Thesis (Ph. D.)--University of Sydney, 2006. / Title from title screen (viewed May 1, 2007). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Communication Sciences and Disorders. Includes bibliographical references. Also issued in print.

<p> This research study investigates the manifestations of the core deficits of autism spectrum disorder (ASD) in the writing process of three school-aged individuals diagnosed with this disorder. A qualitative research design was employed in order uncover the effects of the core deficits on the social interactions surrounding a constructivist approach to writing development. The ethnographic methods used during this investigation allowed the identification behavioral strategies employed as a result of the core deficits of ASD as they occurred during the authentic context of interest. The results of this study suggest underlying cognitive deficits described as an inaccurate locus of joint attention, rigid and restrictive conceptualizations of the writing process, and non-social use of the writing process. These underlying cognitive capacities decrease the ability of the individual with ASD to engage in the writing process in conventionally appropriate and effective manners. In response to a social constructivist approach to the writing process, the manifestations of the core deficits changed in each of the three participants followed in this study to include the establishment of joint action routines, integrated conceptualizations of the writing process, and the emergent use of writing for social purposes. The results of this research investigation support the theoretical standing of pragmatics as an emergent epiphenomenon (Perkins, 2005). For the three participants in this investigation, the social use of both the writing process and of written language emerged as other core capacities in social interaction and rigid conceptualizations responded to the social constructivist approaches employed in this study. As the writing process and written language became part of the social interactions of these IASD, the communicative functions of writing became apparent as a way to share their interests and experiences with others.</p>

<p> The purpose of this study was to evaluate the effects of a social participation based aphasia treatment called conversational coaching. Conversational coaching involves teaching individuals with aphasia and their communication partners (e.g., spouses/caregivers) strategies to facilitate more efficient and meaningful conversation. Two dyads participated in a multiple baseline experimental design across subjects. During baseline sessions, the individual with aphasia watched a videotaped story and then attempted to communicate the story&rsquo;s content to his/her spouse. During treatment sessions, the same general procedure was used, but the investigator coached both participants in the use of selected communicative strategies to facilitate transmission of information and improve the quality of their conversations. The primary dependent variable was the percentage of main concepts successfully co-constructed during conversations. In addition, social outcome measures were used to evaluate the treatment&rsquo;s impact on communicative confidence and quality of life. Positive outcomes were obtained for both dyads</p>

No description available.

<p> ABSTRACT Augmentative and alternative communication (AAC) is defined as &ldquo;all forms of communication (other than oral speech)&hellip;used to express thoughts, needs, wants and ideas&rdquo; (&ldquo;Augmentative and Alternative Communication (AAC),&rdquo; 2012). Working memory is a temporary cognitive process, which briefly maintains and manipulates information while it is being encoded as a part of long-term memory (Engle, Nations, &amp; Cantor, 1990; &ldquo;Introduction to Working Memory&rdquo;, 2007). It has been suggested that based upon the unique skill set and needs of users of AAC systems, the design of these systems should reflect knowledge gleaned from the cognitive sciences (Light &amp; Lindsay, 1991) with training and implementation of AAC incorporating an understanding of the cognitive processes impacting memory, learning, and visual processing (Light &amp; Lindsay, 1991; Wilkinson &amp; Jagaroo, 2004). This study sought to examine how users of AAC managed and perceived the cognitive load associated with working memory demands while communicating and what specific strategies and/or design features users of AAC perceived they used during conversation when using AAC. Results revealed an overall large amount of variability in participants&rsquo; responses. Length of symbol/word sequences, word prediction, seeing the message as it is being created, attention to the conversational topic, and attempting to remember what their conversational partner said appeared to be judged as having the highest degree of importance for the use of a speech generating device and success and message completion in conversation. Errors in conversational while using a speech generating device and stressors during the conversational process appeared to be most closely related to reported lack of time to create messages and the time it takes to create messages. Users of AAC did not report high frequency of actives attention to the working memory processes and design features.</p>

<p> Purpose: Non-verbal cognition and language functions were examined in adult stroke survivors with aphasia. The specific purpose of the study was twofold: 1) to examine the relationship between self-reported outcomes from people with aphasia (PwA), measures of non-verbal cognition (Delis-Kaplan Executive Function Systems Test (D-KEFS), Delis, Kaplan, &amp; Kramer, 2001) and measures of language (Western Aphasia Battery-Revised (WAB-R), Kertesz, 2007; Boston Naming Test Second Edition (BNT-2), Kaplan, Goodglass, &amp; Weintraub, 2001) and 2) to examine these same relationships using partner-reported outcomes for that same group of PwA. This study used the Aphasia Communication Outcome Measure (ACOM, Doyle et al., 2013) to gather both self-reported ACOM data and partner-reported ACOM data (ratings of the person with aphasia&rsquo;s communication made by a regular conversation partner). </p><p> Method: Seventeen participants with aphasia underwent examination with an extensive test battery including measures of functional communication, non-verbal cognition, and language impairment. In addition, 16 of their regular communication partners rated functional communication performance. </p><p> Results: Self-reported functional communication is strongly related to the number of errors committed on the D-KEFS design fluency test (r = .81, p = .001). Furthermore, a modified form of the D-KEFS design fluency test (in which the examinee is allowed unlimited time) shows that the proportion of errors contributes significantly to a two- predictor linear regression model. These two predictors account for 66% of the variance in self-reported functional communication ratings. These results suggest that non-verbal cognition for people with mild to moderate aphasia may serve an important role in functional communication. By contrast, self-reported functional communication was uncorrelated with aphasia severity (r = .04, p = .88), naming performance on either the WAB-R (r=.059, p=.823) or the BNT-2 (r=.097, p=.713), and category fluency (r=.086, p=.741). Partner-reported functional communication was highly correlated to the naming subtest on Western Aphasia Battery-Revised (WAB-R) scores (r=.71, p=.02) and to performance on the Boston Naming Test (BNT-2; r=.56, p=.026). </p><p> Partner-reported functional communication was also strongly predicted based on the number of animals named during the category fluency task on the WAB-R (r=.782, p=.000). A linear regression model including WAB-R category fluency accounted for 61.1% of the variance in partner-reported ratings. A second linear regression adding naming as a predictor was not significant (F_change = 2.18, p=.163). By contrast, none of the non-verbal cognition measures were useful predictors of partner-reported functional communication. These results suggest that aphasia severity serves an important role in partner ratings of functional communication whereas non-verbal cognition does not. </p><p> Taken together, these results suggest that PwA and their partners rely on different aspects of communication when judging functional communication. </p><p> Further work to explore the use of patient-reported outcome (PRO) measures and to identify factors that contribute to self-reported functional communication is needed. The discussion addresses the appropriateness of using PRO measures in aphasia and the use of surrogate reports.</p>

