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Smartphones and tablets are part of everyday family life. Experts who work with children or deal with various aspects of early childhood development warn of the resulting harmful consequences. It is also feared that research on the impact of the use of smartphones and tablets on children's development cannot keep up with rapid technological development. Bearing these facts in mind, in this research we tried to evaluate the quality of speech, sensorimotor development and socio-emotional behavior in children in the most sensitive period of their growth, preschool age. The research sample consisted of 40 participants, 28 boys and 12 girls, aged 5 to 6 years. Only children whose parents declared that their child spends more than three hours a day in front of the screen were included in the sample. The research used an adapted test for assessing the articulation abilities of children, the Global Articulation Test and the Scale for assessing the psychophysiological abilities of children from 0 to 7 years of age. The results of this research show that there are differences in the quality of speech in preschool children. Statistically significant differences in sensorimotor development and socioemotional behavior in preschool children were obtained by applying one-factor multivariate ANOVA. Knowledge and understanding of the harmful effects of screens on the functioning and development of children in the immediate environment is essential for taking measures to control screen exposure by parents and educators in order to prevent further regressions in the development of speech, language, sensorimotor and socio-emotional maturity and thereby stimulate optimal early development.

Introduction. Sensory processing difficulties can pose a risk for the development of language and speech disorders in the earliest period and require professional intervention and intense involvement of parents in homework with children with developmental dysphasia, which might cause parental burnout and lower level of their self-esteem when parents are not able to help, not only the children, but themselves too. Aim. The aim of the research was to examine the relationship between the sensory sensitivity of children with developmental dysphasia and the characteristics of parents. Method. The sample consisted of 50 parents of children aged 3 to 6 years. The following questionnaires were used in the research to assess the characteristics of sensory processing: The Child Sensory Profile 2, Parental Burnout Inventory, and Rosenberg Self-Esteem Scale. Measures of descriptive statistics and Pearson's correlation coefficient were used in data processing. Results. The results of the research show that the level of parental burnout is relatively low (parents showed a high level of personal accomplishment (M = 4.16, SD = .67), mild level of emotional exhaustion (M = 2.34, SD = .78) and low level of emotional distancing (M = 1.72, SD = .72), but also that they are characterized by lower self-esteem (M = 3.11, SD = .34). Also, self-esteem and burn-out are not related. On the Sensory Profile, subscales of behavior elements are highly correlated, while the intensity of correlations in subscales of the basic system of processing oscillates. There is a weak correlation between the general self-esteem of parents with subscales of body posture and behavior. Conclusion. The obtained results were discussed in the context of practical pedagogical implications, considering that if the difficulties in the child's functioning are not eliminated in the preschool period, the child's departure to school may be delayed, or long-term difficulties in learning may appear.

In order to examine the differences in people suffering from depression (EG, N=18) compared to the healthy controls (CG1, N=24) and people with the diagnosed psychogenic voice disorder (CG2, N=9), nine acoustic features of voice were assessed among the total of 51 participants using the MDVP software programme ("Kay Elemetrics" Corp., model 4300). Nine acoustic parameters were analysed on the basis of the sustained phonation of the vowel /a/. The results revealed that the mean values of all acoustic parameters differed in the EG compared to both the CG1 and CG2 as follows: the parameters which indicate frequency variability (Jitt, PPQ), amplitude variability (Shim, vAm, APQ) and noise and tremor parameters (NHR, VTI) were higher; only the parameters of fundamental frequency (F0) and soft index phonation (SPI) were lower (F0 compared to CG1, and SPI compared to CG1 and CG2). Only the PPQ parameter was not significant. vAm and APQ had the highest discriminant value for depression. The acoustic features of voice, analysed in this study with regard to the sustained phonation of a vowel, were different and discriminant in the EG compared to CG1 and CG2. In voice analysis, the parameters vAm and APQ could potentially be the markers indicative of depression. The results of this research point to the importance of the voice, that is, its acoustic indicators, in recognizing depression. Important parameters that could help create a programme for the automatic recognition of depression are those from the domain of voice intensity variation.

