SUVAG Polyclinic Repository
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Modaliteti postupka integracije u svjetlu novih dijagnostičkih entiteta i potreba društva
No full textU radu se predstavljaju modaliteti postupka integracije u svjetlu novih dijagnostičkih entiteta i potreba društva na primjeru Poliklinike SUVAG Zagreb
Postupci u direktnoj terapiji kod MTD-a u Poliklinici SUVAG Zagreb
No full textMišićna tenzijska disfonija (MTD) je poremećaj glasa kod kojeg je ustanovljena napetost paralaringealnih mišića. Može biti primarna i sekundarna. Kod primarne MTD-e nema organske podloge, a osoba koristi govor i glas na neodgovarajuć način radi čega dolazi do neusklađene upotrebe mišića koji sudjeluju u fonaciji. Mišići kojima fonacija nije primarna uloga (paralaringealni) preuzimaju ulogu fonatornih laringealnih mišića te se nepotrebno aktiviraju. Nastaje napetost aktivnih mišića, te dodatna smanjena aktivnost mišića koji bi trebali sudjelovati u fonaciji. Ovakav način foniranja nije optimalan. Kod sekundarne MTD-e postoji organska podloga zbog koje je fonacija narušena, a aktiviraju se paralaringealni mišići kao kompenzatorna tehnika.
Uspostavljanje optimalne fonacije nakon što je ona jednom narušena može biti zahtjevan zadatak. Potrebna je detaljna fonijatrijska i logopedska dijagnostika koju slijedi sustavna, vođena terapija koja se prilagođava sposobnostima pojedinca. Dok se indirektnom terapijom utječe na pravilnu vokalnu higijenu kod pacijenta, u direktnoj terapiji mijenjamo mehanizme respiracije, fonacije i rezonancije kroz niz metoda prikazanih u ovom predavanju. Terapijsku bazu čine pravilna postura tijela te vježbe aktivacije ošita uz pravilnu primjenu abdominalnog disanja koje su praćene vježbama opuštanja prenapetih mišića lica, vrata i ramenog obruča. Vježbama se pridružuju vježbe poluzatvorenog vokalnog trakta (bez fonacije i uz fonaciju) te zahvati za opuštanje mišića manualnom laringealnom manipulacijom. Primjenjuju se i tehnike za ublažavanje naglog početka fonacije te vježbe za aktivaciju pravilne rezonancije. Primjenom ovih tehnika te mijenjanjem mjesta impostacije glasa uz pravilnu primjenu govornog disanja postiže se glas uredne kvalitete. Gradacijom vokalnih zadataka prema verbotonalnim principima proširuje se pravilno primjenjena fonacija te se postupno postiže optimalan način fonacije kod pacijenata, a razvojem auditivne povratne sprege omogućuje se automatizacija normofoničnog glasa
Hearing development dynamics of the second implantet ear
No full textMost implanted patients in Croatia are implanted unilaterally. Polyclinic SUVAG provides services to most of them, more than 600 patients with CI, of which 40 are bilateral. SUVAG is an institution dealing with hearing and speech impairments for more than 60 years, and provides preoperative diagnostic treatment, programming, postoperative follow-ups, preoperative and postoperative verbotonal rehabilitation of prelingually and postlingually deaf patients for 26 years, since the beginning of the CI program. The goal of bilateral CI implantation is the development of binaural hearing. Bilateral implantation can be simultaneous or sequential. Bilateral hearing benefits are well known ; better hearing in noise, and better localization of sounds. Motivation for the implantation on the other side are expected benefits, but in children with slow hearing progress, very often, there is an additional parental expectation that a second CI will make a significant difference in the overall progress. The aim of this paper is to analyze the development of bilateral listening skills in sequential implantation, based on audiometric findings, focusing on results in speech audiometry. The questions we were focusing on: 1.How long does it take for the second implanted ear to reach maximum results in speech audiometry of the first implanted ear? 2.Is there a difference in time needed for the second implanted ear to reach maximum results in speech audiometry of the first implanted ear? 3.Are the expectations of overall significant progress and compensation fulfilled? Method: Evaluate speech recognition in quiet for a group of 10 children, all of whom underwent sequential bilateral cochlear implantation at various ages (range, 1y, 8m to 7y 8m at the time of the second implant). The time of auditory experience with a unilaterally implanted CI enables faster development in the hearing pathways receiving stimulation form CI in the second operated ear in all patients, but there were also some differences. In spite of the diversity, it can be concluded that auditory behavioral performance with the first implanted ear was a better predictor of performance with the second implanted ear than some other relevant factors. As expected, the development of listening skills with bilateral CI depends on a number of factors. But, as each factor that deviates from the optimal affects the final development individually, the evaluation of results should always be approached individuall
