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<p> This applied dissertation will provide a deeper understanding of how high school students with nonverbal learning disabilities perceive themselves. Persons with nonverbal learning disabilities are defined primarily through performance measures with less qualitative information available. In this study, high school students identified with nonverbal learning disabilities will have the opportunity to voice their feelings about their disability. </p><p> The researcher developed open-ended questions about nonverbal learning disabilities and how it has impacted the students. Information was gathered through a narrative format and transcribed. Information was coded for important themes.</p><p>

<p> Intonation is one of the prosodic features manifested acoustically in the fundamental frequency (F0). Intonation abnormality is common and prominent in the speech of persons with Parkinson's disease (PD). Intensive speech therapies such as Lee Silverman Voice Treatment (LSVT-LOUD^&reg;) have been demonstrated effective for increasing vocal intensity and F0 variability, but no prior studies have examined linguistic features of intonation before and after treatment in PD. Additionally, transcranial magnetic stimulation (TMS) has been demonstrated as an appropriate adjuvant to a primary treatment. It is reasonable to hypothesize that intonation abnormality will be improved after the combined modality treatment of LSVT-LOUD^&reg; and TMS. To examine this hypothesis, the current research investigated acoustically five intonational features including F0 declination, resetting, emphasis, terminal fall, and syntactic pre-junctural fall in twenty PD participants, receiving LSVT-LOUD^&reg; alone, or combined with TMS delivered to the left or right cerebral hemisphere. The primary experiment was designed and carried out by Shalini Narayana and colleagues in their project funded by the Michael J. Fox Foundation for Parkinson's Research. They collected and provided the recorded reading samples for the current study. </p><p> F0 changes of each of five intonational feature were measured before and after the combined modality treatment, and at two months follow-up, then analyzed statistically. The results revealed that F0 declination, emphasis, and terminal fall changed significantly from pre- to post-treatment, and the changes of declination and terminal fall were maintained at the follow-up evaluations. </p><p> The observed changes in intonation were attributed to LSVT alone, which caused large changes of F0 magnitude. F0 resetting and syntactic pre-junctural fall did not change significantly following treatment, probably because these intonational features need very precise fine motor control of the intrinsic laryngeal muscles to make small-range, rapid F0 adjustments, which were not improved by LSVT in present PD participants. Difficulties with syntactic processing previously reported in PD may have contributed to the lack of improvement in resetting and pre-junctural fall, since these F0 features are used to mark syntactic boundaries within utterances. Consideration of incorporation of linguistic intonation to speech intervention for speakers with PD is suggested for future clinical research.</p><p>

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Purpose: Signaled by the completion of the Human Genome Project in 2003, rapid and escalating discovery in genome science has initiated a paradigm shift in education training and healthcare practices. This shift has required healthcare educators and professionals to possess a level of genetic and genomic literacy and competency. The current study was designed to survey the current state of the perceptions of genetics and genomics in educational and clinical practices within the field speech-language pathology. Method: Seventy-five program directors of degree programs and 265 speech-language pathologists participated in two web-based surveys. Results: Program directors and speech-language pathologist reported to be aware of recent genetic and genomic advancements in speech-language pathology. Ninety-six percent of program directors expected graduated students to demonstrate competency in genetic and genomic related clinical services. Thirty-six percent of program directors reported graduated students were prepared to understand genetics. Seventy-three percent of speech-language pathology programs offered genetic content in their curricula. In comparison, eighty-three percent of speech-language pathologists reported performing genetic related services within their clinical practices. Less than half of respondents reported confidence in performing clinical services. Speech-language pathologists reported minimal to no knowledge of at least 85% of genetic or genomic principles related to speech-language pathology. Sixty-three percent of speech-language pathologists reported their degree-training program had not prepared them to understand genomics in speech-language pathology. Results of a needs index revealed discrepancies between perceptions of speech-language pathologist's performed clinical services and program director's expected competencies, and between level of perceived preparedness and perceived knowledge. Thematic analysis across perceptions, course content, expected competencies, clinical services, and areas of knowledge reflected principles of Mendelian inheritance and single gene disorders. This "medical genetics" perspective is one typically used prior to the completion of Human Genome Project in 2003. Conclusion: The results of this investigative study suggest the field of communication sciences and its disorders is not keeping pace with the demands of new advancements in genetics and genomics. Several discrepancies may contribute to misconceptions and misinformation surrounding genetics and genomic in speech-language pathology. This study provides a foundation for discussion of curriculum reform at the graduate level and policy changes in standard practices of speech-language pathologists at the national level.

