<p>Parents and speech language pathologist (SLP) typically establish and maintain hierarchical relationships which ascribe excessive authority to the therapist, thus limiting the possibilities for dialogue and mutual learning. The SLPs discussions of children?s communication development often fail to acknowledge the contributions that parents can make, based on their knowledge and experiences with children at home. Neglecting parents? voices in communication intervention means the parents? critical role in supporting children?s communication development is overlooked. By investigating with parents their perspectives on children?s communication facilitation and social interaction experiences in and out of the home environment, this study sought to understand the relationships between parent?s beliefs and practices for communication facilitation and to model processes by which parents and SLP?s develop a reciprocal dialogue. This study draws insights into how parent initiated communication facilitation and social interaction for children with complex communication needs (CCNs) in a rural rehabilitation center in Kerala can be improved through examining a collaboratively created communication partner training program for parents and used a participatory action research approach centered on cooperative inquiry. Six parents of children younger than 6.5 years with CCNs, joined me in a six-month long co-investigation. Individually and collectively we raised questions, observed, documented, and reflected on communication facilitation strategies in and out of the homes. Weekly meetings were held involving all the participants and occasionally with individual families. Data sources included research diaries written by myself about parent?s experiences, audiotapes of meetings, participants? reflective journal entries, and children?s communication profiles constructed jointly by parents and the researcher. When children?s communication was documented based on children?s communication at home, we observed a wide variety that was not assessed in the standard communication assessments. The study?s findings provide evidence that parents can be a rich resource for SLPs and researchers. The data reveal the perceptions and practices of parents for communication facilitation. It also shows some of the real-life challenges for communication and interaction facilitation. Parents raised issues about current practices in communication interventions, misunderstandings about speech therapy, and training/teaching and learning relationships. This suggests that organizing parent training programs based on western models would be inappropriate. Through the parent practitioner research process, we were able to develop and introduce `conversation books? as a way for viewing the child as a communication partner and to provide more interaction opportunities for the children viewed as `sick child.? This process provides further evidence for the importance of including parents? knowledge and experience in the design of effective learning contexts for their children. These findings suggest that beyond the currently existent routine clinician-parent meeting (5 minute or lesser sessions, of giving instructions to parents), alternative structures for dialogue with practitioners are needed that allow for parents? critical reflection and substantive contributions to the children?s communication intervention plans.

<p> The purpose of this study is to identify the complex features of writing intervention of Graduate Student Clinicians (GSCs) for children with Language and Learning Difficulties (LLD) upon the qualitative research paradigm. To do this, verbal and non-verbal interactions, a total of two hours 18 minutes and 44 four seconds and a total of 2,170 turns of the four writing sessions of the two dyads, were video-taped, transcribed, and encoded depending on the contexts, purposes, and strategies. </p><p> The complexity in the process of writing by the two dyads was revealed and compared in terms of the activities of turns exchanged and time allocated in the two GSCs&rsquo; strategies for writing intervention and the two children&rsquo;s responses throughout the writing sessions. The findings of this study indicate the two dyads demonstrated two distinct interactional features in verbal and non-verbal behaviors in terms of whether GSCs were concentrated on process or products, and they used different strategies for verbal and non-verbal intervention. The responses of children with LLD revealed in the overall dynamic features of writing sessions were greatly influenced by the GSCs&rsquo; verbal and non-verbal strategies. </p><p> The child in Dyad One in which GSC-One focused more on implicit and symmetric process-oriented mediations successfully engaged in various writing activities while the child in Dyad Two in which GSC-Two focused on explicit asymmetric product-oriented mediations tended to be confused while less effectively engaged in the verbal and non-verbal interactions. The conclusion was made to emphasize that the transferability of GSCs&rsquo; writing interventions strategies into the writing process of children with LLD, and the importance of training future Speech Language Pathologists by allowing them understand their roles in the process rather than the results of writing.</p><p>

