Fatma Esen Aydinli

Investigating the Effects of Glottal Stop Productions on Voice in Children With Cleft Palate Using Multidimensional Voice Assessment Methods

OBJECTIVES The aim was to investigate the effects of glottal stop productions (GS) on voice in children with cleft palate using multidimensional voice assessment methods. STUDY DESIGN This is a prospective case-control study. METHODS Children with repaired cleft palate (n = 34) who did not have any vocal fold lesions were separated into two groups based on the results of the articulation test. The glottal stop group (GSG) consisted of 17 children who had GS. The control group (CG) consisted of an equal number of age- and gender-matched children who did not have GS. The voice evaluation protocol included acoustic analysis, Pediatric Voice Handicap Index (pVHI), and perceptual analysis (Grade, Roughness, Breathiness, Asthenia, Strain method). The velopharyngeal statuses of the groups were compared using the nasopharyngoscopy and the nasometer. RESULTS The total pVHI score and the subscales of the pVHI were found to be significantly higher in the GSG. The F0, jitter, and shimmer were found to be numerically higher in the GSG with the difference being statistically significant in jitter (P < 0.05). Audioperceptual analysis revealed a difference in overall voice quality and roughness between the groups. Greater incidence of significant velopharyngeal insufficiency and higher nasalance scores were found in the GSG (P < 0.05). CONCLUSIONS These results may indicate that the vocal quality characteristics of children with GS differ from children who do not have this type of production. It is suggested that children with cleft palate who have GS should receive a comprehensive speech and language pathology intervention including voice therapy techniques.

Comparing the effects of Essix and Hawley retainers on the acoustics of speech

Objective The aim of this study was to compare the effects of two retainer types (Essix and Hawley) on speech performance. Subjects and methods The speech articulation of 30 patients was evaluated prospectively. Five patients did not appear during the follow-up periods. The patients were randomly divided into retention groups by treatment allocation cards as Essix and Hawley. The Essix group included 13 participants with a mean age of 15.3±2.4 years; the Hawley group included 12 participants with a mean age of 16.3±2.56 years. Speech sound assessments were performed on the first day and 1 week, 4 weeks, and 3 months later. On the first day, the assessments were conducted prior to inserting the retainers, immediately after maxillary and mandibular retainer application, individually, and with both retainers applied. The acoustic analyses were obtained using spectral and temporal parameters. Results Statistical analyses were performed with IBM SPSS for Windows, version 20. A P value less than 0.05 was considered statistically significant. The most apparent changes were found in the [a] vowel in the Hawley group, the [e] vowel in the Essix group, and the [u] vowel in both groups (P < 0.05). While the number of affected consonant-vowel couples in the Essix group was low, alterations were common in the Hawley group. There was a statistically significant difference (P < 0.05) in voice onset time of the [d] sound between the groups. Limitations The trial had a small sample size and a short follow-up period. Conclusions The Hawley retainer affected articulatory movements in consonant-vowel combinations more prominently than the Essix retainer did. Voice onset time of the consonant [d] in the Hawley group was shorter than normal, indicating rapid articulatory movement in the alveolar region.

Consensus statement: Long-term results of ABI in children with complex inner ear malformations and decision making between CI and ABI

Consensus statement : Long-term results of ABI in children with complex inner ear malformations and decision making between CI and ABI

Turkish Standardized Reading Passage for the Evaluation of Hard Glottal Attack Occurrence Frequency

OBJECTIVE This study aimed to develop a Turkish reading passage that can be used in evaluating the frequency of hard glottal attack (HGA) and to assess its reliability. STUDY DESIGN This is a prospective case-control study. METHODS The Towne-Heuer reading passage is a valuable tool that can be used for the auditory-perceptual assessment of voice. The characteristics of the first four paragraphs of the reading passage were analyzed by a linguist. Then, a Turkish reading passage with similar characteristics was developed. The control group (n = 21) consisted of individuals with no voice disorder. The study group consisted of two subgroups that were diagnosed as having vocal fold nodules (n = 11) and muscle tension dysphonia (n = 10). A total of three listeners were evaluated for the frequency of HGAs. One of the listeners was a masters student, whereas the other two listeners were speech-language pathologists. Consistency between the listeners was evaluated by using the percent agreement and the kappa statistics. Intrarater reliability was assessed by the Wilcoxon sign test. The t test was used to evaluate potential differences between the groups. The results were considered as significant if the P value was <0.05. RESULTS The average attack number in the study group was found to be significantly higher than the controls (P < 0.05). No significant difference could be discerned between the muscle tension dysphonia and vocal nodule subgroups (P > 0.05). CONCLUSIONS Findings confirmed that HGAs are clearly related to the vocal hyperfunction; however, the mechanism of action needs more research. In addition, the relationship between syllable stress and HGA should be further researched to clarify the cause of the attack number differences between English and Turkish languages.

