This document summarizes a study on the effectiveness of speech therapy in treating orofacial myofunctional disorders. It administered a self-evaluation test called ASO to 50 patients both before and after therapy to measure outcomes. The results showed statistically significant reductions in reported physical, functional, and emotional discomfort across all scales of the test after therapy. Patients also generally reported being satisfied with the results of treatment and considering their health needs met. The study demonstrates the ASO test is a useful tool for evaluating speech therapy and outcomes from the patient's perspective.

1. !
Monica Checchin, Pasqualina Andretta!
Outcome and Customer Satisfaction of Speech Therapy in the treatment of
Orofacial Myofunctional Disorders!
BACKGROUND and OBJECTIVES! RESULTS and DISCUSSION!
METHODS!
The purpose of this research is to demonstrate the effectiveness and efficiency of myofunctional
therapy for the treatment of Orofacial Myofunctional Disorders (OMD) using the " Self-Evaluation
test “ASO" (mod. Andretta P., Elia C., 2004), administered at the beginning and at the end of
therapy: it is so established the customer satisfaction, crucial for the determination of the
outcome of Myofunctional Therapy in the process of health that the patient is concerned.
The research aims to investigate the results of a study carried out in 2005 on a sample of 15
patients with OMD (P. Andretta, E. Morselli), which was conducted in order to verify the
applicability and validity of the Self-Evaluation Test as a tool that, by determining customer
satisfaction, allows to objectify (as well as the diagnostic-instrumental quantitative evaluation and
the photographic documentation) the effectiveness of Myofunctional Therapy from the patient’s
point of view. "
.
The case study considered was composed of 50 patients, both adults and adolescents (mean age
24.76 years), including 38 women and 12 men."
The results from the individual compilations were collected by examining both the total score pre-and
post–treatment and the score divided by scales (physical, functional, emotional) so that it was possible
to perform a quantitative analysis, and even a qualitative analysis of what experienced by the patient."
"
Università degli Studi di Padova, Dipartimento di Neuroscienze: Scienze Neurologiche, Psichiatriche, Sensoriali, Ricostruttive e Riabilitative, Corso di Laurea
in Logopedia, a.a.2012/2013!
Tab.1 “A.S.O.” table of equivalence between score and severity
(Andretta P., Checchin Monica, 2013)"
CONCLUSIONS!
It was therefore possible to verify that the therapy has fulfilled the health needs of the patients,
who generally consider their needs met. "
In addition, having administered the questionnaire to a large and statistically significant sample, it
was possible consequently to demonstrate the validity and applicability of the questionnaire, by
standardizing the results obtained. "
Thus the “A.S.O.” proves to be a useful tool for clinical practice and the management of the
quality of the speech therapy intervention, since it is a fundamental process indicator that can
point to well-defined outcomes in every aspect: physical, functional, emotional.
It also provides to the speech therapist useful informations to ensure a better grip of the treatment
to the needs of the subject who is the center of the care intervention."
Fig.2 Modification of discomfort. " Fig.3 “A.S.O.” mean values before and after the
speech therapy treatment. "
!
Fig.1 Self Evaluation Test “A.S.O.” (mod.
P.Andretta, 2004)"
"
Based on the findings from the statistical analysis completed, it was proven the statistical significance
of the reduction of discomfort perceived by the user in the scales physical, functional, emotional, and in
the total score (with a p-value well below the level of significance, that has allowed to reject the Null
Hypothesis that the initial and final values​were equal, in favor of the Alternative Hypothesis that the
degree of discomfort decreased after the treatment): therefore the statistics analysis confirmed the
effectiveness of myofunctional therapy for OMD."
The collected data were then analyzed qualitatively, confirming further the reduction of the discomfort
after the therapy, previously proven by statistical processing of data (Fig.2)."
From the above analysis, it was found a decrease between the average scores obtained by the
administration of “A.S.O.” Self Evaluation Test before and after the therapy, as regards both the total
score that the scores of each scale (Fig.3):
P scale mean value of discomfort decreased from 10,78/30 to 3,68/30;"
F scale mean value of discomfort decreased from 15,04/30 to 3,86/30;"
E scale mean value of discomfort decreased from 12,68/30 to 7,16/30;"
Total score mean value decreased from 38,5/90 to 14,7/90 .
Analyzing the composition of discomfort it emerges that: the discomfort average aftercare on the P
scale reduced by about 3 times, that of the F scale of about 4 times, and that of the E scale was almost
halved (Fig.4)."
To come to get the sample, 1778 cases were examined.
The research took place in the Otolaryngology Department of the Hospital located in Bassano del
Grappa (Vicenza, Italy), and considered patients who were taken in charge from 2005 until
October 2012 (and completed the therapy by June 2013)."