The readiness to start school includes the emotional and social maturity of the child. In order for a child to master the demands of the school program as easily as possible, a certain harmony is needed in the development of his abilities. The ability of sensory perception and the ability to integrate sensory stimuli specifically determine the development of reading and writing skills. The aim of this study is to analyze the ability to read and write in hypersensitive and hyposensitive types of sensory integration disorders, with special reference to the analysis of individualization measures in the work with these students in the school system. Disorder of sensory integration is expressed in two basic forms: increased sensitivity (hypersensitivity) and decreased sensitivity (hyposensitivity). In the school system, both forms of sensory integration disorders dominate. Hypersensitivity is manifested by rapid mental fatigue compared to other children. These children have difficulty reading and writing at the same time. They can read a word in many different ways without realizing it. Compared to the hypersensitive child who seems inert, the hyposensitive child is in constant motion, craving additional sensory stimuli in the classroom. These children have great problems with reading and writing figures and symbols such as tables, geometric shapes and musical symbols. Adjusting the teaching material for these children means increasing the font and font color before reading, dividing large-scale tasks into smaller units, using different types of writing pens, constantly emphasizing important units in the lesson, providing a summary of the lesson at the end of the lesson, and occasionally checking the legibility of the handwriting. In this way, students are provided with easier visual, auditory and tactile processing, and therefore more successful writing, reading and understanding of the read material. Thus, a student with sensory processing disorder can achieve academic success, but it is necessary to adapt the curriculum to the appropriate level of sensations.

Introduction. Emotions are one of the most important psychological processes, with a decisive influence on a person's voice. Faced with the great challenges and changes that primary and secondary socialization agents impose in the process of growing up, children consequently experience a spectrum of various unpleasant feelings: anxiety, fear, anger, frustration and sadness. Due to the fast-paced lifestyle, it often happens that the child ignores unpleasant feelings, which further worsens the condition in which he finds himself. Among other conditions, psychogenic aphonia in children has become more frequent in recent years. The current case report aims to determine the frequency of psychogenic aphonia in children, to identify the most common causes that lead to psychogenic aphonia and highlight the methods of vocal treatment that give the best results during rehabilitation. Case report. The current paper presents the results collected in a two-year period at the Clinic for Ear, Throat and Nose of the Clinical Hospital Center "Zvezdara". In the period from March 2017 to May 2019, psychogenic aphonia was diagnosed in 31 patients, which is an evident increase compared to the previous ten-year period in which psychogenic aphonia was diagnosed in 38 younger patients. Analyzing heteroanamnestic data obtained from parents, the most common answer about the cause of psychogenic aphonia is dissatisfaction with school success. After successful diagnostics by an otorhinolaryngologist, psychiatrist and vocal pathologist, in the process of rehabilitation of psychogenic aphonia, methods of digital manipulation of the larynx, methods of restoring the voice with cough reflex and methods of turning out the feedback system were applied. In this particular case, the method of digital manipulation of the larynx gave the best results. Conclusion. Optimal evaluation of patients with voice disorders requires the joint efforts of experts from different disciplines. Having in mind the tendency of recurrence of psychogenic aphonia, these findings suggest that the integration of the interventions of a vocal pathologist and a psychiatrist could give effective results in the process of rehabilitation voice.

Stuttering is defined as a speech disorder characterized by involuntary repetitions and prolongations of speech elements, i.e. voices, syllables or words. The evaluation of interpersonal anxiety in stuttering pathology should indicate and encourage a new perspective and provide a conceptual approach that has the potential to enable better understanding of the affective field of a stuttering person, thus completing a guide to stuttering rehabilitation. The aim of this study is to compare the degree of interpersonal anxiety of stuttering subjects and the typical population and the potential effect of age differences and different forms of stuttering on the degree of interpersonal anxiety. The sample included 48 subjects, 24 stuttering subjects and 24 non-stuttering subjects. Interpersonal anxiety was evaluated using the Willoughby questionnaire which assesses the degree of interpersonal anxiety. The obtained results show that the subjects who stutter are more anxious than the subjects of the typical population [F(1, 44) = 13.66, p

