The Immediate Effect of Straw Phonation in Children With Repaired Cleft Palate.

OBJECTIVE: This study aims to investigate the immediate effect of straw phonation on the phonation of Persian-speaking children with repaired cleft palate. STUDY DESIGN: Quasi-experimental preintervention and postintervention. METHODS: Seventeen children with repaired cleft palate and velopharyngeal dysfunction were investigated. A control group was established comprising children without a cleft palate (control group), carefully matched in terms of age and gender. All participants underwent straw phonation and assessment. The assessments were made two times: at baseline and immediately after straw phonation. Each participant performs straw phonation (a short straw measuring 3 mm in inner diameter and 20 cm in length) once for 3 minutes. The acoustic analysis including parameters, such as jitter, shimmer, harmonics-to-noise ratio (HNR), cepstral peak prominence (CPP) parameters, as well as the electroglottography (closed quotient [CQ]) analysis were performed at pretreatment and immediately after treatment. RESULTS: Compared with the pretreatment values, after-treatment observation demonstrated a significant reduction in Jitter % and Shimmer %, and a significant enhancement in HNR and CPP among children with repaired cleft palate. There is no significant difference in intragroup data in the CPP and CQ in pretreatment. CONCLUSIONS: The proposed straw phonation technique results in an immediate positive change in the quality of voice in both groups. Moreover, assessments in the clinical group showed a significant decrease in shimmer and jitter perturbation, alongside elevated levels of HNR and CPP subsequent to straw phonation, irrespective of the phonatory task.

Effectiveness of Oral-Motor Stimulation on Oral Feeding in Premature Infants: A Protocol for Systematic Review and Meta-Analysis of Controlled Randomized Trials.

Objectives: Premature infants (born before 37 weeks of gestational age) frequently experience feeding difficulties due to underdeveloped oral motor skills and poor chewing, swallowing, and breathing coordination. In order to improve oral feeding efficiency in these infants, Oral-Motor Stimulation (OMS) has been used in various studies. This systematic review study will aim to assess the effectiveness of OMS for oral feeding in preterm infants. Materials & Methods: The authors will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. They will conduct a search in electronic databases, including PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials in The Cochrane Library (CENTRAL), Medline via PubMed, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for nursing and related healthcare texts without language restrictions from the first month of 1991 to the fifth month of 2024 to achieve the study objectives. All Randomized Controlled Clinical Trials (RCT) examining the effect of OMS on oral feeding in preterm infants will be included in this study. Results: The primary outcome of this systematic review will be oral feeding, and the secondary outcomes will include duration of hospitalization, weight gain, and feeding efficiency. Two independent reviewers will select and extract data for the study. The Cochrane Risk of Bias Tool (RoB2) will be used to evaluate potential biases in the study. Publication bias will be evaluated using funnel plots, Begg's, and Egger's tests. The degree of heterogeneity among the studies will be assessed using the I2 statistic and the χ2 test. Analyses of subgroups will also be carried out. All meta-analyses will be conducted using Stata V.14. Conclusion: This systematic review protocol for preterm infants will aim to promote evidence-based decision-making and support the development of clinical practice guidelines in preterm feeding.

The Vocal Hygiene Treatment Programs for Singers: A Systematic Review.

OBJECTIVES: This systematic review aims to explore the effectiveness of voice health education interventions among singers, particularly focusing on vocal hygiene treatment programs tailored for professional voice users. STUDY DESIGN: Systematic review. METHODS: Preferred Reporting Items on Systematic Reviews and Meta-Analysis guidelines were followed to conduct this systematic review. Comprehensive searches were conducted in PubMed, Web of Science, Scopus, Science Direct, and Cochrane Library databases. Four articles were selected for detailed review. The studies were evaluated using the Effective Public Health Practice Project tool for quality assessment. RESULTS: The four reviewed studies primarily utilized the pretest-posttest design to examine the effectiveness of vocal hygiene interventions on singers' vocal health. Two studies investigated the effect of hydration as a treatment method, while the remaining two focused on vocal hygiene instruction. Significant improvements were observed in various vocal health parameters, including maximum phonation time, intensity, Dysphonia Severity Index, and number of daily vocal breaks taken. CONCLUSION: This systematic review provides valuable insights into the efficacy of vocal hygiene treatment programs for singers. The positive outcomes observed in the reviewed studies underscore the importance of voice health education tailored to singers' specific needs. However, the limited number of eligible studies and the common limitation of small sample sizes highlight the need for further research in this area. Vocal health practitioners, educators, and researchers can utilize the findings of this review to develop evidence-based vocal hygiene interventions that promote the well-being and longevity of singers' vocal performance careers.

The quantitative ultrasound study of tongue shape and movement in normal Persian speaking children.

