Search

Background High numbers of women experience a traumatic birth, which can lead to childbirth-related post-traumatic stress disorder (CB-PTSD) onset, and negative and pervasive impacts for women, infants, and families. Policies, suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic birth experience, but currently there is little insight into whether and what is provided in different contexts. The aim of this knowledge mapping exercise was to map policy, service and training provision for women following a traumatic birth experience in different European countries. Methods A survey was distributed as part of the COST Action “Perinatal mental health and birth-related trauma: Maximizing best practice and optimal outcomes”. Questions were designed to capture country level data; care provision (i.e., national policies or guidelines for the screening, treatment and/or prevention of a traumatic birth, service provision), and nationally mandated pre-registration and post-registration training for maternity professionals. Results Eighteen countries participated. Only one country (the Netherlands) had national policies regarding the screening, treatment, and prevention of a traumatic birth experience/CB-PTSD. Service provision was provided formally in six countries (33%), and informally in the majority (78%). In almost all countries (89%), women could be referred to specialist perinatal or mental health services. Services tended to be provided by midwives, although some multidisciplinary practice was apparent. Seven (39%) of the countries offered ‘a few hours’ professional/pre-registration training, but none offered nationally mandated post-registration training. Conclusions A traumatic birth experience is a key public health concern. Evidence highlights important gaps regarding formalized care provision and training for care providers.

Moroov refleks je obično najranije ispitivani koordinacijski obrazac prilikom procene neurološkog statusa novorođenčeta. Brojne studije još uvek diskutuju poreklo aferentnih puteva za izazivanje Moroovog reflek- sa, bilo da je ono primarno vestibularno, proprioceptivno ili ekstero- ceptivno. Ipak, većina autora zastupa stanovište da je Moroov refleks vestibularni refleks i da nastaje stimulacijom otolita labirinta. Od- sustvo Moroovog refleksa tokom perioda novorođenčeta i ranog odojčeta je bitan dijagnostički znak koji može ukazivati na širok spektar oboljenja centralnog nervnog sistema. Cilj ovog rada je bio da se kroz procenu prisutnosti Moroovog refleksa utvrdi u kojoj meri vestibularno čulo ostvaruje svoju funkciju kod zdrave terminske novorođenčadi. Kliničko ispitivanje Moroovog refleksa (MOR) primenjeno je na uzor- ku od N=100 zdrave, terminske novorođenčadi iz urednih trudnoća, 3. dan po rođenju. Za način ispitivanja MOR-a odabran je najčešće primenjivan, t.zv. „head-drop“ metod koji podrazumeva aktivaciju vestibularisa, oto- lita, a ne taktilnih i proprioceptivnih receptora. Testiranje MOR u ispitivanom uzorku izvodilo je isključivo obučeno medicinsko osoblje, a ispitivač je vršio instruiranje, opservaciju i beleženje podataka. Kod sve novorođenčadi uzeti su podaci o polu, telesnoj težini (TT), telesnoj dužini (TD) i obimu glave (OG). Dobijeni podaci su dokumentovani uz po- moć digitalne kamere, zatim bodovani, statistički i deskriptivno ob- rađeni. Rezultati istraživanja su pokazali da je maksimalna prisutnost MOR utvrđena kod ukupno 52% ispitanog uzorka, dok je bez punog opsega po- kreta ovaj refleks registrovan kod 46% ispitanika. Odsustvo MOR nije zabeleženo ni kod jednog novorođenčeta. Statistički značajna povezanost između pola beba, TT, TD i OG , s jedne strane, i stepena prisutnosti MOR, s druge strane, nije utvrđena. Moro reflex is commonly the earliest examined coordination pattern when assessing the neurological status of the newborn. Numerous studies are still discussing the origin of afferent pathways for the Moro reflex, whether it is primarily vestibular, proprioceptive, or exteroceptive. Nevertheless, most authors support the viewpoint that Moro reflex is vestibular reflex and that occurs by stimulation of the labyrinth otoliths. The absence of the Moro response during the neonatal period and early infancy is of especial clinical significance and may indicate to a wide range of disorders of the central nervous system. The purpose of this paper was to determine the degree of presence of Moro reflex in the function of evaluating the vestibular sense maturity in healthy term newborns. In a sample of N = 100 healthy, term newborns from normal pregnancies, the 3th day upon birth, clinical trial of Moro reflex (MOR) were applied. For examining of Moro reflex, the so-called head-drop method which involves the activation of vestibularis, otoliths, and not tactile and proprioceptive receptors, has been chosen as the most widely used. Testing of MOR in all babies from the examined sample, was carried out by trained medical staff, whereas the examiner performed instructing, observation and data recording. Besides that, data on body mass on birth, body weight (BW), body length (BL) and head circumference (HC) were recorded for all newborns. The obtained results were recorded by means of a digital camera, then scored and statistically and descriptively processed. Obtained results showed that the maximum presence of MOR was identified in 52% of tested sample, while the reflex without full range of motion, was recorded in 46% of patients. The absence of MOR was not recorded in any of the newborn. Statistically significant connection between babies’ gender, BW, BL and HC, on the one side, and MOR, on the other side, was not established.

