The Saint Louis University Mental Status (SLUMS) Examination is a relatively new brief cognitive screening measure developed for use with veterans. To date, there has been a paucity of research on its psychometric properties. Using a sample of 148 male veterans referred to a VA Mild Cognitive Impairment (MCI) Clinic for evaluation, the SLUMS’ ability to discriminate between MCI versus other diagnoses or no diagnosis was compared to results from a more comprehensive neuropsychological battery. Approximately 51% of the sample was diagnosed with MCI, 16% with Major Depressive Disorder (MDD), 17% did not meet criteria for a diagnosis, and 16% were given some other DSM-IV-TR diagnosis. The SLUMS demonstrated poor internal consistency (Cronbach’s alpha = .57), but scores were significantly correlated with scores on every neuropsychological measure, except for Trails B. Diagnostic discriminability was comparable to that of the more time intensive neuropsychological battery for discriminating between MCI and no diagnosis, and MCI and MDD. In the current sample, a cutoff score of 25 was optimal for discriminating between MCI and no diagnosis, whereas a slightly lower cutoff score of 24 is recommended for discriminating between MCI and those with MDD. Diagnostic indicators were poor for the SLUMS and the battery when discriminating between MCI and a heterogeneous group of other disorders. Possible reasons for low reliability in such a screening measure in the context of convergent validity are discussed. It is concluded that the SLUMS may be a viable brief cognitive screening measure in such veteran populations, particularly when discriminating between MCI and MDD; however, additional studies should be completed to evaluate other forms of consistency, such as test-retest reliability.

The Picture Exchange Communication System (PECS) is an augmentative and alternative communication program (Frost & Bondy, 2002). Although PECS has been effectively used to teach functional requesting skills for children with autism, mental retardation, visual impairment, and physical disabilities (e.g., Anderson, Moore, & Bourne, 2007; Chambers & Rehfeldt, 2003), there are limited studies examining the effectiveness of PECS to teach requesting skills for children with multiple disabilities including visual impairment (Lund & Troha, 2008).This study explored the effectiveness of combining tangible symbols and other adaptations with PECS to teach requesting skills to students with multiple disabilities. Specifically, the participants were four students with multiple disabilities including visual impairment who also had many challenges in communication skills. The research design was the multiple probe design across subjects, a variation of a multiple baseline design. A notable benefit to this design is that there was no need to collect continuous recordings of baseline measures, because a strong a priori assumption of stability and the possibility of causing strong participant reactions existed before introducing the intervention. Instead, the researcher made periodic recordings of baseline levels to insure no significant changes have occurred before introducing the intervention.The study included four parts: (a) the assessment of reinforcers, (b) baseline, (c) the implementation of the intervention, which was teaching the three PECS phases and conducting generalization sessions, and (d) the maintenance condition. Three important research questions were posed:1. Can students with multiple disabilities including visual impairment learn to make requests for preferred items using adapted PECS materials and procedures?2. Can students with multiple disabilities including visual impairment generalize requesting skills for preferred items using adapted PECS from training rooms to classrooms?3. Can students with multiple disabilities including visual impairment maintain requesting skills after training?The results indicated that all four participants learned requesting skills using adapted PECS, generalized the newly acquired skills to their classrooms, and maintained the requesting skills after training. Results of this study provided preliminary evidence that PECS with adaptations could be used effectively to teach requesting skills for students with multiple disabilities including visual impairment.

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This thesis explores the experiences of emerging adulthood for men with an acquired impairment. Qualitative semi-structured interviews were conducted with four men with acquired impairments in an urban center of Canada. Through thematic analysis, three themes emerged: internal perceptions, dynamics of social relationships, and barriers and opportunities. Their stories illustrate many common emerging adult experiences as well as some divergent experiences, which may potentially be due to their acquired impairment. The main findings include the importance of friends and family and the fact that the timing for some of the developmental tasks of emerging adulthood may be delayed. Implications for professionals and researchers are presented, focusing on ways to best support men in emerging adulthood with acquired impairments.

