The purpose of the study was to examine the developmental effects of duration cues by comparing the phonetic boundaries and slopes of typically-developing (TD) children to adults on a stop-glide continuum, to examine the effects of duration cues in children with cochlear implants (CIs) on a stop-glide contrast (i.e., [ba] [wa] and [da]-[ja]) as they relate to the auditory temporal deficit hypothesis (Tallal, 2000) and, to explore the impact of auditory sensitivity (i.e., hearing loss versus normal hearing) by comparing the slopes and phonetic boundaries of children with CIs to TD children on a stop-glide continuum. Three groups of participants participated in the study: eight adults, eight five- to eight-year-old TD children, and seven five- to eight-year-old children with CIs. The participants were presented with two nine-step stop-glide continua (i.e., [ba] [wa] and [da]-[ja]) with each step presented ten times for a total of 180 stimuli. The presentations of the stimuli were blocked for place of articulation and were randomly presented within each continuum. The results of the study revealed developmental effects in the perception of duration cues between the adults and TD children. The performance of children with CIs did not support the prediction of auditory temporal processing deficit in that there were no differences in the ability to label the endpoints of the continua. The auditory temporal deficit predicted that the children would have improved performance at the glide end compared to the stop end of the continua. However, the children with CIs have phonetic boundaries that are significantly shifted to the glide end of the continuum compared to the TD children. This finding suggests that children with CIs require longer duration cues to make the phonetic shift compared to TD children, which supports the auditory sensitivity hypothesis. The children with CIs had significantly shallower slopes and shifted phonetic boundaries compared to the TD children. This suggests that degraded auditory sensitivity such as hearing loss adversely impacts speech perception on a stop-glide continuum.

For this dissertation, primary aims included investigating the effects of musical training on attention, working memory, and auditory stream segregation as they relate to music perception and speech understanding in noise. Specifically, an evaluation of performance was conducted for musicians and non-musicians using tests of attention (dichotic listening task), working memory (automated operation span task), and auditory stream segregation (i.e., melodic schema-based task, music achievement test, and speech-in-noise tests). By assessing participant performance on specific aspects of attention, working memory, and auditory stream segregation, critical information about the impact of musical training on these factors was gathered.

Voice rest is frequently prescribed for patients following vocal fold surgery; however, patient compliance with voice rest has been found to be relatively low. This study examined the impact of text-to-speech (TTS) communication on amount of patient self-reported voice use during voice rest. Seven vocal fold surgery patients prescribed up to seven days of voice rest were randomized to receive either the standard of care treatment or the standard of care treatment plus a TTS augmentative and alternative communication (AAC) device. Amounts of post-surgical voice and TTS use were measured via participant self-report on 100 mm visual analogue scales (VAS). Participants mean VAS scores for voice use ranged from .5 52.4 mm; however, six participants reported mean VAS scores of 8 mm or less, suggesting that TTS access was not a factor in compliance with voice rest. In a comparison of voice use and TTS use within the TTS group, the two participants with the lowest mean VAS scores for voice use had substantially higher mean VAS scores for TTS use than the other members of the TTS group, suggesting that for some patients on voice rest, access to a TTS device may improve or support compliance by decreasing voice use. Additional data must be collected to allow for extensive group comparisons and analyses for a treatment effect associated with the TTS device. Limitations of the present study and considerations for enhancing continued and future research are discussed.

