| 1. |
- Lundeborg Hammarström, Inger, 1956-, et al.
(författare)
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Acoustic and perceptual aspects of vocal function in children with adenotonsillar hypertrophy : effects of surgery
- 2012
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Ingår i: Journal of Voice. - New York, USA : Mosby-Elsevier. - 0892-1997 .- 1873-4588. - 9789173933339 ; 26:4, s. 480-487
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate outcome of two types of tonsil surgery (tonsillectomy [TE] + adenoidectomy or tonsillotomy [TT] + adenoidectomy) on vocal function perceptually and acoustically.Study Design: Sixty-seven children, aged 50–65 months, on waiting list for tonsil surgery were randomized to TE (n = 33) or TT (n = 34). Fifty-seven age- and gender-matched healthy preschool children were controls. Twenty-eight of them, aged 48–59 months, served as control group before surgery, and 29, aged 60–71 months, served as control group after surgery.Methods: Before surgery and 6 months postoperatively, the children were recorded producing three sustained vowels (/ɑ/, /u/, and /i/) and 14 words. The control groups were recorded only once. Three trained speech and language pathologists performed the perceptual analysis using visual analog scale for eight voice quality parameters. Acoustic analysis from sustained vowels included average fundamental frequency, jitter percent, shimmer percent, noise-to-harmonic ratio, and the center frequencies of formants 1–3.Results: Before surgery, the children were rated to have more hyponasality and compressed/throaty voice (P < 0.05) and lower mean pitch (P < 0.01) in comparison to the control group. They also had higher perturbation measures and lower frequencies of the second and third formants. After surgery, there were no differences perceptually. Perturbation measures decreased but were still higher compared with those of control group (P < 0.05). Differences in formant frequencies for /i/ and /u/ remained. No differences were found between the two surgical methods.Conclusion: Voice quality is affected perceptually and acoustically by adenotonsillar hypertrophy. After surgery, the voice is perceptually normalized but acoustic differences remain. Outcome was equal for both surgical methods.
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| 2. |
- Lundeborg Hammarström, Inger, 1956-, et al.
(författare)
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Influence of adenotonsillar hypertrophy on /s/-articulation in children-effects of surgery
- 2011
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Ingår i: Logopedics, Phoniatrics, Vocology. - New York, USA : Informa Healthcare. - 1401-5439 .- 1651-2022. ; 36:3, s. 100-108
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Tidskriftsartikel (refereegranskat)abstract
- Tonsillar hypertrophy is common in young children and affects several aspects of the speech such as distortions of the dento-alveolar consonants. The study objective was to assess s-articulation, perceptually and acoustically in children with tonsillar hypertrophy and compare effects of two types of surgery, total tonsillectomy and tonsillotomy. Sixty-seven children, 50-65 months, on waiting list for surgery, were randomized to tonsillectomy or tonsillotomy. The speech material was collected pre-operatively and six months post-operatively. Two groups of age-matched children were controls. /S/-articulation was affected acoustically with lower spectral peak locations and perceptually with less distinct /s/-production before surgery, in comparison to controls. After surgery /s/-articulation was normalized perceptually, but acoustic differences remained. No significant differences between surgical methods were found.
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| 3. |
- Lundeborg Hammarström, Inger, 1956-
(författare)
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Oral Motor Function, Voice, Speech and Language in Children with Tonsillar Hypertrophy in Relation to Surgical Outcome
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was two-fold: first, to evaluate four different functional aspects of the speech and language spectrum; oral-motor function, voice, /s/-articulation and phonology in preschool children with tonsillar hypertrophy before and after surgical treatment. The second aim was to investigate weather the outcome of surgery was equal for two surgical techniques; tonsillectomy or tonsillotomy combined with adenoidectomy when necessary. In all included publications (I-IV), 67 children on waiting list for tonsil surgery and randomized to either tonsillectomy (33) or tonsillotomy (34) participated. The children were assessed and audio-recorded within a month before surgery and six months postoperatively. Results were compared to age-matched control groups.In the first study, oral motor function was assessed using the Nordic Orofacial Test-Screening, NOT-S, consisting of a structured interview and a clinical examination. Before surgery, the children in the study group differed in all domains of the structured interview in comparison to age-matched controls and in the clinical examination regarding the parameters deviant lip position and trouble nose-breathing. Postoperatively oral motor functions were normalized in both surgical groups and no differences to age matched controls were observed. In study two, recordings of three sustained vowels (/α , u, i/) and 14 words elicited by picture naming were analysed both perceptually and acoustically. Compared to the controls, significant differences were found in the study group preoperatively with higher ratings on Visual Analogue Scales (VAS) for the voice quality parameters “hyponasality” and “compressed/throaty” and also lower for pitch. Significantly higher values on all studied perturbation measures (jitter, shimmer and Noise to Harmonics Ratio) were found. Regarding center frequencies of formants, the study groups had lower F3 values for /u / and also lower F2 and F3 for / i / compared to age-matched controls. After surgery there were no significant differences between the perceptual ratings of voice quality of the two surgical groups and there were no significant differences between the children in