Introduction. Children born prematurely have an increased risk of immediate medical complications, as well as socioemotional, cognitive, linguistic and sensory processing disorders later in life. Studies have examined the effects of prematurity on developmental outcomes, such as cognition, however, there is a need for a more detailed examination of sensory processing disorders in preterm infants. Not only is prenatal neurosensory development interrupted in utero, but these children may also experience intense stimulation in the neonatal unit, which can further alter the development and function of the sensory system. Objective. The paper presents an overview of research on sensory processing disorders in premature infants, with special emphasis on the impact of the environment of the neonatal unit. Method. Insight into the relevant literature was performed by specialized search engines on the Internet and insight into the electronic database. Results. Sensory processing disorders affect 39% to 52% of newborns born prematurely, with some evidence to suggest that children born before 32 weeks are most at risk. The literature to date has consistently reported difficulties in sensory modulation of preterm infants, within the tactile, vestibular, auditory, oral, and visual domains. Conclusion. Sensory processing disorders in preterm infants appear to occur as a result of their immature neurological and biological system and being in the environment of a neonatal intensive care unit, which is unable to meet the sensory needs of preterm infants. Altered sensory experiences, during periods of neurodevelopmental vulnerability and fragility, can result in sensory processing disorders, which may include enhanced responses or less response to stimuli (hyper or hyposensitivity).

The development of the child's speech sound articulation ability and phonological awareness goes through different stages during the child's preschool years. The aim of our research was to determine the articulation abilities and phonological awareness level in children with typical development. Our sample comprised 195 children aged five to seven. Speech sound articulation abilities and phonological awareness were assessed by means of the Global Test of Articulation and the FONT Phonological Awareness Test. The research results indicate that, depending on age, 42% to 78.3% of children are able to articulate clearly all 30 sounds of the Serbian language. An analysis of the Phonological Awareness Test results shows children performed best in the following tasks: syllable blending (99.1%), syllable segmentation (85%) and initial phoneme identification (86.1%), while they were least successful in the task of initial phoneme deletion (48.8%). Results have shown that children's success in most tasks within the framework of the elements of phonological awareness assessed - such as initial phoneme identification, rhyme recognition, phoneme segmentation, final phoneme identification, initial phoneme deletion and phoneme substitution (initial phoneme) - increases with children's age. The development of final phoneme identification, initial phoneme deletion and phoneme substitution (initial phoneme) abilities continues after children start school, as shown by data on the success rate among seven-year-olds. In view of the fact that phonological awareness plays an important role in the development and acquisition of reading ability, when working with preschool-age children particular attention should be devoted to tasks that stimulate the development of phonological awareness.

Total laryngectomy is a radical surgery where the larynx is completely removed. Each type of surgical treatment has an impact on voice quality and speech intelligibility. However, it is important to know that the methods of speech adoption, esophageal speech and speech with use of tracheoesophageal prosthesis, are available and applicable methods for establishing functional communication between laryngectomy patients. The main objective of this research is to ascertain whether there is a correlation between the acoustic and perceptual characteristics of voice and speech intelligibility observed among persons with use of esophageal speech and persons with tracheoesophageal prosthesis, as well as to examine which of the following characteristics have the greatest impact on speech intelligibility among these two groups of respondents. The research was conducted on a sample of 85 laryngectomy patients, of both genders, 48 to 85 years old. Acoustic vocal characteristics were examined with a computer program for multidimensional analysis of vocals, model 4300 of 'Kay Elemetrics' corporation. Perceptual vocal characteristics were analyzed on GRBAS scale. Phonetically balanced text was used for the subjective assessment of speech intelligibility. For statistical analysis of the obtained data we used: arithmetic mean, standard deviation, frequencies, percentages, ANOVA, Pearson correlation coefficient, linear regression analysis and the multiple correlation coefficient. Study results have shown that the contribution on explaining the assessment of speech intelligibility are provided by parameters of speech perceptual analysis. The highest degree of variance in the speech intelligibility assessment is explained with the model composed of scores on the GRBAS scale, R parameters (F=26.1; p=0.000) (roughness of the voice), A (F=26.1; p=0.001) (asthenia) and S (F=18.33; p=0.000) (strain).

