SUVAG Polyclinic Repository
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Results of voice self-assessment of the mainstream teachers and the teachers of students with special educational needs in elementary schools
No full textGlasovne sposobnosti iznimno su važne za osobe koje svoj glas koriste kao sredstvo rada, posebice kod nastavnika koji se ističu kao podskupina vokalnih profesionalaca koja je izložena mnogim rizičnim čimbenicima za nastanak poremećaja glasa. Malo je poznato u kojoj mjeri specifičnosti učenika, u smislu dodatnih zahtjeva koje njihovo poučavanje stavlja pred nastavnika, mogu negativno utjecati na vokalne sposobnosti nastavnika. Pritom se poglavito misli na razliku u načinu vokalne prezentacije nastavnika koji rade s učenicima bez teškoća i učenicima s posebnim obrazovnim potrebama u redovnim školama. U ovom istraživanju ispitane su dvije skupine: nastavnici koji rade u redovnoj osnovnoj školi s učenicima bez teškoća (N = 40) i nastavnici koji provode redovni program s učenicima koji imaju poremećaje komunikacije, jezika, govora i/ili oštećenje sluha (N = 30). Cilj je ispitati samopercepciju teškoća uzrokovanih poremećajem glasa između dviju skupina nastavnika na VHI (Indeks vokalnih teškoća) te utvrditi moguću prediktivnost kronološke dobi, godina staža, spola i pozitivne anamneze na rezultate samoprocjene. Dobiveni rezultati pokazuju kako su statistički značajne razlike između dviju skupina nastavnika prisutne na podljestvici VHI-emocionalno u smislu lošijih rezultata nastavnika učenika bez teškoća, dok na drugim dvjema podljestvicama i ukupnom rezultatu ne postoje statistički značajne razlike. Regresijskom analizom potvrđena je prediktivnost pozitivne anamneze na rezultate VHI. Rezultati ovog istraživanja potvrđuju manju pojavnost poremećaja glasa unutar skupine nastavnika koji rade s učenicima s posebnim obrazovnim potrebama. Manja prevalencija i incidencija poremećaja glasa vjerojatno je posljedica boljih znanja o produkciji i higijeni glasa, manjeg broja učenika u razrednim odjeljenjima te korištenje elektroakustičkih uređaja tijekom nastave. No s obzirom na mali uzorak ispitanika i samo rezultate samoprocjene sudionika istraživanja, buduća istraživanja trebala bi uključiti veći uzorak i objektivnije varijable u cilju provjere rezultata ovog istraživanja i implikacija koje iz njega proizlaze.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
Rehabilitacija na daljinu u Dječjem vrtiću Poliklinike SUVAG za vrijeme pandemije virusa SARS-CoV-2 – prikaz prakse i evaluacija
No full textZbog pandemije koronavirusa u ožujku 2020. godine počelo je provođenje rehabilitacije na daljinu u Poliklinici za rehabilitaciju slušanja i govora SUVAG, Zagreb. U Dječjem vrtiću Poliklinike SUVAG rehabilitaciju su provodili rehabilitatori (voditelji skupine), fonetski muzičari, ritmičari i stručni tim, ukupno 29 stručnjaka. Rehabilitacija na daljinu provedena je za svu djecu vrtića (225 djece raspoređene u 20 skupina) od 16.3.2020. do 22.5.2020., dok je od 25.5.2020. obuhvaćala djecu koja iz objektivnih i/ili subjektivnih razloga nisu mogla dolaziti na kompleksnu rehabilitaciju nakon aktivacije rada u punom opsegu. U razdoblju kada je bio onemogućen boravak djece u vrtiću, roditelji su svakodnevno – putem informacijske i komunikacijske tehnologije – komunicirali s rehabilitatorima, dobivali stručne i razvojno primjerene materijale. U ovome radu prikazano je provođenje rehabilitacije na daljinu za djecu sa slušno-govornim oštećenjem i govorno-jezičnim poremećajima i rezultati njene evaluacije od roditelja. Rezultati evaluacije pokazuju da je 84,8 % roditelja zadovoljno provedbom rehabilitacije na daljinu, 92 % zadovoljno je dobivenim materijalima, a 92 % roditelja zadovoljno je komunikacijom s djelatnicima Dječjeg vrtića Poliklinike SUVAG tijekom rehabilitacije na daljinu. Na osnovi navedenih rezultata, zaključujemo da je provedba rehabilitacije na daljinu bila uspješna