Reliability and Validity of the Turkish Version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V)

OBJECTIVES The main purpose of this study was to culturally adapt the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) to Turkish and to evaluate its internal consistency, validity, and reliability. MATERIALS AND METHODS The Turkish version of CAPE-V was developed, and with the use of a prospective case-control design, the voice recordings of 130 participants were collected according to CAPE-V protocol. Auditory-perceptual evaluation was conducted according to CAPE-V and Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale by two ear, nose, and throat specialists and two speech and language therapists. The different types of voice disorders, classified as organic and functional disorders, were compared in terms of their CAPE-V scores. RESULTS The overall severity parameter had the highest intrarater and inter-reliability values for all the participants. For all four raters, the differences in the six CAPE-V parameters between the study and the control groups were found to be statistically significant. Among the correlations for the comparable parameters of the CAPE-V and the GRBAS scales, the highest correlation was found between the overall severity-grade parameters. There was no difference found between the organic and functional voice disorders in terms of the CAPE-V scores. CONCLUSIONS The Turkish version of CAPE-V has been proven to be a reliable and valid instrument to use in the auditory-perceptual evaluation of voice. For the future application of this study, it would be important to investigate whether cepstral measures correlate with the auditory-perceptual judgments of dysphonia severity collected by a Turkish version of the CAPE-V.

The Effects of Age and Gender on Laryngeal Aerodynamics in the Children Population

OBJECTIVES Normal voice can be differentiated from dysphonic voices by comparing their characteristics using an established normative database. Pediatric normative data using the Phonatory Aerodynamic System (PAS) have been established in a preliminary study for English-speaking children. However, aerodynamic measures, including physical characteristics varying by geographic region, race, and culture, must be investigated between children with different native languages. Aerodynamic analysis of connected speech requires the collection of language-specific samples and the establishment of language-specific norms. Thus, the main purpose of the present study was to establish pediatric normative data using the PAS for a large pediatric population of healthy Turkish-speaking children of 4-17.11years of age. Another research aim was to determine age-dependent and/or gender-dependent aerodynamic parameters for this pediatric population. METHODS In total, 120 children were divided into four age groups: Group I, 4-5.11 years; Group II, 6-9.11 years; Group III, 10-13.11 years; and Group IV, 14-17.11years. An equal number of male and female participants were assigned to each group. The PENTAX Medical PAS Model 6600 was used. Descriptive statistics for 56 parameters across six protocols were expressed as mean, standard deviation, and range values. Each protocol was analyzed for age, gender, and age-gender interaction. RESULTS Age was the most predominant factor, affecting 37 of the 56 aerodynamic parameters investigated. Gender and age-gender factors were observed at an equal frequency, each affecting 16 parameters. Pitch-related parameters were the most altered parameters in each protocol. Age-gender interaction was observed in parameters related to the expiratory airflow. CONCLUSIONS This study established the normative values of phonatoary aerodynamics for a large pediatric population with a wide age range and developed a normative database for healthy Turkish-speaking children. This is the first study to investigate running speech protocol in aerodynamic assessment.

Effects of distractors on upright balance performance in school-aged children with attention deficit hyperactivity disorder, preliminary study

INTRODUCTION Attention deficit hyperactivity disorder is a common impairing neuropsychiatric disorder with onset in early childhood. Almost half of the children with attention deficit hyperactivity disorder also experience a variety of motor-related dysfunctions ranging from fine/gross motor control problems to difficulties in maintaining balance. OBJECTIVES The main purpose of this study was to investigate the effects of distractors two different auditory distractors namely, relaxing music and white noise on upright balance performance in children with attention deficit hyperactivity disorder. METHODS We compared upright balance performance and the involvement of different sensory systems in the presence of auditory distractors between school-aged children with attention deficit hyperactivity disorder (n=26) and typically developing controls (n=20). Neurocom SMART Balance Master Dynamic Posturography device was used for the sensory organization test. Sensory organization test was repeated three times for each participant in three different test environments. RESULTS The balance scores in the silence environment were lower in the attention deficit hyperactivity disorder group but the differences were not statistically significant. In addition to lower balance scores the visual and vestibular ratios were also lower. Auditory distractors affected the general balance performance positively for both groups. More challenging conditions, using an unstable platform with distorted somatosensory signals were more affected. Relaxing music was more effective in the control group, and white noise was more effective in the attention deficit hyperactivity disorder group and the positive effects of white noise became more apparent in challenging conditions. CONCLUSION To the best of our knowledge, this is the first study evaluating balance performance in children with attention deficit hyperactivity disorder under the effects of auditory distractors. Although more studies are needed, our results indicate that auditory distractors may have enhancing effects on upright balance performance in children with attention deficit hyperactivity disorder.