Načini potpore postupku inkluzije djece oštećena sluha i/ili govora
No full textCilj je ovoga rada prikazati kako Poliklinika za rehabilitaciju slušanja i govora SUVAG Zagreb nastoji pomoći u procesu inkluzije djeci s oštećenjem sluha i/ili govora u redovne škole. Osposobljavanje učitelja razredne nastave jedan je od glavnih čimbenika uspješne obrazovne integracije u redovni obrazovni sustav učenika s teškoćama. Agencija za odgoj i obrazovanje Republike Hrvatske kontinuirano uvodi programe za unaprjeđenje kvalitete odgoja i obrazovanja djece s teškoćama u razvoju, usklađujući postojeći sustav s europskim standardima. Ovaj cilj ostvaruje se u suradnji sa specijaliziranim institucijama kao što je Poliklinika SUVAG (zdravstvena ustanova u kojoj se pruža specijalistička i savjetodavna zdravstvena zaštita osoba s poteškoćama u govornoj komunikaciji). Znanja odgajatelja, učitelja i nastavnika u redovnom odgojno-obrazovnom sustavu, stečena tijekom formalnoga obrazovanja, nisu dostatna za rad s učenicima s teškoćama u razvoju. Agencija za odgoj i obrazovanje RH i Poliklinika SUVAG pokrenule su rad mobilnoga tima u cilju edukacije odgajatelja, učitelja i nastavnika redovnih institucija Republike Hrvatske. Mobilnim se timom osigurava dostupnost stručnjaka svim osnovnim i srednjim školama RH koje iskažu potrebu za dodatnom edukacijom u svrhu unaprjeđenja inkluzivnoga obrazovanja. Podrška mobilnoga tima odnosi se na upoznavanje s osnovnim spoznajama o oštećenju sluha i/ili govora i funkcioniranju učenika u obrazovnom procesu; izradu individualiziranih programa; prilagodbu programa za učenike s navedenim teškoćama te oglednu nastavu u OŠ Poliklinike SUVAG za učitelje. Članovi mobilnoga tima su stručnjaci Poliklinike SUVAG koji rade na pripremi i provođenju inkluzivnoga obrazovanja učenika oštećena sluha i/ili govora, uglavnom pacijenata Poliklinike SUVAG. Budući da u sustavu treba promijeniti i osigurati još niz čimbenika kako bi inkluzija bila u potpunosti uspješno provedena, ovakav način potpore zasigurno je velika pomoć kako učiteljima, nastavnicima i stručnoj službi tako i učenicima koji sudjeluju u procesu inkluzije
Monaural test results in auditory processing and repeating verbal stimuli in children with developmental language disorders and children with typical development
No full textU praktičnom radu s nekom djecom koja imaju teškoće u čitanju uz dijagnosticiran razvojni jezični poremećaj, uočene su i teškoće aktivnog slušanja. Još se istražuje način na koji su ta dva procesa povezana. Poznato je da određene poteškoće u slušnom procesiranju izravno utječu na razinu uspješnosti u vještinama čitanja. Cilj ovog istraživanja bio je ispitati postignuća na testovima slušnog procesiranja upotrebom testova filtriranih riječi i test govora u buci i ponavljanje riječi i besmislenih riječi kod djece s razvojnim jezičnim poremećajem i djece tipičnog jezičnog razvoja. Navedeni testovi slušnog procesiranja su dio baterije Testa PSP-1, ponavljanja riječi PredČip testa, a lista besmislenih riječi je preuzeta uz suglasnost autora. Sudionici ispitivanja bili su djeca s dijagnosticiranim razvojnim jezičnim poremećajem kod kojih su bile prisutne i teškoće čitanja. Djeca tipičnog jezičnog razvoja bila su polaznici jedne osnovne škole u Gradu Zagrebu. Ovo pilot-istraživanje provedeno je na ukupno 30-ero djece, od kojih su njih 15-ero djeca s razvojnim jezičnim poremećajem i teškoćama čitanja. Ispitanici su bili izjednačeni po kronološkoj dobi, u rasponu od 9 do 10 godina. Rezultati istraživanja pokazuju da djeca s razvojnim jezičnim poremećajem i teškoćama čitanja postižu značajno lošije rezultate na svim ispitanim varijablama. Rezultati potvrđuju potrebu uvođenja specifičnih terapijskih postupaka usmjerenih razvijanju vještina slušanja u terapiju djece s jezičnim poremećajima i teškoćama čitanja.While working in a clinical setting with children with reading difficulties along with a diagnosed developmental language disorder we sometimes notice difficulties in auditory processing. The way in which these two processes are connected is still being researched. It is however known that certain auditory processing difficulties have a direct effect on the level of reading skills. The aim of this research was to measure abilities using filtered word tests and speech in noise test and repeating words and meaningless words in children with developmental language disorders and children with typical language development. The above mentioned auditory processing tests are a part of the PSP-1 test battery and the list of meaningless words was obtained with