The relationship between respiratory muscle fatigue and the function of swallowing is examined here. The main objective of this study is to examine the effects of respiratory muscle fatigue on swallowing physiology in healthy young adults. Specifically, this study aims to determine if differences exist in several swallowing-related parameters (a. the muscle recruitment pattern of the submentals and infrahyoids associated with swallowing, b. the pattern of breathing and swallowing coordination, c. the duration of the breath phases associated with swallowing, d. the duration of swallowing apnea, and e. the secondary swallow frequency) during several different swallowing conditions before, following respiratory muscle fatigue and following recovery. Fifty-four healthy young adults were randomly assigned into two groups, either an inspiratory (MIP) or an expiratory (MEP) muscle fatigue group. Respiratory and swallowing measurements were obtained, during 3 experimental conditions: a baseline condition, after exercise-induced fatigue, and finally, after a 15min rest period. A loaded breathing device was used in order to induce fatigue to the respiratory muscles. Presence of fatigue was determined with the assessment of Maximum Expiratory (PEmax)/Maximum Inspiratory (PImax) Pressures measured with a mouth pressure manometer. Electrophysiologic data were obtained with the use of sEMG on the submental and infrahyoid muscle groups, and with the use of three respiratory belt transducers, placed around the thorax, abdomen and neck. The Borg Scale was used to behaviourally assess perceived sense of breathing effort. Descriptive and inferential statistics were conducted to allow for detailed analysis of differing measures and variances between individuals. Results revealed significant differences between the three experimental conditions in the muscle recruitment patterns of the submental and infrahyoids, in the pattern of breathing and swallowing coordination, in the duration of the swallow-related respiratory cycle and in the frequency of secondary swallows. The duration of the deglutitive apnea was not affected by the presence of respiratory muscle fatigue. In particular, the sEMG Integral of the infahyoids was significantly reduced during the fatigued condition compared to the baseline and post-rest conditions, as opposed to an increase in sEMG integral of the submental muscles observed only in the MEP subject group. Additionally, the occurrence of swallows followed by inspiration was significantly increased during the fatigued condition. Secondary swallow frequency was significantly increased during the fatigued condition. These results suggest an effect of respiratory muscle fatigue on selective swallowing related parameters. These results are of great clinical importance since the observed patterns may increase the risk of aspiration. Results will be discussed with respects to the implications for patients and their therapeutic interventions.

Phonation onset and offset are important aspects of singing and speech. Their execution requires control of timing and coordination of complex vocal fold kinematics, glottal configuration, laryngeal muscular adjustments, and respiration. The purpose of this study was to examine effects of timing and coordination of vocal fold adductory and abductory movements on vocal fold vibratory behavior from offset to onset in a series of repeated phonation gestures, using high-speed digital imaging. Of particular interest were differences in vocal fold adductory positioning for slower and faster tempi; patterns of oscillation during onset and offset for the different tempi, and effects of onset and offset timing events on subsequent vibratory patterns. Method: 11 subjects, all classically trained, experienced professional singers, were videoendoscopically recorded singing a series of repeated notes at two different tempi, using high-speed digital imaging. Vocal fold adductory positioning was measured in terms of relative glottal width during onset in slower and faster tempi. Vocal fold vibratory behavior was measured in timing of offset and onset “events,” number, spacing, and timing of PPOs and pSSOs. Results: Relative glottal widths were significantly smaller for the faster tempo, supporting a hypothesis that vocal agility requires closer vocal fold approximation before onset. Significant differences were found in offset vs. onset timings and numbers of prephonatory and post-steady-state oscillations, supporting a theory of oscillation hysteresis.