<p> <b><u>Objective:</u></b> This is a pilot study designed to assess speech and swallowing characteristics of participants with idiopathic Parkinson&rsquo;s disease (IPD) before deep brain stimulation surgery of the subthalamic nucleus (DBS-STN), after the DBS-STN surgery, and at follow up evaluation sessions.</p><p> <b><u>Method:</u></b> A within participant, single-subject experimental A-B-A-A design was used to measure changes in the dependent variables for each participant. The primary dependent variables were intelligibility scores of words and sentences, vowel space area (VSA), vocal sound pressure level (dB SPL) of sustained vowels, single words, and contextual speech, Multidimensional voice program (MDVP) analysis of phonatory stability of sustained vowel phonation, lip pressure, tongue tip to alveolar ridge pressure, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and diadochokinetic rate. The secondary dependent variables were: duration of sustained vowel phonation, Visual analog scales (VAS) for communicative difficulties and swallowing difficulties, the EAT-10 swallowing questionnaire, and the qualitative narrative of life with IPD before and after the DBS-STN surgery.</p><p> <b><u>Results:</u></b> DBS-01 had significant declines of intelligibility with individual words, but did not have statistically significant changes for complete sentences. The VSA declined over the course of the study. The MDVP analyses indicated general declines in phonatory stability, but not significantly. There was a statistically significant increase in dB SPL for sustained vowel phonation, but there were overall declines in loudness for connected speech. The duration of sustained vowel phonation increased and the DDK rate varied across the experiment. Left lip and tongue pressures had overall declines, but right and center lip pressures increased. The VAS for communicative difficulties revealed worsening of symptoms. The VAS and the EAT-10 questionnaire for swallowing difficulties both recorded worsening of symptoms after surgery, and symptom improvements later on. The timed swallow test did not show any meaningful impairment in drinking or eating.</p><p> DBS-02 had statistically significant gains of intelligibility with individual words after the DBS-STN surgery, but had statistically significantly declines later on. The changes in the intelligibility of complete sentences were not significant. The VSA contracted after the surgery, but it increased afterwards. The MDVP analyses indicated an overall significant increase of phonatory stability. The dB SPL had a statistically significant increase for sustained vowel phonation, but the connected speech loudness had mixed results. The duration of sustained vowel phonation increased after surgery, but then declined later on. The DDK rate varied across the experiment. Lip and tongue pressures had overall increases. The VAS for communication difficulties revealed an overall increase in communicative abilities. The VAS and the EAT-10 questionnaire for swallowing difficulties both recorded a decrease in symptoms after surgery, and an increase later on. The timed swallow test did not show any meaningful impairment in drinking or eating.</p><p> <b><u>Conclusions:</u></b> DBS-01 had an overall result that the DBS-STN surgery and electrode adjustments were not apparently beneficial to speech and swallowing symptoms, although the delay in assessment after the surgery made distinguishing the effects of the surgery from progressive IPD symptoms difficult. DBS-02 had an overall result that the DBS-STN surgery was beneficial to speech and swallowing symptoms in the short term, although later progression of IPD symptoms, as well as electrode adjustments likely caused later declines.</p>

No description available.

Four main experiments were conducted to investigate the effectiveness of language treatment methods with aphasic stroke patients. Experiment 1 was designed to compare an operant speech training procedure devised by Goodkin (1966) with speech therapy and with an attention placebo treatment. Twenty-four patients with moderate aphasia (35 to 65 %ile on the PICA) received four weeks of speech therapy and four weeks of either operant training, or non-specific treatment. Results indicated no significant differences between the treatments. Patients showed significant improvement in language abilities but this was unrelated to age, months post onset or handedness. Experiment 2, was a preliminary investigation of speech therapy with eighteen severe aphasics (below 35 %ile on the PICA). Patients shov/ed significant improvement in language abilities but this was unrelated to age, months post onset or amount of speech therapy received. In Experiment 3 operant training and an attention placebo were each given for 4 weeks, in addition to speech therapy, to twelve severe aphasics. No significant differences occurred between treatments and patients showed significant change which was unrelated to age or months post onset. Experiment 4 compared the treated patients in Experiments 1 and 2 with a no treatment control group. Results indicated no significant differences between the groups over a four week interval. Three subsidiary experiments were carried out to assess the reliability of some assessment procedures used, the Token Test shortened version, the Object Naming test and the Speech Questionnaire. Language retraining methods, as used at Rivermead Rehabilitation Centre, were shown not to improve language abilities more than attention placebo treatments or no treatment. Patients' language abilities improved, but this was unrelated to biographical variables, such as age, months post onset and handedness.

Thesis (Ed.M.)--Boston University