngeal function in Chilean adults.
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Affiliation(s)
- Felipe Inostroza-Allende
- Departamento de Fonoaudiología, Universidad de Chile - Santiago, Chile.,Fundación Gantz - Hospital del Niño con Fisura - Santiago, Chile.
| | - Mirta Palomares-Aguilera
- Fundación Gantz - Hospital del Niño con Fisura - Santiago, Chile.,Smile Train - South American Medical Advisory Council – SAMAC - Santiago, Chile.
| | - Matías Gonzalez Jara
- Escuela de Fonoaudiología, Sede Santiago, Facultad de Salud, Universidad Santo Tomás - Santiago, Chile.
| | - Camilo Quezada Gaponov
- Departamento de Fonoaudiología, Universidad de Chile - Santiago, Chile.,Universidad de los Andes - Santiago, Chile.
| | - Carlos Giugliano Villarroel
- Fundación Gantz - Hospital del Niño con Fisura - Santiago, Chile.,Smile Train - South American Medical Advisory Council – SAMAC - Santiago, Chile.,Unidad de Cirugía Plástica, Servicio de Cirugía, Clínica Alemana - Santiago, Chile.
| | - María Inés Pegoraro-Krook
- Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru, Universidade de São Paulo – USP - Bauru (SP), Brasil.,Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo – USP - Bauru (SP), Brasil.
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Verma S, Bhupali NR, Singh SP, Vir D, Lal C. Nasalance Scores as a Function of Skeletal Malocclusion of English-Speaking Adults in the North Indian Population. Folia Phoniatr Logop 2021; 74:78-88. [PMID: 34412052 DOI: 10.1159/000516225] [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: 10/15/2020] [Accepted: 03/28/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The objective of this study is quantitative assessment of nasalance for skeletal Class I (normative values), Class II, and III malocclusion in the English language for the North Indian population and to compare the normative values with the nasalance scores obtained from individuals with skeletal Class II and III malocclusion and to evaluate the normative values as a function of gender. MATERIAL AND METHODS The study was conducted on a total sample of 200 patients with 100, 50, and 50 in group 1 (control group, Skeletal Class I), group 2 (Skeletal Class II), and group 3 (Skeletal Class III), respectively. ANB angle (anteroposterior angle formed by point A, nasion, and point B) measured on lateral cephalogram was used to categorize the patients into 3 groups. The normative nasalance scores were compared for males and females in the control group. The nasalance scores of skeletal Class II and III subjects were compared to the combined normative scores of the control group. The NasalView was used for the objective assessment of nasalance. Oral syllables (/pa/and/pi/), nasal syllables (/ma/and/mi/), and 3 passages (Zoo passage, Rainbow passage, and Nasal sentences) were used to determine the nasalance scores. RESULTS The intragroup comparison of nasalance scores in group 1 showed statistically significant differences for different stimuli. The gender-related comparison showed no statistically significant differences in nasalance scores. The intergroup comparison of nasalance scores for skeletal malocclusion showed no statistically significant differences for different stimuli except statistically significant lower nasalance values for nasal sentences in group 3 compared to the control group. CONCLUSION The study concluded that the nasalance scores for nasal sentences in skeletal Class III malocclusion were significantly lower than in the control group and were not statistically significant between the 3 groups for all other stimuli.
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Affiliation(s)
- Sanjeev Verma
- Unit of Orthodontics and Dentofacial Orthopaedics, Oral Health Sciences Centre (OHSC), Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | | - Satinder Pal Singh
- Unit of Orthodontics and Dentofacial Orthopaedics, Oral Health Sciences Centre (OHSC), Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Dharam Vir
- Department of Otolaryngology, Audiology and Speech Therapy, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Chaman Lal
- Unit of Orthodontics and Dentofacial Orthopaedics, Oral Health Sciences Centre (OHSC), Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Pokharel A, Naina P, Sebastain S, Syed KA, John M, Varghese AM. Normative nasalance scores in Tamil-speaking Indian children. LOGOP PHONIATR VOCO 2020; 47:43-48. [PMID: 33269640 DOI: 10.1080/14015439.2020.1849391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to obtain normative nasalance scores for Indian Tamil-speaking children. METHODS Mean nasalance scores were obtained from 175 consecutive Tamil-speaking normal children (95 males, 80 females) aged 5-16 years during the repetition of six standardized sentences: two oral, two oronasal, and two nasal sentences. The nasal view was used to obtain nasalance scores for the standardized sentences. RESULTS Group mean and standard deviation (SD) nasalance scores of children for oral, oronasal, and nasal sentence were 35.65(SD 7.20), 44.42(SD 7.37), and 57.21(SD 8.15), respectively. The mean nasalance values of children aged 9-12 years were greater than children aged 5-8 years and 13-16 years for nasal sentences (p < .001). Males were found to have significantly higher nasalance scores for oral and oronasal sentences (p < .05) although these differences were within the range of normal variation. CONCLUSIONS The present study provides normative nasalance scores for Tamil-speaking Indian children.
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Affiliation(s)
- Apar Pokharel
- Department of ENT, Christian Medical College, Vellore, India
| | - P Naina
- Department of ENT, Christian Medical College, Vellore, India
| | | | | | - Mary John
- Department of ENT, Christian Medical College, Vellore, India
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Yang X, Pratama GB, Choi Y, You H, Tâm NPM, Kim GW, Jo YJ, Ko MH. Measurement of Nasalance Scores Without Touching the Philtrum for Better Comfort During Speech Assessment and Therapy: A Preliminary Study. Cleft Palate Craniofac J 2020; 58:446-454. [PMID: 32924600 DOI: 10.1177/1055665620953340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The Kay Pentax nasometer uses a separator plate that touches the philtrum of a patient to separate the nasal and oral sound energies for nasalance measurement. However, the separator plate can restrict the natural movement of the patient's upper lip and generate unpleasant pressure on the patient's philtrum. The present study was intended to measure nasalance scores without touching the philtrum for better comfort during speech assessment and therapy. METHODS Nasalance scores of 10 males and 10 females having no speech disorders were measured under 4 levels (0, 5, 10, and 15 mm) of the gap between the plate and the philtrum (denoted as plate-to-philtrum gap) using Nasometer II 6450 for nasal (Nasal Sentences) and oral (Zoo Passage) stimuli. Regression formulas were established to examine the relationships between nasalance score and plate-to-philtrum gap for the stimuli. To provide nasalance scores equivalent to those measured for the contact condition, compensation factors for the 5 mm plate-to-philtrum gap measurement condition were identified for the stimuli. RESULTS The nasalance scores were significantly different between the 4 different plate-to-philtrum gaps for the stimuli. Compensation factors for the Nasal Sentences and the Zoo Passage were identified as 1.17 and 0.71, respectively. CONCLUSIONS The 5 mm plate-to-philtrum gap condition after multiplying the compensation factors can provide equivalent nasalance scores to the conventional contact measurement condition which may provide better comfort in speech assessment and therapy.
