Impact of inter-judge agreement on perceptual judgment of nasality

Scarmagnani, Rafaéli Higa; Oliveira, Adriana de Almeida Santos Furlan de Cristina; Fukushiro, Ana Paula; Salgado, Manoel Henrique; Trindade, Inge Elly Kiemle; Yamashita, Renata Paciello

doi:10.1590/2317-1782/20142014068

Cited by 8 publications

(14 citation statements)

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“…Similar to the present study, previous investigations also observed variable agreement between different listeners (12,16,17) . A study on hypernasality, based on three examiners with more than 10 years of experience with cleft lip and palate, revealed moderate agreement between them, evidencing that the result can be associated with related to internal standards of each examiner (12) .…”

Section: Discussionsupporting

confidence: 92%

“…Thus, the examiners' experience is a determining factor for the evaluation of results, indicating that an experienced examiner is more demanding in the analysis, which favors the accurate diagnosis of speech disorders. This highlights the importance of training and previous experience in the evaluation and treatment of cleft lip and palate (12) . The visual support from the videos is a variable that should be considered and which may have influenced the assessment by examiners.…”

Section: Discussionmentioning

confidence: 93%

“…Considering that normal speech Subtitlte: SPE = speech pathologist experienced with cleft lip and palate; SPNE = speech pathologist not experienced with cleft lip and palate; NSP = professional (non-speech pathologist) experienced with cleft lip and palate; NH1 = non-health related professional; NH2 = non-health related professional development is the main objective of surgical repair of cleft palate, intervention at this age provides satisfactory speech outcomes. The quality of speech, according to auditory perception, remains the most important standard through which the clinical results and success of surgical procedure may be analyzed (9,12) . In fact, in the presence of cleft palate, varied speech disorders are observed, from simple distortions up to unintelligible speech, which may affect the social interactions, precluding the individual from expressing his or her thoughts and feelings effectively.…”

Section: Discussionmentioning

confidence: 99%

“…A study on hypernasality, based on three examiners with more than 10 years of experience with cleft lip and palate, revealed moderate agreement between them, evidencing that the result can be associated with related to internal standards of each examiner (12) . Speech intervention plays a fundamental role in the correction of speech disorders in the presence of cleft lip and palate and may influence the results of palatoplasty.…”

Section: Discussionmentioning

confidence: 99%

“…For this reason, analysis by more than one examiner is necessary. The utilization of examiners to evaluate the subjective aspects of speech in individuals with clef lip and palate has been strongly recommended in the last years, especially for research or institutional audits (11,12) . Based on these considerations, this study evaluated the speech intelligibility after primary palatoplasty, according to the perception of five different listeners.…”

Section: Introductionmentioning

confidence: 99%

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Inteligibilidade de fala após palatoplastia primária: percepção do ouvinte

Andreoli

Yamashita

Trindade‐Suedam

et al. 2016

Audiol., Commun. Res.

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Purpose: To verify the results of speech intelligibility in individuals submitted to primary palatoplasty, according to perceptual analysis by five examiners, experienced or not with the treatment of cleft lip and palate. Methods: Analysis of spontaneous speech records, registered in audiovisual system, of 78 individuals with repaired cleft lip and palate, of both genders, aged more than 4 years old, submitted to primary palatoplasty. The speech samples were analyzed by five different examiners, who scored the speech intelligibility using a three-point scale (1=good, 2=regu-lar, and 3=bad). The interexaminer agreement was assessed by the Kappa coefficient. The treatment success was analyzed descriptively regarding the proportion of patients according to the postoperative speech intelligibility, as determined by the examiners. Significance between differences was verified by the chi-square test (p<0.05). Results: The interexaminer agreement ranged from fair to substantial. Full agreement between the five examiners was observed in more than half of cases. Based on the mean values assigned by the examiners, a significant proportion of cases showed good speech intelligibility after palatoplasty. Conclusion: The present outcomes evidenced adequate speech intelligibility after primary palatoplasty in the majority of cases, suggesting that these individuals are well understood in their social environment. The examiner experience presented to be an important variable in the analysis.Keywords: Cleft palate; Speech intelligibility; Speech perception; Velopharyngeal insufficiency; Reconstructive surgical procedures RESUMO Objetivo: Verificar os resultados de inteligibilidade da fala de pacientes submetidos à palatoplastia primária, de acordo com o julgamento perceptivo de cinco examinadores, experientes ou não, no tratamento de fissuras labiopalatinas. Métodos: Foram analisados os registros de fala espontânea, armazenados em sistema audiovisual, de 78 pacientes com fissura labiopalatina previamente reparada, de ambos os gêneros, a partir de 4 anos de idade, submetidos à palatoplastia primária. As amostras de fala foram analisadas por cinco diferentes examinadores, que classificaram a inteligibilidade de fala utilizando uma escala de 3 pontos (1=boa, 2=regular e 3=ruim). A concordância interexaminadores foi verificada por meio do coeficiente de Kappa. O sucesso da reabilitação foi analisado descritivamente quanto às proporções de pacientes, de acordo com o grau de inteligibilidade pós-operatória, determinada pelos examinadores. A significância entre as diferenças das proporções obtidas para cada categoria foi verificada pelo teste Qui-quadrado (p<0,05). Resultados: A concordância entre os examinadores variou de discreta a substancial. Em mais da metade das amostras os examinadores obtiveram concordância plena. Com base nos valores médios dos julgamentos dos avaliadores, uma proporção significativa dos casos apresentou boa inteligibilidade de fala. Conclusão: Verificou-se adequação da inteligibilidade de fala após a ...

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Inteligibilidade de fala após palatoplastia primária: percepção do ouvinte

Andreoli

Yamashita

Trindade‐Suedam

et al. 2016

Audiol., Commun. Res.

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Normative nasalance scores for Estonian children

Lehes

Horn

Lippus

et al. 2018

Clinical Linguistics & Phonetics

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Normative nasalance scores are essential for the treatment and assessment purposes for clinicians. Till date, no studies have been done on nasalance in Estonia. This research was conducted to develop Estonia-specific optimized speech stimuli for Nasometer II and establish the normative nasalance scores. Ninety-two randomly selected healthy and 14 cleft palate Estonian monolingual children, aged four to seven years, were included as participants. Estonian language-specific test material was developed. The Estonian test material consisted of 24 speech stimuli. Based on the phoneme content, the stimuli were divided into three groups: (1) sentences that included oral and nasal phonemes and targeted the same phoneme distribution as in spontaneous speech, (2) sentences that included only oral phonemes and (3) sentences that were loaded with nasal phonemes. Nasometer II software was used to calculate the nasalance scores for each child and each sentence. Results indicated that there were significant differences in nasalance scores for oronasal and oral stimuli scores, and no significant differences were found in nasal stimuli scores between the study and control group. The threshold for oronasal stimuli was 42.1-18.9, oral stimuli was 27.9-3.9 and nasal stimuli was 69.4-46.2. In conclusion, Estonia-specific optimized speech stimuli were developed and normative nasalance scores were established. These normative scores can be used for the diagnosis and follow-up treatment of patients with resonance disorders, especially for patients with cleft palate.

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