Legal mandates, educational reform, and professional policy changes, have emphasized the need to promote the integration of services for students with communication impairments within the general education curriculum. However, speech-language pathologists (SLPs) continue to report the provision of primarily pull-out services with intervention content separate from the general education curriculum. SLPs report minimal use of collaboration required for evidenced-based models of service delivery--like response to intervention (RTI). Graduate training programs are challenged to provide coursework targeting competencies consistent with educational reform and professional policy efforts. Graduate students in the School of Communication Science and Disorders (SCSD) distance education master's degree program received instruction infused with experiential learning opportunities related to evidence-based practice, collaboration, problem solving models such as response to intervention, and embedding social communicative intervention in the curriculum to measure change in content knowledge and application. This study documented changes in content knowledge related to the preceding content areas, practical application of content knowledge through an action research project, and practices and perceptions related to collaboration and service delivery through questionnaires completed by graduate students and school personnel (e.g. collaborating teachers, graduate supervisors, and principals). The course led to gains in content knowledge and offered meaningful practical experiences to apply through implementation of a social communicative intervention in an elementary or secondary general education classroom. Significant change did not occur in practices related to collaboration and service delivery as supported by questionnaire results; however, some positive changes were noted in perceptions. Common themes emerged and informed results related to the selection of service delivery models and obstacles to collaboration. Overall results indicate sustained efforts may be needed to change actual behaviors in practice as future SLPs will continue to be challenged to use service delivery options compatible with including students with disabilities in general education settings. / A Dissertation submitted to the School of Communication Science and Disorders in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2012. / March 13, 2012. / classroom-based services, collaboration, distance education, personnel preparation, response to intervention, speech and language therapy / Includes bibliographical references. / Juliann J. Woods, Professor Directing Dissertation; Michelle M. Kazmer, University Representative; Carol M. Connor, Committee Member; Julie A. G. Stierwalt, Committee Member.

The ability to use language effectively is a function we rely on every day. Unfortunately for many individuals, language ability can be impaired following damage to the language centers of the brain. Aphasia is the term that applies to individuals who have suffered such language impairment, and while there are six general classifications of aphasia, word retrieval difficulty is a universal component across them. As such, factors that influence word retrieval have been widely studied in individuals with aphasia. One such factor, word fluency, has been the focus of numerous investigations, leading to an understanding of the "word frequency effect". The word frequency effect is the understanding that words which occur with high frequency (i.e. hat, pen) are much easier to produce than words that occur with low frequency (i.e. violin, binoculars). More specifically, words of high frequency are produced more accurately and faster than low frequency words. This frequency effect in word retrieval is well documented. However, to date, there has been no investigation on the errors that are produced on high and low frequency words. Studying the error productions of individuals with aphasia might offer a greater understanding of word retrieval and where the breakdown may occur. The purpose of the current study was to conduct an analysis on the errors produced by individuals with aphasia across two word retrieval conditions (high and low frequency). Seven individuals with aphasia participated in this investigation. All seven were native English speakers, originally right-handed, suffered a single episode, left hemisphere thrombo-embolic CVA, were at least six months post onset, and had no overt sensory or severe motor speech impairments. Each participant completed word retrieval across conditions of high frequency (30 words) and low frequency (30 words). An analysis of the errors produced in the two conditions was completed according to the Foygel and Dell (2000) classification system. After the errors were coded, the expected configuration of errors (fewer errors in the high frequency condition) was obtained by this sample of individuals with aphasia. Specific analysis of error productions indicated several individual patterns of errors, which were similar across the two conditions. With a few exceptions (perseverations and "I don't know" responses), semantic errors were produced with the greatest frequency across both conditions. The remaining breakdown of errors differed slightly across conditions. The unique contribution of this study was the systematic analysis of error productions. These findings offer preliminary evidence that error patterns are similar across the two conditions, as a differential effect was not revealed. These results suggest that the underlying mechanism of word retrieval difficulty operates the same, regardless of word frequency. Finally, the knowledge of error patterns (in this case semantic errors) may have clinical implications for guiding treatment, although additional study is warranted to either support or refute these preliminary findings. / A Thesis submitted to the School of Communication Science and Disorders in partial fulfillment of the requirements for the degree of Master of Science. / Summer Semester, 2012. / July 13, 2012. / aphasia, naming, word frequency / Includes bibliographical references. / Julie A. G. Stierwalt, Professor Directing Thesis; Leonard L. LaPointe, Committee Member; Charles Ouimet, Committee Member.