A hearing impairment is one of the three leading causes of disability worldwide. It is estimated that 600 million people around the world have a hearing impairment, which affects their communication abilities, causes them to feel isolated and depressed, and impacts their economic situation. Because a decrease in the ability to hear is associated with getting older and life expectancy is increasing, the number of hearing impaired individuals is expected to increase. Much of the current research on adults with a hearing impairment focusses on a disabling hearing impairment, which is a loss of at least 40 dB HL or worse in the better ear. The research on a mild hearing impairment is predominantly focussed on children, specifically on educational effects. The aims of this study were to identify demographic, audiometric and quality of life differences between adults with a mild hearing impairment who adopt hearing aids and those who choose not to adopt hearing aids, and to measure clinical outcomes for adults with a mild hearing impairment who adopt hearing aids. Two groups of clients with a mild hearing impairment were compared. One group consisted of hearing aid adopters whilst the other group consisted of non-adopters. There was no significant difference between the groups in terms of demographic variables, such as age, gender or working status, or objective audiometric variables. We found a statistically significant difference between the groups in terms of subjective audiometric variables. Hearing aid adopters rated their hearing impairment worse than the non-adopters and were more inclined to change their current situation than the non-adopters. In addition, the adopters showed significant clinical improvement after wearing their hearing aids for an extended period of time.

Objective: The purpose of this current study was to develop an audiovisual speech perception test for New Zealand English (NZE) speaking children by adapting the American version of the Children’s-Build-A-Sentence (Ch-BAS) test. Three hypotheses were formulated for this study. First, it was predicted that the New Zealand version of the Ch-BAS test would show list equivalency. A second hypothesis was that all children would perform significantly better on the auditory-visual (AV) condition of the test in comparison to the vision-only (V-only condition). A third hypothesis was that older children would perform significantly better than younger children on both test conditions. Design: The American version of the Children’s-Build-A-Sentence test was adapted for use with NZ children and an audiovisual recording was made of an adult NZE speaker saying the sentence stimuli. This was then edited into a picture response matrix format to make up the NZ Ch-BAS test which is comprised of three lists made up of mono, bi, and tri-syllabic words. Equal numbers of sentences were allocated to the three test conditions: auditory-only (A-only), V-only, and AV conditions. The NZ Ch-BAS test was then administered to 30 normal hearing (NH) NZE-speaking children aged between 7-11 years with equal numbers (n=6) in each age group. All testing was conducted in the presence of multi-talker babble noise, set individually for each child to obtain approximately equivalent performance for the A-only condition. Results: Results revealed that the NZ Ch-BAS test lists were equivalent for both the V-only and AV test conditions when testing NH children. A significant age effect was also found, where older children showed superior speech reading performance in comparison to younger children. A stronger age effect was seen for the V-only condition in comparison to the AV condition. All children performed significantly better on the AV condition in comparison to the V-only condition. Conclusions: The three Ch-BAS test lists demonstrate list equivalency and therefore can be used to develop a reliable test for NZ-English speaking children. As anticipated, there was an age effect in regard to speech reading performance; however this effect was only found for the V-only condition. All children performed significantly better on the AV condition in comparison to the V-only condition. A number of possible explanations for superior performance are provided and clinical uses for the NZ Ch-BAS test are discussed.