Background/Aim. The major role of larynx in speech, respiration and swallowing makes carcinomas of this region and their treatment very influential for patients’ life quality. The aim of this study was to assess the importance of voice therapy in patients after open surgery on vocal cords. Methods. This study included 21 male patients and the control group of 19 subjects. The vowel (A) was recorded and analyzed for each examinee. All the patients were recorded twice: firstly, when they contacted the clinic and secondly, after a three-month vocal therapy, which was held twice per week on an outpatient basis. The voice analysis was carried out in the Ear, Nose and Throat (ENT) Clinic, Clinical Hospital Center “Zvezdara” in Belgrade. Results. The values of the acoustic parameters in the patients submitted to open surgery on the vocal cords before vocal rehabilitation and the control group subjects were significantly different in all specified parameters. These results suggest that the voice of the patients was damaged before vocal rehabilitation. The results of the acoustic parameters of the vowel (A) before and after vocal rehabilitation of the patients with open surgery on vocal cords were statistically significantly different. Among the parameters - Jitter (%), Shimmer (%) - the observed difference was highly statistically significant (p < 0.01). The voice turbulence index and the noise/harmonic ratio were also notably improved, and the observed difference was statistically significant (p < 0.05). The analysis of the tremor intensity index showed no significant improvement and the observed difference was not statistically significant (p > 0.05 ). Conclusion. There was a significant improvement of the acoustic parameters of the vowel (A) in the study subjects three months following vocal therapy. Only one out of five representative parameters showed no significant improvement.

Modern methods of speech rehabilitation after a total laryngectomy have come to a great success by giving the patients a possibility to establish an intelligible and functional speech after an adequate rehabilitation treatment. The aim of this paper was to examine speech intelligibility of laryngectomized patients who use different types of vocal communication: esophageal speech, speech with tracheoesophageal prosthesis and speech with electronic laringeal prosthesis. The research was conducted on a sample of 125 laryngectomized patients of both sexes, between 48 and 85 years of age. For the subjective assessment of speech intelligibility, we used the phonetically balanced text. In the paper we used the descriptive statistics methods (the arithmetic mean with standard deviation, as well as minimum and maximum). The differences between the groups were determined by the t-test for independent samples. Pirson's correlation coefficient was used to examine the correlation between the two variables. The examinees are statistically different by the results achieved on the speech intelligibility test. The esophageal patients have the highest scores (1.13±0.86), while the patients with the vocal prosthesis and patients who use electrolarynx have similar scores (0.14±0.35; 0.15±0.36). The differences of the analyzed values were statistically significant (p

Laryngeal carcinoma is the most common malignant tumor of the head and neck, which leads to changes in the normal anatomical relationships in the neck, causing a communication disorder and changes in the patient's psychosocial status. The aim of this paper was to examine the quality of life of laryngectomized patients before and after vocal rehabilitation, and the importance of early intervention. The sample consisted of 50 patients who underwent total laryngectomy, aged 51 to 83. The survey was conducted at the Clinical Hospital 'Sveti Vračevi' in Bijeljina and Military Medical Academy in Belgrade, from April 2014 to November 2015. A subjective assessment of voice was conducted by means of Voice Handicap Index (VHI). Patients filled in a questionnaire for the first time when they registered with the speech therapy clinic before vocal rehabilitation, and for the second time after the end of the vocal rehabilitation. Statistical analysis was performed using the arithmetic mean of the corresponding standard deviation, minimum and maximum, frequency, percentages and t-test. The difference between groups was determined by single-factor analysis of variance (ANOVA). With regard to data obtained before vocal rehabilitation, all participants belonged to the group with severe speech disorder. After vocal rehabilitation, there was an improvement in all subsets of the scale and the total score. Vocal rehabilitation had a positive impact on physical, emotional and functional status of patients who underwent total laryngectomy, which resulted in the improvement of their life quality.

The aim of our study was to assess the outcome of treatment of horizontal canal benign paroxysmal positional vertigo and to analyze the influence of the different prognostic factors on treatment failure. Fifty-nine patients with horizontal canal benign paroxysmal positional vertigo were included in the study. They were divided into two groups according to the treatment protocol, randomly. The first group, after treatment with the barbecue maneuver or inverted Gufoni, depending on the nystagmus form, was instructed to sleep on the side with weaker nystagmus, and the second group did not. In the first group, 88.9% of patients were cured and 91.3% in the second one. There was no significant difference between the two groups. Migraine and the apogeotropic form of nystagmus had a significant effect on treatment outcome, while other variables had no effect.

