Psychometric Validation of a Hearing Screening Questionnaire for Preschoolers based on language development evaluation by caregivers.

INTRODUCTION: This study aimed to validate three age-adjusted versions of a Hearing Screening Questionnaire for Preschoolers, in Brazilian Portuguese, based on parents' perception of their children's hearing and oral language. METHODS: Psychometric validation was conducted on three questionnaires, each comprising nine items with Yes/No responses. Three items focused on hearing screening at birth, and six assessed hearing and oral language. The study included 152 parents and their children, who attended day care centers in Belo Horizonte, Brazil. The children were categorized into three age bands: 12 to 18 months, 19 to 35 months, and 36 to 48 months. Audiological assessments, including tympanometry, transient-evoked otoacoustic emissions (TOAE) and pure-tone audiometry (when applicable), were performed on the children. In case of abnormal findings in the previous exams, auditory brainstem response (ABR) testing was conducted. Descriptive data, false alarm, and false-negative analyses were carried out. RESULTS: Considering any type of hearing loss, whether unilateral or bilateral, the questionnaires showed a false-negative rate of 41.17% (7/17 children). However, when considering only bilateral hearing loss, the questionnaire showed a false alarm rate of 31.69% (45/142) and a false-negative rate of 30.0% (3/10). When focusing exclusively on sensorineural hearing loss, the questionnaire identified two children (1.31%), with a false-negative rate of 0% but a false-positive rate of 33.33%. CONCLUSION: Language-development oriented questionnaires allowed quick screening of potential hearing loss in preschoolers. This study found a robust hit rate with these questionnaires. Their validation signifies a promising and cost-effective tool for conducting hearing screenings in preschool children, especially in nations lacking a comprehensive school screening policy.The validated questionnaire affords an easy-to-apply, low-cost and effective instrument for preschool hearing screening.

Adaptación lingüística y cultural chilena del Voice Handicap Index (VHI) y del Voice Handicap Index 10 (VHI-10) / Chilean linguistic and cross-cultural adaptation of the Voice Handicap Index (VHI) and the Voice Handicap Index 10 (VHI-10)

El presente estudio buscó adaptar lingüística y culturalmente el cuestionario de autovaloración vocal norteamericano Voice Handicap Index (VHI) al español chileno. Para esto se realizaron cuatro traducciones directas del VHI al español chileno de forma independiente. Luego, se consensuó una traducción general (TG) a partir del juicio de tres profesionales de la fonoaudiología. Esta TG fue traducida inversamente al idioma original para ser comparada con la versión original por el mismo grupo de profesionales de la fonoaudiología, llegando a la primera versión del Índice de Desventaja Vocal Chileno(IDV-Cl). Esta versión fue aplicada a veinte personas con diagnóstico de disfonía, considerando una escala Likert de frecuencia. Durante la adaptación, se consideró pertinente dejar constancia de las consignas no comprendidas o que resultaron inapropiadas culturalmente para el vocabulario chileno. De acuerdo con las observaciones recogidas, se revisó y modificó el instrumento, dando paso a la segunda versión del IDV-Cl, que fue aplicada a seis personas con diagnóstico de disfonía. En esta etapa no se plantearon nuevas sugerencias de cambio. El IDV-Cl refleja la versión original del inglés, tanto en la cantidad de ítems, como en los subcomponentes físico, funcional y emocional que lo conforman. Mediante la síntesis de esta encuesta se pudo obtener también una versión abreviada, que consta de diez ítems (IDV-Cl-10). En conclusión, se establece la equivalencia cultural y lingüística del cuestionario VHI en español chileno, del que se origina la versión IDV-Cl e IDV-Cl-10.