Različiti oblici povreda mogu da spreče normalnu integraciju re- fleksa. Faktori koji mogu da poremete razvoj normalnih obrazaca pokre- ta uključuju: povrede na rođenju ili posle, lekovi uzimani u trudnoći ili u vreme dojenja, alergije, prekomerna fizička i emocionalna stimulacija. Starija deca mogu manifestovati neintegrisane reflekse pri upotrebi svog tela. U literaturi novijeg datuma se navodi da deca koja naležu na jednu stranu svog stola, čitaju ili pišu domaći zadatak glavom naslo- njenom na ruku kako bi se odmarala, pokazatelj su nedovoljno integrisanog asimetričnog toničnog refleksa vrata. Smatra se da asimetrični tonič- ni refleks vrata igra važnu ulogu u normalnom razvoju ljudskih pokreta, u uspostavljanju koordinacije oko-ruka, kao i pri modifikovanju simetrije novorođenčeta. Cilj ovog rada je bio da se ispitaju stepen prisustva i karakteristike asimetričnog toničnog refleksa vrata kod beba neposredno po rođenju. Na uzorku od N=100 zdrave, terminske novorođenčadi iz urednih trud- noća, 3. dan po rođenju primenjeno je kliničko ispitivanje asimetričnog to- ničnog refleksa vrata (ATRV). Testiranje ATRV u ispitivanom uzorku izvo- dilo je isključivo obučeno medicinsko osoblje, a ispitivač je vršio instru- iranje, opservaciju i beleženje podataka. Pored toga, kod sve novorođenčadi uzeti su podaci o polu, telesnoj težini (TT), telesnoj dužini (TD) i obimu glave (OG). Dobijeni podaci su dokumentovani uz pomoć digitalne kamere, zatim bodovani, statistički i deskriptivno obrađeni. Dobijeni rezultati su pokazali da je maksimalna prisutnost ATRV utvrđena kod 35% ispitanog uzorka, dok je bez punog opsega pokreta ovaj re- fleks registrovan kod 64% ispitanika. Odsustvo ATRV zabeleženo je u 1% beba. Statistički značajna povezanost između pola beba, TT, TD i OG , s jedne strane, i stepena prisutnosti ATRV, s druge strane, nije utvrđena. Different types of injuries can prevent the normal integration of reflexes. The factors that can disrupt the normal development of the movement patterns include: injury at birth or later, drugs taken during pregnancy or while breastfeeding, allergies, excessive physical and emotional stimulation. Older children may manifest unintegrated reflexes in the use of of his body. In the recent literature states that children who fitting tight to the one side of its desk, read or write homework head resting on hand, provide an indication of insufficient integrated asymmetric tonic neck reflex. It is believed that the asymmetric tonic neck reflex plays an important role in the normal development of human movement, in the establishment of eye-hand coordination, as well as in modification of the symmetry of the newborn. The aim of this study was to examine the degree of presence and characteristics of asymmetric tonic neck reflex in babies immediately after birth. In a sample of N = 100 healthy, term newborns from normal pregnancies, the 3th day upon birth, clinical trial of asymmetric tonic neck reflex (ATNR) were applied. Testing of ATNR in all babies from the examined sample, was carried out by trained medical staff, whereas the examiner performed instructing, observation and data recording. The obtained results were recorded by means of a digital camera, then scored and statistically and descriptively processed. Besides that, data on body mass on birth, body weight (BW), body length (BL) and head circumference (HC) were recorded for all newborns. Obtained results showed that the maximum presence of ATNR was identified in 35% of tested sample, while the reflex without full range of motion, was recorded in 64% of patients. The absence of ATNR was noted in 1% of babies. Statistically significant connection between babies’ gender, BW, BL and HC, on the one side, and ATNR, on the other side, was not established.

