An estimated 15 million individuals in the United States have been formally diagnosed with dysphagia, defined as swallowing dysfunction -- the fifth leading cause of death in Americans over the age of 65. Statistical findings indicate that at least 50% of these individuals have limited access to treatment. However, despite the rapid expansion of telepractice (defined as the use of telecommunications technology to provide services at a distance) as a statistically valid online method for the provision of medical and clinical intervention to those without access, telepractice has yet to consistently incorporate online dysphagia service delivery (referred to as tele-dysphagia) into its clinical scope. This investigation compared the outcomes of traditional face-to-face intervention to online tele-dysphagia intervention by measuring the correct and incorrect responses to visual and auditory cues presented by a clinician during dysphagia intervention sessions. Data analysis conducted via t-test indicated that there was no significant difference in the mean scores from tele-dysphagia method (M = 9.67, SD = 3.74) as compared to face-to-face method (M = 9.00, SD = 2.70), t (28) = - 0.56, p = 0.580. Additionally, inter-rater reliability scores were obtained by determining a Cohen’s kappa coefficient in order to measure the degree of agreement between the two raters. Findings indicated a kappa statistic of k=1 for all items, given a 100% agreement for all trials. Additionally, results of a mixed-design analysis of variance suggested a significant within-subject effect with the use of cues, but there were no significant main effects of between-subject factors (gender, delivery type, etiology, or age) on the patients’ responses. Given that there was no significant statistical difference between the two delivery methods and inter-rater reliability scores demonstrated perfect agreement, we can suggest that the online tele-dysphagia method can potentially yield clinical outcomes similar to a traditional face-to-face method. Results from a mixed-design analysis of variance additionally suggested that there is a significant within-subject effect given the use of cues (F (1, 29)=14.99, p = .001) on patients’ responses. However, there were no significant main effects of between-subject factors (gender, delivery type, etiology, or age) on the patients’ responses. It is hoped that the results of this study will lend validity and direction to future attempts to provide much-needed dysphagia intervention via online service methods. Such attempts, in turn, would have the potential to promote increased longevity and quality of life in those populations currently unable to access such services.

<p> This investigation explores the manifestation of motivation as well as the systematic strategies that speech-language pathology graduate students employ to facilitate motivation in struggling learners. A qualitative paradigm was utilized to study three participant dyads, each one consisting of a child with a language disorder and a speech-language pathology graduate student. The primary source of data was video transcript analysis of a total of 17 representative shared reading sessions. The findings of this study demonstrate that motivation to participate in shared reading is manifested in the continued willingness of the child to participate in shared reading and that motivation was facilitated by the graduate clinician via a variety of therapeutic strategies. </p><p> Eleven common patterns emerged. 1) motivation as sustained participation, 2) a distinct set of functional therapeutic strategies were employed, 3) a wide range of therapeutic strategies were employed, 4) variable but systematic application of the different strategies, 5) interweaving of bursts of mediation and singular episodes of mediation, 6) utilization of collaborative therapeutic strategies/culture of co-investigation, 7) a high level of support prior to turn allocation, 8) successful communicative and reading attempts, 9) responsive collaboration by participants, 10) engagement even in the presence of struggle, and 11) rare occurrence of avoidant behaviors. Results indicate that motivation to engage in learning to read was the result of a wide range of instructional, evaluative, and interactional strategies that worked together to promote motivation to read. In response to these strategies, each participant produced responses that were overwhelmingly successful and even expected. These key variables helped to facilitate therapeutic interaction that was characterized by motivation and success.</p><p> Ultimately, it is apparent that motivation to read is best facilitated by complex, multi-faceted strategy use led by instructional strategies with a significant presence of evaluative and interactional strategies. It can be concluded that the participant behaviors that indicate motivation include primarily successful, expected responses that were facilitated by meaningful, strategic interactional devices.</p>

The effects of intensive multisensory speech training, with and without the use of Visual Phonics techniques, on the speech production of a profoundly hearing-impaired child were studied over a period of 6 weeks. A nine-year-old profoundly hearing-impaired child received 30-40 minutes of intensive speech training daily. Three target phonemes were trained using only multisensory speech training techniques and three target phonemes were trained using multisensory and Visual Phonics training techniques. The subject's productions of target phonemes in trained words and syllables were audio-taped at the end of each training period. Audio-taped productions were rated as correct or incorrect. The number of correct productions in words and syllables were tallied daily. Results show a general trend of improved production for all phonemes trained. There was no differential effect for the training technique used. It was concluded that intensive training, regardless of the technique used, has a positive effect on the speech productions of a profoundly hearing-impaired child.

