Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 2P1, 9000, Ghent, Belgium.
Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10 2P1, 9000, Ghent, Belgium.
Int J Pediatr Otorhinolaryngol. 2020 Sep;136:110191. doi: 10.1016/j.ijporl.2020.110191. Epub 2020 Jun 19.
To meet the scarcity of training and/or educational initiatives in Uganda regarding state-of-the-art speech diagnosis and treatment in patients with cleft palate, a workshop was organized for all interested speech-language pathologists and health care workers.
To evaluate and compare the inter- and intra-rater reliability of the perceptual evaluation of hypernasality, hyponasality, nasal emission, nasal turbulence and speech acceptability before and after a two-day workshop in Ugandan speech-language pathologists.
On the first day, perceptual speech evaluation was discussed and practiced. Perceptual exercises included individual ratings of a specific speech variable followed by a group discussion and consensus listening exercises in listener pairs. The second day focused on speech treatment. Ten Ugandan speech-language pathologists rated speech samples of Ugandan patients with a CP ± L before and immediately following the two-day workshop. Inter- and intra-rater reliability of the perceptual ratings of hypernasality, hyponasality, nasal emission, nasal turbulence and speech acceptability were determined by means of the absolute percentage of agreement. The Wilcoxon signed-rank test was used to compare results at both time points.
Overall inter- and intra-rater reliability improved when observing the absolute percentage agreement. However, median agreement results only showed enhanced reliability for hypernasality, hyponasality and nasal turbulence whereas (limited) deteriorated reliability was observed for nasal emission and speech acceptability. Regarding inter-rater reliability only the median percentage agreement for hyponasality exceeded 50% (median: 56.3%). Overall, better results were found for intra-rater reliability, with only weak results for speech acceptability.
Training positively affected reliability results. Nonetheless, this improvement was not achieved for each speech variable and reliability improvements were modest. Findings indicate the need for continued training and the search for the most effective training paradigm and feedback techniques, whilst taking into account clinical relevance and practical considerations.
为了解决乌干达在腭裂患者的现代语音诊断和治疗方面培训和/或教育计划不足的问题，为所有有兴趣的言语-语言病理学家和医疗保健工作者组织了一次研讨会。
评估和比较乌干达言语-语言病理学家在为期两天的研讨会前后，对超鼻音、低鼻音、鼻音发射、鼻音湍流和语音可接受性的感知评估的组内和组间可靠性。
第一天讨论和练习了语音感知评估。感知练习包括对特定语音变量的个体评分，然后在听众对中进行小组讨论和共识听力练习。第二天的重点是语音治疗。十位乌干达言语-语言病理学家在为期两天的研讨会之前和之后，对患有 CP ± L 的乌干达患者的语音样本进行了评分。通过绝对百分比一致来确定超鼻音、低鼻音、鼻音发射、鼻音湍流和语音可接受性的感知评分的组内和组间可靠性。使用 Wilcoxon 符号秩检验比较两个时间点的结果。
当观察绝对百分比一致时，总体组内和组间可靠性提高。然而，中位数一致结果仅显示超鼻音、低鼻音和鼻音湍流的可靠性增强，而（有限）鼻音发射和语音可接受性的可靠性降低。关于组间可靠性，只有低鼻音的中位数百分比一致超过 50%（中位数：56.3%）。总体而言，组内可靠性的结果更好，只有语音可接受性的结果较弱。
培训对可靠性结果产生了积极影响。然而，并非每个语音变量都取得了这种改进，而且可靠性的提高是适度的。研究结果表明需要继续培训，并寻找最有效的培训范例和反馈技术，同时考虑到临床相关性和实际考虑因素。