Gubitak sluha kod dece je uvek teži problem nego u odraslih. Njegove posledice prvenstveno zavise od momenta nastanka oštećenja, njegovog in- tenziteta i proteklog vremena do odgovarajuće intervencije. Obostrana oštećenja sluha onemogućavaju adekvatan razvoj govora, jezika, mentalnih i intelektualnih sposobnosi, a sve ovo dovodi do emocionalnih poremećaja i socijalne izolacije. Kod teških kongenitalnih ili perinatalno stečenih senzorineuralnih oštećenja sluha, najveći terapijski efekat se postiže ako se odmah počne sa habilitacijom. Kasnije, kada nastupe atrofija i izumiranje nervnih ćelija, habilitacijom se koristi samo preostali deo nervnog tkiva i njegova funkcija. U dečijem uzrastu su međutim češće prisutne konduktivne nagluvosti gde se auditorna disfunkcija javlja kao rezultat akutne upale srednjeg uva, seroznog otitisa ili cerumena. Ako se na vreme otkriju, pre nego što se proces proširi na unutrašnje uvo i izazove nepopravljivo oštećenje i progresivan gubitak sluha, ovakva oštećenja se najčešće uspešno medikamentno i hirurški leče. Pravovremenom i adekvatnom terapijom u najvećem broju slučajeva, njihov negativan uticaj na razvoj govora, kognicije i intelekta može se sprečiti. Hearing loss in children is still more difficult problem than in adults. Its effects primarily depend on the the moment of their disability, its intensity and the time elapsed until the appropriate intervention. Bilateral hearing impairment prevents proper development of speech, language, mental and intellectual skills, and all this leads to emotional disturbances and social isolation. In severe congenital or perinatally acquired sensorineural hearing loss, the most therapeutic effect is achieved if the habilitation treatment starts immediately. Later, when it comes to atrophy and extinction of nerve cells, only remaining part of the nervous tissue and its function have been used by habilitation. Conductive hearing loss, however, is more common in children where the auditory dysfunction occurs as a result of acute otitis media, serous otitis, or cerumen. If detected in time, before the process is extended to the inner ear and cause irreparable impairments and progressive hearing loss, such impairment is usually successfully treated medically and surgically. In most cases, their negative impact on language development, cognition and intellect can be prevented by timely and adequate treatment.

Deca sa obostranim gubitkom vestibularne funkcije od rođenja ili u detinjstvu, pokazuju veliko kašnjenje u motornom razvoju. Iako ne ugrožavaju život, ovi poremećaji u velikom mogu uticati na sam kvalitet života. Rad predstavlja pregled literature novijeg datuma koja se bavi poremećajima vestibularne funkcije kod dece, njihovim uzrocima i prevalencom. Kroz prikaz različitih tehnika i metodoloških postupaka uz pomoć kojih se ovi poremećaji utvrđuju, rad ima za cilj da proširi znanje i poveća svest stručnjaka koji rade sa decom – surdoaudiologa i logopeda, u pomenutoj oblasti, kako bi mogli što lakše da prepoznaju poremećaje udružene sa vestibularnim simptomima i na taj način sprovedu svrsishodniji tretman. S obzirom da su šanse za uspešan oporavak dece sa vestibularnim poremećajima, znatno veće nego u odraslih, pravovremeno dijagnostikovanje narušene vestibularne funkcije je preduslov uspešne rehabilitacije. Children with bilateral loss of vestibular function at birth or in childhood, manifest a long delay in motor development. Although not life threatening, these disorders can have a big influence on the quality of life. The paper presents an overview of recent literature that deals with disorders of vestibular function in children, their causes and prevalence. Through a review of techniques and methodological procedures by which these disorders are determined, the purpose of this paper is to broaden knowledge and increase awareness of professionals who work with children – surdoaudiologists and speech therapists, in the above mentioned fields, so they can more easily recognize the disorders associated with vestibular symptoms and thus carry out more expedient treatment. Since that the chances for successful recovery of children with vestibular disorders, significantly better than in adults, the timely diagnosis of disturbed vestibular function is a prerequisite for successful rehabilitation.

