Telepractice facilitates services in exceptional settings and situations. The ongoing COVID-19 pandemic is certainly such a situation. Due to pandemic-related restrictions, speech-language ...pathologists (SLPs) needed to adopt new approaches to their professional functioning. The aim of the paper is to examine SLP professionals' perceptions and application of telepractice in SLP settings in Croatia during the COVID-19 pandemic. Two hundred and fifty-five SLPs completed an online survey. The results demonstrated that most SLPs had provided direct online therapy, mainly those employed in health care and private practice. The chief reasons for clients' refusal of therapy delivered via telepractice included the lack of equipment, insufficient independence, and doubts on the effectiveness of telepractice. Although only 3% of SLPs had acquired some formal knowledge of telepractice before the pandemic, over 70% expressed satisfaction with telepractice because it allowed them to provide undisturbed clinical services in an exceptional situation.
The preconditions for successful voice communication are good hearing and listening, and auditory processing that includes the ability to process the audio signal. Damage or deceleration of sound ...signal processing at any level from the periphery to the central structures leads to disintegration and inability to process the signal effectively. Auditory processing in people with aphasia has not been examined in Croatia to date. Results of studies conducted in other languages point to negative effects of auditory processing difficulties on the receptive and expressive component of the language. This study was conducted on a sample of subjects with chronic aphasia and a group of control subjects with no neurological or any other disorders that can affect auditory processing. The inclusion criteria for persons with aphasia were impaired language skills as a result of cerebrovascular accident that occurred at least six months before the examination, regardless of severity and type of aphasia and normal hearing status. The study did not include persons with aphasia who were unable to repeat the six-word sentence, due to impaired comprehension or speech expression, and those whose comprehension was not sufficient to cooperate well during the test. The test was conducted individually for 30 minutes per subject using the Auditory processing test (PSP) that is standardized for the Croatian language. Results from this study showed statistically significant lower achievement on all subtests on PSP-1 (filtered words, speech in noise, dichotic words test, and dichotic sentence test) in people with aphasia compared with the control group. People with aphasia and control group subjects showed better results in favor of the left ear on variable speech in noise. Filtered words were easily processed through the left ear in people with aphasia while dichotic sentences were easily processed through the left ear in the control group. The results of this study confirm the hypothesis of the presence of auditory processing difficulties in people with aphasia and are consistent with previous studies conducted in other languages. In addition, the study points to the need of introducing specific therapeutic procedures in rehabilitation in order to improve the function of auditory processing in persons after a cerebrovascular accident.
Preduvjeti uspješne govorne komunikacije su dobar sluh i
slušanje, te slušno procesiranje koje uključuje sposobnost obrade zvučnog
signala. Oštećenja ili usporavanja obrade zvučnog signala na bilo kojoj razini
od periferije do središnjih struktura dovodi do dezintegracije i nemogućnosti
učinkovite obrade signala. U Hrvatskoj do sada nije ispitivano slušno
procesiranje kod osoba s afazijom. Rezultati istraživanja provedenih u drugim
jezicima upućuju na negativan utjecaj poremećaja slušnog procesiranja na
receptivnu i ekspresivnu sastavnicu jezika. Istraživanje je provedeno na uzorku
ispitanika s kroničnom afazijom i skupini kontrolnih ispitanika bez neuroloških
ili drugih bolesti koje mogu utjecati na slušno procesiranje. Kriteriji
uključivanja osoba s afazijom su bili sljedeći: slabije jezične sposobnosti kao
posljedica CVI koji se dogodio najmanje šest mjeseci prije ispitivanja bez
obzira na težinu i vrstu afazije te uredan sluh. U istraživanje nisu uključene
osobe s afazijom koje nisu bile u mogućnosti za ispitivačem ponoviti rečenicu
od šest riječi, bez obzira radi li se o poremećaju razumijevanja ili govorne
ekspresije, te osobe kod kojih razumijevanje nije bilo dovoljno za dobru
suradnju tijekom provođenja testa. Ispitivanje je provedeno individualno u
trajanju od tridesetak minuta po ispitaniku pomoću testa PSP-1 koji je
standardiziran za hrvatski jezik. Dobiveni rezultati pokazuju statistički
značajno slabija postignuća na svim subtestovima Testa slušnog procesiranja
(filtrirane riječi, govor u buci, dihotički test riječi, dihotički test
rečenica) kod osoba s afazijom u odnosu na kontrolne ispitanike. Osobe s
afazijom i skupina kontrolnih ispitanika pokazuju statistički značajne razlike
u smislu boljih rezultata na lijevom uhu na varijabli govor u buci. Filtrirane
riječi su osobe s afazijom bolje procesirale na lijevo uho dok su kontrolni
ispitanici na lijevo uho bolje procesirali rečenice na subtestu dihotički test
rečenica. Rezultati potvrđuju hipotezu o prisustvu poremećaja slušnog
procesiranja kod osoba s afazijom i u skladu su s ranije provedenim
istraživanjima na drugim jezicima. Osim toga, ukazuju na potrebu uvođenja
specifičnih terapijskih postupaka u rehabilitaciji u cilju poboljšanja funkcije
slušnog procesiranja kod osoba nakon moždanog udara.