Dysphagia after prolonged orotracheal intubation is reported to increases a patient's risk for aspiration, leading to increased risk for morbidity and mortality. Identification of specific risk factors that may predispose a patient to post-extubation dysphagia and aspiration risk is important. However, previous studies have not consistently identified concrete risk factors of post-extubation dysphagia in critically-ill patients. This two part study sought to identify specific risk factors for post-extubation dysphagia and increased aspiration risk in critically-ill patients. Study A retrospectively and Study B prospectively examined 70 medical and surgical ICU patients who endured mechanical ventilation for >/= 72 hours. Study A participants underwent either a Modified Barium Swallow Study (MBS) or Fiberoptic Endoscopic Evaluation of Swallowing (FEES) examination to objectively identify swallowing disorders. Two independent reviewers analyzed charts from a Speech Pathology database for post-extubation dysphagia. Study B participants underwent a FEES examination to objectively assess swallowing function. Two expert Speech-Language Pathologists (SLPs) that were blinded to the patient's medical diagnoses and purpose of the study conducted the FEES examinations and interpreted their outcomes. A third rater analyzed an additional 20 percent of randomly selected swallows. In both studies, participants were clustered into one of 7 admission diagnoses groups, and one of 5 reasons for intubation groups. Duration of intubation, gender, reintubation, Penetration Aspiration Scale (PAS outcomes) and 4 Point Dysphagia Severity Scale Ratings were analyzed. The results of Study A (retrospective) revealed that age and duration of intubation were independently associated with post-extubation dysphagia severity. The odds of a participant presenting with a more severe dysphagia was increased by 7.5% for each additional year of age (p= 0.009). The odds of a participant presenting with a more severe dysphagia severity rating was increased by 48.2% for each additional day of intubation (p=0.032). Age and duration of intubation were also independently associated with aspiration. The odds of a participant exhibiting aspiration was increased by 4.1% for each additional year of age (p=0.018). The odds of a participant exhibiting aspiration was increased by 25% for each additional day of intubation (p=0.004). Reintubation (0=0.008) was significantly associated with dysphagia severity. Pneumonia (p=0.034) was also significantly associated with increased aspiration risk. The Results of Study B (prospective) demonstrated that age was independently associated with post-extubation aspiration risk. The odds of a participant exhibiting aspiration was increased by 4.5% for each additional year of age (p=0.027). Admission diagnosis, particularly infectious, was significantly associated with aspiration (p=0.046). Excellent inter-rater reliability was demonstrated for 20% of patient's overall dysphagia severity ratings (r=0.918). In conclusion, age was independently significantly associated with increased post-extubation dysphagia severity and aspiration. Further investigation is warranted to examine the risk factors that were only found to be significant in one of the two studies, i.e. duration of intubation, presence of PNA, reintubation and admission diagnosis.

The studies contained in this dissertation were driven by a desire to improve the methods for sensory testing of cough for clinical research and practice. Two scientific gaps in the cough evaluation literature were identified and investigated using two specific studies on healthy young adult participants. The first study focused on validating an appropriate descriptor for cough sensations (Chapter 2) and the second study (Chapter 3) focused on evaluating magnitude estimation tools to measure cough sensations. The findings of this dissertation make several unique contributions to the cough literature. The first study systematically compared two descriptive responses to cough stimuli (i.e., capsaicin) within subjects in terms of both cough sensory and cough motor outcomes. Findings revealed two types of descriptive responses for capsaicin stimuli, warm/burn and urge-to-cough (UTC). The UTC descriptor was, however, more sensitive and a valid predictor of cough response. The second study systematically compared two magnitude estimation tools, the Modified Borg Scale (MBS) and the generalized Labeled Magnitude Scale (gLMS) to measure the UTC sensations. Findings revealed that both tools were reliable and valid in detecting UTC sensations and predicting cough response. However, a differential effect to detection of UTC sensations across neighboring stimuli concentrations were demonstrated by the two tools. This dissertation provides the first set of normative reference values for UTC responses across a wide range of sensory continua using the conventional metric, the MBS, and an additional metric, the gLMS. Limitations are acknowledged and future work is suggested.