This paper examines the correlation between vestibular and cochlear responses, obtained in newborns immediately after birth, for the purpose of improving procedures of early detection of possible hearing and vestibular impairment. A group of reflexes which indicate whether the vestibular apparatus is already realizing its function were tested in 100 healthy, full-term newborns from regular pregnancies, on the third day upon birth. At the same time, hearing ability in all newborns was examined by transient otoacoustic emission (TEOAE). Testing each reflex in newborns, was carried out in three attempts by trained medical staff, whereas the examiner performed instructing, observation and data recording. The obtained data were recorded by means of a digital camera, then scored and statistically and descriptively processed. For each examinee in the sample, data on gender and body size on birth, body weigh (BW), body length (BL) and head circumference (HC), were recorded. Research results indicate that 91% of babies have normal TEOAE finding bilaterally, whereas in 9% of newborns TEOAE was absent on both sides or just on one ear (bilaterally 3%, on the left side 4% and on the right side 2%). In the examined sample, maximal presence of reflexes in total (MOR+ATRV+VOR+LRIG) was established in 7% of newborns, while minimal presence was recorded just in 1%. Absence of these four reflexes together, was not established in any of the newborns. Reflexes in total were significantly more developed in babies with normal TEOAE results bilaterally, then in babies whose TEOAE findings were bilaterally or unilaterally absent (p