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Affiliation(s)
- Xiaopeng Yang
- School of Artificial Intelligence and Computer Science, 66374Jiangnan University, Wuxi, PR China
| | - Gradiyan Budi Pratama
- Department of Industrial Engineering, 89224Bandung Institute of Technology, Bandung, Indonesia
| | - Younggeun Choi
- Department of Industrial and Management Engineering, 34995Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Heecheon You
- Department of Industrial and Management Engineering, 34995Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Nguyễn Phu'ò'c Minh Tâm
- Department of Medicine, 90158Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Gi-Wook Kim
- Department of Physical Medicine and Rehabilitation, 90158Chonbuk National University Medical School, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of 65377Chonbuk National University Hospital, Jeonju, Republic of Korea
| | - Yun-Ju Jo
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of 65377Chonbuk National University Hospital, Jeonju, Republic of Korea
| | - Myoung-Hwan Ko
- Department of Physical Medicine and Rehabilitation, 90158Chonbuk National University Medical School, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of 65377Chonbuk National University Hospital, Jeonju, Republic of Korea
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Mohd Ibrahim H, Lim HW, Ahmad Rusli Y, Lim CT. Speech stimuli and nasalance scores for the assessment of resonance in in Mandarin speaking Malaysian children. CLINICAL LINGUISTICS & PHONETICS 2020; 34:554-565. [PMID: 31537131 DOI: 10.1080/02699206.2019.1668480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 09/06/2019] [Accepted: 09/12/2019] [Indexed: 06/10/2023]
Abstract
This study was designed to develop language-specific stimuli for the assessment of resonance and to obtain nasalance scores using the newly developed speech stimuli in Mandarin. Gender and age influences on nasalance scores for each of the stimulus were also examined. Participants recruited were typically developing Mandarin-speaking ethnic Chinese children aged 6;00-7;11 growing up in Malaysia. Perceptual ratings of nasality were made based on the GOS.SP.ASS.'98 (revised) for children while nasalance scores were recorded for each stimulus using the Nasometer II (Model 6400). Fifty Mandarin-speaking children (24 males and 26 females) were recruited. None of the participants were perceived with abnormal nasality on the three stimuli. The mean nasalance scores for the Mandarin stimuli were 16.08% (SD = 2.57, 95% CI = 15.35-16.81) for the Oral passage, 25.20% (SD = 3.63, 95% CI = 24.17-26.23) for the Oral-Nasal passage and 55.44% (SD = 4.17, 95% CI = 54.25-56.63) for the Nasal passage. No significant age- and gender-related differences were observed for all the three stimuli. This is the first set of Mandarin stimuli and nasalance norms for Mandarin-speaking children in Malaysia. The influence of phonetic content on nasalance is supported. Findings call for language-specific normative nasalance data and careful selection of stimuli for the assessment of resonance.
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Affiliation(s)
| | - Hui W Lim
- Speech Sciences Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Yazmin Ahmad Rusli
- Speech Sciences Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chia T Lim
- Speech Sciences Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Nasometric evaluation of resonance disorders: A norm study In Turkish. Int J Pediatr Otorhinolaryngol 2020; 131:109888. [PMID: 31981919 DOI: 10.1016/j.ijporl.2020.109888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 01/14/2020] [Accepted: 01/14/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this study was to adapt the Simplified Nasometric Assessment Procedures-Revised (SNAP-R) [1] to Turkish, gather norms from Turkish speakers, and test the sensitivity and specificity of the adapted test. Finally, this study was designed to determine if there are any differences in average nasalance scores due to age, gender, and vowel content of the passage. METHODS 240 children without any known speech, language or hearing disorders and 40 children with cleft palate participated in the study. Participants were divided into three groups according to their age (ages 4-7; 8-12; and 13-18). Data for this descriptive study was collected in the school settings and in a center of speech and language therapy. RESULTS This study showed a slight increase in nasalance with age, but no difference in nasalance based on gender. Furthermore, the nasalance score is determined by vowel content of the passage and that high vowels have higher nasalance than the low vowels. CONCLUSION This paper offers a new test for nasometric evaluation in the Turkish language, which has relatively high specificity and sensitivity in the evaluation of hypernasality.
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Abstract
Purpose
The acoustic characteristics of oral–nasal coupling (nasalization) have clinical implications for speech-language pathologists because excessive oral–nasal coupling results in a resonance disorder referred to as
hypernasality
. Nasometry is a tool that allows clinicians to measure the effect of oral–nasal coupling in the clinical setting. This clinical focus article summarizes the large volume of research on nasometry and clarifies its clinical application.
Conclusion
Although the precise relationship between the acoustics of oral–nasal coupling and the perception of hypernasality remains unclear, measuring the acoustic effects of oral–nasal coupling is useful in the evaluation and treatment of resonance disorders.
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Affiliation(s)
- Thomas Watterson
- Department of Speech Pathology and Audiology, School of Medicine, University of Nevada, Reno
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Saber-Moghadam R, Faham M, Ghavami FS, Ghayoumi-Anaraki Z. Normative data on nasalance scores for Farsi speaking children: Influence of age, gender and phonetic context. Int J Pediatr Otorhinolaryngol 2019; 127:109680. [PMID: 31536853 DOI: 10.1016/j.ijporl.2019.109680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/09/2019] [Accepted: 09/09/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Normative nasalance scores are essential for treatment and assessment purposes for clinicians. The purpose of the current study is to determine the normative data on nasalance scores for Farsi speaking children. Comparing to the obtained normative data, hypernasal or hyponasal speech (i.e. the higher or lower nasalance score) can be evaluated. METHODS Ninety-six Farsi speakers ranging from 4 years to 11 years old with typically developing speech were included in this study. Mean nasalance scores were obtained using the Universal Parameters System sentences with nasometer II (model 6450). The nasalance data was also analyzed for any gender, age and phonetic context dependence. RESULTS Normative nasalance values were determined, Nno differences were found for gender and age for the school-aged children. With an increasing in age, the nasalance score also increased in oral passages but not in nasal passages. Furthermore, amongst the nasalance scores there was a significant difference between these four categories of sentences: 7 sentences loaded with oral stop consonants, 5 sentences loaded with oral fricative consonants, 2 sentences loaded with oral affricatives and 3 sentences loaded with nasal consonants. CONCLUSIONS The absence of age and gender differences led to a computation of an overall mean nasalance score for different types of phonetic context (Nasal, oral and oronasal). These normative nasalance data for Farsi speaking children will provide important reference information during speech assessments of children with velopharyngeal insufficiency.
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Affiliation(s)
- Reihane Saber-Moghadam
- Department of Speech Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Faham
- Department of Speech and Language Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh-Sadat Ghavami
- Department of Speech Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Ghayoumi-Anaraki
- Department of Speech Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
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Srinivas V, Bressmann T. Effects of Knowledge of Task on Control of Oral-Nasal Balance in Speech. Folia Phoniatr Logop 2019; 73:15-21. [DOI: 10.1159/000503861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 10/01/2019] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> Previous research has shown that altering the nasal signal level auditory feedback changed the control of oral-nasal balance in normal speakers. The present study investigated whether knowledge of the task and the instruction not to compensate would change the participants’ response to the manipulation. <b><i>Methods:</i></b> Twenty participants (10 females) in 2 groups continuously repeated a sentence while their nasal signal level was increased or decreased and fed back to them via headphones, so the speakers heard themselves as more or less nasal, respectively. After the first recording session, participants were debriefed about the true nature of the experiment. They were instructed not to compensate in the second recording session. The outcome measures were the percentage changes of nasalance scores from the first baseline. <b><i>Results:</i></b> Statistical analysis using a repeated measures analysis of variance showed an effect of the nasal signal level, <i>F</i>(5,80) = 2.51, <i>p</i> = 0.049, and a nasal signal level by knowledge of task interaction effect, <i>F</i>(5,80) = 3.25, <i>p</i> = 0.019. Post hoc tests showed that the maximum nasal signal level auditory feedback resulted in a significant decrease of nasality from the initial baseline. <b><i>Conclusion:</i></b> Despite knowledge of the task, speakers were unable to resist compensating. As found in previous research, there was a numerically higher compensation response at the maximum than at the minimum nasal signal level auditory feedback condition.