During the COVID-19 pandemic, remote schooling was conducted on several occasions in the Republic of Croatia. The aim of this study is to compare the remote schooling experiences of parents of ...elementary school children with hearing and/or speech and language disorders and those of parents of typically developing children during the COVID-19 pandemic. Parental time involvement and predictors of general parenting self-efficacy were examined using two online surveys based on the same questionnaire. The first survey involved 267 parents of typically developing children, while the second involved 109 parents of children with hearing and/or speech and language disorders. Data were analysed using chi-square tests and hierarchical regression analysis. Our results show that, on working days and on weekends, parents of children with developmental disorders invested significantly more time in their child’s remote schooling than parents of typically developing children. Furthermore, higher general parenting self-efficacy was reported by parents who had more children, those whose children were more independent regarding remote schooling, those whose children did not suffer from developmental disorders, as well as those who experienced less stress due to their child’s remote schooling. Our study highlights the importance of adapting the remote schooling model based on the different needs and abilities of students, as well as the requirements of their families in order to prevent low parenting self-efficacy and improve students’ educational achievements.
Voice skills are extremely important for people who use their voice as a means of everyday work, especially for teachers who stand out as a subgroup of voice professionals who are exposed to many ...risk factors for voice disorders. Little is known about the extent to which the specificities of the students, in terms of the additional demands that their teaching puts on the teacher, can negatively affect the voice abilities of the teacher. Here we mainly consider the difference in the the manner of vocal performance of teachers working in mainstream schools as compared to vocal performances of those working in schools for special educational needs. In this study, two groups were examined: teachers working in a regular primary school (N = 40) and teachers conducting a regular program in special conditions with students who have communication, language, speech and/or hearing impairment (N = 30). The aim was to examine self-assessment of voice difficulties between two groups of teachers on VHI (Voice Handicap Index) and to identify the possible predictivity of chronological age, years of working experience, gender and positive medical history on voice disorders on the results of self-assessment. Results show that statistically significant differences between two groups of teachers exist on the VHI subscale emotionally in terms of poor results of teachers of students without difficulties, whereas on the other two subscales and the overall result there are no significant differences. Regression analysis confirms the predictivity of positive medical history on VHI results. Results of this research confirm less occurrence of voice disorder within the group of teachers who work with students with specific educational disorders. Less prevalence and incidence of voice disorders is probably a consequence of a better knowledge of voice production and hygiene, a smaller number of students and the use of electroacoustical equipment during the teaching process. However, given the small sample of respondents and only the results of the research participants' self assessment, future research should include a larger sample and objective variables in order to verify the results of this research and its implications.
There is no available data on the prevalence of voice disorders in Croatia. The objective of this research was to determine the prevalence of perceived voice disorders (PVD) in teachers and general ...population in Croatia using the Croatian Voice Handicap Index (VHI-HR) questionnaire.
