Programa de Pós-graduação em Fonoaudiologia, Universidade Estadual Paulista Júlio de Mesquita Filho - UNESP - Marília (SP), Brasil.
Pós-graduação em Ciência da Reabilidação, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo - USP -Bauru (SP), Brasil.
Codas. 2023 Sep 15;35(6):e20220069. doi: 10.1590/2317-1782/20232022069pt. eCollection 2023.
To analyze the effect of auditory-perceptual training by inexperienced speech-language pathologists in the classification of hypernasality in individuals with cleft lip and palate and compare their classification of hypernasality individually, with the gold standard evaluation, before and after this training.
Three inexperienced speech-language pathologists used a four-point scale to assess 24 high-pressure speech samples from individuals with cleft lip and palate, before and after auditory-perceptual training. The speech samples corresponded to six samples of each degree of hypernasality. The speech-language pathologists received auditory-perceptual training during the assessments. They had access to anchor samples and immediate feedback of correct answers regarding the degree of hypernasality in training.
There was no significant difference in the overall percentage of correct answers when comparing before and after the auditory-perceptual training. There was a significant association and agreement of the three evaluators with a gold standard evaluation after training, with an increase in agreement for a single evaluator for absent and mild degrees of hypernasality. The dichotomous analysis of the data showed an increase in the Kappa Index of Agreement of this evaluator. Although there was an increase in the Index of Agreement between evaluators for absent, mild, and severe hypernasality, this increase did not reach statistical significance.
The auditory-perceptual training provided did not result in a significant improvement in the hypernasality classification for the inexperienced speech-language pathologists, even though the individual data analysis showed that the training favored one of the evaluators. Further studies involving gradual and more extensive auditory-perceptual training may favor the classification of hypernasality by inexperienced SLPs.
分析未经训练的言语治疗师在腭裂患者鼻音过高分类中的听觉感知训练效果，并比较他们在接受训练前后对鼻音过高的个体进行分类，与金标准评估进行比较。
三名未经训练的言语治疗师使用四点量表对 24 名唇腭裂患者的高压力语音样本进行评估，在听觉感知训练前后进行。语音样本对应于每一度鼻音过高的六个样本。言语治疗师在评估期间接受听觉感知训练。他们可以访问锚定样本，并在训练中获得有关鼻音过高程度的正确答案的即时反馈。
在比较听觉感知训练前后，总体正确答案百分比没有显著差异。在训练后，三名评估者与金标准评估之间存在显著的相关性和一致性，对缺失和轻度鼻音过高的单一评估者的一致性有所增加。数据的二项分析显示，该评估者的一致性 Kappa 指数增加。尽管对于缺失、轻度和重度鼻音过高，评估者之间的一致性指数有所增加，但这并未达到统计学意义。
提供的听觉感知训练并未导致未经训练的言语治疗师在鼻音过高分类方面有显著改善，尽管个体数据分析表明，训练有利于其中一名评估者。涉及逐步和更广泛听觉感知训练的进一步研究可能有利于未经训练的言语治疗师对鼻音过高的分类。