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Sampaio-Teixeira ACM, Oliveira DND, Yamashita RP, Fukushiro AP, Trindade IEK. Normative nasalance scores in the production of words and syllables for Brazilian Portuguese speakers. CLINICAL LINGUISTICS & PHONETICS 2019; 33:1139-1148. [PMID: 30894033 DOI: 10.1080/02699206.2019.1590733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 03/01/2019] [Accepted: 03/02/2019] [Indexed: 06/09/2023]
Abstract
The objective of this study was to determine normative nasalance scores for non-cleft children, adolescents and adults, native speakers of Brazilian Portuguese, during the production of words and syllables, for cross-linguistic comparisons in populations with and without cleft palate. Nasalance was assessed in 62 individuals, aged 6-10 years (n = 20), 11-17 years (n = 20) and 18-35 years (n = 22), using a nasometer II model 6450 (KayPENTAX), during production of one sequence of nine oral words (pipa, bis, burro, tatu, pilha, cuca, gui, fila, luz) and of sequences of isolated syllables (e.g. pa, pa, pa, pa, pa, pa) composed of plosive, fricative, liquid and nasal consonants with high and low vowels. In order to validate the new nasalance stimuli, nasalance scores for traditional oral and nasal stimuli were also obtained. Differences were analyzed at a significance level of 0.01. Mean nasalance scores (±SD) during the production of the sequence of words were 18 ± 5% (children), 18 ± 7% (adolescents) and 21 ± 5% (adults). Differences between age groups were not significant. During the production of syllables, adults had the highest mean nasalance scores (except for syllable /mi/); significant differences between age groups were observed only for /pa/ ,/sa/ and /la/. Nasalance scores were significantly higher in oral and nasal syllables with high vowels than with low vowels, and in nasal syllables than in oral syllables with high and low vowels. The nasalance scores obtained for the sentences were comparable to previously established norms. In conclusion, the nasalance scores defined for Brazilian Portuguese speakers, in different stimuli, may be adopted as normative values for local and cross-language comparisons in the identification of hypernasality related to conditions such as cleft palate, neurogenic disorders and syndromes.
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Affiliation(s)
| | | | | | - Ana Paula Fukushiro
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo , Bauru , Brazil
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Boyce JO, Raj S, Sanchez K, Marazita ML, Morgan AT, Kilpatrick N. Speech Phenotyping in Unaffected Family Members of Individuals With Nonsyndromic Cleft Lip With or Without Palate. Cleft Palate Craniofac J 2019; 56:867-876. [PMID: 30696259 DOI: 10.1177/1055665618823936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Subclinical phenotypes of nonsyndromic cleft lip with or without cleft palate (CL ± P) may be identified from clinically "unaffected" relatives and could be associated with specific cleft-related gene mutations. It has been hypothesized that velopharyngeal insufficiency (VPI) may be a subclinical phenotype of interest in this population, but this has not been explored quantitatively with appropriate control cohorts. The aim of this case-control study was to compare VPI in at-risk clinically unaffected relatives of individuals with nonsyndromic CL ± P with a low-risk matched normative Australian cohort. PARTICIPANTS Clinically unaffected (ie, with no overt cleft) first-degree relatives of a proband with nonsyndromic CL ± P (n = 189) and noncleft controls (n = 207). MAIN OUTCOME MEASURE(S) Perceptual measures of VPI encompassing resonance, nasal emission, and articulation were evaluated using the Great Ormond Street Speech Assessment. Quantitative measures of VPI were obtained from the Nasometer II using standardized adult and pediatric speech stimuli. RESULTS Both perceptual and instrumental measures showed no significant difference (P > .01) between the VPI in unaffected relatives and the noncleft comparison group. Mean nasalance scores for both groups were calculated and reported according to speech stimuli, age, and sex. CONCLUSIONS Results suggest that VPI, measured through speech, is not a significant subclinical phenotype of nonsyndromic CL ± P. Therefore, further familial genetic investigations exploring VPI may not yield meaningful results. Exploration across multiple subclinical phenotypes in larger cohorts may enable researchers to better understand the multifaceted nature of this complex and heterogeneous anomaly.
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Affiliation(s)
- Jessica O Boyce
- 1 Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC, Australia.,2 Speech and Language Group, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Supriya Raj
- 3 Musculoskeletal Group, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Katherine Sanchez
- 1 Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC, Australia.,2 Speech and Language Group, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Mary L Marazita
- 4 Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,5 Department of Human Genetics, Graduate School of Public Health, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Angela T Morgan
- 1 Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC, Australia.,2 Speech and Language Group, Murdoch Children's Research Institute, Parkville, VIC, Australia.,6 Speech Pathology Department, Royal Children's Hospital, Parkville, VIC, Australia
| | - Nicky Kilpatrick
- 7 Plastic and Maxillofacial Surgery, Royal Children's Hospital, Parkville, VIC, Australia.,8 Facial Sciences Group, Murdoch Children's Research Institute, Parkville, VIC, Australia
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Xu J, Kang YA, Park SK, Yoon YH, Bai SJ, Jin YD, Kim YM, Rha KS. Nasality Changes With Age in Normal Korean-Speaking Adults. Clin Exp Otorhinolaryngol 2018; 12:95-99. [PMID: 30257547 PMCID: PMC6315219 DOI: 10.21053/ceo.2018.00717] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 08/03/2018] [Indexed: 11/24/2022] Open
Abstract
Objectives This study was performed to investigate the effects of aging on nasality and the influence of age-related changes in nasal cavity volume and nasal patency on nasality. Methods A total of 180 healthy Korean-speaking adult volunteers, who had no nasal or voice-related complaints, were enrolled in this study. Nasometry, acoustic rhinometry, and rhinomanometry were performed to obtain the nasalance score, nasal cavity volume, and nasal resistance, respectively. Changes in these parameters with age were analyzed. Results Nasal cavity volume increased significantly, and nasal resistance decreased significantly, with age. The nasalance scores for the nasal passage and oronasal passage decreased significantly with age, while there were no age-related changes in nasalance scores for the oral passage. Conclusion Nasalance scores for the passages containing nasal consonants decreased with age although significant increases were observed in nasal cavity volume and nasal patency with age. Therefore, the age-related decreases in nasalance scores may result from factors other than changes in the nasal cavity.
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Affiliation(s)
- Jun Xu
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Yanbian University Hospital, Yanji, China
| | - Young-Ae Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Soo-Kyoung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Young Hoon Yoon
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Shang Jie Bai
- Department of Otorhinolaryngology-Head and Neck Surgery, Yanbian University Hospital, Yanji, China
| | - Yong De Jin
- Department of Otorhinolaryngology-Head and Neck Surgery, Yanbian University Hospital, Yanji, China
| | - Yong Min Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Ki-Sang Rha
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
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15
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Pua E, Holt Y, Kollara L, Rangarathnam B, Fang X, Perry JL. Evaluating Nasalance Values Among Bilingual Mandarin–English Speakers. Cleft Palate Craniofac J 2018; 56:462-470. [DOI: 10.1177/1055665618791942] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Eshan Pua
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Yolanda Holt
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Lakshmi Kollara
- Department of Clinical Health Sciences, Texas A&M University-Kingsville, Kingsville, TX, USA
| | - Balaji Rangarathnam
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Xiangming Fang
- Department of Biostatistics, East Carolina University, Greenville, NC, USA
| | - Jamie L. Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
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16
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Watterson T, Lewis KE. Test-Retest Nasalance Score Variability in Hypernasal Speakers. Cleft Palate Craniofac J 2017; 43:415-9. [PMID: 16854198 DOI: 10.1597/05-104.1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective The objective of this study was to evaluate test-retest nasalance score variability in subjects with hypernasal resonance. Design Two groups of subjects with hypernasal speech recited both the Turtle Passage and the Mouse Passage two times each. For one group, the Nasometer headgear was not changed between repetitions of each stimulus (NCHG; n = 17); and for the other group, the headgear was changed between repetitions (CHG; n = 18). Three subjects in the CHG group would not recite the Mouse Passage two times. Participants The subjects were 35 patients with hypernasal speech followed by a cleft palate team. Main Outcome Measures The outcome measures were the four nasalance scores obtained for each subject. Results There was no significant difference between first and second repetitions for either stimulus in either the NCHG group or in the CHG group. Cumulative frequency tables showed that for the Turtle Passage-NCHG condition, 15 of the 17 (88%) repeated nasalance scores were within 5 nasalance points of each other. For the CHG condition, however, only 9 of 18 (50%) repeated nasalance scores were within 5 points. For the Mouse Passage-NCHG condition, 15 of the 17 (88%) repeated nasalance scores were within 5 points. For the CHG condition, however, only 11 of 15 (73%) repeated scores were within 5 points. Conclusions Test-retest variability was greater in a population of hypernasal patients than that reported in other studies for normal speakers, and headgear change increased test-retest variability.