The present study aimed to linguistically and culturally adapt the North American vocal self-assessment questionnaire, Voice Handicap Index (VHI), to Chilean Spanish. To this end, four direct translations of the VHI were carried out independently into Chilean Spanish. Subsequently, a general translation (GT) was agreed upon based on the judgment of three speech-language therapists. This GT was back-translated into the original language and compared with the original version by the same group of speech therapy professionals, which resulted in the first version of the Chilean Índice de Desventaja Vocal [Vocal Disadvantage Index] (IDV-Cl). This version was then applied to twenty people diagnosed with dysphonia, using a Likert scale for frequency. During the adaptation, it was deemed pertinent to make a note of the statements that were not understood or were culturally inappropriate for the Chilean vocabulary. The instrument was revised and modified based on the observations made by the participants, thus creating a second version of the IDV-Cl, which was then applied to six people diagnosed with dysphonia. No new suggestions for change were made at this stage. The IDV-Cl reflects the original version in English, both in the number of items and in the physical, functional, and emotional subcomponents that comprise it. Through the synthesis of this survey, it was also possible to obtain an abbreviated version, consisting of ten items (IDV-Cl-10). In conclusion, the cultural and linguistic equivalence of the VHI questionnaire in Chilean Spanish is established, resulting in the IDV-Cl and IDV-Cl-10 versions of this instrument.

Effect of Nebulization on Laryngeal Parameters: Analysis Using High-Speed Digital Videolaryngoscopy.

INTRODUCTION: Superficial laryngeal hydration, obtained through nebulization, is related to the moisture level on the epithelial surfaces of the vocal folds, modifying their biomechanical and aerodynamic properties. Through high-speed videolaryngoscopy it is possible to obtain objective data for laryngeal analysis after nebulization and a better understanding of this phenomenon OBJECTIVE: To verify the effects of nebulization with saline solution on laryngeal parameters of digital videokymography obtained by high-speed videolaryngoscopy examination in women and men with and without laryngeal alterations METHOD: This is a clinical, comparative intra-subject study. Fifty-nine adults were selected, with and without laryngeal alterations, 30 females and 29 males. Digital videokymographs in the anterior, middle and posterior thirds of the vocal folds of the participants were analyzed before and after nebulization with 0.9% saline solution. RESULTS: Women without laryngeal alterations showed more parameters changes after nebulization, in which there was a decrease in maximum and medium opening, amplitude of opening of the left and right vocal fold in the anterior glottal third, and an increase of the percentage of closure of the vocal folds. These results indicate a minor extent of lateral excursion of the vocal folds during phonation. In women with laryngeal alterations, the parameters that changed after nebulization were the increased frequency of opening of the left and right vocal folds in the topography of the posterior third. In men, nebulization did not change the variables studied, except for the amplitude of the right vocal fold in men with laryngeal alterations, in the analysis of the posterior glottic third. CONCLUSION: The results suggest that surface hydration modifies laryngeal dynamics differently between genders. After nebulization with saline solution, women without laryngeal alterations showed a decrease in the lateralization of the vocal folds during phonation, suggesting a better phonatory efficiency.

Fear of Public Speaking: Perception of College Students and Correlates.

OBJECTIVES: The aims of the study were to determine the prevalence of fear of public speaking among college students and to assess its association with sociodemographic variables and those related to the voice and oral communication. METHODS: A cross-sectional descriptive and analytic study was conducted with 1135 undergraduates aged 17-58 years. The assessment instruments were (1) a questionnaire addressing the variables sex, age, field of undergraduate study, voice, and frequency of exposure to public speaking, and (2) the Self-statements During Public Speaking Scale (SSPS), which includes variables implicated in specific domains of public speaking. A descriptive analysis was performed of the variables as well as uni- and multivariate logistic regressions to examine their association with fear of public speaking. The level of significance was set at 5%. RESULTS: In all, 63.9% of the college students reported fear of public speaking. As many as 89.3% of the students would like their undergraduate program to include classes to improve public speaking. Being female, having infrequent participation as speakers in groups, and perceiving their voice as high-pitched or too soft increase the odds of exhibiting fear of public speaking compared with students without those features. CONCLUSION: A great number of undergraduates report fear of public speaking. This fear is more prevalent among women, students who participate in few activities involving speaking to groups of people, and those who have a self-perception of their voice as high-pitched or too soft.