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Tam Yuk Yin. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references. / Abstracts in English and Chinese. / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1. --- Biometrics for User Authentication --- p.2 / Chapter 1.2. --- Voice-based User Authentication --- p.6 / Chapter 1.3. --- Motivation and Focus of This Work --- p.7 / Chapter 1.4. --- Thesis Outline --- p.9 / References --- p.11 / Chapter Chapter 2 --- Fundamentals of Automatic Speaker Recognition --- p.14 / Chapter 2.1. --- Speech Production --- p.14 / Chapter 2.2. --- Features of Speaker's Voice in Speech Signal --- p.16 / Chapter 2.3. --- Basics of Speaker Recognition --- p.19 / Chapter 2.4. --- Existing Approaches of Speaker Recognition --- p.20 / Chapter 2.4.1. --- Feature Extraction --- p.21 / Chapter 2.4.1.1 --- Overview --- p.21 / Chapter 2.4.1.2 --- Mel-Frequency Cepstral Coefficient (MFCC) --- p.21 / Chapter 2.4.2. --- Speaker Modeling --- p.24 / Chapter 2.4.2.1 --- Overview --- p.24 / Chapter 2.4.2.2 --- Gaussian Mixture Model (GMM) --- p.25 / Chapter 2.4.3. --- Speaker Identification (SID) --- p.26 / References --- p.29 / Chapter Chapter 3 --- Data Collection and Baseline System --- p.32 / Chapter 3.1. --- Data Collection --- p.32 / Chapter 3.2. --- Baseline System --- p.36 / Chapter 3.2.1. --- Experimental Set-up --- p.36 / Chapter 3.2.2. --- Results and Analysis --- p.39 / References --- p.42 / Chapter Chapter 4 --- Subband Spectral Envelope Features --- p.44 / Chapter 4.1. --- Spectral Envelope Features --- p.44 / Chapter 4.2. --- Subband Spectral Envelope Features --- p.46 / Chapter 4.3. --- Feature Extraction Procedures --- p.52 / Chapter 4.4. --- SID Experiments --- p.55 / Chapter 4.4.1. --- Experimental Set-up --- p.55 / Chapter 4.4.2. --- Results and Analysis --- p.55 / References --- p.62 / Chapter Chapter 5 --- Fusion of Subband Features --- p.63 / Chapter 5.1. --- Model Level Fusion --- p.63 / Chapter 5.1.1. --- Experimental Set-up --- p.63 / Chapter 5.1.2. --- "Results and Analysis," --- p.65 / Chapter 5.2. --- Feature Level Fusion --- p.69 / Chapter 5.2.1. --- Experimental Set-up --- p.70 / Chapter 5.2.2. --- "Results and Analysis," --- p.71 / Chapter 5.3. --- Discussion --- p.73 / References --- p.75 / Chapter Chapter 6 --- Utterance-Level SID with Text-Dependent Weights --- p.77 / Chapter 6.1. --- Motivation --- p.77 / Chapter 6.2. --- Utterance-Level SID --- p.78 / Chapter 6.3. --- Baseline System --- p.79 / Chapter 6.3.1. --- Implementation Details --- p.79 / Chapter 6.3.2. --- "Results and Analysis," --- p.80 / Chapter 6.4. --- Text-Dependent Weights --- p.81 / Chapter 6.4.1. --- Implementation Details --- p.81 / Chapter 6.4.2. --- "Results and Analysis," --- p.83 / Chapter 6.5. --- Text-Dependent Feature Weights --- p.86 / Chapter 6.5.1. --- Implementation Details --- p.86 / Chapter 6.5.2. --- "Results and Analysis," --- p.87 / Chapter 6.6. --- Text-Dependent Weights Applied in Score Combination and Subband Features --- p.88 / Chapter 6.6.1. --- Implementation Details --- p.89 / Chapter 6.6.2. --- Results and Analysis --- p.89 / Chapter 6.7. --- Discussion --- p.90 / Chapter Chapter 7 --- Conclusions and Suggested Future Work --- p.92 / Chapter 7.1. --- Conclusions --- p.92 / Chapter 7.2. --- Suggested Future Work --- p.94 / Appendix --- p.96 / Appendix 1 Speech Content for Data Collection --- p.96

Yang Chen. / "November 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 131-141) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.