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Affiliation(s)
- Thomas Watterson
- University of Nevada School of Medicine, Reno, Nevada 89557, USA.
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17
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Abstract
Objective State-of-the-art activity demands a look back, a look around, and, importantly, a look into the new millennium. The area of speech and language has been an integral part of cleft palate care from the very beginning. This article reviews the development and progression of our knowledge base over the last several decades in the areas of speech; language; anatomy and physiology of the velopharynx; assessment of velopharyngeal function; and treatment, both behavioral and physical, for velopharyngeal problems. Method The clear focus is on the cleft palate condition. However, much of what is reviewed applies to persons with other craniofacial disorders and with other underlying causes of velopharyngeal impairment. A major challenge in the next several years is to sort through speech disorders that have a clear anatomic underpinning, and thus are more amenable to physical management, versus those that may be treated successfully using behavioral approaches. Speech professionals must do a better job of finding and applying ways of treating individuals with less severe velopharyngeal impairment, thus avoiding the need for physical management in these persons or ignoring the speech problem altogether. Conclusion Early and aggressive management for speech and language disorders should be conducted. For most individuals born with cleft conditions, a realistic goal should be normal speech and language usage by the time the child reaches the school-age years.
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Affiliation(s)
- David P. Kuehn
- University of Illinois at Urbana-Champaign, Champaign, Illinois
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18
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Bressmann T. Comparison of Nasalance Scores Obtained with the Nasometer, the NasalView, and the OroNasal System. Cleft Palate Craniofac J 2017; 42:423-33. [PMID: 16001925 DOI: 10.1597/03-029.1] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To compare nasalance scores obtained with the Nasometer, the NasalView, and the OroNasal System; evaluate test-retest reliability of the three systems; and explore whether three common text passages used for nasalance analysis could be shortened to a sentence each. Subjects Seventy-six adults with normal speech and hearing (mean age 26.5 years). Procedures Subjects read the complete Zoo Passage, Rainbow Passage, and Nasal Sentences. Main Outcome Measures Mean nasalance magnitudes and mean nasalance distances were obtained with the three devices. Results The Nasometer had the lowest nasalance scores for the nonnasal Zoo Passage. The NasalView had the highest nasalance scores for the phonetically balanced Rainbow Passage. The OroNasal System had the lowest nasalance scores for the Nasal Sentences. The nasalance distance was largest for the Nasometer and smallest for the OroNasal System. Over 90% of the recordings were within 4% to 6% nasalance for most materials recorded with the Nasometer and the NasalView and within 7% to 9% for materials recorded with the OroNasal System. There were significant differences between the complete Zoo Passage and the Nasal Sentences and the individual sentences from these passages for the Nasometer and the OroNasal System. Conclusions The three systems measure nasalance in different ways and provide nasalance scores that are not interchangeable. Test-retest variability for the Nasometer and the NasalView may be higher than previously reported. Individual sentences from the Zoo Passage and the Nasal Sentences do not provide nasalance scores that are equivalent to the complete passages.
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Affiliation(s)
- Tim Bressmann
- Graduate Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Canada.
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19
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Tachimura T, Kotani Y, Wada T. Nasalance Scores in Wearers of a Palatal Lift Prosthesis in Comparison with Normative Data for Japanese. Cleft Palate Craniofac J 2017; 41:315-9. [PMID: 15151451 DOI: 10.1597/02-107.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective This study was designed to examine whether nasalance score is changed in association with placement of a palatal lift prosthesis (PLP) and whether normative data previously reported are applicable to evaluate the effect of a PLP on velopharyngeal function as it relates to nasality. Design Nasalance scores were obtained as subjects read the Kitsutsuki Passage three times with the PLP in place and then removed. Participants Forty-three children (mean age 9.0 years, SD = 3.6 years) with repaired cleft palate who were treated with a PLP were selected as subjects. Their speech was characterized by nasal emission of air, slight hypernasality without a PLP but within normal limits with a PLP in place, or both. Main Outcome Measures Comparisons were made between normative scores and the average mean nasalance score of subjects with and without the PLP. Results Average values of the mean nasalance score for subjects were 17.3% (SD 7.6%) with the PLP in place and 33.5% (SD 13.3%) without the PLP in place. These scores were greater than the mean score of 9.1% (SD 3.9%) obtained from normal controls previously reported. Conclusion A PLP can decrease nasalance scores for speakers with repaired cleft palate who exhibit velopharyngeal incompetence. It was suggested that the normative score obtained from normal adult speakers is not applicable to evaluate the effect of a PLP to improve velopharyngeal function for children wearing the PLP.
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Affiliation(s)
- Takashi Tachimura
- Division of Functional Oral Neuroscience, Osaka University Graduate School of Dentistry, Osaka, Japan.
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20
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Sweeney T, Sell D, O'Regan M. Nasalance Scores for Normal-Speaking Irish Children. Cleft Palate Craniofac J 2017; 41:168-74. [PMID: 14989687 DOI: 10.1597/02-094] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To obtain normal nasalance values during the production of a standardized speech sample for Irish children and determine whether significantly different scores exist for different speech stimuli for female and male speakers. Design Mean nasalance scores were obtained for normal-speaking children during the repetition of 16 test sentences that were categorized according to consonant type within the sentences (high-pressure consonants, low-pressure consonants, nasal consonants). Participants Seventy children (36 girls and 34 boys, aged 4 years 11 months to 13 years) with normal articulation, resonance, and voice were included. Procedures Children repeated each of the 16 test sentences individually. The sentences were presented in groups according to consonant type, referred to as sentence categories. Data were collected and analyzed using the Kay nasometer (model 6200.3). Nasalance scores were obtained for the total speech sample and each sentence category. Data were statistically analyzed to investigate the effects of gender, sentence category, and gender by sentence category. Results Normative nasalance scores were obtained for the total speech sample (26%), high-pressure consonant sentences (14%), low-pressure consonant sentences (16%), and a nasal consonant sentence (51%). There was no significant difference in nasalance scores between male and female speakers. Significant differences were found between each sentence category (p ≤ .001), except between the high-pressure and low-pressure consonant sentence categories (p = .09). Conclusion The present study provides normative nasalance data for English-speaking Irish children. There was a significant difference between nasalance scores for different speech stimuli.