the author’s consent. Participants in this research were children with diagnosed developmental language disorder who also exhibit reading difficulties. Children with typical language development were students of a primary school in the City of Zagreb. This pilot research was carried out on 30 participants, 15 of which were children with diagnosed developmental language disorder and reading difficulties. Participants were all equal in terms of chronological age, i.e. 9-10 years of age. The results of the research showed that children with developmental language disorder and reading difficulties achieve significantly lower results in all tested variables. These results confirm the need to implement specific therapeutic methods in therapy of children with language disorders and reading difficulties aimed at developing auditory skills
Testing the functionality of the auditory pathway in children with cochlear implant using the CAEP method
No full textPrelingually hearing impaired children, users of the cochlear implant (CI) have the opportunity for development of hearing and speech. There are three factors that influence successful use of CIs: age at implantation, duration of speech and hearing rehabilitation and auditory level after implantation. If all these criteria are satisfied most children reach the expected outcome. In this study, using cognitive auditory evoked potential technique (CAEP), the way of processing auditory stimuli was investigated. The study included 10 children who are CI users, aged 8-10 years who are successful CI users. In the second group were 10 healthy age-matched controls. The measurements were performed with a 32-channel Neuroscan electroencephalographic system. The cap with channels according to the international 10-20 system was used. Recording was performed twice. Different type of stimuli were used: (1) tone burst stimulation (TB, 1 kHz, 2 kHz) and (2) speech stimulation (DS, double syllable stimuli, both consisting of two consonants and two vocal characteristic of Croatian language) were used. The stimuli were presented in an oddball paradigm, requiring a conscious reaction of the subjects to target stimuli. Latencies and amplitudes of CAEP waves were analyzed, as well as the reaction time and number of responses. The results showed differences in the CAEP peak amplitudes between these two groups. The latencies of the waves did not differ for the DS stimulus, while for TB stimulus there was a difference for the N2 wave. There is also a difference in reaction times for both stimuli, while there was no difference in response accuracy
Procjena debljine djece i rizika od nastanka kardiovaskularnih bolesti s pomoću omjera opsega struka i tjelesne visine
No full textChallenge of teletherapy - Speech and Language therapy under the shadow Of COVID-19
No full textProglašenje COVID-19 pandemije u ožujku 2020. godine rezultiralo je privremenom obustavom pružanja logopedske terapije u standardnom obliku i znatnim povećanjem korištenja usluga logopedske teleterapije u sustavu zdravstva. Budući da je mišljenje i zadovoljstvo korisnika i njihovih roditelja/skrbnika provedenom teleterapijom značajan čimbenik koji može utjecati na učinkovitost terapije i budućnost teleterapije u logopediji, cilj je bio ispitati mišljenje korisnika i/ ili njihovih roditelja/ skrbnika o provedenoj teleterapiji, otkriti što korisnici vide kao prednosti, a što kao nedostatke ovakvog načina rada i doznati njihovo mišljenje o provođenju iste izvan okvira COVID-19 pandemije. Za potrebe ovog istraživanja oblikovan je anonimni upitnik s 19 pitanja pod nazivom „Logopedska terapija na daljinu - stavovi korisnika“, sastavljen pomoću
platforme Survey Monkey. Upitnik je ispunilo 252 sudionika, koji su tijekom COVID-19 pandemije sudjelovali u nekom od oblika teleterapije. U istraživanju su sudjelovali korisnici stariji od 16 godina koji su mogli samostalno ispuniti anketu i roditelji/skrbnici djece mlađe od 16 godina, te roditelji/skrbnici odraslih osoba koji nisu mogli samostalno ispuniti anketu, a bili su uključeni u neki od oblika logopedske terapije na daljinu u sustavu zdravstva. Od ukupnog broja sudionika, njih 79,2 %, izjasnilo se zadovoljnim pruženom uslugom. Kao najznačajniju prednost teleterapije vide dostupnost logopedske terapije tijekom izolacije i/ili bolesti, te kontinuitet u radu. Od 252 sudionika, njih 137 (54,46 %) smatra da bi terapija na daljinu
