Marino Viviane Cristina de Castro, Dutka Jeniffer de Cássia Rillo, Manicardi Flora Taube, Gifalli Giovana, Silva Patrick Pedreira, Pegoraro-Krook Maria Inês
Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP - Marília (SP), Brasil.
Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo - USP - Bauru (SP), Brasil.
Codas. 2020 Dec 11;32(6):e20190269. doi: 10.1590/2317-1782/20202019269. eCollection 2020.
To investigate the influence of speech stimuli in the auditory perceptual identification of hypernasality in individuals with Cleft Lip and Palate (CLP).
Speech samples from 80 individuals with operated unilateral CLP, ages ranged from nine to 17 years (the mean age of: 12y7m), both genders, were edited for this study. Samples were recorded over the production of nine different speech stimuli, including counting and short sentences characterized by oral sounds, one loaded with low pressure consonants and seven loaded with high pressure consonants. Three speech-language pathologists rated the presence or absence of hypernasality while analyzing 864 recordings (80 individuals X 9 stimuli + 144 repeated recordings, for measuring the intra-rater agreement). Intra-rater and inter-rater indexes of agreement were established for all nine stimulus conditions. The indexes of inter-rater agreement were compared using the Z test (p<0.005), with samples comprising significant indexes of agreement interpreted as better stimuli for identifying the hypernasality in these individuals.
Intra-rater agreement for high pressure stimuli with voiced consonants were significantly lower than indexes for other stimuli. Inter-rater agreement between each pair of SLPs ranged from 0.11 (plosive voicing stimuli) to 0.57 (12 short sentences, one of each high pressure consonant). The values of mean inter-rater agreement between all SLPs was 0.47 indicating moderate agreement for identifying hypernasal speech.
Speech recordings obtained over the production of longer speech samples including 12 short sentences, for instance one for each high pressure consonant, may favor inter-rater agreement for identifying hypernasality.
研究语音刺激对唇腭裂（CLP）患者鼻音过重听觉感知识别的影响。
本研究选取了80例接受过单侧唇腭裂手术的患者的语音样本，年龄在9至17岁之间（平均年龄为12岁7个月），涵盖了男女两性。对样本进行编辑，记录了九种不同语音刺激下的发音，包括计数和以口腔音为主的短句，其中一个包含低压辅音，七个包含高压辅音。三名言语语言病理学家在分析864次录音（80名个体×9种刺激+144次重复录音，用于测量评分者内一致性）时，对鼻音过重的有无进行评分。针对所有九种刺激条件建立了评分者内和评分者间的一致性指标。使用Z检验（p<0.005）比较评分者间一致性指标，将具有显著一致性指标的样本解释为更有利于识别这些个体鼻音过重的刺激。
浊辅音高压刺激的评分者内一致性显著低于其他刺激的指标。每对言语语言病理学家之间的评分者间一致性范围为0.11（爆破浊音刺激）至0.57（12个短句，每个高压辅音一个）。所有言语语言病理学家之间的平均评分者间一致性值为0.47，表明在识别鼻音过重语音方面具有中等一致性。
通过较长语音样本（包括12个短句，例如每个高压辅音一个）的发音获得的语音记录，可能有利于评分者间在识别鼻音过重方面达成一致。