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21
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Bae Y. Nasalization Amplitude-Timing Characteristics of Speakers With and Without Cleft Palate. Cleft Palate Craniofac J 2017; 55:45-56. [PMID: 34162060 DOI: 10.1177/1055665617718826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To examine the amplitude-temporal relationships of acoustic nasalization in speakers with a range of nasality and to determine the extent to which each domain independently predicts the speaker's perceived oral-nasal balance. DESIGN Rate-controlled speech samples, consisting of /izinizi/, /azanaza/, and /uzunuzu/, were recorded from 18 participants (14 with repaired cleft palate and 4 without cleft palate) using the Nasometer. The mean nasalance of the entire mid-vowel-nasal consonant-vowel (mid-VNV) sequence (amplitude-domain) and the duration of the nasalized segment of the mid-VNV sequence (temporal-domain) were obtained based on nasalance contours. RESULTS Strong linear and vowel-dependent relationships were observed between the 2 domains of nasalization (adjusted R2 = 71.5%). Both the amplitude- and temporal-domain measures were found to reliably predict the speaker's perceived oral-nasal balance, with better overall model fit and higher classification accuracy rates observed in /izinizi/ and /uzunuzu/ than in /azanaza/. Despite poor specificity, the temporal-domain measure of /azanaza/ was found to have a strong correlation with the participants' Zoo passage nasalance scores (rs = .897, p < .01), suggesting its potential utility as a severity indicator of perceived nasality. CONCLUSIONS With the use of relatively simple speech tasks and measurements representing the amplitude and temporal domains of nasalization, the present study provided practical guidelines for using the Nasometer in assessing patients with oral-nasal resonance imbalance. Findings suggest that both domain measures of nasalization should be examined across different vowel contexts, given that each domain may provide clinically relevant, yet different, information.
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Affiliation(s)
- Youkyung Bae
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA
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Nguyen VT, Lehes L, Truong TTH, Hoang TVA, Jagomägi T. Normative nasalance scores for Vietnamese-speaking children. LOGOP PHONIATR VOCO 2017; 44:51-57. [DOI: 10.1080/14015439.2017.1389985] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Van Thai Nguyen
- Institute of Dentistry, University of Tartu, Tartu, Estonia
- Faculty of Odonto-Stomatology, Hue University of Medicine and Pharmacy, Hue, Vietnam
| | - Lagle Lehes
- Tartu University Hospital ENT Clinic, Tartu, Estonia
| | | | - Thi Van Anh Hoang
- The Office of Genetic Counseling and Disabled Children, Hue, Vietnam
| | - Triin Jagomägi
- Institute of Dentistry, University of Tartu, Tartu, Estonia
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Shin YJ, Kim Y, Kim HG. The comparative study of resonance disorders for Vietnamese and Korean cleft palate speakers using nasometer. Maxillofac Plast Reconstr Surg 2017; 39:9. [PMID: 28497031 PMCID: PMC5403777 DOI: 10.1186/s40902-017-0108-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 02/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nasalance is used to evaluate the velopharyngeal incompetence in clinical diagnoses using a nasometer. The aim of this study is to find the nasalance differences between Vietnamese cleft palate children and Korean cleft palate children by measuring the nasalance of five oral vowels. METHODS Ten Vietnamese cleft palate children after surgery, three Vietnamese children for the control group, and ten Korean cleft palate children after surgery with the same age participated in this experimentation. Instead of Korean control, the standard value of Korean version of the simplified nasometric assessment procedures (kSNAP) was used. RESULT The results are as follows: (1) the highest nasalance score among the Vietnamese normal vowels is the low vowel /a/; however, that of Korean normal vowels is the high vowel /i/. (2) The average nasalance score of Korean cleft palate vowels is 18% higher than that of Vietnamese cleft palate vowels. There was a nasalance score of over 45% among the vowels /e/ and /i/ in Vietnamese cleft palate patients and /i/, /o/, and /u/ in Korean cleft palate patients. CONCLUSION These different nasalance scores of the same vowels seem to cause an ethnic difference between Vietnamese and Korean cleft palate children.
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Affiliation(s)
- Yu-Jeong Shin
- Department of Speech-Language Therapy, Howon University, Gunsan City, Republic of Korea
| | - Yongsoo Kim
- Department of Oral & Maxillofacial Surgery, Institute of Oral Bioscience, School of Dentistry, Clinical Research Institute of Chonbuk National University Hospital, Chonju City, Korea
| | - Hyun-Gi Kim
- Department of Speech-Language Therapy, Graduate School, Research Institute of Speech Sciences, Chonbuk National University, 20 Gungiro Road, Duckjin-Gu, Jeonju City, Chonbuk 561-180 Korea
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Bettens K, Wuyts FL, Jonckheere L, Platbrood S, Van Lierde K. Influence of gender and age on the Nasality Severity Index 2.0 in Dutch-speaking Flemish children and adults. LOGOP PHONIATR VOCO 2016; 42:133-140. [PMID: 27841710 DOI: 10.1080/14015439.2016.1245781] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study aimed to explore the influence of gender and age on the Nasality Severity Index 2.0 (NSI 2.0), an instrumental multiparametric index to determine hypernasality. Additionally, reference values will be established for this new index. Influence of gender and age on the NSI 2.0 was explored in 80 Flemish-speaking children (4-12 years; 40 boys, 40 girls) and 60 Flemish-speaking adults (18-60 years, 30 men, 30 women) without resonance disorders by determining its incorporated acoustic parameters: nasalance of the vowel/u/and an oral text, determined by a Nasometer, and voice low tone to high tone ratio (VLHR) of the vowel/i/. The equation yields NSI 2.0 = 13.20 - (0.0824 × nasalance/u/(%)) - (0.26 × nasalance oral text (%)) - (0.242 × VLHR/i/4.47*F0 Hz (dB)). No effect of gender or age was found on the NSI 2.0 in children. However, significant differences were found for the NSI 2.0, nasalance of/u/and an oral text between adult men and women. Additionally, an interaction effect between gender and age was found for these parameters. Consequently, separate reference values for the NSI 2.0 in children, adult men and adult women were established. Based on these reference scores, deviation of the NSI 2.0 score in patients with resonance disorders can be defined, which can determine the need for (additional) intervention. Further research can explore the possible influence of language on the index.
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Affiliation(s)
- Kim Bettens
- a Department of Speech, Language and Hearing Sciences , Ghent University , Ghent , Belgium
| | - Floris L Wuyts
- a Department of Speech, Language and Hearing Sciences , Ghent University , Ghent , Belgium.,b Department of Biomedical Physics , University of Antwerp , Antwerp , Belgium
| | - Lisa Jonckheere
- a Department of Speech, Language and Hearing Sciences , Ghent University , Ghent , Belgium
| | - Shanah Platbrood
- a Department of Speech, Language and Hearing Sciences , Ghent University , Ghent , Belgium
| | - Kristiane Van Lierde
- a Department of Speech, Language and Hearing Sciences , Ghent University , Ghent , Belgium.,c Department of Speech-Language Pathology and Audiology , University of Pretoria , Pretoria , South Africa
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Karnell MP, Moon JB, Nakajima K, Kacmarynski DS. Quantitative Endoscopic Phototransducer Investigation of Normal Velopharyngeal Physiology. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2016; 59:722-731. [PMID: 27410772 DOI: 10.1044/2016_jslhr-s-15-0268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 01/27/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE The purpose of this research was to learn the extent to which healthy individuals vary in their ability to achieve velopharyngeal closure for speech. METHOD Twenty healthy adult volunteers (10 women, 10 men) were tested using an endoscopic phototransducer system that tracks variations in velopharyngeal closure during speech production. Each speaker produced multiple repetitions of three utterances that differed in phonetic content. The data were amplitude normalized and averaged for each speaker. RESULTS Average phototransducer measurements were similar across subjects for utterances containing only oral phonemes. Average percentage of velopharyngeal closure varied considerably among subjects when producing utterances containing both oral and nasal phonemes (54%-95%). Average percentage of velopharyngeal closure levels were significantly lower (p < .05) for utterances that included nasal consonants. CONCLUSIONS Phototransducer measurements of velopharyngeal closure for speech are sensitive to nasal phoneme content. The findings suggest that motor programming that accomplishes rapid oral-nasal velopharyngeal valving for speech may differ among healthy subjects. However, such variations in motor programming may not perceptually affect typical speakers. If present in individuals with abnormal velopharyngeal mechanisms, these variations may help explain variations among speakers in speech outcomes after physical and behavioral management.