Postojeći podaci i istraživanja na ljudima i životinjama ukazuju na to da emocionalni status trudnice utiče na prenatalni i postnatalni razvoj ploda. Rezultati nedavnih studija pokazali su da postoji veza između prenatalne anksioznosti trudnice i učestalosti gestacijske hipertenzije, kao i povezanost anksioznosti kao osobine ličnosti i razvoja gestacijske hipertenzije tokom trudnoće. Primenom kolor dopler ultrasonografije mogu se na neinvazivan način posmatrati, pratiti i meriti fiziološki i patološki procesi u fetalnoj cirkulaciji kod trudnica sa određenim faktorima rizika u trudnoći. Mapiranjem krvnih sudova i spektralnom analizom brzine protoka krvi moguće je ispitati vaskularni otpor u krvnim sudovima fetusa. Prenatalni slušni skrining (PSS) se zasniva na ultrazvučnom merenju brzine protoka krvi kroz srednju moždanu arteriju fetusa (ACM) nakon primene definisanog zvučnog stimulusa. Cilj ovog longitudinalnog istraživanja bio je utvrđivanje korelacije između fizičkog stanja (prisustvo ili odsustvo gestacijske hipertenzije) i emocionalnog (nivo anksioznosti) zdravlja trudnice, reakcije fetusa u PSS testu i dinamike postnatalnog razvoja deteta. Dobijeni rezultati dali bi mogućnost predikcije neonatalnog i ranog postnatalnog razvoja deteta primenom neinvazivne i dostupne metode ultrasonografije. Istraživanjem je obuhvaćeno 83 trudnica (43 trudnice sa urednim trudnoćama – K grupa, 40 trudnica sa gestacijskom hipertenzijom – GH grupa) i njihove dece longitudinalno praćene prenatalno (merenje fetalnog protoka krvi kroz srednju cerebralnu arteriju nakon definisanog zvučnog stimulusa), na rođenju (mere telesne težine, dužine, Apgar skora i gestacijske nedelje pri porođaju) i na uzrastu od tri godine (govorno-jezički, senzomotorni i socio-emocionalni status). Rezultati su pokazali da su trudnice iz GH grupe imale statistički značajno više skorove na STAI-T u poređenju sa K grupom. Fetusi iz GH grupe su imali veće vrednosti RePi u poređenju sa fetusima iz K grupe. Utvrđene su veće vrednosti RePi u stratumu visoke STAI-S i STAI-T anksioznosti u poređenju sa niskom (p = 0,001) i umerenom (p = 0,004) u K grupi. Sličan rezultat dobijen je i za GH grupu gde su veće vrednosti RePi izmerene u stratumu visoke STAI-S i i STAI-T anksioznosti u poređenju sa niskom (p = 0,023) i umerenom (p = 0,004). U GH grupi utvrđena je pozitivna linearna korelacija između RePi i sistolnog, dijastolnog krvnog pritiska kao i STAI-S i STAI-T skorova. Primenom linearne regresije pokazano je da se količina varijacija RePi u GH grupi može predvideti na osnovu vrednosti STAI-S, STAI-T i sistolnog krvnog pritiska. Utvrđen je značajno veći broj preterminskih porođaja u GH grupi u poređenju sa K grupom. Rezultati su pokazali značajno nižu telesnu težinu kod beba iz K grupe čije su majke imale visok nivo anksioznosti na STAI-T u odnosu na bebe majke koje su imale nizak (p = 0,008) i umeren nivo (p = 0,042) STAI-T anksioznosti. Sličan rezultat dobijen je i u GH grupi gde su bebe majki sa visokim nivoom STAI-T anksioznosti imale nižu telesnu težinu u poređenju sa bebama majki koje su imale nizak (p = 0,001) i umeren nivo anksioznosti (p = .008). Nije utvrđen statistički značajan efekat STAI-S na telesnu težinu beba u K i u GH grupi. Rezultati ukazuju na korelaciju nivoa STAI-T anksioznosti i gestacijske starosti na rođenju u obe grupe. Linearna regresiona analiza je pokazala da se na osnovu vrednosti RePi, STAI-T i sistolnog krvnog pritiska može predvideti telesna težina beba na rođenju. Rezultati ove studije pokazuju efekat STAI-T na rani govorno-jezički razvoj dece na uzrastu od tri godine u obe grupe... Existing human and animal data and research suggest that the emotional status of a pregnant woman affects prenatal and postnatal fetal development. The results of recent studies have shown that there is a relationship between prenatal anxiety of a pregnant woman and the incidence of gestational hypertension, as well as an association between anxiety as a personality trait and the development of gestational hypertension during pregnancy. Physiological and pathological processes in the fetal circulation in pregnant women with certain risk factors in pregnancy can be observed, monitored and measured in a non-invasive way using color Doppler ultrasonography. Vascular resistance in fetal blood vessels can be examined by mapping blood vessels and by spectral analysis of blood flow velocity. Prenatal auditory screening (PSS) is based on ultrasound measurement of the rate of blood flow through the middle cerebral artery (ACM) after applying a defined auditory stimulus. The aim of this longitudinal study was to establish a correlation between physical (presence or absence of gestational hypertension) and emotional (anxiety level) health of a pregnant woman, fetal response in the PSS test and the dynamics of postnatal development of the infant. The obtained results would provide a possibility to predict the neonatal and early postnatal development of the infant using the non-invasive and available ultrasonography method. The study included 83 pregnant women (43 pregnant women with a non risk pregnancy - K group, 40 pregnant women with gestational hypertension - GH group) and their children longitudinally monitored prenatally (measurement of fetal blood flow through the middle cerebral artery after a defined auditory stimulus), at birth (body measures weight, length, Apgar score, and gestational week at birth) and at the age of three years (speechlanguage, sensorimotor, and socio-emotional status). The results showed that pregnant women from the GH group had statistically significantly higher scores on STAI-T compared with the K group. GH group fetuses had higher RePi values compared to K group fetuses. Higher RePi values were found in the stratum of high STAI-S and STAI-T anxiety compared with low (p = 0.001) and moderate (p = 0.004) anxiety in the K group. A similar result was obtained for the GH group where higher RePi values were measured in the stratum of high STAI-S and STAI-T anxiety compared with low (p = 0.023) and moderate (p = 0.004). In the GH group, a positive linear correlation was found between RePi and systolic, diastolic blood pressure as well as STAI-S and STAI-T scores. Linear regression showed that the amount of RePi variation in the GH group could be predicted based on the values of STAI-S, STAI-T, and systolic blood pressure. Significantly more preterm births were found in the GH group compared with the K group. The results showed significantly lower body weight in babies from the K group whose mothers had high levels of anxiety on STAI-T compared to babies of mothers who had low (p = 0.008) and moderate levels (p = 0.042) of anxiety on STAI-T. A similar result was obtained in the GH group, where babies of mothers with high levels of STAI-T anxiety had lower body weight compared to babies of mothers who had low (p = 0.001) to moderate levels of anxiety (p = 0.008). No statistically significant effect of STAI-S on the body weight of infants in the K and GH groups was found. The results indicate a correlation between STAI-T anxiety level and gestational age at birth in both groups. Linear regression analysis showed that based on RePi, STAI-T, and systolic blood pressure, infant body weight can be predicted at birth.The results of this study show the effect of STAI-T on the early speech and language development of children at the age of three years in both groups...