Telepractice as a Reaction to the COVID-19 Crisis: Insights from Croatian SLP Settings
No full textTelepractice 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
Važnost upotrebe govornih vrednota u interpretaciji teksta s naročitim osvrtom na tekst namijenjen djeci
No full textRad opisuje važnost upotrebe govornih vrednota u interpretaciji teksta s naročitim osvrtom na tekst namijenjen djeci
Putting the CAT-HR out: key properties and specificities
No full textBackground: The Comprehensive Aphasia Test (CAT) is a comprehensive test useful in establishing the language profiles of people with aphasia (PwA). Until the recent publication of the CAT- HR, there were no tests or language batteries in the Croatian language for evaluating language among PwA. Aims: The aim of this paper is to present the results of PwA on tasks and modalities of the first Croatian language test developed for language assessment among PwA – the CAT-HR. To this end, their results are compared to that of neurologically healthy individuals (control group ; CG). The relationship between PwA’s objective and self- perceived difficulties as measured by the CAT-HR are also described. This paper additionally outlines the entire process of developing the CAT-HR, emphasising the similarities and differences from the original version, and presenting some of its psychometric properties. Methods & Procedures: The sample consisted of 114 PwA and 123 CG participants. PwA completed all three sections of the CAT-HR, while the CG completed only the Cognitive Screen and Language Battery. Their results were compared using independent t-tests with Bonferroni correction for multiple comparisons. Correlations were calculated for all CAT-HR modalities. Finally, results of PwA on objective measures were compared with their self-assessment scores. Outcomes & Results: The performed analyses indicate that the CG and PwA differ significantly on all tasks and modalities of the CAT-HR. Correlations among modalities within the Language Battery are significant, as well as those within the Disability Questionnaire. Language Battery modalities correlate significantly with all scales of the Disability Questionnaire, except with Emotional consequences. Conclusions: The test has been demonstrated to possess promising psychometric properties, i.e. the internal consistency of its tasks and modalities ranges from moderate to high and the measures on the modality mean can discriminate 85% of PwA from neurologically healthy individuals. Results and findings are discussed with respect to their clinical and scientific implications. As a final point, limitations related to the analyses (e.g. lack of data on test-retest reliability and sensitivity), and suggestions for further research are provided
Models of Service Delivery: A Comparative Analysis of Croatian and European Contexts
No full textLogopedsku terapiju čini niz aktivnosti o kojima je potrebno unaprijed promišljati, a terapijski bi pristupi i modeli trebali počivati na teorijskim činjenicama i znanstveno utemeljenim dokazima. U Hrvatskoj još uvijek manjka istraživanja o načinima rada logopeda, metodama podrške koje primjenjuju i čimbenicima koji određuju strukturu terapije. U skladu s time, svrha je ovoga rada bila prikupiti spoznaje o terapijskim modelima koji se primjenjuju u radu s djecom s razvojnim jezičnim poremećajem (RJP), a cilj je ispitati zastupljenost izravne i neizravne terapije u logopedskom radu te provesti korelacijsko ispitivanje radi utvrđivanja čimbenika koji utječu na odluku o primjeni određenoga modela. Rezultati su pokazali da u Hrvatskoj i dalje prevladava izravan model rada te da manji dio logopeda u svoj rad uključuje treću stranu, najčešće roditelje. U tom se smislu logopedi u Hrvatskoj ne razlikuju od onih u Europi. Nije dobivena povezanost između sustava rada i modela pružanja usluga, ali je dobivena granično značajna negativna povezanost između većeg radnog iskustva i odabira kombiniranih modela. Nije utvrđena ni povezanost djetetove dobi, vrste i jakosti poremećaja s načinom rada. Podatci o niskoj zastupljenosti neizravne terapije upućuju na potrebu dodatne edukacije logopeda o njezinim prednostima i nedostatcima te načinima njezine implementacije. Nepotvrđivanje povezanosti između niza ispitanih varijabli upućuje na potrebu za dodatnim promišljanjem o čimbenicima koji usmjeravaju logopedski rad