Voice of vocal professionals is exposed to great temptations, i.e. there is a high probability of voice alterations. Smoking, allergies and respiratory infections greatly affect the voice, which can change its acoustic characteristics. In smokers, the vocal cords mass increases, resulting in changes in vocal fold vibratory cycle. Pathological changes of vocal folds deform the acoustic signal and affect voice production. As vocal professionals, teachers are much more affected by voice disorders than average speakers. The aim of this study was to examine the differences in acoustic parameters of voice between smoking and nonsmoking teachers, in a sample of vocal professionals. The sample consisted of 60 female subjects, aged from 25 to 59. For voice analysis we used Computer lab, model 4300, 'Kay Elemetrics Corporation'. The statistical significance of differences in the values of acoustic parameters between smokers and nonsmokers was tested by ANOVA. Results showed that in the sample of female teachers, professional use of voice combined with the smoking habit can be linked to the changes in voice parameters. Comparing smokers and nonsmokers, average values of the parameters in short-term and long-term disturbances of frequency and amplitude proved to be significantly different.

Total laryngectomy is a radical procedure that leads to permanent loss of the voice generator and a part of the voice resonator, the larynx, where the basic laryngeal tone is created. One method of voice and speech rehabilitation is implantation of tracheoesophageal prosthesis. The aim of this study was to determine the characteristics of tracheoesophageal speech in patients with primary and secondary vocal prosthesis, to analyze the influence of gender and age on characteristics of the tracheoesophageal speech and self-assessment by patients themselves. This paper presents the results of voice and speech rehabilitation in 48 laryngectomized patients aged 44 to 77 years, with implanted vocal prosthesis during the period from 2008 to 2010 at the Clinic for Ear, Nose and Throat of the Clinical Centre of Vojvodina. The assessment of voice and speech characteristics included: maximum phonation time for the sound /a/, the length of phrases, reading of phonetically balanced word lists, intelligibility of words, reading phonetically balanced text and self-assessment of speech quality of patients referred to their communicative needs. Characteristics of voice and speech in patients who underwent primary vocal prosthesis in relation to secondary placement show no statistically significant difference. In patients under the age of 60, statistically significant better result in terms of speech intelligibility was found. There were no statistically significant differences depending on the patients' gender. Only one patient (1/48) assessed his speech as unsatisfactory. As developing countries cannot provide adequate number of prostheses and their continuous supply for all laryngectomy patients, the installation of a secondary vocal prosthesis could be an adequate method of rehabilitation. A large percentage of success in education of tracheoesophageal speech recommends the placement of vocal prosthesis.

Background⁄Aim. A school teacher's occupation is one of the most vocal demanding professions. Vocal tiredness affects acoustic characteristics of voice, leads to the change in acoustic quality during vocal production. The aim of this study was to examine the influence of vocal tiredness on voice acoustic characteristics of school teachers. Methods. The study included 36 school teachers (16 male and 20 female) of 27-58 years of age. Vocal tiredness was evaluated by analyzing acoustic parameters of voice, using computerized laboratory “Kay Elemetrics”. The voices were recorded before the first class on the beginning of a working week and after the last class at the end of a working week. Signal, noise and tremor parameters were processed. In their analysis the methods of descriptive statistics, as well as the analytical statistics (Student's t-test for paired samples, χ2 test, Mann Whitney U-test and Pearson’s correlation coefficient) were applied. Results. The obtained results showed statistically significant differences in average values of parameters as a consequence of the vocal tiredness (p < 0.01), while gender, age and being smoker or not, did not have a significant effect on voice acoustic characteristics in this group of examinees (p > 0.05). Conclusion. The results of the study suggest a casual relationship between vocal tiredness and voice quality in vocal professionals.

Background/Aim. Prevention of the consequences of hearing loss can be accomplished by early hearing screening of the cochlear function in newborus, but also with continuous hearing screening in the early childhood. The aim of this study was to investigate the reliability and feasibility of otoacoustic emissions (OAE) in hearing screening in children, evaluate the frequency and type of hearing loss and determine etiological factors of these losses. Methods. In the study, 133 children, aged 2 to 7.5 years, were tested on both ears with transient evoked otoacoustic emissions (TEOAE) and distortionproduct otoacoustic emissions (DPOAE). Before screening tests all children had undergone otoscopic examination. If children had not passed either or both hearing screening tests and/or abnormal otoscopic findings in at least one ear, audiological evaluation was scheduled to confirm or exclude hearing loss. Results. Eighty-five percent of children passed the hearing and otoscopic screening bilaterally. For additional audiologic tests 15% of children were referred. Agreement between otoscopic examination and screening tests was very good (agreement for TEOAE 95%, for DPOAE 93%). The results showed that normal tympanograms were very likely to be associated with normal screening tests. Sensitivity of TEOAE test was 94.12%, specificity 78.95%, while DPOAE sensitivity was 87.50% and specificity 75%. Hearing loss was found in 6.76% of the cases, conductive in 6.01% and sensorineural in 0.75%. Conductive hearing loss was a consequence of chronic otitis media with effusion in 25% of the cases, and a consequence of adhesive process in the middle ear in 8.33% of cases. Sensorineural hearing loss was a consequence of using ototoxic medications. Conclusion. TEOAE and/or DPOAE tests are reliable, noninvasive, and feasible methods for hearing screening in childhood.

