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https://codas.org.br/article/doi/10.1590/2317-1782/e20240044pt
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Original Article

Classificação da nasalidade de fala de indivíduos com fissura labiopalatina com escalas ordinais distintas

Classification of speech nasality of individuals with cleft lip and palate with distinct ordinal scales

Gisele Fonseca do Carmo; Jeniffer de Cássia Rillo Dutka; Flora Taube Manicardi; Beatriz Campanine Geremias; Maria Inês Pegoraro-Krook; Viviane Cristina de Castro Marino

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Resumo

RESUMO: Objetivo: Investigar se há diferença na classificação da hipernasalidade de fala de ouvintes não experientes usando escalas ordinais distintas; verificar a concordância dos ouvintes nas análises ao empregar estas escalas e verificar se a ordem de apresentação das escalas influencia os resultados.

Método: Vinte acadêmicos em Fonoaudiologia classificaram os graus de hipernasalidade de 40 amostras (orais) de pacientes com fissura labiopalatina. Dez realizaram as classificações utilizando escala de 4 pontos (ausente, leve, moderada e grave) e, após duas semanas, utilizando escala de 3 pontos (ausente, pouco hipernasal e muito hipernasal). Outros dez alunos realizaram as mesmas classificações, porém em ordem inversa. As classificações foram feitas de forma remota e documentadas em um formulário.

Resultados: A porcentagem média de respostas corretas dos alunos, em relação ao padrão-ouro, foi significativamente maior para a escala de 3 pontos. Não houve interação significativa entre ordem de apresentação e escala para o percentual de acerto das classificações. A concordância dos alunos em relação à avaliação padrão-ouro foi regular (escala de 3 pontos) e moderada (escala de 4 pontos). A porcentagem média de concordância das análises intra-avaliador foi significativamente maior para a escala de 3 pontos. Não houve interação significativa entre ordem de apresentação e escala para o percentual das classificações intra-avaliadores. O índice de coeficiente Kappa mostrou concordância intra-avaliador mais favorável para a escala reduzida.

Conclusão: A escala reduzida favoreceu a classificação da hipernasalidade de fala pelos ouvintes e pode ser considerada uma importante estratégia para favorecer as avaliações iniciais de acadêmicos em Fonoaudiologia durante sua formação.

Palavras-chave

Fissura Palatina, Insuficiência Velofaríngea, Distúrbios da Fala, Percepção da Fala, Fala

Abstract

Purpose  To investigate whether there is a difference in the classification of speech hypernasality by inexperienced listeners using different ordinal scales; to verify the agreement of the listeners in the analyses when using these scales; and to verify whether the order in which the scales are presented influences the results.

Methods  Twenty Speech-Language Pathology students classified the degrees of hypernasality of 40 (oral) samples from patients with cleft lip and palate. Ten performed the classifications using a 4-point scale (absent, mild, moderate, and severe) and, after two weeks, using a 3-point scale (absent, slightly hypernasal, and very hypernasal). Other ten students performed the same classifications, but in reverse order. The classifications were made remotely and documented on a form.

Results  The average percentage of correct responses by the students, in relation to the gold standard, was significantly higher for the 3-point scale. There was no significant interaction between the order of presentation and the scale for the percentage of correct classifications. The students' agreement with the gold standard assessment was fair (3-point scale) and moderate (4-point scale). The mean percentage of agreement of the intra-rater analyses was significantly higher for the 3-point scale. There was no significant interaction between presentation order and scale for the percentage of intra-rater classifications. The Kappa coefficient index showed more favorable intra-rater agreement for the reduced scale.

Conclusion  The reduced scale favored the classification of speech hypernasality by listeners and can be considered an important strategy to favor the initial evaluations of students in Speech Therapy during their training.

Keywords

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

References

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Submitted date:
02/21/2024

Accepted date:
05/27/2024

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