The purpose of this study was to evaluate the effectiveness of a caregiver-implemented vocabulary intervention for toddlers with language delays using mobile device applications (apps). This study used two apps to teach caregivers to use evidence-based communication intervention strategies to teach expressive vocabulary in everyday activities. A "talking" storybook app served as a personalized intervention support to teach targeted vocabulary words, and a videoconference app supported communication between the researcher and caregivers. Three caregiver-child dyads participated in the study. The researcher used a multiple baseline design across routines, with replication across participants to measure gains in children's communication and changes in caregiver's use of intervention strategies. Following the six-week intervention, caregivers participated in an interview to determine the social validity of using apps with toddlers in an intervention context and completed a survey to determine their level of satisfaction with the project. Results indicated that children made gains in their communication skills and learned targeted vocabulary words, and that caregivers learned to use intervention strategies through coaching sessions via videoconference. These results contribute to the literature on caregiver-implemented intervention and demonstrate how mobile devices can be incorporated into evidence-based practice in early communication intervention. / A Dissertation submitted to the School of Communication Science and Disorders in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2012. / July 2, 2012. / caregiver, early intervention, iPad, language intervention, mobile device, routines / Includes bibliographical references. / Juliann Woods, Professor Directing Dissertation; Mary Frances Hanline, University Representative; Carla Wood Jackson, Committee Member; Joanne Lasker, Committee Member.

The present design examined teachers' use of expository text during the dedicated block of time devoted to literacy instruction. Teachers and students were participating in an instructional intervention (Individualizing Student Instruction [ISI]). Teachers (n = 33) and their students (n = 448) were randomly assigned to either the ISI intervention or a vocabulary intervention, which was not individualized. The teachers in both conditions received equal hours of professional development. Classroom observations were videotaped and conducted in 2008-2009, in the fall, winter, and spring to document the instruction that each student in the classroom received. Results indicated that teachers and students spent far less time in expository text interactions (3.5 minutes) during the literacy block than in narrative text interactions (21 minutes). There were no differences in use of expository text across interventions. Finally, the use of expository text in the classroom did not have a significant effect on the primary outcome measures of students' spring reading and language factor scores. The results of this study suggest a need to learn more about teacher's use of expository text and its place in third grade classrooms. / A Dissertation submitted to the School of Communication Science and Disorders in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Fall Semester, 2012. / October 19, 2012. / expository text, informational text, third grade / Includes bibliographical references. / Carol Connor, Professor Co-Directing Dissertation; Juliann Woods, Professor Co-Directing Dissertation; Barbara Foorman, University Representative; Carla Jackson, Committee Member; Alysia Roehrig, Committee Member.

Purpose: This study examined the triadic relationships between the early interventionist, the parent and the child in a parent-implemented communication intervention for toddlers. Specifically, relationships between coaching strategies used by interventionists, parents' implementation of communication intervention strategies, child communication targets, and the intervention context were explored. Method: A series of multiple-baseline single-case designs with replication across nine parent-child dyads was used to evaluate the effects of the family-guided routines-based intervention for toddlers eligible for IDEA Part C service due to developmental delays. Sequential analyses from aggregate data across the intervention phase provided a preliminary exploration of contingent relationships between coaching strategies, parent intervention strategies, and child communication. Results: Coaching strategies that provided opportunities for an active parent role (i.e., caregiver and guided practice with feedback and observation) were associated with higher parent implementation of intervention strategies. Responsive parent communication strategies yielded stronger relationships with child communication than modeling or prompting/milieu teaching strategies. Conclusions: Parent-implemented communication intervention focused on building parents' capacity through a collaborative coaching process in family-guided routines shows promise for enhanced parent and child outcomes as well as implementation of recommended practices in the early intervention system. / A Dissertation submitted to the School of Communication Science and Disorders in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Fall Semester, 2012. / October 24, 2012. / coaching, communication, early intervention, parent-implemented, toddlers / Includes bibliographical references. / Juliann Woods, Professor Directing Dissertation; Mary Frances Hanline, University Representative; Amy Wetherby, Committee Member; Carla Wood Jackson, Committee Member.

