Voice Improvement after Voice Therapy in Female Patients with Unilateral Vocal Fold Paralysis after Thyroid Surgery.

INTRODUCTION: Dysphonic voice is present in patients with unilateral vocal fold paralysis (UVFP). The aim of this study was to present outcomes following rehabilitation of patients with UVFP, performed according to a voice therapy protocol. METHODS: This prospective study comprised 27 women with UVFP who underwent pre- and post-voice therapy assessment. The mean age of patients was 53.19 ± 10.06 years. The protocol included the following: (1) multidimensional assessment of voice quality before treatment; (2) digital laryngeal manipulation voice therapy; (3) voice therapy evaluation which implied repeated multidimensional assessment of voice. RESULTS: The results showed improvement in voice quality following voice therapy with regard to the parameters of the objective voice analysis (maximum fundamental frequency of voice, minimum intensity of voice, jitter, shimmer, harmonics-to-noise ratio, and signal-to-noise ratio, p ˂ 0.05), maximum phonation time, subjective analysis of voice, as well as self-assessment of voice quality on all the subscales and overall score (p ˂ 0.001). CONCLUSION: Implementing a protocol provides clear guidelines at each stage of the treatment. Voice therapy performed using digital laryngeal manipulation improves the majority of the acoustic and perceptual characteristics of the voice.

Phonological Awareness as the Foundation of Reading Acquisition in Students Reading in Transparent Orthography.

Phonological skills have been found to be strongly related to early reading and writing development. Accordingly, the aim of this study was to examine the extent to which the development of phonological awareness facilitates reading acquisition in students learning to read a transparent orthography. Our research included 689 primary school students in first through third grade (Mean age 101.59 months, SD = 12,690). The assessment tools used to conduct this research include the Phonological Awareness Test and the Gray Oral Reading Test. According to the results from the present study, 13.7% of students have reading difficulties. Students with reading difficulties obtained low scores in phonological awareness within each subscale compared to students who do not have reading difficulties (p < 0.01). Components of phonological awareness which did not singled out as strongly related to early reading success include Phoneme Segmentation, Initial Phoneme Identification, and Syllable Merging. Thus, understanding the nature of the relationship between phonological awareness and reading should help effective program design that will be aimed at eliminating delayed development in children's phonological awareness while they are still in preschool.

Persons with Intellectual Disability: Sexual Behaviour, Knowledge and Assertiveness.

BACKGROUND: Persons with ID most often have incomplete, contradictory and imprecise knowledge of sexuality and sexual intercourse itself. They are not provided with sufficient information on their own body and sexuality, and are often discouraged from and sanctioned for trying to sexually express themselves. Sexual abuse due to low sexual assertiveness is also common. AIM: The principal aim of this study was to establish the presence or absence of sexual activity in adults with ID residing in institutional housing, as well as the level and structure of their knowledge of sexuality, their sexual assertiveness and preparedness to react in a sexually dangerous situation. METHODS: The sample consisted of 100 participants with ID residing in institutional housing. The instruments used included the General Sexual Knowledge Questionnaire, What-if test and Hulbert index of sexual assertiveness. Comparative statistics included coefficient of linear correlation and multiple regression analysis. RESULTS: The results showed that 82% of the participants are sexually active. Most participants admitted to sometimes having sexual intercourse against their wishes as well as to having difficulty asserting themselves. Their knowledge of pregnancy, contraception and sexually transmitted diseases was very low. Female participants and those that reported having sexual intercourse had more sexual knowledge and were also more sexually assertive. CONCLUSION: Knowledge of sexuality and sexual assertiveness of persons with ID residing in institutional housing is very low. Additional information on sexuality is necessary, as well as support in learning to express their own desires and to deal with unwanted sexual activity.

Systemic multimodal approach to speech therapy treatment in autistic children.

INTRODUCTION: Conditions in which speech therapy treatment is applied in autistic children are often not in accordance with characteristics of opinions and learning of people with autism. A systemic multimodal approach means motivating autistic people to develop their language speech skill through the procedure which allows reliving of their personal experience according to the contents that are presented in the their natural social environment. This research was aimed at evaluating the efficiency of speech treatment based on the systemic multimodal approach to the work with autistic children. MATERIAL AND METHODS: The study sample consisted of 34 children, aged from 8 to 16 years, diagnosed to have different autistic disorders, whose results showed a moderate and severe clinical picture of autism on the Childhood Autism Rating Scale. The applied instruments for the evaluation of ability were the Childhood Autism Rating Scale and Ganzberg II test. The study subjects were divided into two groups according to the type of treatment: children who were covered by the continuing treatment and systemic multimodal approach in the treatment, and children who were covered by classical speech treatment. RESULTS: It is shown that the systemic multimodal approach in teaching autistic children affects the stimulation of communication, socialization, self-service and work as well as that the progress achieved in these areas of functioning was retainable after long time, too. CONCLUSION: By applying the systemic multimodal approach when dealing with autistic children and by comparing their achievements on tests applied before, during and after the application of this mode, it has been concluded that certain improvement has been achieved in the functionality within the diagnosed category. The results point to a possible direction in the creation of new methods, plans and programs in dealing with autistic children based on empirical and interactive learning.

[Impact of hearing impairment on quality of life of adolescents].

INTRODUCTION: Hearing impairment, as a type of sensory disability affects the quality of life of adolescents. The aim of this study was to determine whether the quality of life of adolescents with hearing impairments was different from the quality of life of adolescents without disabilities, and to examine the correlation between self--reported quality of life and proxy--report by their parents. MATERIALS AND METHODS: The study included 52 adolescents with hearing impairment and 122 adolescents without developmental disabilities, aged from 13 to 18 years and their parents. Data were collected by a standardized questionnaire, the PedsQL 4.0 Generic Core Scale. The survey was conducted during May and June 2011 in 6 schools in Novi Sad and Belgrade. RESULTS: Adolescents with hearing impairment and their parents reported lower scores on all scales of questionnaire. The average score of physical health was 77.58; p < 0.001 (adolescents), and 75; p = 0,006 (parents); on psycho-social summary scale 75.35; p = 0.025 (adolescents), and 73.37; p = 0.02 (parents). On the overall scale, the adolescents scored 76.13; p < 0.001, and parents reported 73.93; p < 0.001. The parents assessed the quality of life lower than their children. On the total summary scale, a moderate agreement (r = 0.51) was found between self- report and proxy- report. CONCLUSION: Hearing loss affects all aspects of the quality of life of adolescents. A multidisciplinary approach is required in order to provide better conditions for functioning of these children and improve their quality of life.