Fourteen native Spanish-speaking adults participated in a study on tense and aspect in Spanish. Subjects viewed videos that depicted completed events or videos that ended with an ongoing event and chose a sentence in the past tense that best described the event. One condition included adverbial cues and the other condition did not. Subjects also read paragraphs describing bounded and unbounded events and chose a past tense verb that best fit the context. It was found that subjects consistently chose preterit responses for completed event videos in both the adverb and non-adverb condition, but responses varied more in the videos that ended with ongoing events. The majority of subjects selected preterit verbs for bounded events and imperfect verbs for unbounded events. Implications and further directions of research are discussed.

Traumatic brain injury (TBI) is a global health epidemic that has deleterious consequences for the individuals with the brain injury, their families, and society. The development and validation of effective treatments is imperative. The current study was inspired by Ylvisaker's collaborative intervention approach with individuals with TBI and draws on a line of work by Duff and colleagues (e.g., Duff et al., 2006; Gupta et al., 2011) documenting patterns of spared and impaired learning abilities in individuals with various types focal brain damage (e.g., hippocampus) and selective neuropsychological impairment (e.g., declarative memory) using a collaborative referencing paradigm. This study extends this line of work by examining the ability of individuals with mild to moderate traumatic brain injury to develop and use referential labels for novel picture cards across repeated interactions with a familiar partner as they complete a collaborative referencing task. Five TBI participant pairs (an individuals with TBI and their partner) and five healthy comparison pairs completed 24 trials (6 trials in each of 4 sessions) of the collaborative referencing task across two days. As a group, the performance of four of the five TBI pairs did not differ from healthy comparison pairs on the primary dependent variables of card placement accuracy, time to complete each trial, and reduction in communicative resources across trials. That is, despite having TBI, these individuals were able to develop and use unique and concise labels to reference the novel cards in collaboration with a familiar partner. The fifth TBI participant pair (3591) differed from the other TBI and healthy comparison pair on both quantitative and qualitative measures. Speculating that 3591's husband may have contributed to their poor performance, a follow-up study was conducted whereby 3591 was brought back to lab several months later and she complete one session of the collaborative referencing task with a new partner. The results of the follow-up study were striking. 3591 and her new partner were as successful as other pairs on all measures of learning in the study. Given the complex nature of cognitive, neurological, behavioral, personality, and communicative impairments associated with TBI, the findings here, that all participants with TBI were successful in the task, are surprising and provides further evidence that these interactive sessions are potent learning environments. The results of the study support the idea that use of a social and collaborative interaction paradigm facilitates learning in adults at least one year time post injury with mild to moderate brain injuries. Aspects of the collaborative referencing task that exemplify Ylvisaker's contextualized invention approach are completion of a goal-directed task, working with a partner who was relevant to the participant's everyday life, supports were provided by the partner as needed, the task was repeated many times in order to increase chances of the pair's success, and skills were taught through collaboration rather than explicit instruction. Although this was not an intervention study, these findings provide further evidence supporting the use of Ylvisaker's social, interactive, and collaborative approach for individuals with TBI. This study is the first to our knowledge to investigate learning during a collaborative referencing task with individuals with TBI and the positive results obtained here suggest that this may be a fruitful way to deploy Ylvisaker's contextualized intervention approach in more controlled research settings.

In order to verbally communicate successfully, people need the ability to retrieve a desired word. However, the inability to do this, called “anomia,” is a common impairment for people with aphasia, and frequently persists into the chronic stage of recovery. Strategies that facilitate verbal expression may reduce or compensate for instances of anomia. Verbal strategies, such as Semantic Feature Analysis (SFA) have been researched extensively and shown to be effective. Nonverbal strategies, such as drawing and gesture, have research on their effects as a substitution for verbalization, but less on their facilitative effects. However, the research suggests they may work in a similar manner to verbal approaches, by activating semantic networks. Thus, the facilitative effects of nonverbal strategies should be explored further. The aim of this experiment was to determine the facilitative effects of drawing and gesturing during a picture naming task in one participant with chronic aphasia. Results revealed that all conditions evaluated, drawing, gesture, and wait (control), produced improvements in the picture naming task. However, contrary to expectations, the facilitated conditions (i.e. drawing and gesture) did not create more effects than the unfacilitated condition (i.e. wait). This finding may indicate the benefits of a factor common to all conditions. Further results of this study and directions for future research are discussed.

