Normal Patterns of Nasometric Values in Adult Jordanian Speakers of Arabic.

PURPOSE: The study sought to establish normative nasometric values for adult Jordanian speakers of Arabic. Gender-related differences and intraspeaker variability of nasalance scores were investigated. METHODS: A total of 113 adult speakers of Jordanian Arabic (56 men and 57 women) without speech-language and hearing impairments or craniofacial anomalies ranging in age between 18 and 55 participated in the study. Nasometer II, Model 6400 was used to obtain nasalance scores as speakers produced 3 recitations for each of the 3 standardized passages consisting of an oral passage, an oronasal passage, and nasal sentences. Descriptive statistics of nasalance scores for each passage were obtained and gender-related differences were determined by ANOVA. Standard deviation for the 3 repetitions for each passage was considered an index for intraspeaker variability. RESULTS: Average nasalance for each passage was (11.23%) for the oral passage, (25.48%) for the oronasal passage, and (51.92%) for the nasal sentence. There was no gender effect on nasalance on the oral passage, however women exhibited higher nasalance scores than men on the both oronasal passage (P = 0.002) and nasal sentences (P = 0.017). Intraspeaker variability for all speakers fell below 4.5% with repeated readings. CONCLUSION: The study provides normative nasometric data for Arabic speaking Jordanian adults to serve as references for the assessment of velopharyngeal dysfunction in craniofacial clinics. Arabic speakers demonstrated different nasalance scores than speakers of other languages. Gender differences can be attributed to variations in anatomical structure and velopharyngeal function between men and women.

Validity of test stimuli for nasalance measurement in speakers of Jordanian Arabic.

OBJECTIVE: The objective of the study was to establish the validity of passages for measuring nasalance of Jordanian speakers of Arabic. DESIGN: Two Arabic text passages were constructed; the Spring Passage is devoid of nasal consonants and the Home Passage contains both oral and nasal consonants. Nasalance was measured for participants while reciting each passage three times. Perceptual ratings of hypernasality were also obtained for each participant on each passage using a 5-point equal-appearing rating scale. PARTICIPANTS: Forty-seven children and adults ranging in age between 9 and 26 years participated in the study. Twenty-three participants had no history of communication disorders, and 24 had repaired cleft palate. RESULTS: Correlation coefficient between ratings of hypernasality and the nasalance scores was significant for the Spring Passage (r = 0.88, p > 0.001) and for the Home Passage (r = 0.78, p > .001). Using cutoff scores of 17% and 36% of nasalance for the Spring and the Home Passages, respectively, and a threshold score of 1.5 for hypernasality, sensitivity for the Spring Passage was 88% and the Home Passage was 78%. CONCLUSIONS: Results showed the validity of the Spring Passage and the Home Passage in measuring nasalance scores as proved by their high sensitivity and strong correlation with perceptual rating of hypernasality.

Prosthodontic Rehabilitation of Arabic Speaking Individuals with Velopharyngeal Incompetence: A Preliminary Study.

BACKGROUND: Hypernasality is a frequently encountered problem in the speech of individuals with velopharyngeal incompetence. The use of palatal lift appliance (PLA) is the main treatment option for correction of velopharyngeal incompetence. The literature on the outcomes of using prosthetics treatment for Arabic speaking patients is scarce. OBJECTIVE: The aim of this study was to investigate the effect of using PLA on hypernasality of Arabic speaking patients with velopharyngeal incompetence. METHODS: Six participants with age ranging from 9 to 61 years (4 males and 2 females) were recruited between October 2013 and August 2014. Written informed consents were taken from all the adult participants/the guardians of under-aged participants. All patients exhibited hypernasality with different etiologies for velopharyngeal incompetence (head injury, cerebrovascular accident, and neurological disorders). They were treated with PLAs which were constructed to elevate the dysfunctional soft palate. Nasalance scores and perceptual speech acceptability ratings were measured/evaluated in both situations; with and without appliances. Paired t-test was used to analyze the perceptual ratings and nasalance scores in order to detect any significant change in hypernasality pre and post insertion of PLA. RESULTS: There was a statistically significant decrease (p>0.05) in nasalance scores (Pa, Pi, Ma, Mi, a, i) after PLA insertion. The subtest /u/ showed insignificant change (p= 0.056). Perceptual ratings showed significant reduction in hypernasality which was consistent with nasalance measurements. CONCLUSION: PLAs can reduce hypernasality in Arabic speaking patients who suffer from velopharyngeal impairment.

Cleft Lip and Palate: Demographic Patterns and the Associated Communication Disorders.

PURPOSE: This study investigated demographical characteristics, health status, and associated communication disorders in patients with orofacial clefts (OFCs) in Northern Jordan. METHODS: A retrospective study of 226 cleft patients and their families was carried out between March 2012 and September 2016 at the Speech and Hearing Clinic and the Maxillofacial Center at King Abdullah University Hospital. Data were collected by interviewing patients and caregivers, having patients or caregiver to complete a questionnaire and reviewing the patient's medical records. The frequencies of OFC type, demographic, health status, and communication disorders variables were calculated. χ analysis was used to test for significance of associated demographic and communication disorders variables with OFC type. RESULTS: Results revealed higher percentage of males compared with female patients. The majority of OFC patients were born to families who lived in urban areas, obtained high school diploma or lower educational level, lived below poverty cutoff, and showed nonconsanguineous marriages. Most mothers took the prescribed pregnancy supplements. Only one-third of the families received health education and reported other incidences of OFCs. Twenty percent of the patients had other congenital anomalies, 80% experienced dysphagia prior to the cleft repair, dropped to 14% after the repair. Higher percentage of patients with isolated cleft palate and cleft lip and palate exhibited hearing loss, hypernasality, articulation and phonological disorders, and dysphagia compared with those with cleft lip only. None of the demographic variables was associated with OFC type. CONCLUSIONS: Data suggested that families who had children with OFCs displayed poor socioeconomic status and low educational level which may impede the delivery of health education by health practitioners. Increased risk of comorbid communication disorders and malformations in OFC patients must be emphasized and disseminated to health professionals involved in the management of patients with OFC.

Outcomes of Palatal Lift Prosthesis on Dysarthric Speech.

PURPOSE: This study was designed to investigate the effect of palatal lift prosthesis (PLP) on the speech of individuals with different types of dysarthria. PARTICIPANTS: Thirty (19 males and 11 females) native speakers of Jordanian Arabic with dysarthria participated in the study. The age of the participants ranged from 8 to 67 years with an average of 34.1 years. Traumatic brain injury was the most common etiology of dysarthria among 12 participants, stroke among 11, multiple sclerosis among 3, and pseudobulbar palsy among 2; 1 participant had Parkinson disease, and another participant had amyotrophic lateral sclerosis. METHODS: Five acoustic and aerodynamic measures were evaluated to determine the speech outcomes including nasalance scores, sequential motion rate, speech rate, vital capacity, and sound pressure level. The acoustic measures were obtained from the participants in PLP-out and PLP-in conditions. RESULTS: Results showed statistically significant decrease in the nasalance scores of the syllable repetition, vowel prolongation, and sentence repetition tasks in the PLP-in condition below the 28% cutoff score. Furthermore, results revealed statistically significant increase in sequential motion rate, speech rate, vital capacity, and sound pressure level (P = 0.000). CONCLUSION: The use of PLP is an effective treatment option of dysarthric speech. Besides nasalance scores, the sequential motion rate, speech rate, vital capacity, and sound pressure level are considered reliable speech measures that may be used to evaluate the effect of PLP on dysarthria.