Medidas de nasalância da fala de crianças com fissura lábio-palatina e sua correlação com o julgamento perceptivo-auditivo da nasalidade / Nasalance measures in children with cleft lip and palate and its correlation with auditory-perceptual ratings of nasality

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

The objective of the present study was to correlate nasalance scores and speech nasality of 79 operated unilateral cleft lip and palate children (males and females), with ages ranging from 4 to 9 years (mean 6.5 years), all speakers of Brazilian Portuguese. All children had already undergone perceptual evaluation of speech nasality, nasometric evaluation, and audio recordings, which took place at the (HRAC-USP).Out of the pré-existed audiorecordings it have been selected to this study the words: "papai" and "bebê", and the phrases "Papai pediu pipoca" and "O bebê babou". In spite of the indication that all children had already been judged to present mild, moderate or severe hypernasal speech, speech stimulate which have been audio recorded simultaneously to nasometry were judged again by 3 other experienced speech pathologists. The three speech pathologists were instructed to judge speech nasality. Each speech sample was judged individually by means of a 4 point scale (1 = normal nasality, 2 = mild hypernasality, 3 = moderate hypernasality, and 4 = severe hypernasality). The scores given by the three speech pathologist for the words and phrases varied from 1.0 to 3.3. Considering the cutoff value of 1.5 for perceptual judgements of nasality, 50 (63%) of the children were judged to present means equal 1.5 or below, and 29 (37%) presented means above 1.5 for the word "papai". For the word "bebê", 46 (58%) presented means equal 1.5 or below, and 33 (42%), means above this value. For "Papai pediu pipoca", 42 (53%) presented means equal 1.5 or below, and 37 (47%) means above this value. For the phrase "O bebê babou", 43 (54%) of the children presented with means equal 1.5 or below, and 36 (46%) means above this value. The obtained results have also shown that the sensibility of the nasometer to identify hypernasality for the word "papai" was 44%, 23% for "bebê", 45% for "Papai pediu pipoca", and 30% for "O bebê babou". With regard to specificity, the results have shown 70% for the word "papai", 93% for "bebê", 81% for "Papai pediu pipoca", and 92% for "O bebê babou". The nasalance scores obtained in the present study were 24% for the word "papai", 39% for "bebê, 32% for "Papai pediu pipoca", and 39% for O " bebê babou". We have concluded in this study that the correlation between nasalance and nasality in a sample of children presenting with speech resonance ranging between normal and mild hypernasality is low, specially when using short speech stimulae with the predominance of only one consonant. We suggest for future studies which aims to correlate nasalance and nasality be designed to use longer speech stimulate with different phonemic context. Besides that the control of possible variables which might influence perceptual judgements of nasality, such as presence of snort, nasal air emission, compensatory articulations should also be considered. We also suggest that the cutoff value for nasalance scores should be established for each sample of individuals, because what might be good for one sample, might not be for another.

ASSUNTO(S)

julgamento perceptivo-auditivo auditory-perceptual judgment cleft lip and palate ressonância de fala hipernasalidade nasometry nasometria speech resonance fissura lábio-palatina hypernasality

ACESSO AO ARTIGO

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