The purpose of this study was to further investigate the effects of articulation errors on perceptual ratings of nasality in speakers with repaired cleft palates, specifically looking at the effect of varying magnitudes of articulation errors and education on perception of nasality. A group of expert listeners, speech-language pathologists with significant clinical experience in the area of cleft palate and resonance disorders, first rated the articulatory proficiency and nasality of a number of utterances produced by children with repaired cleft palates, on separate 6-point scales. Their ratings were then used to categorize stimuli into a three-by-three matrix (mild, moderate, severe) using articulation deficit and nasality as the two dimensions of interest. Untrained listeners (undergraduates and graduate students in a speech-language pathology training program) were then asked to rate the level of nasality on a 1 (normal) to 6 (severe) scale. Listener group ratings were compared to each other and to the expert listeners. Significant differences (p=0.004) were found between the undergraduate and graduate students' ratings when compared to the expert listeners. Graduates, had lower inter- and intra-rater reliability compared to the undergraduates. For both undergraduates and graduates, the difference between their ratings and those of the expert listeners was significantly lower for stimuli with mild articulation errors compared to those with moderate (p<0.0001) and severe (p<0.0001) articulation errors. No significant differences (p=0.416) were found between difference scores for stimuli with moderate versus severe articulation errors. The results were interpreted to suggest that the magnitude, and perhaps type, of articulation errors affects perceived nasality, and that there are group differences between perceptual nasality ratings. These findings support the importance of articulation therapy for children with repaired cleft palates to both decrease articulation errors and decrease perceived nasality. Further, this study highlights the need for including awareness of this interaction in the training of speech-language pathologists in order for the “gold standard” of perceptual judgements to remain a valid and reliable measure.

The apparent effect of superior semicircular canal dehiscence (SSCD) on middle ear- and cochlear impedance has led researchers to investigate the use of wideband acoustic immittance as a screening tool when SSCD is suspected. The purpose of the study was to describe the absorbance characteristics and tympanometric values of ears with confirmed SSCD measured at tympanometric peak pressure (TPP) and at ambient pressure. Wideband Acoustic Immittance was performed at ambient pressure and at TPP on ten participants (12 ears) with confirmed SSCD, as well as on an age- and gender matched control group (12 ears). Inferential statistics were used to determine whether statistical differences existed for the absorbance values at each of the averaged frequencies, the resonance frequency (RF) and tympanometric data between the SSCD and control groups. The mean absorbance of the SSCD group reached a maximum at 890.9 Hz and a minimum at 6349.6 Hz. When testing absorbance at TPP, a statistically significant increase/peak in the absorbance values of the SSCD group (compared to those of the control group) was found from 630 to 890.9 Hz and a decrease from 4489.8 to 6349.6 Hz. Similar patterns were observed for absorbance at ambient pressure. A lower mean RF for ears with SSCD as well as an increased mean admittance magnitude (AM) value at RF was found compared to those of the control group. The peak in absorbance around 890 Hz that was found on SSCD ears in the current study is similar to findings from earlier studies that found a peak in absorbance/notch in reflectance around 1000 Hz, reiterating its use as a screening tool when SSCD is suspected. No significant difference was found between absorbance measured at ambient pressure and at TPP in the current study; however, the stringent inclusion criteria with regard to TPP most likely affected this outcome. As a result of the significant difference in RF of SSCD ears compared to the RF of the control group, the potential value of measuring the RF of the middle ear as well as AM at the RF, to differentiate between mass-and stiffness dominated pathologies, was also illustrated. Further research measuring the AM at RF in normal and pathological ears was suggested for comparison to the current study and to determine its clinical value. / Dissertation (MA (Audiology))--University of Pretoria, 2020. / Speech-Language Pathology and Audiology / MA (Audiology) / Unrestricted