Background/Purpose: Despite its widespread use, limited research exists exploring compliance with prescribed voice rest. The current study explored the relationship between personality and level of patient compliance with voice rest. We hypothesized that Extraversion and Neuroticism has a negative relationship with compliance to voice rest, and that Conscientiousness has a positive relationship with compliance to voice rest. Method: Case study of seven patients (mean age of 42; 5 males, 2 females) undergoing surgical excision of benign vocal fold lesions prescribed up to 7 days of voice rest following surgical intervention. Participants completed the following self-report instruments: NEO-FFI-3, pre-surgical questionnaire, post-surgical questionnaire, and the VHI. Results: Descriptive analysis revealed that similar to medication adherence, Conscientiousness and Neuroticism seem to play at least a partial role in compliance with voice rest, a treatment that requires behavioral adherence. Less clear is the relationship between Extraversion and adherent behavior, leaving us unable to provide support in favor of or against Roy and Bless (2000) hypothesis. Discussion: Further understanding of the role that personality plays in compliance may lead to the development of more evidence-based and individualized protocols for voice rest and foster increased success with this treatment.

Mother-infant attachment is a connection between a child and his/her mother that is dependent upon maternal sensitivity and accessibility. This relationship is well studied in children with typical development as well as in those with special needs. However, our knowledge of attachment in children with hearing loss is minimal compared to other mother-infant dyads. To confound this issue, most of this knowledge was collected prior to the implementation of newborn hearing screenings, a process that leads to earlier diagnosis of hearing loss in children. The attachment development in 21 young children (i.e., 2-6 years-old) with hearing loss was evaluated using the Attachment Q-Set (AQS; Waters, 1985; 1995). Results of this study support the conclusion that children with hearing loss can develop attachment security similarly to typical peers. Furthermore, there was some evidence to suggest that age of diagnosis of hearing loss might not be an influencing factor in attachment development. In summary, even with early knowledge of hearing loss, the attachments of children and their mothers are consistent with attachment development in the typical population.

The purpose of this study was to assess whether sympathetic (i.e., skin conductance level, SCL) and parasympathetic (i.e., respiratory sinus arrhythmia, RSA) activity differs between preschool-age children who do (CWS) and do not stutter (CWNS). Participants were 20 preschool-age CWS (15 male) and 21 preschool-age CWNS (11 male). Participants were exposed to two emotion-inducing child video clipsnegative and positivewith neutral clips used to establish pre- and post-arousal baselines, and then performed age-appropriate narrative tasks. Respiratory sinus arrhythmia and SCL were measured while participants listened to/watched the audio-video clip presentation and performed the narrative task. Findings indicated that CWS, compared to CWNS, displayed lower RSA (i.e., physiological regulation) at baseline as well as greater SCL (i.e., physiological reactivity) during the speaking task following the positive, compared to the negative, condition. Lastly, CWS displayed a positive relation between SCL and RSA during speaking, whereas CWNS did not display a significant relation between the two variables. In conclusion, during environmental challenge, preschool-age CWS, when compared to their CWNS peers, differed in physiological reactivity and regulation. These differences may divert CWSs resources away from attentional, cognitive, and speech-language processes needed to fluently initiate and/or maintain communication, a possibility that must await further empirical study.

Despite improvements in amplification technology, the vocabulary growth of children with cochlear implants lag behind that of typically developing children. Maternal input may influence opportunities for children with cochlear implants to learn new vocabulary words. This pair of studies compared mothers multimodal cues about word referents available to and used by children with cochlear implants and children with normal hearing. The first quantified the proportion of converging and diverging auditory-visual cues present in maternal speech to children with cochlear implants as compared to children with normal hearing matched for chronological age and matched for vocabulary size. Mothers provided input to children with cochlear implants in a way that was different from the way that mothers provide input to children matched for vocabulary size. The second study evaluated the effects of synchronous and asynchronous auditory-visual cues on the word-learning performance of children with cochlear implants and children with normal hearing matched for chronological age. Children with cochlear implants did not learn words in either condition, whereas children with normal hearing made use of synchronous cues to learn words. These findings represent a first step toward determining how environment-level factors influence the lexical outcomes of children with cochlear implants.

