Subjektivna procjena nazalnosti govora kod predškolske djece s postalveolarnim rascjepom nakon palatoplastike

master's thesis

• Title (english): Subjective assessment of nasality in speech of preeschool children with a repaired cleft palate
• Author: Ljerka Ljubas
• Mentor: Mladen Heđever (mentor)
• Mentor: Draženka Blaži (mentor)
• Committee member: Mladen Heđever (predsjednik povjerenstva)
• Committee member: Draženka Blaži (član povjerenstva)
• Committee member: Emica Farago (član povjerenstva)
• Granter: University of Zagreb; Faculty of Education and Rehabilitation Sciences; Zagreb
• Defense date and country: 2019-02-26, Croatia
• Scientific / art field, discipline and subdiscipline: SOCIAL SCIENCES; Speech Therapy

Abstract

Govorni ishodi nakon palatoplastike nedovoljno su istražena tema u Hrvatskoj. Nazalnost je glavna karakteristika govora djece rođene s rascjepom nepca, a vrlo često ostaje prisutna u govoru i nakon kirurške korekcije. Za procjenu posljedica koje rascjep ima na govor najvažnija je subjektivna procjena govora.
Cilj ovog istraživanja je subjektivnom procjenom procijeniti i opisati nazalanost i razumljivost govora kod šestero djece predškolske dobi s rascjepom nepca nakon palatoplastike, u obliku prikaza šest studija slučaja.
Prikupljen je govorni uzorak od šestero djece rođene s rascjepom mekog i/ili tvrdog nepca predškolskog uzrasta (KD=4;02-6;02 godine). Govorni uzorak sastoji se od riječi i rečenica zasićenih glasovima koji se tvore usmjeravanjem zračne struje na usta (okluzivi, frikativi, afrikate) i ne sadrže nazale.
Subjektivna procjena provedena je na Edukacijsko-rehabilitacijskom fakultetu u Laboratoriju za slušnu i govornu akustiku. Za provedbu istraživanja sastavljen je upitnik za subjektivnu procjenu nazalnosti i razumljivosti govora. Procjenjivači, studenti logopedije, dva su puta slušali snimke riječi i rečenica i procjenjivali najprije nazalnost, a zatim i razumljivost govora te bilježili odgovore na upitniku prema ponuđenoj ljestvici brojeva od jedan do pet pri čemu jedan označava najveću nazalnost i nerazumljiv govor, a broj pet razumljiv izgovor bez nazalnosti. Svi prikupljeni podaci, anamnestički kao i rezultati procjene opisno su prikazani. Prva pretpostavka da će govor djece biti nazalniji i manje razumljiv u produkciji rečenica potvrdila se kod četiri od ukupno šest ispitanika. Druga pretpostavka djelomično je potvrđena jer je govor djeteta s rascjepom i tvrdog i mekog nepca procijenjen kao najviše nazalan, dok je govor djeteta s rascjepom samo mekog nepca procijenjen kao najmanje nazalan. Treća pretpostavka također je djelomično potvrđena. Najviše ocjene na varijabli razumljivost govora dobila su djeca koja su bila uključena u program rane intervencije i kasnije su praćena ili uključena u direktni oblik terapije.
Ovaj prikaz niza slučajeva otvara prostor za daljnja temeljitija istraživanja koja će moći dati odgovor o stupnju narušenosti govora i govornim ishodima i u drugim parametrima govora i glasa.

Abstract (english)

Speech outcomes after a palatoplasty is not sufficiently researched in Croatia. Nasality is the main characteristic of speech of children born with a cleft palate which very often remains present in speech even after surgical correction.To assess the effects that cleft palate has on speech the most important is a subjective assessment of speech.
The aim of this research is to subjectively evaluate and describe in detail nasality and speech intelligibility in six preschool children born with cleft palate, as a form of six case studies. A speech sample of 6 preeschool children born with soft and/or hard cleft palate was collected. The age range is from 4,2 to 6,2 years. The recorded speech sample contains isolated words and sentences saturated with plosives and fricatives and doesn't contain nasal sounds.
The assessment was conducted in a Laboratory for hearing and speech acoustics in the Faculty of Education and Rehabilitation Sciences, University of Zagreb. Assessors were speech and language pathology (SLP) students. Each word and sentence was listened twice, after which the students first evaluated nasality, and then comprehensibility by comparing the answers to the questionnaire according to the offered scale of numbers from one to five, one indicating the greatest nasality and incomprehensible speech, and the number five indicating comprehensible speech without nasality. All collected data, anamnestic as well as evaluation results are descriptively presented. The first premise that children's speech will be more nasal and less understandable in the production of sentences is confirmed in four out of six respondents. The second hypothesis was partially confirmed because the speech of the child with the clef of hard and soft palate was evaluated as the most nasal, while the speech of the child with the only soft palate cleft was evaluated as the least nasal. The third premise has also been partially confirmed. The highest scores on the speech intelligibility variable were obtained by children who were included in the early intervention program and were later monitored or included in the direct form of therapy.
This case series study opens up space for further thorough research that will provide an answer to the degree of speech nasalance in preschool children as well as outcomes in other speech and voice parameter.

• Keywords: rascjep nepca; nazalnost; subjektivna procjena govora; prikaz niza slučaja
• Keywords (english): cleft palate; nasality; perceptual assessment of speech; case series study
• Language: croatian
• URN:NBN: urn:nbn:hr:158:637224
• Study programme: Title: Speech and Language Pathology; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra logopedije (magistar/magistra logopedije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-03-05 09:10:18