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Nasalance scores for normal Korean-speaking adults and children: Effects of age, vowel context, and stimulus length. Int J Pediatr Otorhinolaryngol 2015; 79:1235-9. [PMID: 26089139 DOI: 10.1016/j.ijporl.2015.05.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 05/15/2015] [Accepted: 05/16/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purpose of this study was to collect nasalance scores for normal Korean-speaking children and adults and to determine whether age, vowel contexts, and stimulus length influence nasalance scores. METHODS Fifty-seven children aged 4-6 years and 17 adults participated in the study. Mean nasalance scores were obtained for eight sentences devoid of nasal consonants divided into the vowel/a/and/i/contexts; the sentences consisted of 4, 8, 16, and 31 syllables. All subjects were asked to repeat the speech stimuli twice after the examiner. The headset of the nasometer was replaced between the first and second recordings. An average value of the nasalance scores from the two recordings for each stimulus was calculated and used in the statistical analysis as a representative measure for each subject. RESULTS Mean and standard deviations of nasalance scores were obtained for each speech stimulus and each age group. The statistical analysis indicated significant effects of age and vowel context and a significant interaction between age and the vowel context on nasalance scores. However, the effect of stimulus length on nasalance scores was not significant. All speakers had higher nasalance scores for the vowel/i/contexts than for the vowel/a/contexts. Adults had higher nasalance scores compared to children in both vowel contexts. CONCLUSIONS These normal nasalance values from Korean-speaking children aged 4-6 years will provide important reference information for resonance assessment of children with cleft palate who have been considered for secondary palatal surgery. The results of the study suggest that subjects' age and the vowel content of speech stimuli should be carefully considered when interpreting the nasalance scores.
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Bettens K, Van Lierde KM, Corthals P, Luyten A, Wuyts FL. The Nasality Severity Index 2.0: Revision of an Objective Multiparametric Approach to Hypernasality. Cleft Palate Craniofac J 2015; 53:e60-70. [PMID: 25794017 DOI: 10.1597/14-247] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Due to the multidimensional nature of resonance disorders, multivariate diagnostic assessment is advisable. The nasality severity index (NSI) is based on this point of view. Because of the influence of personal and environmental variables on the current NSI, this study aims to refine this index. DESIGN Prospective case-control study. SETTING Tertiary university hospital. PATIENTS Forty-two patients with cleft lip and palate and 50 children without resonance disorders were tested. INTERVENTIONS Resonance was investigated by perceptual as well as objective measurements. A Nasometer was used to score nasalance, and spectral speech characteristics of a sustained sound /i:/ were determined, among which the voice low tone to high tone ratio (VLHR). Binary logistic regression analysis was performed to calculate the optimal index to discriminate patients from control children. Additionally, the validity of the index was determined based on data from an independent patient and control group. RESULTS The NSI 2.0, a weighted linear combination of three variables, can be obtained using the equation NSI 2.0 = 13.20 - (.0824 × nasalance /u:/ [%]) - (.260 × nasalance oral text [%]) - (.242 × VLHR 4.47*F0 [dB]). The NSI has a sensitivity of 92% and a specificity of 100%. Moreover, it has excellent validity (sensitivity 88%, specificity 89%). CONCLUSIONS The NSI 2.0 discriminates patients from control children with high sensitivity, specificity, and validity. This multiparametric method can offer a more powerful approach in the assessment and treatment planning of individuals with hypernasality.
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Awan SN, Bressmann T, Poburka B, Roy N, Sharp H, Watts C. Dialectical effects on nasalance: a multicenter, cross-continental study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2015; 58:69-77. [PMID: 25260176 DOI: 10.1044/2014_jslhr-s-14-0077] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 09/08/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE This study investigated nasalance in speakers from six different dialectal regions across North America using recent versions of the Nasometer. It was hypothesized that many of the sound changes observed in regional dialects of North American English would have a significant impact on measures of nasalance. METHOD Samples of the Zoo Passage, the Rainbow Passage, and the Nasal Sentences were collected from young adult male and female speakers (N=300) from six North American dialectical regions (Midland/Mid-Atlantic; Inland North Canada; Inland North; North Central; South; and Western dialects). RESULTS Across the three passage types, effect sizes for dialect were moderate in strength and accounted for approximately 7%-9% of the variation in nasalance. Increased differences in nasalance tended to occur between speakers from distinctly different geographical regions, with the highest nasalance across all passages observed for speakers from the Texas South dialect region. CONCLUSION Clinicians and researchers who use perceptual and instrumental measures of speech production should be aware that dialectical and socially acquired speech patterns may influence the acoustic characteristics of speech and may also influence the interpretation of normative expectations and typical versus disordered cutoff scores for instruments such as the Nasometer.
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Lee J, Hustad KC, Weismer G. Predicting speech intelligibility with a multiple speech subsystems approach in children with cerebral palsy. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2014; 57:1666-78. [PMID: 24824584 PMCID: PMC4192090 DOI: 10.1044/2014_jslhr-s-13-0292] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 05/08/2014] [Indexed: 05/06/2023]
Abstract
PURPOSE Speech acoustic characteristics of children with cerebral palsy (CP) were examined with a multiple speech subsystems approach; speech intelligibility was evaluated using a prediction model in which acoustic measures were selected to represent three speech subsystems. METHOD Nine acoustic variables reflecting different subsystems, and speech intelligibility, were measured in 22 children with CP. These children included 13 with a clinical diagnosis of dysarthria (speech motor impairment [SMI] group) and 9 judged to be free of dysarthria (no SMI [NSMI] group). Data from children with CP were compared to data from age-matched typically developing children. RESULTS Multiple acoustic variables reflecting the articulatory subsystem were different in the SMI group, compared to the NSMI and typically developing groups. A significant speech intelligibility prediction model was obtained with all variables entered into the model (adjusted R2 = .801). The articulatory subsystem showed the most substantial independent contribution (58%) to speech intelligibility. Incremental R2 analyses revealed that any single variable explained less than 9% of speech intelligibility variability. CONCLUSIONS Children in the SMI group had articulatory subsystem problems as indexed by acoustic measures. As in the adult literature, the articulatory subsystem makes the primary contribution to speech intelligibility variance in dysarthria, with minimal or no contribution from other systems.
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Prunkngarmpun C, Sumita YI, Taniguchi H. Three monosyllables for standard words in Nasometer test: to evaluate air leakage in maxillectomy patients. ACTA ACUST UNITED AC 2009; 52:507-12. [PMID: 19037147 DOI: 10.2186/jjps.52.507] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The purpose of this study was to establish an evaluation method using a Nasometer, with several monosyllabic test words, to reveal the level of air leakage in maxillectomy patients without limitations due to language or ability to read. METHODS 20 normal Japanese (Group 1) and 20 international adults (Group 2), were asked to read 7 monosyllables, (5 vowels and 2 combined vowels, /a/, /i/, /u/, /e/, /o/, /am/, /aj/), 6 times each and 12 Japanese maxillectomy patients (Group 3) were asked to read only 3 monosyllables (/a/, /am/, /aj/) 6 times each. The "Nasalance Score" was calculated using a Nasometer (Nasometer II, model 6400 KayPentax, Lincoln Park, NJ, USA). RESULTS Coefficient of variations (CVs) of three monosyllables /a/, /am/, /aj/ of Group 1 and Group 2 showed less than 0.33. There is significant difference in all pairs of three monosyllables between Group 1 and Group 3 (p < 0.05). CONCLUSION Using a Nasometer, these three monosyllables, /a/, /am/ and /aj/, could be used as standard test words and could reveal the level of air leakage in maxillectomy patients.
