gms | German Medical Science

100 Jahre Phoniatrie in Deutschland
22. Wissenschaftliche Jahrestagung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie
24. Kongress der Union Europäischer Phoniater

Deutsche Gesellschaft für Phoniatrie und Pädaudiologie e. V.

16. bis 18.09.2005, Berlin

Phoniatrics and epidemiology: what do we know?

Phoniatrie und Epidemiologie: aktueller Stand

Vortrag

  • corresponding author presenting/speaker A. Schindler - Department of Otorhinolaryngology and Ophtalmology, University of Milan, Italy
  • E. Favero - Audiology - Phoniatric Clinic, University of Turin, Italy
  • R. Musto - Audiology - Phoniatric Clinic, University of Turin, Italy
  • D. Ginocchio - Department of Otorhinolaryngology and Ophtalmology, University of Milan, Italy
  • F. Ottaviani - Department of Otorhinolaryngology and Ophtalmology, University of Milan, Italy

100 Jahre Phoniatrie in Deutschland. 22. Jahrestagung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie, 24. Kongress der Union der Europäischen Phoniater. Berlin, 16.-18.09.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05dgppV09

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgpp2005/05dgpp100.shtml

Veröffentlicht: 15. September 2005

© 2005 Schindler et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Abstract

The field of communication disorders is primarily involved in the knowledge of the normal functioning of some human abilities and specifically of the following: voice, speech, language, non verbal and verbal communication, fluency of the above mentioned functions, swallowing, academic learning, and interpersonal relationship. The nosological catalogue could be divided into the following chapters: voice disorders, organic speech disorders, fluency disorders, aphasias, dysarthrias, retardations and dementiae, swallowing disorders, verbal disorders in the deaf and related disabilities and problems, learning disorders, socio-cultural and emotional troubles. Phoniatrics is the medical specialty involved in the management of communication and swallowing disorders; physical, developmental, functional and behavioural aspects of verbal communication and swallowing can be taken care of in phoniatrics with competence.

Prevalence and incidence data are essential for health planning, and phoniatrics is no exception. Large epidemiologic studies on communication disorders in the general population barely don't exist; prevalence and incidence scores therefore are available for some diseases only, such as cleft palate or child deafness. Prevalence of the following disorders are reviewed: primary child language impairment, reading disability, mental retardation, cerebral palsy, autism spectrum, tongue thrust, stuttering, cleft lip/palate, child deafness, dysphagia, traumatic brain injury, dysarthria, aphasia, dementia, chronic dysphonia.

Estimate of prevalence of voice disorders, organic speech disorders, fluency disorders, primary language impairment, aphasias, dysarthrias, mental retardation, dementia, swallowing disorders, verbal disorders in the deaf, learning disorders as well as socio-cultural and emotional troubles will be shown.


Text

Introduction

Phoniatrics is the medical specialty involved in the management of communication and swallowing disorders; physical, developmental, functional and behavioural aspects of verbal communication and swallowing can be taken care of in phoniatrics with competence [1]. The field of communication disorders is primarily involved in the knowledge of the normal functioning of some human abilities and specifically of the following: voice, speech, language, hearing, non verbal and verbal communication, fluency of the above mentioned functions, swallowing, academic learning, and interpersonal relationship. The nosological catalogue could be divided into the following chapters: voice disorders, organic speech disorders, fluency disorders, aphasias, dysarthrias, retardations and dementiae, swallowing disorders, verbal disorders in the deaf and related disabilities and problems, learning disorders, socio-cultural and emotional troubles [2], [3].

Prevalence and incidence data are essential for health planning, and phoniatrics is no exception [4]. Large epidemiologic studies on communication disorders in the general population barely don't exist [5], [6]; prevalence and incidence scores therefore are available for some diseases only, such as cleft palate or child deafness.

Aim of the study is to review the prevalence of the following disorders: primary child language impairment, reading disability, mental retardation, cerebral palsy, autism spectrum, tongue thrust, stuttering, cleft lip/palate, child deafness, dysphagia, aphasia, dementia, chronic dysphonia.

Materials and method

The human abilities the phoniatrician is asked to manage in his/her everyday clinical practice were searched in the Body functions section of the International Classification of Functioning Disability and Health (ICF) [7]. The following have been considered in the study: hearing, voice, speech, language, swallowing. The main areas of a phoniatrician clinical practice were then linked to one of these five human functions. The areas of clinical practice considered were: child deafness, voice disorders, organic speech disorders, motor speech disorders, functional speech disorders, fluency disorders, primary language impairment, aphasia, mental retardation, dementia, pervasive developmental disorders, learning disability, deviate swallowing, dysphagia.