the surgical groups and the corresponding controls. The acoustic analyses showed a decrease in all the measures of perturbation for the study group after surgery with a slight difference between the two surgical groups. The children in the tonsillotomy group had higher shimmer value for /u/ and higher NHR for /α/. In comparison to the older controls significantly higher values were found an all perturbation measures and the difference seen regarding formant frequencies for the /i/-sound in comparison to controls still remained. The significantly lower third formant (F3) of the /u/-sound also remained. When comparing pre- versus postoperative results for the surgical group as a whole, a decrease was found on all perturbation measures postoperatively, however the differences were not statistically significant. A significant increase was found in formant 3 for /α/ and /u/ was found.The material used in the third study were speech samples containing the /s/-sound and elicited by picture naming and sentence repetition. Before surgery the study group was rated to have more indistinct /s/-sounds than agematched controls. The acoustic analyses showed that the study group had lower spectral peak values for the /s/-sound than controls. After surgery the operated children’s /s/-production did not differ perceptually from the older controls, neither as a whole group nor when divided according to surgical methods. Regarding the acoustic analyses however, the study groups differed from the age-matched control group showing that noise duration was longer and the peak location higher in the study groups.In study four, a Swedish phonology test was performed and transcribed phonetically. The transcription of each child was analyzed in terms of phonological processes and categorized into one of six developmental stages according to the model developed by Nettelbladt (1983) and adapted by Sahlén, Reuterskiold-Wagner, Nettelbladt & Radeborg (1999). A majority of the children in the study group (62.7 %) showed a slowed phonological development preoperatively (developmental stages 0-4), compared to the age-matched control group. Postoperatively the children in both surgical groups had improved their phonological skills. However, they were still behind in comparison to age-matched controls and the difference was even larger than before surgery.The results of this thesis project have clinical relevance for both speech and language pathologists (SLP’s) and ear-nose and throat-surgeons (ENT-surgeons). SLP’s must be aware of the potential impact of tonsillar hypertrophy on oral-motor function and the speech and language spectrum to be able to help affected children adequately and ENT- surgeons should include oral motor and speech and language problems as additional indications for tonsillar surgery.
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| 4. |
- Lundeborg Hammarström, Inger, 1956-, et al.
(författare)
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Oral sensorimotor function in typically developing children 3 to 8 years old as assessed by the Nordic orofacial test, NOT-S
- 2014
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Ingår i: Journal of medical speech-language pathology. - 1065-1438. ; 21:1, s. 51-59
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Tidskriftsartikel (refereegranskat)abstract
- Background: Oral senorimotor development is the basis for several vital functions for the child, hence orofacial dysfunction may be severely disabling. Recently, a comprehensive screening instrument assessing different aspects of orofacial function in adults and children age three and up was developed, the Nordic Orofacial Test-Screening (NOT-S). The aim of the present study was to establish developmental profiles of orofacial function for children 3 to 7:11 years old using NOT-S methods: A total of 231 typically developing children 3:0 to 7:11 years old were included. Data were compiled from previous investigations. Comparisons across ages and gender were made.Results: The total NOT-S score was below two for 58% (133) of all children in the study.There was a clear trend of lower total NOT-S score with increased age according to a best linear fit regression, R2= .81, p = .014. The number of children without any score on NOT-S increases dramatically for the seven-year-old children, 44% compared to 20% or lower for the other age groups. Boys had statistically significant higher scores than girls on the total NOT-S score and also for the clinical examination according to a Mann-Whitney U-test, p<.000 for both cases.
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| 5. |
- Samuelsson, Christina, 1966-, et al.
(författare)
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Experiences from Two Swedish Speech and Language Pathology Education Programmes Using Different Approaches to Problem-Based Learning
- 2012
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Ingår i: Problem-Based Learning in Clinical Education. - Dordrecht : Springer Netherlands. - 9789400725140 ; , s. 47-58
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- In many programmes within higher education, including speech language pathology (SLP) education, students are expected to develop collaborative skills alongside acquisition of theoretical knowledge. The focus of the present chapter is to evaluate SLP graduates’ opinions on how well prepared for the professional life they feel after their education. A questionnaire, focusing on perceived professional skills in relation to education, was distributed to former SLP students from two programmes with different applications of problem-based learning (PBL). A total of 55 students (69%) completed the questionnaire. PBL has been identified as one efficient way to facilitate the development of speech and language pathology students’ abilities to meet the demands of self-directed learning in everyday worklife. Moreover, it has been shown that the use of PBL throughout the programme is beneficial to the perception of attaining general competencies. It is also demonstrated that the students from both the PBL throughout and the semi-PBL curricula rated themselves high on many specific competencies.
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