The Influence of Native Language on Auditory-Perceptual Evaluation of Vocal Samples Completed by Brazilian and Canadian SLPs.

OBJECTIVE: This study aimed to determine the influence of native language on the auditory-perceptual assessment of voice, as completed by Brazilian and Anglo-Canadian listeners using Brazilian vocal samples and the grade, roughness, breathiness, asthenia, strain (GRBAS) scale. STUDY DESIGN: This is an analytical, observational, comparative, and transversal study conducted at the Speech Language Pathology Department of the Federal University of Minas Gerais in Brazil, and at the Communication Sciences and Disorders Department of the University of Alberta in Canada. METHODS: The GRBAS scale, connected speech, and a sustained vowel were used in this study. The vocal samples were drawn randomly from a database of recorded speech of Brazilian adults, some with healthy voices and some with voice disorders. The database is housed at the Federal University of Minas Gerais. Forty-six samples of connected speech (recitation of days of the week), produced by 35 women and 11 men, and 46 samples of the sustained vowel /a/, produced by 37 women and 9 men, were used in this study. The listeners were divided into two groups of three speech therapists, according to nationality: Brazilian or Anglo-Canadian. The groups were matched according to the years of professional experience of participants. The weighted kappa was used to calculate the intra- and inter-rater agreements, with 95% confidence intervals, respectively. RESULTS: An analysis of the intra-rater agreement showed that Brazilians and Canadians had similar results in auditory-perceptual evaluation of sustained vowel and connected speech. The results of the inter-rater agreement of connected speech and sustained vowel indicated that Brazilians and Canadians had, respectively, moderate agreement on the overall severity (0.57 and 0.50), breathiness (0.45 and 0.45), and asthenia (0.50 and 0.46); poor correlation on roughness (0.19 and 0.007); and weak correlation on strain to connected speech (0.22), and moderate correlation to sustained vowel (0.50). CONCLUSION: In general, auditory-perceptual evaluation is not influenced by the native language on most dimensions of the perceptual parameters of the GRBAS scale.

Discriminant capacity of acoustic, perceptual, and vocal self: the effects of vocal demands.

OBJECTIVES: To analyze the discrimination ability of acoustic, auditory parameters, and perception of vocal effort during professional and social voice use, and the correlations of these parameters with the vocal demands. STUDY DESIGN: Longitudinal study. METHODS: Seventy-three subjects participated in the study: 31 females aged from 28 to 65 years (G1; professional voice users) and 42 females aged from 31 to 59 years (G2, social voice users; ). All the subjects were subjected to acoustic voice analysis including F0 median, semiamplitude interquartile, quantile 99.5%, and skewness; first F0 derivate mean, standard deviation (SD), and skewness; intensity skewness; spectral slope mean, SD, and skewness; long-term average spectrum-frequency SD, perceptual parameters (GRBASI scale), and self-perception of vocal effort, before and after 2 hours and 30 minutes of voice use. Statistical analyses were completed via multivariate discriminant analysis and canonical correlation analysis. RESULTS: Discriminant analysis of acoustic, perceptual, and self-rating variables and analysis of the grouped parameters did not differentiate the samples before and after vocal use. Higher levels of canonical correlation were found for the professional voice group after voice use, with a correlation between perceptual analysis and acoustic measures. CONCLUSIONS: The current measures could not discriminate the differences of the type of vocal demands, professional or social.

Voice performance evaluation of street children from Aracaju, Brazil using perceptual-auditory and acoustic analyses.