A non systematic review of the indexed literature was performed through the Pubmed website. The keywords used were: incidence, prevalence, epidemiology, specific language impairment, developmental dyslexia, reading disability, mental retardation, cerebral palsy, autism, Asperger, pervasive developmental disorder, tongue thrust, deviate swallowing, stuttering, cleft lip/palate, dysphagia, swallowing impairment, child deafness, motor speech disorder, dysarthria, aphasia, dementia, mild cognitive impairment, chronic dysphonia. The articles which appeared to have the best epidemiological design were used to estimate the prevalence.

Results

The prevalence data found in the literature are reported in Table 1 [Tab. 1]. When feasible the prevalence data for each area of clinical practice was reported; when no data were found, it was reported the prevalence of the most important disease/disorder for that area. For instance, no data were found on the prevalence of organic speech disorders: prevalence of cleft lip/palate was therefore condered.

While for voice disorders the estimated prevalence is < 100/100.000, there are three areas related to the speech function whose prevalence is > 100/100.000; the area of fluency disorders has a prevalence of about 1.000/100.000. As for the areas linked to the language function, three of them have a prevalence > 1.000/100.000, while the remaining > 100/100.000. In the three areas of clinical practice linked to the swallowing function, the prevalence reported is well >1.000/100.000.

Discussion

Estimated prevalence of patients in the main areas of phoniatrics clinical practice have been reported; data were obtained from a non systematic review of the literature, and should be considered with care. However, it appears that the patients with a language impairment, either primary or secondary to an intellectual or social problem, are the largest group; on the contrary subjects with a voice disorders or with a severe hearing impairment leading to a communication limitation represent a minor group from an epidemiological point of view.


References

1.
Wendler J, Wellens W. European voice and speech disorders symposium. Communication professional aspects of Phoniatrics. Definition and training in phoniatrics. Arch Otorhinolaryngol 1989; 246: 390-394.
2.
Schindler O. Morbidity, epidemiology and system analysis in phoniatrics: introduction, literature, updating. Folia Phoniatr 1990; 42: 320-326.
3.
Schindler A, Manassero A, Dao M, Giraudo E, Grosso E, Tiddia C, Schindler O. The ß-2 draft of the international classification of impairment, disabilities and handicap. Eur Med Phys 2002; 38: 123-129.
4.
Enderby P, Davies P. Communication disorders: planning a service to meet the needs. Br J Disord Comm 1989; 24: 301-331.
5.
Ruben RJ. Redefining the survival of the fittest: communication disorders in the 21st century. Laryngoscope 2000; 110: 241-245.
6.
Enderby P, Philipp R. Speech and languae handicap: towards knowing the size of the problem. Br J Disord Comm 1986; 21: 151-165.
7.
International Classification of Functioning Disability and Health (ICF). World Health Organization. Basel, 2001.
8.
Fortnum H, Davis A. Epidemiology of permanent childhood hearing impairment in Trent Region, 1985-1993. Br J Audiol 1997; 31: 409-446.
9.
Bellis TH, Wohlgemuth B. The incidence of cleft lip and palate deformities in the south-east of Scotland. Br J Orthodon 1999; 26: 121-125.
10.
Fombonne E. The epidemiology of autism: a review. Psychol Med 1999; 29: 769-786.
11.
Katusic SK, Colligan RC, Barbaresi WJ, Schaid DJ, Jacobesn SJ. Incidence of reading disability in a population-based birth cohort, 1976-1982, Rochester, Minn. Mayo Clin Proc 2001; 1081-1092.
12.
Roeleveld N, Zielhuis GA, Gabreels F. The prevalence of mental retardation: a critical review of recent literature. Dev Med Child Neurol 1997; 39: 123-132.
13.
Craig A, Hancock K, Tran Y, Craig M, Peters K. Epidemiology of stuttering in the community across the entire life span. J Speech Lang Hear Res 2002; 45: 1097-1105.
14.
Enderby P, Emerson J. Speech and language theraoy: does it work? BMJ 1996; 312: 1655-1658.
15.
Law J, Boyle J, Harris F, Harkness A, Nye C. Prevalence and natural history of primary speech and language delay: findings from a recent systematic review of the literature. Int J Lang Comm Disord 2000; 35: 165-188.
16.
Bertolini MM, Paschoal JR. Prevalence of adapted swallowing in a population of school children. Int J Orofac Myol 2001; 28: 33-42.
17.
Lindgren S, Janzon L. Prevalence of swallowing comnplaints and clinical findings among 50-79-year-old men and women in an urban population. Dysphagia 1991; 6: 187-192.
18.
Johnson A. Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol 2002; 44: 633-640.
19.
Rudolph CD, Link DT. Feeding disorders in infants and children. Pediatr Clin North Am 2002; 49: 97-112.
20.
Kirkpatrick E, Ward J. Prevalence of articulation errors in NSW school pupils. Aust J Hum Comm Disord 1984; 12: 55-62.