Comparison of the effect of clear twin block and traditional twin block on speech: a randomized clinical trial.

OBJECTIVES: To compare the effect of clear twin block (CTB) and traditional twin block (TTB) appliances on speech. MATERIALS AND METHODS: In this randomized clinical trial, 18 skeletal Class II (Class II, division 1) growing patients were selected and randomly divided into CTB and TTB groups. Objective and semiobjective speech assessment tests were performed for vowel and consonant analyses at four time intervals: before (T0), immediately after (T1), 1 month after (T2), and 3 months after (T3) inserting the appliance. Data were analyzed using analysis of variance and independent t-test at the .05 significance level. RESULTS: Intergroup comparisons showed that the CTB group had less speech distortion immediately after insertion of the appliance (P < .05) than the TTB group; however, the differences were not significant at other time intervals. Intragroup comparisons showed that the number of distortions decreased significantly from T1 to T3 in both groups (P < .05). In contrast to CTB, the T0-T3 comparison was significant in the TTB group. CONCLUSIONS: Although both appliances had some effects on speech, CTB had less speech distortion immediately after insertion, which is a very crucial moment in patient compliance. Additionally, articulation structures adapted to CTB faster than to TTB.

Validation of the Persian version of dysphagia in multiple sclerosis questionnaire for the assessment of dysphagia in multiple sclerosis.

Background: About one third of patients with multiple sclerosis (MS) experience dysphagia. Dysphagia can cause complications such as malnutrition, lung infections, aspiration pneumonia and dehydration, thus it is very helpful to diagnose dysphagia as soon as possible. The aim in this study was to translate dysphagia in multiple sclerosis (DYMUS) questionnaire into Farsi and and validate it. Methods: Forward-backward method was used to translate original English version of DYMUS into farsi, and then the questionnaire (one for each patient) was filled in through asking questions from 200 patients with MS by a speech and language pathologist. Confirmatory factor analysis (CFA) was used to examine the construct validity. Internal consistency and test-retest reliability of the DYMUS were evaluated using Cronbach's alpha and the intraclass correlation coefficient (ICC), respectively. Results: CFA showed that a two-factor model of DYMUS including "dysphagia for solid" and "dysphagia for liquid" fitted the data well [relative chi-square [χ2/degree of freedom (df) = 1.55, CFI = 0.967, Tucker-Lewis index (TLI) = 0.957, root mean square error of approximation (RMSEA) = 0.053, and weighted root mean square residual (WRMR) = 0.874]. The Cronbach's alpha for total score and liquid and solid subscales were 0.776, 0.557, and 0.725, respectively. The DYMUS showed adequate test-retest reliability for the total and subscales (ICC: 0.880-0.956). Moreover, this study has shown a significant relationship between DYMUS score and Expanded Disability Status Scale (EDSS) score, disease duration, type of MS, and self-reported dysphagia. Conclusion: The Persian version of DYMUS is a reliable and valid tool to screen dysphagia among patients with MS.

A comparison of speech intonation production and perception abilities of Farsi speaking cochlear implanted and normal hearing children.

INTRODUCTION: Cochlear implant prosthesis facilitates spoken language development and speech comprehension in children with severe-profound hearing loss. However, this prosthesis is limited in encoding information about fundamental frequency and pitch that are essentially for recognition of speech prosody. The purpose of the present study is to investigate the perception and production of intonation in cochlear implant children and comparison with normal hearing children. METHOD: This study carried out on 25 cochlear implanted children and 50 children with normal hearing. First, using 10 action pictures statements and questions sentences were extracted. Fundamental frequency and pitch changes were identified using Praat software. Then, these sentences were judged by 7 adult listeners. In second stage 20 sentences were played for child and he/she determined whether it was in a question form or statement one. RESULTS: Performance of cochlear implanted children in perception and production of intonation was significantly lower than children with normal hearing. The difference between fundamental frequency and pitch changes in cochlear implanted children and children with normal hearing was significant (P < 0/05). Cochlear implanted children performance in perception and production of intonation has significant correlation with child's age surgery and duration of prosthesis use (P < 0/05). DISCUSSION: The findings of the current study show that cochlear prostheses have limited application in facilitating the perception and production of intonation in cochlear implanted children. It should be noted that the child's age at the surgery and duration of prosthesis's use is important in reduction of this limitation. According to these findings, speech and language pathologists should consider intervention of intonation in treatment program of cochlear implanted children.