<p> Rubinstein-Taybi Syndrome (RTS) is a rare congenital neurodevelopmental disorder that often presents with corresponding speech and language delays. However, the available literature on communicative development in RTS is currently very limited. The purpose of this retrospective single-case research study was to evaluate the effectiveness of the Picture Exchange Communication System (PECS), an aided augmentative and alternative communication (AAC) system developed to teach functional communication to children with limited communication, on communicative abilities in RTS by providing a detailed profile of the intervention procedures utilized for a 6-year-old child with RTS. The aim of this investigation was both to contribute to the existing literature on the syndrome, as well as to document the success of the PECS system in children with RTS. Specifically, the current study explored the participant&rsquo;s communicative progression and development in the areas of (a) communication initiation, (b) vocalization, and (c) eye contact after Phases 1-4 of the PECS protocol were implemented. Data records from 26 evaluation and intervention sessions completed during the participant&rsquo;s Spring 2014 attendance at the CSULB Department of Speech-Language Pathology&rsquo;s Speech and Language Clinic were analyzed in order to evaluate the effects of the PECS protocol on the participant&rsquo;s communicative abilities. Results indicated that the PECS treatment significantly improved the participant&rsquo;s communicative abilities, namely, by increasing her initiation of communicative exchanges, increasing use of vocalizations and word/phrase approximations, and increasing eye contact with communication partners. The current study supports the use of the PECS protocol in children with RTS as a functional communication system.</p>

published_or_final_version / Speech and Hearing Sciences / Master / Master of Philosophy

No description available.

<p> The purpose of this study was to evaluate the efficacy of a treatment package including a modified protocol of the Picture Exchange Communication System (PECS) implemented via an autism-specific iPad application. A multiple probe design (Horner &amp; Baer, 1978) was replicated across four individuals with severe, non-verbal autism to investigate effects on requesting skills, natural speech production, and social-communicative behaviors. Results suggest beneficial effects, if implemented with high fidelity. The largest effects were on the participants&rsquo; requesting skills. All four participants were able to consistently request for desired items by activating the tablet device, and this skill was maintained after a six week break. Generalization probes suggest the newly acquired requesting skills generalize to untrained items. However, individuals may not be able to complete all phases of the modified PECS protocol. Facilitative effects are more noticeable for social-communicative behaviors than for natural speech production. For the three participants that made speech gains, these gains occurred when speech elicitation was more actively implemented. Such patterns are consistent with previous research on the traditional PECS protocol. These results are discussed in regards to clinical applications and research directions.</p>

<p> To date, research on direct attention training (DAT) has focused primarily on adult populations with considerable gaps regarding DAT for children with attention-deficit/hyperactivity disorder (ADHD). The purpose of this study was to examine the effects of a DAT program, namely the Pay Attention! program, with a school-aged student with ADHD. The principle investigator hypothesized that this program would improve attention abilities on trained attention tasks, psychometric measures of attention, functional measures of attention, as well as improve reading comprehension abilities. A pre- and post-test single case study design was used to compare performance on impairment and participation-levels of attention, as well as measures of reading comprehension. Post-test results demonstrated improvement in accuracy or completion time on all impairment-level attention testing with some improvements noted on reading comprehension and measures at the participation level. These results contribute to existing research on DAT for children, as well as suggest that some generalization to participation-level activities and reading comprehension may be achieved.</p>

Thesis (Ed.M.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Despite the tremendous amount of phonetic variability in speech across talkers, listeners seem to effortlessly process acoustic signals while attending to both the linguistic content and talker-specific information. Previous studies have explained this phenomenon by providing evidence for talker normalization, a process in which our perceptual system strips away information about a talker so that the abstract, canonical linguistic units are all that remain for further linguistic analysis. However, it is currently unknown whether or how talker normalization is facilitated by familiar talkers. In this study, we investigated whether talker familiarity had an impact on the speed in which listeners perceived highly confusable words under varying contexts. Over the course of three days, listeners were explicitly trained on the voices of four talkers. Baseline and post-test measures were administered to determine the effect of talker training and to see whether this effect was impacted by the presence of a carrier phrase as well as the variability of talker presentation. The results demonstrated that listeners adapted to the talker regardless of familiarity. Having immediate information about a talker from preceding speech appeared to play a larger role in managing talker variability than a long-term familiarity with the talker’s voice. Our findings suggest that talker normalization is a feedforward process that does not rely on prior memory traces.