trebala postati jedan od uobičajenih oblika logopedskog rada i nakon COVID-19 pandemije. Rezultati koji su dobiveni analizom odgovora sudionika o zadovoljstvu, kao i navedenim prednostima logopedske teleterapije, potiču na razmišljanje o mogućnosti uređenja terapije na daljinu u sustavu zdravstva Republike Hrvatske kao dijela redovite ponude u načinima provođenja logopedske usluge.The global outbreak of the COVID-19 pandemic in 2020 necessitated the temporary suspension of in-person speech therapy services, leading to a significant surge in the utilization of telepractice within the healthcare system. Understanding the clients’ opinions, satisfaction, and preferences regarding teletherapy is crucial for evaluating its effectiveness and future integration. This study aimed to explore the advantages and disadvantages of teletherapy as perceived by clients, as well as their perspectives on its implementation beyond the context of the COVID-19 pandemic. A web-based survey titled “Speech and Language Teletherapy - Clients’ Experience” was developed and completed by 252 participants. The survey targeted clients above the age of sixteen capable of respondingindependently and parents/guardians of those who could not, as well as parents/guardians of children under sixteen receiving teletherapy within the healthcare system. The survey consisted of 19 questions designed to gather data on client experiences with teletherapy. Among the respondents, 79.2% expressed satisfaction with the teletherapy services provided. The most significant advantages reported were the availability of speech therapy during isolation and/or illness, as well as its the continuity. Out of the total respondents, 54.46% (137 individuals) believed that teletherapy should continue as a regular form of speech and language therapy even
after the COVID-19 pandemic. The findings from the analysis of participant responses regarding satisfaction and perceived advantages of speech and language teletherapy suggest the potential integration of teletherapy as a routine offering within the speech and language therapy services of the Republic of Croatia’s healthcare system. The perspectives and preferences of clients, as outlined in this study, can guide future policy decisions and facilitate the effective and sustainable integration of teletherapy services beyond the pandemic era
Croatian Association of Graduate Students AMCA-ERF
No full textThe Croatian Association of Graduated Students of the UNIZG, Faculty of Education and Rehabilitation Sciences (AMCA-ERF) was founded in 2010 in order to preserve and nurture the tradition and reputation by connecting former and current students of all three study programs represented at the home Faculty. It is a place where former students, teachers, and friends of the Faculty come together. The goals and activities of the AMCA-ERF association include fostering ethics among university students, building and strengthening connections and cooperation between ERF graduates, encouraging and establishing connections between ERF and similar or related institutions in Croatia and the world, as well as publishing activities, organising members’ meetings (lectures, round tables), and celebrating important anniversaries and successes of the alumni. Since 2013, AMCA-ERF has been a member of the AMCA University Association. As part of the LOSPER project, a platform was created for the base of the alumni promoting the improvement of the study programmes of Speech Therapy, Educational Rehabilitation, and Social Pedagogy, in addition to the three Occupational and Qualification Standards. This poster will present an overview of the activities of the AMCA-ERF over a period of 12 years
Impact of Sensorineural Hearing Loss on Subjective Tinnitus Quality in Patients with Bilateral Tinnitus
No full textIntroduction: Tinnitus is a frequent condition that indicates the sensation of sound in the absence of a corresponding external stimulus and can significantly impair the quality of life. The main risk factor for developing tinnitus is hearing loss. The diagnosis of tinnitus is based on history, assessment of tinnitus severity, clinical examination, and audiological tests. The main purpose of this research was to examine the relationship between the presence and level of hearing loss and the characteristics of tinnitus in patients with bilateral subjective tinnitus. Methods: Total number of 50 participants, 20 men, and 30 women were included in the research. Demographic data, data on hearing impairment obtained by tone audiometry, and data on difficulties caused by tinnitus obtained in two questionnaires - Tinnitus Handicap Inventory (THI) and Tinnitus Functional Index (TFI) were used. Results: Age above 30 years is significantly associated with tinnitus with hearing loss. Hearing impairment is also significantly more often associated with an auditory TFI index >6.7, a total THI index >20, and an emotional THI index >3. Hearing loss was noted in 76% of patients. Conclusion: Tinnitus represents a significant burden for patients, therefore it is important to assess the impact of tinnitus on daily activities and quality of life