LANGUAGE IN INDIA

Strength for Today and Bright Hope for Tomorrow

Volume 14:8 August 2014
ISSN 1930-2940

Managing Editor: M. S. Thirumalai, Ph.D.
Editors: B. Mallikarjun, Ph.D.
         Sam Mohanlal, Ph.D.
         B. A. Sharada, Ph.D.
         A. R. Fatihi, Ph.D.
         Lakhan Gusain, Ph.D.
         Jennifer Marie Bayer, Ph.D.
         S. M. Ravichandran, Ph.D.
         G. Baskaran, Ph.D.
         L. Ramamoorthy, Ph.D.
         C. Subburaman, Ph.D. (Economics)
Assistant Managing Editor: Swarna Thirumalai, M.A.

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Derived Nasalance Measures of Nasality for Sentences in
Children with Repaired Cleft Lip and Palate

A. Navya, M.Sc. (ASLP)
Dr. M. Pushpavathi. Ph.D. (Speech and Hearing)

Abstract

Context: Hypernasality is dominant characteristic of speech exhibited by individuals with cleft lip and palate. Hypernasality can be assessed by subjective and objective methods, Nasometer is one of the instrument widely used as a diagnostic and therapeutic tool to estimate nasality. Nasometer provides nasalance values and other two new derived nasalance measures.

Aim: The aim of the present study is to explore the use of derived nasalance measures in differentiating the children with repaired cleft lip and palate (RCLP) with respect to severity and also from control group.

Settings and design:Institutional setup and standard group’s comparison design.

Methods and material: The study considered ninety children equally divided into three groups. Group Ia included children with repaired cleft lip and palate (RCLP) exhibiting mild hypernasal and group Ib included children with RCLP exhibiting moderate to severe hypernasal, and group II is typically developing age and gender matched children. The children with RCLP were divided into groups based on perceptual evaluation of hypernasality using a standardized four point rating scale. Nasometer II was used to measure the nasalance values, nasalance distance and ratio for oral and nasal sentences.

Statistical analysis: SPSS, Descriptive statistics and Multivariate analysis (MANOVA) were used to analyze the data.

Results: Increased nasalance value was seen in children with moderate to hypernasal than mild hypernasal and control group. The derived nasalance measures (nasalance distance and nasalance ratio) calculated from mean nasalance were significantly differentiating the children with RCLP based on severity and from the typically developing children.

Conclusions: The new nasalance measures can be used potentially in clinical scenario and may be explored across the various methodological conditions to further evaluate the efficacy of these measures.

Key-words: Nasalance distance, Nasalance ratio, Hypernasality.

Introduction

Nasality is one of the important parameters of resonance aspects related to speech production and perception. The varying shape of the vocal tract results in change of resonance characteristics of speech. Individuals with cleft of the lip or palate (CLP) have disorders in speech dominantly exhibiting hypernasality. They exhibit articulation, resonance and voice disorders leading to unintelligible speech. Among these hypernasality resonance disorder is frequently seen. Nasality is assessed through perceptual or instrumental method.

The speech of individuals with repaired cleft lip and palate and/ or velopharyngeal dysfunction can be evaluated primarily using perceptual evaluation (McWilliams, et al. 1990, Sell, et al. 1990). There is diversity across evaluations procedures in terms of reporting parameters and guidelines for usage, speech sampling procedures. The perceptual rating scales usually vary from four to nine points or even eleven points (Whitehill 2002). Most widely used is the ordinal scale with 5 categories (normal nasality, mild, moderate, severe and very severe hypernasality/ nasal emission). To build a consensus in evaluating, reporting and exchanging the information among the professions and for ease of communication Henningsson et al. (2007) developed a universally standardized speech protocol for reporting speech outcomes in individuals with CLP. However, the differences in inter and intra judge reliabilities are high and there found to be significant variations in the use of methodological procedures of using various test and rating scales to measure the speech and language abilities. Hence, subjective assessment procedures can be a supplement along with the objective measures.

This is only the beginning part of the article. PLEASE CLICK HERE TO READ THE ENTIRE ARTICLE IN PRINTER-FRIENDLY VERSION.

A. Navya, M.Sc. (ASLP)
Junior Research Fellow
Department of Speech Language Pathology
All India Institute of Speech and Hearing
Mysore 570006
Karnataka
India
navyaaslp@gmail.com

Dr. Pushpavathi. M. Ph.D. (Speech and Hearing)
Professor of Speech Pathology
Department of Speech Language Pathology
All India Institute of Speech and Hearing
Mysore 570006
Karnataka
India
pushpa19@yahoo.co.in
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