Orientadora: Roberta Gonçalves da Silva / Banca: Célia Maria Giacheti / Banca: Kátia Flores Genaro / Resumo: Introdução: A disfagia orofaríngea neurogênica possui etiologias distintas e a aspiração laringotraqueal é considerada achado de risco co-dependente da sincronia entre vários fatores presentes na biomecânica da deglutição. Objetivo: Este estudo teve por objetivo correlacionar a penetração e/ou aspiração laringotraqueal com resíduos faríngeos e escape oral posterior na disfagia orofaríngea e comparar entre doenças neurológicas distintas. Método: Estudo clínico transversal. Realizada por dois juízes independentes a análise de 74 exames de nasoendoscopia de deglutição de indivíduos com diagnóstico de disfagia orofaríngea por doenças neurológicas distintas como Acidente Vascular Cerebral (AVC), Esclerose Lateral Amiotrófica (ELA) e Doenças de Parkinson (DP), independente do sexo, faixa etária de 32 a 96 anos e média de 65,53 anos. Para análise dos resultados os exames foram divididos em três grupos: o grupo 1 (G1) constou de 41 indivíduos com AVC (média de 68,75 anos), o grupo 2 (G2) de 16 com ELA (média de 57,18 anos) e o grupo 3 (G3) de 17 com DP (média de 72,52 anos). Realizada nasoendoscopia de deglutição nas consistências pastosa, líquida espessada e líquida, no volume de 5 ml, ofertados de uma a três vezes em colher. Para análise dos achados foi aplicada a Yale Pharyngeal Residue Severity Rating Scale (YPRSRS), a Penetration Aspiration Scale (PAS) e foi elaborada escala para mensurar escape oral posterior (EOP) com análise da primeira deglutição e da deglutição considerada ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Neurogenic oropharyngeal dysphagia has different etiologies, and laryngotracheal aspiration is considered a risk finding that is co-dependent on the synchrony between several factors present in swallowing biomechanics. Purpose: The aim of this study was to correlate the laryngotracheal aspiration with pharyngeal residues and posterior oral spillage in oropharyngeal dysphagia and to compare different neurological diseases. Method: Cross-sectional clinical study. Two independent judges performed the analysis of 74 fiberoptic endoscopic examinations of swallowing (FEES) of individuals with diagnosis of oropharyngeal dysphagia due to different neurological diseases such as Cerebrovascular Accident (CVA), Amyotrophic Lateral Sclerosis (ALS) and Parkinson's Disease (PD), regardless of sex, ranging from 32 to 96 years old and mean of 65.53 years old. For the analysis of the results the exams were divided into three groups: group 1 (G1) consisted of 41 individuals with CVA (average of 68,75 years), group 2 (G2) of 16 with ALS (average of 57,18 years), and group 3 (G3) of 17 with PD (average of 72,52 years). FES was performed in in paste, liquid thickened and liquid, in the volume of 5 ml, offered one to three times in a spoon. To analyze the findings was applied the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS), the Penetration Aspiration Scale (PAS) was developed and a scale was used to measure posterior oral spillage (POS) with analysis of the first swallowin... (Complete abstract click electronic access below) / Mestre

The functional speech sound disorder, American English /r/ articulation errors, presents a unique and confounding clinical challenge as "therapy resistant" residual errors persist into adolescence and adulthood in many cases. Finding paucity of empirical research for /r/ treatment, evidence-based practice (EBP) exploration in motor-related disorders informed clinical practice and research directions. This study investigated the efficacy of "manual mimicry" (a kinesthetic, gestural, and visual cue) in treating intractable /r/ errors in a young adult using a single subject ABAB design. Perceptual accuracy judgments of three types of listeners (experts, graduate clinician, and na��ve listeners) indicated a positive treatment effect of manual mimicry cueing on vocalic /r/ sound productions. Electropalatograpy (EPG) outcome measures showed limited ability to accurately reflect perceptual changes quantitatively. These findings from an exploratory study provide initial evidence that perceptual saliency of /r/ productions may be potentially remediated using a kinesthetic, gestural, and visual cue during treatment. / Rangos School of Health Sciences / Speech-Language Pathology (SLP) / MS / Thesis

Thesis (Ed. D.)--Illinois State University, 2006. / Title from title page screen, viewed on April 27, 2007. Dissertation Committee: Kenneth Jerich (chair), Adel AL-Bataineh, Fabiola Ehlers-Zavala, Heidi Harbers. Includes bibliographical references (leaves 93-98) and abstract. Also available in print.

Thesis (Ph. D.)--Florida State University, 2003. / Advisor: Dr. Howard Goldstein, Florida State University, College of Communication, Dept. of Communication Disorders. Title and description from dissertation home page (viewed Mar. 2, 2004). Includes bibliographical references.

Thesis (M.S.)--Missouri State University, 2009. / "May 2009." Includes bibliographical references (leaves 35-36). Also available online.

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