A deficit in communication is not only one of the earliest and most frequently reported concerns by parents of young children later diagnosed with autism spectrum disorder (ASD), but is also among the most frequent reasons for the initial referral to a specialist for young children with ASD. Although extensive research has explored diagnostic features of communication in preschool aged children with ASD, few studies have examined these deficits in toddlers. In addition, the majority of research examining communication is conducted through parent report or within a clinic setting and provides limited information about communication profiles of toddlers with ASD within the home environment. The purpose of the present study was to explore early social communication profiles of toddlers suspected of having ASD (N = 74) during systematic observations within the home environment. Communicative acts were measured for rate, mode and function from video-recorded home observations of toddlers interacting with parents during everyday activities. The results of this study suggest that toddlers suspected of having ASD exhibit lower rates of communication in their home environment when compared to previous research within clinical settings. Toddlers in this study primarily directed their communication to others through the combination of gestures and vocalizations rather than with either a gestures or vocalizations. As expected, they communicated most frequently to regulate the behavior of their parents and communicated less frequently to join or share attention with another person or to interact socially. Results also suggest that the strongest predictors of outcomes at age three were rate of communication, communicative acts with a combination of gestures and vocalizations, and acts for behavior regulation. This study provides further understanding of social communication in toddlers suspected of having ASD, but also provides new information regarding communication within the home environment which may help build consensus with families of young children suspected of having ASD on early diagnostic features and provide the important first step families need in order to seek an evaluation and consider a diagnosis of ASD for their child. / A Dissertation submitted to the School of Communication Science and Disorders in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Fall Semester, 2011. / August 30, 2011. / Includes bibliographical references. / Amy M. Wetherby, Professor Directing Dissertation; Ron Mullis, University Representative; Juliann Woods, Committee Member; Joanne Lasker, Committee Member.

Purpose:This study examined young English language learners' (ELLs) sensitivity to cognate words (i.e., phonologically-similar translation equivalents, such as baby-bebéand telephone-teléfono) during timed comprehension and production tasks.Method:In this descriptive study, thirty-one young ELL children and a control group of thirty-one English monolingual children participated in two researcher-developed tasks. During a comprehension task, children completed a picture-word verification task which required a rapid forced choice to identify whether a picture matched an auditory stimulus (i.e., match: green "smiley face" button, not-match: red "sad face" button). During an expressive task, ELL children completed picture naming in three blocks (i.e., English, Spanish, free-choice). English monolingual children completed two blocks of English picture naming. The order of receptive and expressive task administration was counterbalanced, and word order was randomized within each block. Speed and accuracy were the dependent variables for the picture word verification task, and accuracy was the dependent variable for picture naming tasks.Results:On the picture word verification task, ELLs showed no significant differences between cognates and noncognates on the comprehension task. Possible explanations for this non-significant finding are discussed. On the picture naming task, young ELL children demonstrated higher accuracy on phonologically-similar cognates than noncognates, similar to the cognate effect found with bilingual adults. In contrast, English monolingual children did not perform differently on cognates versus noncognates, confirming that ELL children demonstrate a cognate effect unique to dual language learners. / A Dissertation submitted to the School of Communicative Science and Disorders in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Fall Semester, 2011. / November 7, 2011. / cognate, English language learners, phonological similarity, picture naming, vocabulary / Includes bibliographical references. / Carla Jackson, Professor Directing Dissertation; Gretchen Sunderman, University Representative; Kenn Apel, Committee Member; Christopher Schatschneider, Committee Member.

The purpose of this single case multiple-baseline design was to investigate the utility of using a mobile device application specifically Pictello for the iPad, as a tool to teach and support peer buddies to interact with a student with autism spectrum disorder (ASD). Peer-mediated interventions have been highly successful in improving the social skills of children who have autism spectrum disorder (ASD). However, the high level of support required to implement these interventions is not feasible for many teachers. This study explored the use of technology to support peers' use of communication facilitation strategies, thereby saving teachers' time and increasing opportunities for intervention. Intervention was conducted within the context of peer buddy interactions during typical school activities. Results demonstrated increased responses, initiations and topic maintenance of the target child during the intervention period. This research contributes to the literature on peer-mediated intervention through integrating evidence-based practice and technology to increase feasibility and accessibility to classroom teachers and other school-based professionals. / A Thesis submitted to the School of Communication Science and Disorders in partial fulfillment of the requirements for the degree of Master of Science. / Summer Semester, 2013. / June 20, 2013. / apps, autism, mobile device application, peer-mediated, reciprocity, social skills / Includes bibliographical references. / Juliann Woods, Professor Directing Thesis; Shannon Hall-Mills, Committee Member; Toby Macrae, Committee Member; Julie Stierwalt, Committee Member.