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Affiliation(s)
- Chaivut Prunkngarmpun
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
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Lewis KE, Watterson T, Blanton A. Comparison of Short-Term and Long-Term Variability in Nasalance Scores. Cleft Palate Craniofac J 2008; 45:495-500. [DOI: 10.1597/07-150.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To evaluate long-term nasalance score variability while accounting for short-term variation associated with subject performance and headgear change variability. Stimuli: Turtle and Mouse Passages. Design: Short-term immediate test-retest nasalance score variability was assessed with no headgear change (NCHG) and with change of headgear (CHG). Long-term variability was assessed with scores obtained in the morning and afternoon of the same day, 1 day apart, and 1 week apart. Scores from the long-term conditions necessarily reflect variability associated with headgear change plus variability, which may be attributed to time. Participants: Twenty-six adults (19 to 70 years of age) with normal speech and resonance. Main Outcome Measures: Forty-six nasalance scores per subject. Results: Mean nasalance difference scores across conditions were compared. Three contrasts were significantly different, each involving comparison of nasalance difference scores in the NCHG condition to difference scores from a CHG condition. Overall, long-term variability was slightly greater than short-term variability. For the Turtle Passage, in the short-term CHG condition, 92% of repeated scores were within five points. In the long-term conditions, 83% to 89% of scores were within five points. For the Mouse Passage, 88% of repeated scores in the CHG condition were within five points. In the long-term conditions, 81% to 83% of scores were within five points. Conclusions: Nasalance scores obtained over time showed slightly greater variability than scores obtained in immediate test-retest conditions; however, variability did not increase as the length of time between measures increased.
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Affiliation(s)
| | | | - Ann Blanton
- Department of Speech Pathology and Audiology, University of Nevada School of Medicine, Reno, Nevada
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Vorperian HK, Kent RD. Vowel acoustic space development in children: a synthesis of acoustic and anatomic data. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2007; 50:1510-45. [PMID: 18055771 PMCID: PMC2597712 DOI: 10.1044/1092-4388(2007/104)] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE This article integrates published acoustic data on the development of vowel production. Age specific data on formant frequencies are considered in the light of information on the development of the vocal tract (VT) to create an anatomic-acoustic description of the maturation of the vowel acoustic space for English. METHOD Literature searches identified 14 studies reporting data on vowel formant frequencies. Data on corner vowels are summarized graphically to show age- and sex- related changes in the area and shape of the traditional vowel quadrilateral. CONCLUSIONS Vowel development is expressed as follows: (a) establishment of a language-appropriate acoustic representation (e.g., F1-F2 quadrilateral or F1-F2-F3 space), (b) gradual reduction in formant frequencies and F1-F2 area with age, (c) reduction in formant-frequency variability, (d) emergence of male-female differences in formant frequency by age 4 years with more apparent differences by 8 years, (e) jumps in formant frequency at ages corresponding to growth spurts of the VT, and (f) a decline of f0 after age 1 year, with the decline being more rapid during early childhood and adolescence. Questions remain about optimal procedures for VT normalization and the exact relationship between VT growth and formant frequencies. Comments are included on nasalization and vocal fundamental frequency as they relate to the development of vowel production.
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Affiliation(s)
- Houri K Vorperian
- University of Wisconsin-Madison, 481 Waisman Center, 1500 Highland Avenue, Madison, WI 53705, USA.
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Van Lierde KM, Wuyts FL, Bonte K, Van Cauwenberge P. The nasality severity index: an objective measure of hypernasality based on a multiparameter approach. A pilot study. Folia Phoniatr Logop 2007; 59:31-8. [PMID: 17172784 DOI: 10.1159/000096548] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
There is a need for an objective measure that describes normal resonance and resonance disorders. The current standard of practice has not led to mismanagement but a refined objective assessment protocol will benefit a more precise objective assessment of velopharyngeal disorders. The purpose of the present study is to construct a nasality severity index (NSI) that reflects the multidimensional nature of resonance. Objective and subjective assessment techniques were used to determine the nasalance, the nasality and aerodynamic capacities in 21 children with cleft palate and a control group of 25 children without cleft palate. Stepwise logistic regression was used to determine the optimal index. The NSI consists of a linear combination of 4 variables, where each variable has a different weight. The equation is: NSI = -60.69 - (3.24 x percent oral text) - (13.39 x Glatzel value /a/) + [0.244 x maximum duration time (seconds)] - (0.558 x % /a/) + (3.38 x percent oronasal text). NSI sensitivity is 88% and specificity is 95%. Daily clinical use of the NSI has shown it to be an efficient and practical tool to describe the presence of hypernasality. Three distinct follow-up cases are presented to illustrate the impact of a surgical technique, the use of a speech bulb and velopharyngeal biofeedback training on NSI. The implementation of the NSI may help clinicians to quantitatively assess the severity of nasality disorders beside the perceptual judgments.
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Affiliation(s)
- Kristiane M Van Lierde
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ghent, Ghent, Belgium
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Watterson T, Lewis K, Brancamp T. Comparison of Nasalance scores obtained with the Nasometer 6200 and the Nasometer II 6400. Cleft Palate Craniofac J 2006; 42:574-9. [PMID: 16149843 DOI: 10.1597/04-017.1] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This study was designed to compare nasalance scores obtained with the old Nasometer 6200 and the new Nasometer II 6400, and to evaluate test-retest reliability of nasalance scores on each machine. DESIGN Nasalance scores were obtained for 60 subjects reading each of two stimuli. Each subject read each stimulus two times on one machine; the headgear was removed and replaced and each stimulus was read a third time. The same procedure was then repeated with the second machine. Within machines, nasalance scores were compared for repeated stimuli with and without headgear change. The first reading of each stimulus with each machine was used to compare nasalance scores across machines. PARTICIPANTS The subjects were 60 adults with normal speech ranging in age from 19 to 59 years. MAIN OUTCOME MEASURES The main outcome measures were the 12 nasalance scores obtained for each of 60 subjects. RESULTS For both passages, there was a significant difference in nasalance scores between the old Nasometer and the Nasometer II; however, the actual variability that could be attributed to a difference between machines was small. Most of the variability between machines could be explained as within-subject performance variability and variability associated with headgear change. There was no significant difference in repeated scores within machines with or without headgear change. CONCLUSIONS For clinical purposes, care should be exercised when comparing nasalance scores between the old Nasometer and the Nasometer II.
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Affiliation(s)
- Thomas Watterson
- Department of Speech Pathology and Audiology, Redfield Bldg/152, University of Nevada School of Medicine, Reno, 89557, USA.
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Keuning KHDM, Wieneke GH, van Wijngaarden HA, Dejonckere PH. The correlation between nasalance and a differentiated perceptual rating of speech in Dutch patients with velopharyngeal insufficiency. Cleft Palate Craniofac J 2002; 39:277-84. [PMID: 12019003 DOI: 10.1597/1545-1569_2002_039_0277_tcbnaa_2.0.co_2] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The correlation between the nasalance score and the perceptual rating of several aspects of speech of speakers with velopharyngeal insufficiency (VPI) by six speech-language pathologists was evaluated. PROCEDURE The overall grade of severity, hypernasality, audible nasal emission, misarticulations, and intelligibility were rated on visual analog scales. Speech samples with a normal distribution of phonemes (normal text [NT]) and those free of nasal consonants (denasal text [DT]) of 43 patients with VPI were used. Mean nasalance scores were computed for the speech samples, and Spearman correlation coefficients were computed between the mean nasalance score and the five parameters of the differentiated rating. SETTING The Institute of Phoniatrics, Utrecht University Hospital, The Netherlands. RESULTS The correlation coefficient between the mean nasalance and the perceptual rating of hypernasality ranged among judges from .31 to .56 for NT speech samples and .36 to .60 for DT speech samples. Only small differences were found between speech pathologists with and without expertise in cleft palate speech. The rating of the overall grade of severity appeared to correlate quite well with the rating of the intelligibility (r(NT) = .77, r(DT) = .79). Lower correlation coefficients, ranging from .34 to .71, were found between overall grade of severity and hypernasality, audible nasal emission, and misarticulations. CONCLUSIONS A low correlation between the nasalance and the perceptual rating of hypernasality was found. The parameter overall grade of severity appeared to be determined mainly by the parameter intelligibility. Expertise in rating of cleft palate speech does not guarantee a high correlation between instrumental measurement and perceptual rating.