Movement in speech is present on different levels – form micromovements during articulatory processes to more visible movements such as gestures. In this paper, gross motoric movement in speech correction has been analysed. Gross motoric movement in the Verbotonal method is described as unique, depending on individual aim and possibilities, used in order to improve pronunciation. It should not be replaced with gestures or signs. Although unique and individual, movements are connected with speech sounds on the basis of different elements: height, tension, duration etc. For that purpose basic movements, prone to variations, were recorded in the era of VTM „expansion―. The material used in this research were descriptions of movements made by students whose task was to perform ten lessons of speech correction, respectively, with adult foreign students learning Croatian as L2. The described movements were grouped mainly according to the corrected speech sounds and the variations within the group were compared. Furthermore parts of the body, direction, tension, as well as some other elements were used in movements were observed. The descriptive analysis of the obtained remarks is partly based on Laban Movement Analysis (LMA/LBMA). The results are compared with the material (movements) recorded for each speech sounds in Croatian and discussed in the light of self awareness when it comes to movement. Usage of movement in the verbotonal method is compared with recent work on movement and speech in foreign language learning through dance, emotions and memory.

The aim of this study was to examine how the educated speakers of General Croatian assess the linguistic closeness of Croatian (N=37) and Serbian speakers (N=37) based on the verified tokens of spontaneous speech. In order to determine whether there are acoustic differences between the languages the acoustic analysis included: F0 in Hz and semitones (Pt) and vowel formants (F1-F4). Also, Df was calculated from formant values. The results show the difference in linguistic closeness (p

Foreign language speakers are often recognized as „foreign― on the basis of rhythm and intonation of their speech and only later by more or less inadequate phonology, vocabulary or syntax. Vowels play important role in both rhythm and intonation and therefore their role and characteristics are of great importance in foreign language learning. In this paper, changes in vowel systems in adult foreign language learners were compared on initial and advanced level of learning and for that purpose native Polish speakers studying Croatian as foreign language were recorded. The obtained material was used for measuring F1, F2 and F3 of Croatian vowels in foreign speaker as well as for comparison with F1, F2 and F3 of their native Croatian peers to obtain information on interphonology. Furthermore, a perceptive test was performed to establish whether the differences between native and foreign speakers, as well as between initial and advanced levels of knowledge of foreign learners, can be perceived. Differences in values of F1, F2 and F3 were obtained for all vowels for both groups of Polish speakers. The results for F1, F2 and F3 in Polish speakers were compared with those obtained for their native Croatian peers but also with results of some previous studies. Results of the perceptive test showed clear distinction between foreign and native speaker but not as much between the two groups of foreign learners

In the forensic context formant values (F1, F2 and F3) are measured in speech. Previous Croatian research measured formants in nonsense words or in several phonemes ; therefore the aim of this paper was to determine standard values for General Croatian Pronunciation for male and female speakers in words. Pharyngeal resonance and resonance in the back part of oral cavity is the most important for F1 values and the highest F1 value was found for vowel [a] ; the front/back position of vowel influences F2 values ; the most fronted vowel in Croatian is [i] and it has the highest average F2 value. Due to the contractions in those areas vowel [i] has the lowest values while the most resonant vowel [a] has the highest values. F3 values are important for comparisons of various vowel pronunciations since F3 does not distort in telephone transmission or shows fewer distortions than F1 for most vowels.