Utjecaj umjetne pužnice na slušanje i govor
No full textUredan sluh podrazumijeva da tonski podražaj može nesmetano proći uhom i cijelim slušnim putem do kore mozga i ondje biti prepoznat. Umjetna pužnica (UMP) slušno je pomagalo koje svojim ustrojstvom i načinom rada prevladava oštećenje slušnih stanica i tako omogućuje slušanje, a time i razvoj govora. Radi praćenja i procjene napretka slušanja i govora, nakon ugradnje UMP-e, tonskom i govornom audiometrijom redovito se kontrolira stanje slušne razine i razvoja slušanja. Jedan od načina ispitivanja slušanja jesu i elektrofiziološka mjerenja koja omogućuju analizu moždane aktivnosti izazvane slušnim podražajem. Metoda kortikalnih slušnih evociranih potencijala (CAEP, Cortical Auditory Evoked Potential) daje podatke o funkcionalnosti slušne kore i struktura zaduženih za kognitivnu obradu slušnog podražaja. U ovom radu, metodom CAEP-a, ispitivao se način obrade slušnog podražaja na razini slušne kore u desetero djece s ugrađenom UMP-om, u dobi od 8 do 10 godina, te desetero djece iste dobi bez slušno govornih teškoća. Mjerenje je izvršeno na 32-kanalnom uređaju za moždanu kartografiju tipa Neuroscan. Upotrijebljena je kapa s kanalima prema 10-20 internacionalnom sustavu. Provedena su dva eksperimenta. U prvom je podražaj bio tonski prasak (TB) frekvencije 1000 Hz i 2000 Hz. U drugom su eksperimentu, kao podražaj korištena dva dvostruka sloga sastavljena od jednog suglasnika i jednog samoglasnika hrvatskog jezika, odabrana prema karakteristikama tzv. optimalnog filtra (frekvencijskog područja u kojem se određeni glas najbolje percipira kao glas hrvatskog jezika). Podražaji su bili prezentirani u oddball paradigmi, te se od ispitanika tražila svjesna reakcija. Mjerene su latencije i amplitude CAEP valova, te vrijeme reakcije i broj točnih odgovora. Rezultati za latencije i amplitude analiziranih valova, te vremena reakcije i broja točnih odgovora, u oba eksperimenta, pokazali su da nema značajnijih razlika u slušnoj obradi zvučnog i govornog signala, na razini slušne kore, između ove dvije skupine
Overview of holistic guidelines in the verbotonly rehabilitation-educational approach to education of students with language difficulties and/or hearing impairment
No full textVerbotonalni pristup rehabilitaciji, odgoju i obrazovanju djece s teškoćama u razvoju svoje temelje polaže na poštivanje prava i potreba djeteta s teškoćama u razvoju, te takvim pristupom senzibilizira i demokratizira društvo u cjelini utječući osim svojim stručnim i predanim radom i kontinuiranom edukacijom verbotonlanih stručnjaka te znanstvenom izdavačkom djelatnošću. Verbotonalni zdravstveni, prosvjetni i rehabilitacijski djelatnici svojim znanjem i iskustvom na znanstveno utemeljenim činjenicama, interdisciplinarnim pristupom provode verbotonalnu rehabilitaciju i verbotonalnu edukaciju djecu s govorno-jezičnim poremećajima i/ili oštećenjem sluha. Izlaganje će se uz videoprikaze iz prakse odnositi na sve segmente verbotonalne metode. Istaknut će se značaj rane verbotonane rehabilitacije te izdvojiti specifični postupci koji se u njoj primjenjuju. Posebno će biti riječi o načinu komunikacije s obitelji djece u tretmanu i savjetovanju roditelja jer su oni najbolji partneri svim verbotonalnim stručnjacima te o zajedničkom radu ovisi uspješnost rehabilitacije. Partnerski odnos koji njegujemo, temelji se na međusobnom povjerenju, otvorenosti i toleranciji, a prije svega objektivnosti i sposobnosti za razmjenu