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Affiliation(s)
- Kornelis H D M Keuning
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, The Netherlands.
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Abstract
OBJECTIVE To determine whether oral or nasal acoustic energy is primarily responsible for nonzero nasalance scores observed during the production of nonnasal sentences by individuals with normal speech. METHOD Sixty adults with normal speech were asked to read the Zoo passage and produce three sustained vowels, (/i/, /a/ and /u/), with and without nares occlusion. RESULTS There was a significant decrease in nasalance scores between the unoccluded and occluded conditions for all four stimulus pairs. The mean decrease across conditions ranged from 8 (/u/) to 25 (/i/). In the unoccluded condition, the nasalance score was significantly greater for /i/ than for the other stimuli. CONCLUSIONS The findings suggest that the majority of acoustic energy detected by the nasometer's nasal microphone during the production of nonnasal utterances is the result of sound transmission through the nose. The data obtained during this investigation, coupled with information available from other studies, suggest that this may be due to transpalatal transmission. If correct, such a conclusion would have clinical implications for patients with palatal clefts, since residual structural abnormalities and scar tissue in a repaired cleft palate may increase, dampen, or in some way alter transpalatal acoustic transmission. Thus, surgical normalization of velopharyngeal port control may not be sufficient to eliminate hypernasality in all patients.
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Affiliation(s)
- C E Gildersleeve-Neumann
- Department of Communication Sciences and Disorders, College of Communication, University of Texas at Austin, 78712, USA
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Abstract
OBJECTIVES To establish and evaluate stimulus materials for nasalance measurement in Cantonese speakers, to provide normative data for Cantonese-speaking women, and to evaluate session-to-session reliability of nasalance measures. PARTICIPANTS AND SETTING One hundred forty-one Cantonese-speaking women with normal resonance who were students in the Department of Speech and Hearing Sciences, University of Hong Kong. PROCEDURES Participants read aloud four speech stimuli: oral sentences, nasal sentences, an oral paragraph (similar to the Zoo Passage), and an oral-nasal paragraph (similar to the Rainbow Passage). Data were collected and analyzed using the Kay Nasometer 6200. Data collection was repeated for a subgroup of speakers (n = 28) on a separate day. Nasalance materials were evaluated by using statistical tests of difference and correlation. RESULTS Group mean (standard deviation) nasalance scores for oral sentences, nasal sentences, oral paragraph, and oral-nasal paragraph were 16.79 (5.99), 55.67 (7.38), 13.68 (7.16), and 35.46 (6.22), respectively. There was a significant difference in mean nasalance scores for oral versus nasal materials. Correlations between stimuli were as expected, ranging from 0.43 to 0.91. Session-to-session reliability was within 5 points for over 95% of speakers for the oral stimuli but for less than 76% of speakers for the nasal and oral-nasal stimuli. CONCLUSIONS Standard nasalance materials have been developed for Cantonese, and normative data have been established for Cantonese women. Evaluation of materials indicated acceptable differentiation between oral and nasal materials. Two stimuli (nasal sentences and oral paragraph) are recommended for future use. Comparison with findings from other languages showed similarities in scores; possible language-specific differences are discussed. Session-to-session reliability was poorer for nasal than oral stimuli.
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Affiliation(s)
- T L Whitehill
- Department of Speech and Hearing Sciences, University of Hong Kong, Hong Kong.
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Van Lierde KM, Wuyts FL, De Bodt M, Van Cauwenberge P. Nasometric values for normal nasal resonance in the speech of young Flemish adults. Cleft Palate Craniofac J 2001; 38:112-8. [PMID: 11294538 DOI: 10.1597/1545-1569_2001_038_0112_nvfnnr_2.0.co_2] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The purpose of this study was to obtain normative nasalance scores for adult subjects speaking the Flemish language. Additional objectives of the study were to determine if speaker sex played a role in differences in nasalance scores and if significantly different nasalance scores existed for Flemish compared with other languages or dialects. DESIGN Nasalance scores were obtained while young Flemish adults read three standard nasalance passages. These passages were an oronasal passage (a text that contained the same approximate percentage of nasal consonants as found in the standard Dutch speech), an oral passage (a text that excluded nasal consonants), and a nasal passage (a reading text loaded with nasal consonants). PARTICIPANTS Subjects included 58 healthy young Flemish adults with normal oral and velopharyngeal structure and function, normal hearing levels, normal voice characteristics, and normal resonance and articulation skills. METHODS The Nasometer (model 6200) was used to obtain nasalance scores for the three reading passages. These three reading passages were designed specifically for use with the nasometer. The nasalance data were analyzed for sex dependence, using Student's t test for each reading passage. This same test was used for comparison of our data with data of other languages. RESULTS Normative nasalance data were obtained for the oronasal text (33.8%), the oral text (10.9%), and the nasal text (55.8%). Female speakers exhibited significantly higher nasalance scores than male speakers on the passages containing nasal consonants (normal text, p = .001; nasal text, p = .042). Furthermore, statistically significant cross-linguistic nasality differences were observed. The English and Spanish languages were found to have more nasalance than the Flemish language. For the North Dutch and Flemish languages, this cross-linguistic phenomenon was absent. CONCLUSION These normative nasalance scores for normal young adults speaking the Flemish language provide important reference information for Flemish cleft palate teams. Sex-related differences and cross-linguistic differences were shown.
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Affiliation(s)
- K M Van Lierde
- Medical Faculty of the Ghent University, and Clinician, Speech and Hearing Department, Ghent University Hospital, Belgium.
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Tachimura T, Mori C, Hirata SI, Wada T. Nasalance score variation in normal adult Japanese speakers of Mid-West Japanese dialect. Cleft Palate Craniofac J 2000; 37:463-7. [PMID: 11034028 DOI: 10.1597/1545-1569_2000_037_0463_nsvina_2.0.co_2] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aims of this study were to examine nasalance score variation for normal adult Japanese speakers of Mid-West dialect and the gender difference in average mean nasalance score. DESIGN Nasalance scores were obtained using a nasometer model 6200. The sample stimulus "Kitsutsuki passage," constructed of four sentences containing no Japanese nasal sounds, was used three times by each subject. PARTICIPANTS One hundred normal adult speakers (50 women and 50 men) of Japanese served as subjects. The subjects ranged in age from 19 to 35 years of age (24.0 +/- 3.2). MAIN OUTCOME MEASURE A mean nasalance score as well as an overall average nasalance value across speakers was calculated for each subject. The average mean nasalance scores between men and women were compared. RESULTS The average mean nasalance score for the normal Japanese speakers was 9.1% (+/- 3.9). There was no statistically significant sex difference (p < .01). Average mean scores of 9.8% (+/- 3.5) and 8.3% (+/- 4.0) were obtained for the female and male speakers, respectively. CONCLUSIONS The results provide important information concerning criteria to evaluate hypernasal speech due to velopharyngeal inadequacy of Japanese speakers with cleft palate using the nasometer.
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Affiliation(s)
- T Tachimura
- Division for Oral and Facial Disorders, Faculty of Dentistry, Osaka University, Japan.
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