It is usual in forensic context to measure formant values (F1, F2, F3) in speech. Formant values in previous research were measured in nonsense words or in several phonemes, therefore the aim of this paper was to determine standard values for Croatian Received Pronunciation (RP) for male (N=14, mean age 33) and female (N=14, mean age 30) speakers in words. The results can be used for comparison with vowel pronunciation in dialects and idiosyncratic variations or with vowel pronunciation in telephone transmission. 10 two-syllable words with different phonetic contexts were chosen for every vowel ; every vowel was in stressed position with each of the four Croatian accents and the words were pronounced with falling intonation as statements. F1 and F2 values were presented through vowel space chart indicating the distance between vowels. The average formant values were measured in Praat program and also standard deviation, minimum and maximum formant values (Hz). The results were compared with previous acoustic findings especially for F1 and F2. As expected, the highest F1 value was found for vowel [a] (835 Hz for female speakers and 707 for male speakers), it was confirmed that the front/back position of vowel influences F2 values: the most fronted vowel in Croatian is [i] and it has the highest average F2 value (2375 Hz for female speakers and 2177 for male speakers). It was also comfirmed that for F1 values the most important is pharyngeal resonance and resonance in the back part of oral cavity since due to the contractions in those areas vowel [i] has the lowest values while the most resonant vowel [a] has the highest values. F3 values will be important for comparisons of various vowel pronunciations since F3 does not distort in telephone transmission or shows less distortions than F1 for most vowels. vowels, formant values, Croatian Received Pronunciation

Down syndrome is one of the most widespread genetic disorders with the overall incidence estimated to be 1/600-800 live births. Atypical development in children with Down syndrome can be seen on different levels. In this paper the rehabilitation of a girl with Down syndrome included in an education center is discussed. The descriptive analysis used in this paper focuses on: a/ atypical elements in speech and language as well as in sensory motor development ; b/ elements of early childhood intervention procedures used during rehabilitation that are also used in verbotonal method. The results of the analysis are consistent with earlier findings confirming therefore the differences of the child’s development of speech and language as well as sensory motor level compared to normal development of a child. Spatiality (with movement as the most prominent of all elements) and structure proved to be the unavoidable parts of global approach to the child in rehabilitation which is common to both early interventions and verbotonal method. The authors finally suggest some of possible further procedures in rehabilitation of the child based on verbotonal method.

Short, self-report symptom questionnaires are often used in clinical setting for assessing patient’s perception of voice problems or to monitor the efficacy of the treatment. Voice Handicap Index is a questionnaire developed in the USA for self- assessment of voice difficulties. Aside from American questionnaire, there are several VHI adaptations in Europe (Dutch, Flemish, British, French, German, Italian and Portuguese) compared in several previous researches. The results confirm validity of all questionnaires and are considered appropriate for cross-linguistic comparisons. Also, adaptations for pediatric use and for singers were also developed supporting the quality and practicality of VHI and indicating the necessity for validation of the questionnaire for special groups. Therefore the aim of this paper was to make Croatian adaptation of VHI and validate it for general population but in groups of vocal professionals. This research included several groups of vocal professionals with frequent voice problems: actors, anchors and journalists, teachers, coaches, and kindergarden teachers. Statistical analysis indicated high levels of reliability and validity and also sensitivity of the VHI questionnaire. Controls (general population) showed lower results than voice professionals for the entire questionnaire and on each scale (functional, physical and emotional) confirming the validity of VHI. It can be concluded that Croatian VHI is valid and reliable measure for use in Croatian clinical context and for coparison with similar research.