OBJECTIVES: Ultrasound research on speech production in normal speakers has long used quantitative measurements in different languages. However, no studies in this area have been conducted in the Persian language. This study investigated Persian speaking children scores on two single curve measures of tongue shape, based on midsagittal tongue shape data from ultrasound imaging. METHODS: This is a cross-sectional study conducted on four 7-8 years old Persian speaking children. The data for analysis was collected using an ultrasound machine in 2018-2019. The stimuli included a range of consonants including/p/,/t/,/f/,/k/and/s/in consonant-vowel sequences, with the vowels/a/and/i/. The measures do not require head stabilization. Statistical analyses were done using Linear mixed models in lmer software package of R version 3.6.2. The results were performed by Chi-squared and Tukey post hoc tests in R. RESULTS: In all of the consonants, the mean of two single curve measures in the context of/i/was greater than the context of/a/. However, there was no significant effect of the vowel context on one measure for the/k/. Also, these measures were significantly different in each of the Persian consonants and they showed consistent patterns across all of the participants (P<0.001). CONCLUSION: It seems the single curve measures are the valid value of tongue dorsum excursion for Persian speaking children. This study showed that measures of single curves are reliable for distinguish between consonants in vowel contexts and created robust results on lingual coarticulation of the consonants without the use of head stabilization.

Validity and Reliability of the Persian Version of the Dysphagia Handicap Index (DHI).

INTRODUCTION: The Dysphagia Handicap Index (DHI) is one of the instruments used for measuring a dysphagic patient's self-assessment. In some ways, it reflects the patient's quality of life. Although it has been recognized and widely applied in English speaking populations, it has not been used in its present forms in Persian speaking countries. The purpose of this study was to adapt a Persian version of the DHI and to evaluate its validity, consistency, and reliability in the Persian population with oropharyngeal dysphagia. MATERIALS AND METHODS: Some stages for cross-cultural adaptation were performed, which consisted in translation, synthesis, back translation, review by an expert committee, and final proof reading. The generated Persian DHI was administered to 85 patients with oropharyngeal dysphagia and 89 control subjects at Zahedan city between May 2013 and August 2013. The patients and control subjects answered the same questionnaire 2 weeks later to verify the test-retest reliability. Internal consistency and test-retest reliability were evaluated. The results of the patients and the control group were compared. RESULTS: The Persian DHI showed good internal consistency (Cronbach's alpha coefficients range from 0.82 to 0.94). Also, good test-retest reliability was found for the total scores of the Persian DHI (r=0.89). There was a significant difference between the DHI scores of the control group and those of the oropharyngeal dysphagia group (P<0.001). CONCLUSION: The Persian version of the DHI achieved Face and translation validity. This study demonstrated that the Persian DHI is a valid tool for self-assessment of the handicapping effects of dysphagia on the physical, functional, and emotional aspects of patient life and can be a useful tool for screening and treatment planning for the Persian-speaking dysphagic patients, regardless of the cause or the severity of the dysphagia.

Temporal characteristics of nasalization in Persian speaker children with and without cleft palate.

OBJECTIVES: The purpose of this study was to measure and compare temporal patterns of nasalization in Persian children with and without cleft palate in three vowel contexts. METHODS: A Sample of 14 children with repaired cleft palates with or without cleft lip with moderate to severe hyper nasality and 14 children without cleft palate was chosen as subjects. The subjects were chosen from the ages of 4 to 12 years. The nasal onset interval, nasal offset interval and total nasalization duration were obtained from acoustic waveforms and spectrograms in three vowel contexts using Praat Software. For eliminating the effect of different speed of speech in the cleft palate group and control group, the ratio of nasalization duration was calculated. RESULTS: Total nasalization duration are demonstrated by acoustic signals which shows the total significant different temporal patterns in children with cleft palate and without cleft palate and across the vowel contexts (P<0.000). CONCLUSIONS: Longer nasalization durations in children with cleft palate in comparison to children without cleft palate show the delayed or deviant temporal patterns in children with cleft palate. The duration of nasalization reflecting temporal patterns of the oral-nasal acoustic impedance in children with cleft palate may have an influence on the perception of hyper nasality.

Assessment of hypernasality for children with cleft palate based on cepstrum analysis.

Hypernasality is a frequently occurring resonance disorder in children with cleft palate. In general, an operation is necessary to reduce the hypernasality and therefore an assessment of hypernasality is imperative to quantify the effect of the surgery and design the speech therapy sessions, which are crucial after surgery. In this paper, a new quantitative method is proposed to estimate hypernasality. The proposed method used the fact that an autoregressive (AR) model for vocal tract system of a patient with hypernasal speech is not accurate; because of the zeros appear in the frequency response of the vocal tract system. Therefore in our method, hypernasality was estimated by a quantity calculated from comparing the distance between the sequences of cepstrum coefficients extracted from AR model and autoregressive moving average model. K-means and Bayes theorem were utilized to classify the utterances of subjects by means of proposed index. We achieved the accuracy up to 81.12% on utterances and 97.14% on subjects. Since the proposed method needs only computer processing of speech data, compared with other clinical methods it provides a simple evaluation of hypernasality.