There is substantial heterogeneity within the population of children with language impairment (Bishop, 1998; Leonard, 2014). This heterogeneity has led the research community to consider the possibility of subtypes of language impairment (Bishop & Rosenbloom, 1987; Dollaghan, 2011; Rapin & Allen, 1983; Tomblin et al., 1997). But, previous research on language impairment subtypes is inconclusive (Dollaghan, 2011; Leonard, 2014). This study utilized the EpiSLI database (Tomblin, 2010) to empirically examine the possibility of subtypes by applying statistical analyses designed to detect and classify clusters. Further, this study addressed three key gaps from prior work by: (a) using continuous variables without a priori number of clusters, (b) including cognitive variables, and (c) evaluating subtype models. The EpiSLI database was spilt into two datasets based on clinical status: Typically Developing and Language Impaired. Language and cognitive measures within the datasets were used for clustering analyses. The study included two methods of cluster analysis: Wards and K-means. The results indicated that both the Typically Developing and the Language Impaired datasets did meet the a priori criteria for detecting structure, but this structure did not aggregate into interpretable clusters. Principal components analysis was then applied and reduced the variables to eight components, but did not improve results in terms of yielding interpretable clusters. These results support previous research that argues against subtyping in language impairment (Dollaghan, 2011; Leonard, 2009) while replicating a previous cluster analysis using the EpiSLI data (Tomblin & Zhang, 1999). Because consistent subtypes cannot be demonstrated empirically despite theoretical justification for subtyping patients with SLI, clinicians should focus on individual strength and weaknesses in assessment rather than attempting to subtype patients. Future work should seek to replicate these methods in other databases and with additional measures in order to further explore the possibility of language impairment subtypes.

The vestibulo-ocular reflex (VOR) is responsible for maintaining clear vision on a target in the presence of head motion. A functional VOR driven by a healthy peripheral and central allows for three assumptions: eye velocity and head velocity are equal; eye rotation and head rotation occur in equal and opposite axes; and movements of the head and eye are synchronous. Caloric irrigations have served as the gold standard for assessing lateral semicircular canal function, and until recently video technology inadequately captured eye movement. With the advent of lighter, better-fitting goggles and improved video resolution, the video head impulse test (vHIT) is capable of recording saccades during and following high velocity, low amplitude head thrusts. The purpose of this project was to determine specificity of the EyeSeeCam video head impulse system on young normal participants. Normal vestibular function was confirmed with caloric irrigations, and asymmetry across all subjects was found to be 4%, suggesting sufficient specificity for clinical use pending sensitivity data in a clinical population.

Background/Purpose: <p>Research evidence regarding the efficacy of voice rest after microflap excision of benign vocal fold lesions is limited. This both results from and contributes to a lack of agreed-upon practice patterns regarding voice rest among physicians. Patients report decreased quality of life during voice rest. Basic science findings increasingly support vocal fold mobilization after the inflammatory phase of healing (3-5 days postoperatively). The purpose of the present study was to determine if longer durations of postoperative voice rest were associated with improved postsurgical outcomes. <p>Methods: <p>Retrospective chart review of 74 patients (mean age of 43 years; 53% male, 47% female) who underwent direct microlaryngoscopy with microflap surgery to remove a nodule, polyp, or cyst between June 1, 2009 and May 31, 2014. Outcomes were measured by changes in total Voice Handicap Index (VHI) score and by changes in the stroboscopic parameters mucosal wave and closure. <p>Results: <p>VHI scores improved by an average of 22.5 points after microflap surgery and voice rest. No statistically significant associations between prescribed or actual duration of voice rest and postsurgical outcomes were found. Patients who completed more preoperative voice therapy sessions were statistically more likely to complete more postoperative therapy sessions and to experience less improvement in VHI scores after surgery. Females completed more therapy sessions and experienced less improvement in VHI severity than males. <p>Conclusions: <p>Microflap surgery is an effective treatment of benign vocal fold lesions. The efficacy of postoperative voice rest is still unknown and warrants a well-designed prospective study. Pre- and postoperative voice therapy, adherence, gender, and age may be relevant to patient outcomes.