This study aimed to evaluate the efficacy of different treatment modifications used to prevent or minimise hearing loss during Cisplatin-based chemotherapy as part of patient management at Groote Schuur Hospital. The study also sought to compare different ototoxicity grading criteria; namely the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4 (CTCAE v4) and TUNE criteria, with respect to early identification of changes in the patient’s hearing thresholds following treatment with ototoxic drugs as well as ability to guide recommendations for aural rehabilitation including hearing amplification. Background Non-communicable diseases (NCD) (including cancer, diabetes, cardiovascular and chronic respiratory diseases) are responsible for an estimated 36 million deaths annually across the world. Approximately 80 % of these deaths occur in developing countries. Cancer, the NCD of interest in this study, causes an estimated 8.2 million deaths per year, globally and about 70 % of these occur in developing countries. In South Africa, cancer is estimated to cause approximately 40 000 deaths per annum, which is more than the number of deaths caused by a combination of HIV/AIDS, TB and malaria every year. Cisplatin is the most common and effective anti-cancer drug for most types of cancers. However, it is also associated with severe adverse effects, including hearing loss. Cisplatin-induced hearing loss is usually bilateral, highfrequency sensorineural hearing loss and is permanent. Cisplatin-induced hearing loss can lead to communication difficulties, lack of participation, loss of employment and social isolation. This decreases patients’ quality of life. Prevention of ototoxicity relies on serial audiologic monitoring to detect any significant change in patients’ hearing thresholds that may be resulting from chemotherapy treatment. When a deterioration in the patient’s hearing thresholds is detected, treating physician(s) can decide on whether to modify the patient’s treatment to prevent further deterioration of hearing or not. Some of the common treatment modifications used by physicians include; reducing the drug dose administered to the patient, changing from Cisplatin to a less ototoxic drug such as Carboplatin or keeping a patient on Cisplatin only regimen (no treatment modification). However, there is 8 currently lack of research evidence that document the effectiveness of these treatment modifications with respect to preservation of the patient’s hearing thresholds. Also, given that there are several ototoxicity grading scales available that can be used to grade severity of ototoxicity-induced hearing loss, there is currently a lack of uniformity regarding communication of the severity of hearing loss across different professionals. There is a need to identify or develop an ototoxicity grading criterion which can be adopted by different professionals to communicate results during ototoxicity monitoring of patients. Research design This study employed a descriptive, quantitative retrospective cohort design. Medical folders of patients who underwent cisplatin chemotherapy treatment and had their hearing thresholds monitored at Groote Schuur Hospital during from 2011 up to 2016 were reviewed. Methods A non-probability, convenience sampling method was used to select medical folders that underwent review. Data which were extracted from the patients’ medical folders includes demographic information (for example age and sex,), chemotherapy treatment information including type and dose of treatment; and audiological information including baseline, checkup and exit audiogram thresholds. Data obtained from the folders were analysed using R, a software environment for statistical computing and graphics. Descriptive statistics and the following inferential statistical tests, Chi-squared, Fisher’s exact tests and the Wilcoxon signed-rank test for paired samples, were used to determine significant associations between hearing loss and several factors revealed in the data. The American Speech-Language and Hearing (ASHA, 1994) criteria were used to determined incidence of significant threshold shift whilst the CTCAE v4 was used to determine both incidence of hearing loss and severity of the loss. The CTCAE v4 and TUNE criteria were compared based on incidence of hearing and ability to predict need for hearing amplification Results A total of 128 medical folders met inclusion criteria for this study and the following were the patient characteristics; median age = 43 years (range: 18 – 75 years); 92 males, 36 females; average length on treatment: 13.45 weeks). Out of these, 64 had information on the type and dose information of chemotherapy drug used during the period when monitoring of ototoxicity was conducted. The American Speech-Language and Hearing (ASHA) criteria revealed 9 ototoxicity in 74.2 % (95/128) of the sample. The Wilcoxon signed-rank test for paired samples showed a significant difference (p = 0.0000000039, p < 0.05) between follow-up and exit monitoring thresholds which indicated a significant decline of patients’ hearing thresholds throughout the treatment duration. There were no statistically significant associations between age, duration of treatment and treatment modification. The study showed three treatment modifications which included dose adjustment (reduction), switching drug and continuing with the same drug. There was no significant association between treatment modifications and hearing loss. The CTCAEv4 criteria identified more people (53.9 %) who experienced a deterioration in their hearing thresholds than TUNE criteria (41.7%). However, TUNE performed better with respect to identifying patients who are likely to be candidates for further audiological rehabilitation including hearing amplification. Conclusion This study found a high incidence of cisplatin-induced hearing loss despite the possible modification of treatment. This shows that current strategies that are used by physicians at GSH Radiation Oncology department to prevent or minimize further deterioration of the patient’s hearing thresholds during cisplatin chemotherapy can arguably be rendered ineffective. This is owing to the inability of conventional audiometry to detect hearing loss before it affects the speech frequencies. There was no significant association between hearing loss and age, dose, duration of treatment and treatment modification. The study also showed that CTCAE v4 grading criteria detected a higher incidence of ototoxicity than the TUNE criteria. However, the TUNE criteria were better at detecting the number of patients who need further audiological rehabilitation than the CTCAE v4. Therefore, both scales have their strengths and weaknesses. Implications of the study include the incorporation of Extended High Frequency Audiometry (EHF) and Distortion Product Otoacoustic Emission (DPOAE) testing into the monitoring protocol where possible to allow for early detection and intervention of ototoxicity. Incorporation of otoprotectors into the prevention protocol is suggested as they have recently shown otoprotective efficacy in animal models without interrupting Cisplatin’s therapeutic agency. Finally, more studies are required to validate the TUNE grading criteria to explore its utility as an ototoxicity grading criterion that can be universally used to communicate ototoxicity outcomes during Cisplatin chemotherapy.

