PROPOSAL FOR A SPEECH THERAPY PROTOCOL FOR THE REHABILITATION OF HYPERNASALITY RESULTING FROM VELOPHARYNGEAL DYSFUNCTION

• Grant number: 24/21183-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2025
• End date: December 31, 2025
• Field of knowledge: Health Sciences - Speech Therapy
• Principal Investigator: Flávia Ferlin
• Grantee: Henrique Santos Duque de Almeida
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Introduction: To conceptualize velopharyngeal dysfunction (VPD), how it is diagnosed, forms of treatment and how it affects patients' oral communication. Aim: To develop a speech therapy protocol with a speech and voice approach to improve speech resonance in individuals with VFD. Methods: 10 individuals with moderate velopharyngeal dysfunction aged between 10 and 60 years will take part in the study. All participants will be assessed by the perceptual-auditory judgment of voice (JPA), nasality assessment by the Velopharyngeal Function Test, the self-assessment protocol of the impact of vocal alteration (QLV, IDV-10) and nasopharyngoscopy examination. The participants' voices will be recorded at two points in time, pre- and post-phonotherapy. The speech tasks will be the sustained vowel /a/ and twelve sentences with plosive and fricative phonemes, exclusively oral, from the Velopharyngeal Function Test. Speech hypernasality will be classified using a 4-point scale, where 1=absent, 2=mild, 3=moderate and 4=severe. Speech therapy will involve exercises that stimulate movement and closure of the soft palate: sniffing and blowing exercises, production of words and phrases with fricative phonemes, emission of the vowels /a/ and "â", automatic speech, phonation through a high-resistance straw, production of words and phrases with plosive phonemes and basal sound. Eight individual speech therapy sessions will be held, lasting 45 minutes each. After the 8 sessions, a new nasality assessment will be carried out using the Velopharyngeal Function Test. The participants' voices will be recorded post-phonotherapy for later JPA by three speech therapists experienced in this form of assessment. The vocal sample will be presented to the evaluators in a randomized manner, plus 10% repetition for intra-evaluator reliability analysis. Expected results: We hope to obtain a reduction in nasal deviation, which will be assessed using the Velopharyngeal Function Test and the JPA, and a reduction in the vocal handicap index.