OBJECTIVE: To compare the voice performance of children involved in street labor with regular children using perceptual-auditory and acoustic analyses. METHODS: A controlled cross-sectional study was carried out on 7- to 10-year-old children of both genders. Children from both groups lived with their families and attended school regularly; however, child labor was evident in one group and not the other. A total of 200 potentially eligible street children, assisted by the Child Labor Elimination Programme (PETI), and 400 regular children were interviewed. Those with any vocal discomfort (106, 53% and 90, 22.5%) had their voices assessed for resonance, pitch, loudness, speech rate, maximum phonation time, and other acoustic measurements. RESULTS: A total of 106 street children (study group [SG]) and 90 regular children (control group [CG]) were evaluated. The SG group demonstrated higher oral and nasal resonance, reduced loudness, a lower pitch, and a slower speech rate than the CG. The maximum phonation time, fundamental frequency, and upper harmonics were higher in the SG than the CG. Jitter and shimmer were higher in the CG than the SG. CONCLUSION: Using perceptual-auditory and acoustic analyses, we determined that there were differences in voice performance between the two groups, with street children having better quality perceptual and acoustic vocal parameters than regular children. We believe that this is due to the procedures and activities performed by the Child Labor Elimination Program (PETI), which helps children to cope with their living conditions.

Relationship between adherence to speech therapy in patients with dysphonia and quality of life.

OBJECTIVE: The present study analyzed if aspects of voice-related quality of life (VRQOL) were associated with adherence to voice therapy in teachers. STUDY DESIGN: Retrospective survey in which the medical records of 179 dysphonic teachers (62, abandonment group and 114, discharge group) who underwent speech therapy at the Speech Therapy Clinic at the Hospital das Clínicas of the Universidade Federal de Minas Gerais (AV-HCUFMG) were analyzed. METHODS: Female teachers with dysphonia referred by Gerência de Saúde e Perícia Médica (Department of Health and Medical Analysis) of Belo Horizonte City Hall were included. The variables of interest were: age, number of voice therapy sessions attended (attendance), number of sessions missed (absence), type of dysphonia, and Vocal Activity and Protocol Profile (VAPP) scores administered during the first therapy session as a component of voice assessment. The chi-square test was used to assess categorical variables. For continuous variables, the Mann-Whitney test, a nonparametric test for independent samples, was used. RESULTS: The groups differed with regard to the type of dysphonia as well as the several parameters of the VAPP: vocal self-perception, effects at work, effects on daily communication, effects on emotion, and the total VAPP score. CONCLUSIONS: Individuals with less favorable VRQOL scores were less adherent to voice therapy compared with subjects with more favorable VRQOL.

Quality of life, self-perceived dysphonia, and diagnosed dysphonia through clinical tests in teachers.

OBJECTIVES: To examine the impact of voice on the quality of life of teachers and to assess whether the degree of dysphonia and otorhinolaryngologists' (ORL) diagnostics are correlated with the quality of life. METHODS: Eighty-eight female teachers from the municipal schools of Belo Horizonte who were in speech therapy at the Speech Therapy Clinic of the Hospital das Clínicas of Minas Gerais participated in the study. The variables studied were age, ORL diagnosis, perceptual-hearing assessment of voice through GRBAS scale, and vocal activities and participation profile (VAPP) protocol. Statistical analysis was performed through the descriptive analysis of the data and the Spearman coefficient of correlation. RESULTS: The average age of the participants was 38 years. Vocal deviation: degree 1-56 teachers (63.6%); degree 2-27 teachers (30.6%); and without vocal deviation-five teachers (5.6%). It was found that 57.9% of the teachers presented combined ORL diagnosis. No statistically significant relationship was observed among the ORL diagnosis, the degree of dysphonia, and the parameter values of quality of life assessed by VAPP. CONCLUSIONS: The examined participants of this study presented light degree of vocal deviation and ORL combined diagnosis. According to the figures obtained by VAPP, there was negative impact of voice on the quality of life of female teachers, but these impacts were not correlated with ORL diagnosis and grade of dysphonia.