This research was divided into two phases. In phase I, the potential of the VHI-HR questionnaire to distinguish individuals with and without voice disorders was assessed. A total of 113 participants completed the VHI-HR. Receiver operating characteristic analysis was performed. In phase II, a cross-sectional study was conducted. A total of 1898 participants, including 1088 teachers from 434 Croatian schools, and 810 nonteachers were included in the study. The questionnaire on sociodemographic factors, potential risk factors associated with voice disorders, and the VHI-HR was administered. The differences in the PVD prevalence in teachers and nonteacher adults and adverse effects of PVD were investigated. The multiple logistic regression model was used to examine the factors associated with PVD occurrence.
In phase I, the cut-off point of 18.32 with 93.44% sensitivity and 98.08% specificity for VHI-HR was determined. In phase II, higher lifetime PVD prevalence was found among teachers. The point prevalence of PVD was 45.68% for teachers, and 21.11% for nonteachers. This study demonstrated that being a teacher, a woman, having a family history of voice disorders, reflux, working in environment with elevated noise levels, and having more than 30years of employment are associated with PVD occurrence.
VHI-HR score of 19 and higher proves effective in distinguishing individuals with voice disorders from those without. The odds of having PVD for teachers are 2.83 times higher than for nonteachers. Risk factors for voice disorders, among others, include occupational use of voice and working in environments with elevated noise levels.
The purpose of this study was to compare the duration and variability of speech segments of children who stutter with those of children who do not stutter and to identify changes in duration and ...variability of speech segments due to the effect of utterance length. Eighteen children participated (ranging from 6.3 to 7.9 years of age). The experimental task required the children to repeat a single word in isolation and the same word embedded in a sentence. Durations of speech segments and Coefficients of variation (Cv) were defined to assess temporal parameters of speech. Significant differences were found in the variability of speech segments on the sentence level, but not in duration. The findings supported the assumption that linguistic factors pose direct demands on the speech motor system and that the extra duration of speech segments observed in the speech of stuttering adults may be a kind of compensation strategy.
Aim of this study was to evaluate level of analgesia and hemodynamic response to spinal anesthesia obtained by administering 15 mg 0.5% isobaric bupivacaine at L2-3 vs. L3-4 interspace for inguinal ...herniorrhaphy, since studies comparing analgesia and hemodynamic response at the L2-3 vs. L3-4 interspaces are lacking. In a prospective, randomized clinical study that encountered 72 patients undergoing elective inguinal herniorrhaphy randomly allocated in to two equal groups L2-3 (N = 36) and L3-4 (N = 36) according to lumbar interspace where intrathecal injection of bupivacaine was administered. Analgesia was evaluated by intraoperative "rescue" fentanyl requirements, the absence of pain and the maximal visual analogue scale (VAS) scores reached per patient during the operation. The severity of intraoperative pain was quantified by a 10 cm VAS scale (VAS 0: no pain to 10: worst pain imaginable) every 5 minutes after skin incision until the end of the operation. VAS > 3 was treated with intravenous fentanyl 25 microg. Hemodynamic response was monitored and evaluated, heart rate was continuously monitored as well as, baseline systolic, diastolic and mean arterial pressure prior to induction and every 5 minute after applying spinal anesthesia until surgical completion. Intraoperative fentanyl requirements were significantly higher in group L3-4 (L2-3 0%, 97.5% confidence interval CI 0.0-0.11 vs. L3-4 17%, 95% CI 0.07-0.32, p = 0.025). Absence of pain was significantly higher in L2-3 group at the beginning of the operation (L2-3 89%, 95% CI 0.74-0.96 vs. L3-4 67%, 95% CI 0.50-0.79, p = 0.047). The maximal VAS scores reached per patient during the operation in L2-3 group were lower then in L3-4 group (L2-3 median M 0, range R 0-3, L3-4 M 0, R 0-8, p = 0.014). There were no significant differences (p > 0.05) in the incidence of hypotension (L2-3 19%, 95% CI 0.09-0.35 vs. L3-4 17%, 95% CI 0.07-0.32) and bradycardia (L2-3 19%, 95% CI 0.09-0.35 vs. L3-4 8%, 95% CI 0.02-0.23). Spinal anesthesia with isobaric bupivacaine administered in L2-3 interspace for inguinal herniorrhaphy provides superior analgesia and equal hemodynamic stability as compared to neuroaxial anesthesia administered in the L3-4 interspace.
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