Using the following inclusion criteria, it was obtained a sample of 50 patients:
"
1. Prescription for speech evaluation and therapy;"
2. Age ≥ 14 years;"
3. All subjects were taken into care at Hospital of Bassano del Grappa, from 2005 until
June 2013;"
4. Completion of the therapy.
"
The Self Evaluation Test “A.S.O.” was administered to the sample of 50 adults and adolescents
subjects with OMD: it consists of 30 items, divided into three scales (P scale: physics, F scale:
functional, E scale: emotional) and the patient can give a score from 0 to 3 for each item (0
points: never, no discomfort; 1 point: sometimes, mild discomfort; 2 points: frequently, increasing
discomfort; 3 points: always, maximum discomfort).
The total score obtained has its corresponding degree of discomfort (Tab.1). "
The test was taken before starting therapy and after the conclusion of it, considering both the
magnitude of the overall discomfort, and the individual values obtained for each scale."
The collected data were statistically analyzed by means of various hypothesis tests in order to
verify that there has been an increase in customer satisfaction (given the effectiveness of
therapy) and therefore a decrease of the discomfort felt by the patient in relation to its issue
(expressed through a precise score)."
It was first necessary to apply Shapiro-Wilk test to verify that the data were distributed in a
Gaussian: the test showed that the data of the P and F scales and of the total scale were
distributed normally, while the data on the scale E had an unknown distribution.
As a result, t-student test was applied to the data of the P and F scales and to the total score,
while Wilcoxon test was applied to the E scale.
At last, all the 50 responses to the question (located at the end of the “A.S.O.” answers protocol)
“how do you judge your result today? ” were considered, in order to collect user's feedback on the
progress of therapy and on the results obtained."
!
Contacts:
monica.checchin91@gmail.com"
!
I^ International Meeting of Orofacial Myofunctional Therapy !
Rome, June 6-7-8 2014"
At last, as far as the customer satisfaction is concerned, the general opinion by patients who have dealt
with the treatment was found positive.. "
Fig.4 Composition of discomfort
(mean values) before and after
myofunctional therapy."
Fig.5 Customer Satisfaction at the
end of the treatment"
SELF-EVALUATION OF OROFACIAL DISFUNCTIONS
(DIS-EQUILIBRIUM OF THE OROFACIAL MUSCLE FUNCTIONS)
A.S.O. (mod. Andretta P., Elia C. 2004)
(traduzione Anna Beghetto)
Never/
No
Sometimes/
Little
Most of the
time/ A lot
Always/
Yes
1P – Are my lips normally open?
2 F- Do my upper incisors rest on my lower lip?
3 F– Do I habitually lick my lips?
4 F– Do I usually breathe with my mouth open?
5 E – Do I feel tensed or embarassed when people look at
me straight in the face?
6 F – Do my lips look dry and scaly especially during the
cold season?
7 P – Do I hear clicks or grating sounds when I open my
mouth?
8 F– When I’m relaxed, does the tip of my tongue rest
against or between my teeth?
9 P– When I’m relaxed, does my upper dental arch or my
lower dental arch stick out more than the other one?
(specify which dental arch)
10 F– During swallowing, do my lips “move” or do I
make a “smirk”?
11 P- Do I have speech problems with the sounds /s, /z/, or
/r/?
12 E – Do I think I have an esthetic problem with my
face?
13 P – Do I have pain in the temporomandibulat joint or in
the craniofacial area?
14 E – Am I embarassed of how my face looks in the
mirror?
15 F– Does the tip of the tongue push against the teeth
when I swallow saliva, liquids and solids?
16 P- Do I have pain in my neck, shoulders or back?
17 P- Do I often suffer from headache?
18 F --Do I have troubles paying attention and
concentrating?
19 P- Do I feel like I have humming or whistling sounds
in my ears?
20 E – Do I feel uncomfortable to see my face in pictures
and videos?
21 P- Do I feel like I have a “lump” in my throat?
22 F- Do I clench or grate my teeth at night?
23 P- Do I clench my teeth during the day or when I’m
concentrating on something?
24 F- Do I bite my lips, my cheeks, my fingernails, my
pencils or chew on my cuticles?
Never/
No
Sometimes/
Little
Most of the
time/ A lot
Always/
Yes
25 E – Do I feel especially under scrutiny because of my
speech when I talk directly to one or more people?
26 E--Do I feel observed by friends, family members and
acquaintances when I eat at the restaurant?
27 E – From an esthetic point of view, do I consider my
facial features to be un-interesting or un-attractive?
28 E- Do I believe that others’ judgement and perception
of me can be influenced by my facial appearance?
29 E – Do I think I need a specific therapy?
30 E – Do I think I can complete the therapy cycle?
Last and first name__________________________________________________________
Date____________________ Signature____________________________________
(first compilation)
How do you judge today’s result? Good Quite good Average Not good
enough
Date_____________________ Signature_____________________________________
(second compilation)
RESULTS Never/
No
Sometiems/
Little
Most of the time/
A lot
Always/
Yes
SCALE P
SCALE F
SCALE E
TOTAL