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https://codas.org.br/article/doi/10.1590/2317-1782/20202019269
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Artigo Original

Influence of speech stimuli in the auditory perceptual identification of hypernasality in individuals with cleft lip and palate

Influência de estímulos de fala na identificação perceptivo-auditiva da hipernasalidade em indivíduos com fissura labiopalatina

Viviane Cristina de Castro Marino; Jeniffer de Cássia Rillo Dutka; Flora Taube Manicardi; Giovana Gifalli; Patrick Pedreira Silva; Maria Inês Pegoraro-Krook

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Abstract

Purpose: To investigate the influence of speech stimuli in the auditory perceptual identification of hypernasality in individuals with Cleft Lip and Palate (CLP). Methods: Speech samples from 80 individuals with operated unilateral CLP, ages ranged from nine to 17 years (the mean age of: 12y7m), both genders, were edited for this study. Samples were recorded over the production of nine different speech stimuli, including counting and short sentences characterized by oral sounds, one loaded with low pressure consonants and seven loaded with high pressure consonants. Three speech-language pathologists rated the presence or absence of hypernasality while analyzing 864 recordings (80 individuals X 9 stimuli + 144 repeated recordings, for measuring the intra-rater agreement). Intra-rater and inter-rater indexes of agreement were established for all nine stimulus conditions. The indexes of inter-rater agreement were compared using the Z test (p<0.005), with samples comprising significant indexes of agreement interpreted as better stimuli for identifying the hypernasality in these individuals. Results: Intra-rater agreement for high pressure stimuli with voiced consonants were significantly lower than indexes for other stimuli. Inter-rater agreement between each pair of SLPs ranged from 0.11 (plosive voicing stimuli) to 0.57 (12 short sentences, one of each high pressure consonant). The values of mean inter-rater agreement between all SLPs was 0.47 indicating moderate agreement for identifying hypernasal speech. Conclusion: Speech recordings obtained over the production of longer speech samples including 12 short sentences, for instance one for each high pressure consonant, may favor inter-rater agreement for identifying hypernasality

Keywords

Cleft Palate; Velopharyngeal Insufficiency; Speech; Speech Disorders; Speech Perception; Resonance

Resumo

Objetivo: Investigar a influência de estímulos de fala distintos na identificação perceptivo-auditiva da hipernasalidade em indivíduos com fissura labiopalatina operada (FLP). Método: Foram editadas amostras de fala gravadas em áudio de 80 indivíduos com FLP unilateral operada, de ambos os sexos, com idades entre 9 e 17 anos (média=12 anos e 7 meses). As amostras foram gravadas durante a produção de 9 estímulos de fala distintos: contagem de números e conjuntos de frase orais, sendo 1 constituído por consoantes de baixa pressão e 7 constituídos por consoantes de alta pressão. Três fonoaudiólogas identificaram a presença ou ausência da hipernasalidade ao analisarem 864 gravações (80 indivíduos X 9 estímulos + 144 gravações repetidas para análise de concordância intra-avaliador). Os índices de concordância intra e interavaliadores foram estabelecidos para todos os 9 estímulos de fala e comparados entre si por meio do Teste Z, com nível de significância de 5%, com maiores índices de concordância interpretados como melhores estímulos para identificação da hipernasalidade. Resultados: Índices de concordância intra-avaliadores de estímulos de fala vozeados foram significativamente menores do que outros estímulos. Índices de concordância entre os pares de fonoaudiólogas variaram de 0,11 (concordância estímulos plosivos vozeados) a 0,57 (12 frases, uma com cada consoante de alta pressão), com média de 0,47 entre as três avaliadoras, indicando concordância moderada para identificação da hipernasalidade. Conclusão: Gravações de fala obtidas durante a produção de estímulos mais longos, incluindo 12 frases, uma com cada consoante de pressão, podem favorecer a concordância interavaliador na identificação da hipernasalidade

Palavras-chave

Fissura Palatina; Insuficiência Velofaríngea; Fala; Percepção de Fala; Distúrbios de Fala; Ressonância

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