Efficacy of an Arabic Articulatory Error Remediation Software Program in Patients With Velopharyngeal Valve Dysfunction:

Overview

To develop a remediation software program that is specific for correcting speech errors in patients with velopharyngeal dysfunction in the Arabic language and test its efficacy, on one group comparing pre and post results

Full Title of Study: “Formulatin and Application of a Remediation Software Porgram for Correction of Articulatory Errors in Patients With Velopfaryngeal Dysfunction”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: January 23, 2019

Detailed Description

The study was carried on 40 patients having articulation errors in cases of velopharyngeal valve dysfunction attending the unit of phoniatrics, otorhinolaryngology department, Alexandria University.

The patients met the specified inclusion and exclusion criteria. The patient underwent pre intervention evaluation and 3 parameters were chosen to compare efficacy of the program before and after therapy.

these include auditory perceptual assessment of speech, nasometer test and articulation test.

The patient underwent the remediation software program as individual sessions. then after finishing the therapy, the patients underwent post therapeutic evaluation with the 3 specified criteria

Statistical analysis Was carried out using SPSS statistics software version 23. Quantitative data were tested for normality using the Kolmogorov-Smirnov test. The variables which were normally distributed were described by Mean± SD. The variables which were not normally distributed, were described by median (Min-Max). Qualitative data were expressed by numbers and percentages. The results were calculated at a level of significance of 5% or less.

Interventions

  • Behavioral: Arabic Articulatory Error Remediation software program
    • A speech therapy computerized intervention

Arms, Groups and Cohorts

  • Experimental: the participating group in the intervention
    • patient complaining of seppch rerrors due t ovelopharyngeal insufficiency and underwent the intervention

Clinical Trial Outcome Measures

Primary Measures

  • change in Arabic articulation test
    • Time Frame: base line( pre -intervention)
    • a qualitative test that define presence or absence of articulation errors
  • change in Arabic articulation test
    • Time Frame: immediately after intervention
    • a qualitative test that define presence or absence of articulation errors
  • change in naso meter values
    • Time Frame: pre intervention
    • a device that measure nasalance score as a ratio expressed in percentage between nasal sound energy to nasal plus oral sound in patients pre and post intervention for quantitaive assesment of nasal air emission and nasal tone where the lower values mean beteer results
  • change in naso meter values
    • Time Frame: immediately after intervention
    • a device that measure nasalance score as a ratio expressed in percentage between nasal sound energy to nasal plus oral sound in patients pre and post intervention for quantitaive assesment of nasal air emission and nasal tone where the lower values mean beteer results
  • change in Auditory perceptual assessment of speech
    • Time Frame: pre intervention
    • A qualitative scale of patient speech : 5 grade from 0( not present) to 4 (sever)
  • change in Auditory perceptual assessment of speech
    • Time Frame: immediately after intervention
    • A qualitative scale of patient speech : 5 grade from 0( not present) to 4 (sever)

Secondary Measures

  • effect of the age factor on nasometer values after intervention
    • Time Frame: immediately after intervention
    • statistical tests for correlation
  • effect of the age factor on auditory perceptual assessment after intervention
    • Time Frame: immediately after intervention
    • statistical tests for correlation
  • effect of the surgical repair on the nasometer values after intervention
    • Time Frame: immediately after intervention
    • comparison between two groups

Participating in This Clinical Trial

Inclusion Criteria

  • clinically presented by articulation errors due to velopharyngeal dysfunction
  • Age of 5 years and above with
  • must have normal hearing and vision.

Exclusion Criteria

  • Unrepaired cleft palate.
  • Large palatal fistula.
  • Brain damage and intellectual disability.

Gender Eligibility: All

Minimum Age: 5 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Alaa Mamdouh
  • Provider of Information About this Clinical Study
    • Sponsor-Investigator: Alaa Mamdouh, Assistant lecturer of phoniatrics – Alexandria University
  • Overall Official(s)
    • Engy S Elhakeem, PhD, Study Director, Otorhinolaryngology department,Faculty of Medicine, Alexandria University
    • Reham M Elmaghraby, PhD, Study Chair, Otorhinolaryngology department,Faculty of Medicine, Alexandria University

References

Siegel-Sadewitz VL, Shprintzen RJ. Changes in velopharyngeal valving with age. Int J Pediatr Otorhinolaryngol. 1986 Apr;11(2):171-82.

Ha S, Cho SH. Nasalance scores for normal Korean-speaking adults and children: Effects of age, vowel context, and stimulus length. Int J Pediatr Otorhinolaryngol. 2015 Aug;79(8):1235-9. doi: 10.1016/j.ijporl.2015.05.019. Epub 2015 Jun 4.

Phua YS, de Chalain T. Incidence of oronasal fistulae and velopharyngeal insufficiency after cleft palate repair: an audit of 211 children born between 1990 and 2004. Cleft Palate Craniofac J. 2008 Mar;45(2):172-8. doi: 10.1597/06-205.1.

Sell D. Issues in perceptual speech analysis in cleft palate and related disorders: a review. Int J Lang Commun Disord. 2005 Apr-Jun;40(2):103-21. Review.

BrunnegÄrd K, Lohmander A, van Doorn J. Comparison between perceptual assessments of nasality and nasalance scores. Int J Lang Commun Disord. 2012 Sep-Oct;47(5):556-66. doi: 10.1111/j.1460-6984.2012.00165.x. Epub 2012 Jul 25.

Kummer AW( 2104) Cleft Palat and Craniofacial Anomalies: Effect on speech and resonance, 3rd edition ed. Delmar Cengage, NY. 23-31 p. .

Dudas JR, Deleyiannis FW, Ford MD, Jiang S, Losee JE. Diagnosis and treatment of velopharyngeal insufficiency: clinical utility of speech evaluation and videofluoroscopy. Ann Plast Surg. 2006 May;56(5):511-7; discussion 517.

3. Kirschner RE, Baylis AL(2013) Velopharyngeal dysfunction. In: Neligan PC, Gurtner GC, editors. Plastic Surgery: Principles and practice, 3rd ed. Elsevier Inc, St. Louis. p. 614-30.

Kotby MN, Bassiouny S, El-Zomor M, E M, editors.(1986) Standardization of an Articulation Test (In Arabic). Proceeding of the 9th Annual Ain Shams Medical Congress, Cairo, Egypt.

Abou-Elsaad T, Baz H, Afsah O, Mansy A. The nature of articulation errors in Egyptian Arabic-speaking children with velopharyngeal insufficiency due to cleft palate. Int J Pediatr Otorhinolaryngol. 2015 Sep;79(9):1527-32. doi: 10.1016/j.ijporl.2015.07.003. Epub 2015 Jul 14.

18. Kotby MN E-SA, Alloush T, Gamal N(1992) 3. Dysarthria Annual Bulletin of Yufuin Kosenenkin Hospital. Hiese. 373-80.

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