Purpose: To examine maximum isometric lingual pressure (MIP) and total oral phase duration (oral preparation time + oral transport time) (TOP) in healthy adults, and to explore the relations among these variables. Method: One hundred healthy adults (50 males and 50 females), with no significant medical history affecting oral musculature or swallowing, volunteered to participate in this study. Lingual-palatal pressures were recorded via the Iowa Oral Performance Instrument (IOPI) by placing a tongue bulb at both anterior and posterior locations to obtain maximum isometric lingual pressures generated by the anterior portion of the tongue (MIPa) and maximum isometric lingual pressures generated by the posterior portion of the tongue (MIPp). Surface electromyography (sEMG) using the Biopac MP150WSW System was utilized to record the onset and offset of swallowing muscle activity indicating TOP durations across six consistencies of food and liquid. Results: Significant negative correlations (p < 0.05) were observed between MIPa and all consistencies tested except for puree, and significant negative correlations were evident between MIPp and chewable solids (i.e., banana and graham cracker). MIPa was found to significantly predict TOP duration for thin liquid, mechanical soft and regular solids, and MIPp was found to significantly predict TOP duration for mechanical soft and regular solids. MIPa and MIPp values were significantly greater in males than in females. Age was discovered to significantly predict MIPa but not MIPp. There were no statistically significant differences in TOP durations between sexes. Age was revealed to have the strongest predictive value with TOP durations for liquids as opposed to TOP durations for food consistencies. Conclusion: This was the first study to demonstrate that strong relations exist between MIP and TOP duration in the healthy adult population. Sarcopenia is most likely responsible for the decrease in MIPa and longer TOP durations observed in older adults. Findings from this investigation lend support for implementing regular MIPa exercise in healthy adults to possibly combat lingual weakness and minimize or alleviate symptoms of oral phase dysphagia later in life. / A Dissertation submitted to the School of Communication Science and Disorders in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2013. / June 12, 2013. / healthy adults, IOPI, maximum isometric pressure, oral phase duration, sEMG, swallowing / Includes bibliographical references. / Julie A. G. Stierwalt, Professor Directing Dissertation; Gary Heald, University Representative; Leonard L. LaPointe, Committee Member; Richard Morris, Committee Member.

A discrepancy exists between the age at which children are currently identified with autism spectrum disorder (ASD) in the community and the age at which they can be reliably identified in research. Observational measures are needed to improve screening and early detection of toddlers with ASD as recommended by the American Academy of Pediatrics. The purpose of this study was to examine social communication in three groups of toddlers with ASD, developmental delay (DD), or typical development (TD) using two concurrent methods of observation: a systematic semi-structured clinic observation and a naturalistic home observation of everyday activities. Participants between 16 and 26 months of age with ASD (n = 114), DD (n = 32), or TD (n = 34) were selected from the archival database of the FIRST WORDS® Project, a longitudinal, prospective sample of children identified from the general population. The standard scores of the Communication and Symbolic Behavior Scales (CSBS) Behavior Sample were used to measure social communication skills in the clinic observation. A subset of four social communication items of the Systematic Observation of Red Flags for ASD (SORF-SC) was also rated during the clinic and home observations. The four SORF-SC items selected for this study included lack of sharing enjoyment and interest, lack of coordination of nonverbal communication, lack of vocalizations with consonants, and lack of pointing or showing gestures. Results revealed significant differences among the ASD, DD, and TD groups with both measures (CSBS and SORF-SC) in the clinic observation and in both observations (clinic and home) with the SORF-SC. Medium to large concurrent and predictive correlations were observed among the SORF-SC items across the clinic and home observations and between the SORF-SC and the CSBS. The home observation SORF-SC accounted for 15−36% of the unique variance for predictions of developmental level and autism symptoms and the CSBS standard scores in the clinical observation added significant unique variance of 11−25%. The results of this study suggest that ratings of social communication deficits in prospective home observations of children late in the second year of life can meaningfully add screening information as an initial step towards identifying children with ASD. These findings have important clinical implications for improving early screening tools and reducing the age of identification of children with ASD. / A Dissertation submitted to the School of Communication Science and Disorders in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2013. / June 17, 2013. / assessment, autism, home video, screening, toddlers / Includes bibliographical references. / Amy Wetherby, Professor Directing Dissertation; Jayne M. Standley, University Representative; Juliann Woods, Committee Member; Julie Stierwalt, Committee Member.