informacija. Naglasak izlaganja je na posebnim rehabilitacijskim postupcima kao što su stimulacije pokretom i glazbene stimulacije koji su implementirani u svim segmentima verbotonalne rehabilitacije i obrazovanja. One se provode i kao samostalni postupci, pritom poštivajući prirodni slijed stupnjeva govornog razvoja razvijajući slušanje u skladu s cjelokupnom multisenzorikom. Pomoću makro pokreta razvijajaju se i mikro pokreti koji su u osnovi govora i govorne komunikacije te jačaju kognitivne sposobnosti. Ti specifični verbotonalni postupci se u Poliklinici SUVAG u funkciji razvoja slušanja, govora i jezika i harmonije tijela provode paralelno i sustavno, povezuju se, prožimaju i upotpunjuju
Application of integrated approach through verbotonal model for persons of the third age
No full textThe aim of the poster presentation is to present a Verbotonal Model of empowerment and improvement of the physical, psychological and social abilities of persons of the third age. SUVAG Polyclinic for the rehabilitation of listening and speech, Zagreb, has developed an integrative rehabilitation model in a collaborative setting, based on many years of clinical work with older adults (presbyopia, aphasia, Parkinson's disease etc.) to enhance social inclusion, improve physical and mental health and preserve functional abilities of elderly. The model follows the objectives of the Operational Program Effective Human Resources 2014-2020, Strategy Against Poverty and Social Exclusion in the Republic of Croatia (2014-2020), Social Welfare Strategy for the Elderly in the Republic of Croatia 2017-2020, Ministry of Demography, Family, Youth and Social Policy Strategic Plan for 2019-2021. The Verbotonal Model for elderly consists of 5 units within which specialized workshops are organized: The Speech Therapy Workshop is comprised of various activities aimed at stimulating spontaneous expression, enhancing self- confidence, developing memory, developing abstract thinking, improving short-term memory, and improving logical thinking. The Functional Listening Exercise Workshop is aimed at older people who have some form of hearing impairment. The aim of these workshops is to spot the auditory disorder, to direct further audiological processing and to empower hearing impaired people through a series of auditory exercises. The Assertiveness Workshop aims to raise awareness and strengthen own social skills, to practice assertive behavior in the social environment, to raise awareness of own learning abilities, and to empower oneself to learn about own progress. The Workshop of Rhetoric is intended as a set of activities during which participants will develop their rhetorical skills, improve their social-emotional, as well as strengthen their confidence. The Verbotonal Creative Workshop uses special Verbotonal procedures such as rhythmic stimulation, musical stimulation and dramatization. The Fall Prevention Workshop – Harmony Through Movement consists of different approaches to exercise to achieve overall balance, improve mobility, response speed, improve stability and reduce the risk of falls, improve agility as well as reduce muscle soreness and stiffness. The Neurological Workshop includes a presentation of risk factors for neurological aging and examples of activities aimed at empowering and improving the functional health of persons of the third age – "how to add life to years". Applying the Verbotonal Model for empowering and improving the physical, psychological and social abilities of persons of the third age with its interdisciplinary approach and multidisciplinary collaborative practice raises the quality of life of persons of the third age starting from the basic premise that puts human at the center of all activities using a comprehensive, polysensory approach for everyday life
Auditory Processing in People with Chronic Aphasia
No full textThe 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