Introduction. There are subjective and objective ways to examine the effects of vocal therapy in voice disorders. The most precise and objective check-up is the use of computer voice analysis. Objective. The aim of the research was to perform a detailed analysis of acoustic structure of the vowel A before and after voice treatment in patients with vocal fold nodules in order to obtain objective verification of the vocal rehabilitation success. Methods. We examined 30 female patients, aged 34.6±6.69 years, with vocal fold nodules. Acoustic parameters of voice were compared with the control group consisting of 21 subjects without voice pathology. In all persons the vowel A was recorded and analyzed before and after a month of vocal therapy. The success of the vocal therapy was tracked using computer analysis of vocal structure. Signal, noise and tremor parameters were processed. Results. Of the analyzed vowel A parameters: STD, PER, JITA, JITT, RAP, vFO, ShdB, SHIM, APQ, VTI, SPI, F0, NHR, FTRI, eleven improved (p0.05). Conclusion. Based on the obtained results it was concluded that vocal therapy gave satisfactory results, but that it should be continually applied until full stabilization of the voice.

Over the last several decades, cochlear implantation has been fully proven as the treatment for profound hearing losses. The direct electrical stimulation of the spiral ganglion hair cells through the electrode inserted in the cochlear scala tympani is the essence of the cochlear implant (CI) functioning. Modern technological development has introduced unexpected technical quality possibilities of the device itself, as well as coding strategies, which further enable improved patients' rehabilitation results. Nevertheless, in spite of cochlear implantation becoming a routine surgical procedure, which has been changing lives of thousands of profoundly deaf adults and children, it has possible complications. Though rare, these complications could lead to severe, even fatal consequences. Bacterial meningitis represents one of the most severe postoperative complications. In this article, our five-year experience with cochlear implantation is shown, compared to other, much bigger, experiences. Despite severity and a potentially fatal outcome of meningitis, it has rarely been seen, and the precise connection between surgical procedure and this complication is not yet clear. Do cochlear implants increase the risk of bacterial meningitis? Are deafness-associated factors predisposing the bacterial meningitis occurrence, independently from the implant? These are the questions that the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the CI surgeons have been facing, as well as manufacturers and patients with their families.

Introduction. Laryngectomy is a surgical procedure for the removal of the larynx, either entirely (total laryngectomy) or partially (partial laryngectomy). Rehabilitation of laryngectomy patients is a complex process that involves physical, psychological, and social aspects. To improve the quality of life of laryngectomy patients, rehabilitation consists of several phases that include learning alternative ways of speaking, breathing and swallowing exercises, and psychological support. It is important to emphasize that rehabilitation is a long-term process that requires continuous support for patients to achieve the best results. With the right approach and professional help, rehabilitation can significantly improve the quality of life of laryngectomy patients. This paper aims to review relevant literature in order to present the possibilities of verbal communication in patients after laryngectomy. Methods. The methods used in this study include searching websites such as www.pubs.asha.org, www.cjcrcn.org, www.scielo.org, www.journals.ekb.eg, www.biomedcentral.com, and www.dovepress. com for the papers published in Serbian and English from 2018 to 2022. Overview. This paper provides an overview of speech rehabilitation in laryngectomy patients, various methods of treating larynx cancer, and a review of current literature in the field of laryngectomy. Conclusion. After total laryngectomy, patients need to undergo intensive speech rehabilitation to regain the ability of verbal communication. This process requires a multidisciplinary approach, including various specialists such as speech therapists, phoniatrists, oncologists, surgeons, and psychologists. [ABSTRACT FROM AUTHOR]

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