The purpose of this study was to perform the cultural adaptation of the Brazilian version of the Vocal Fatigue Index (VFI). Two Brazilian bilingual speech-language pathologists (SLP) translated the original version of the VFI in English into Portuguese. The translations were reviewed by a committee of five voice specialist SLPs resulting in the final version of the instrument. A third bilingual SLP back-translated this final version and the same committee reviewed the differences from its original version. The final Portuguese version of the VFI, as in the original English version, was answered on a categorical scale of 0-4 indicating the frequency they experience the symptoms: 0=never, 1=almost never, 2=sometimes, 3=almost always, and 4=always. For cultural equivalence of the Portuguese version, the option "not applicable" was added to the categorical scale and 20 individuals with vocal complaints and dysphonia completed the index. Questions considered "not applicable" would be disregarded from the Brazilian version of the protocol; no question had to be removed from the instrument. The Brazilian Portuguese version was entitled "Índice de Fadiga Vocal - IFV" and features 19 questions, equivalent to the original instrument. Of the 19 items, 11 were related with tiredness of voice and voice avoidance, five concerned physical discomfort associated with voicing, and three were related to improvement of symptoms with rest or lack thereof. The Brazilian version of the VFI presents cultural and linguistic equivalence to the original instrument. The IFV validation into Brazilian Portuguese is in progress.

In summary, although multiple oppositions is a variation of the minimal pair approach, it is specifically designed to treat phoneme collapses, not variability. Treatment procedures provide systematic modeling of larger contrastive sets, not simply a series of minimal pairs.

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