Cognitive impairment in Parkinson’s disease (PD) can impact negatively on caregivers and is associated with carer distress and feelings of burden. To investigate this relationship we examined level of burden, coping strategies, depression, anxiety and potential positive aspects of caregiving in the caregivers of 104 PD patients. The PD patients were classified as either showing normal cognition (PD-N; n=57), with mild cognitive impairment (PD-MCI; n=31) or with dementia (PD-D; n=16). The key finding was that mean Zarit burden score increased between carers of PD-N (M=14.1, SD=12.0) through to PD-MCI (M=21.1, SD=9.86) and PD-D (M=27.8, SD=10.61); F (2,101) =9.96, p<0.001. Post hoc tests (Newman-Keuls) identified significantly higher Zarit burden scores in PD-D caregivers compared to both PD-N (p<.001) and PD-MCI patients (p<.05), but carers of PD-MCI patients also showed increased burden scores relative to those of PD-N patients (p<.05). The proportion of carers showing significant levels of burden (Zarit burden score ≥21) also increased as cognition declined (21% for PD-N; 58% for PD-MCI; and 81% for PD-D). Time spent providing care and problem-focused, emotion-focused and dysfunctional coping strategies also increased with worsening cognition. While caregiver use of problem-focused coping mediated the association between patient cognitive status and caregiver burden, we could not be confident about this relationship as the inverse model was also significant. Caregiver Zarit burden was independent of caregiver depression, anxiety and positive attributions of caregiving. The study highlights the impact of Parkinson’s disease on those providing care when the patients’ cognition is poor, including those with MCI. Caregiver well-being has important implications for nursing home placement and disease course.

This thesis explores the experiences of emerging adulthood for men with an acquired impairment. Qualitative semi-structured interviews were conducted with four men with acquired impairments in an urban center of Canada. Through thematic analysis, three themes emerged: internal perceptions, dynamics of social relationships, and barriers and opportunities. Their stories illustrate many common emerging adult experiences as well as some divergent experiences, which may potentially be due to their acquired impairment. The main findings include the importance of friends and family and the fact that the timing for some of the developmental tasks of emerging adulthood may be delayed. Implications for professionals and researchers are presented, focusing on ways to best support men in emerging adulthood with acquired impairments.

This study was an attempt to combine two research literatures on hyperactivity: the behaviour genetic research and the studies testing psychological theories of hyperactivity. We obtained behavioural ratings from the teachers of 1316 twin pairs, aged 7-12, from the general population. For a subsample of 268 twin pairs we obtained ratings also from their parents. Forty-six hyperactive twin pairs (pairs in which at least one twin was pervasively hyperactive) and 47 control twin pairs were then assessed on tests relating to three theories of hyperactivity, those of response inhibition deficit, working memory impairment and delay aversion. Confirming previous findings, genetic factors accounted for 50-70% of the variance in hyperactivity when considered as a continuous dimension. There was also significant evidence of genetic effects on extreme hyperactivity, although the present group heritability estimates were somewhat lower than previous estimates. The hyperactive group performed worse than the control group on the delay aversion measure and some of the working memory tasks. Controlling for IQ removed the significant group differences on the working memory measures, however. Although there were no significant group differences on the inhibition variables, the inhibition measure, stop task, produced evidence of a pattern of responding that was strongly characteristic of hyperactivity: hyperactive children were variable in their speed, generally slow and inaccurate. This pattern of responding may indicate a non-optimal effort/activation state. To investigate the possibility that the cognitive impairments or task engagement factors associated with hyperactivity mediate the genetic effects on the condition, bivariate group heritability analyses were carried out. There was significant evidence of shared genetic effects only on extreme hyperactivity and the variability of speed. The findings are interpreted as supporting the state regulation theory of hyperactivity. Although delay aversion is a characteristic of hyperactivity, it seems to have an environmental rather than a genetic origin.

This dissertation addresses issues related to teaching and learning middle-school mathematical graphing concepts and provides an in-depth analysis on the impact of introducing a new assistive technology in a visually impaired classroom. The motivation, design, implementation, and deployment of the Graph and Number line Input and Exploration (GNIE) software, an auditory graphing tool that enables students with visual impairment to navigate and interact with a coordinate plane or number line graph is presented. Results include a discussion about how a computer-based auditory graphing software can be a beneficial supplement to aiding teachers and students with vision impairment with middle-school based graphing principles. This work also demonstrates that auditory graphing software support collaboration between students of different levels of vision loss and that bone-conduction headphones can be used with software to perform concurrent think aloud protocols without degradation of qualitative data.