Individuals with mild neurocognitive disorder complete many activities of daily living independently; however, they may require the use of compensatory strategies while performing everyday tasks. Compensatory strategies, such as external memory aids, incorporate a strengths-based approach to enhance the functional needs of individuals. Although external memory aids have a strong evidence-base, limited assessment tools and interventions are available to facilitate the development of individualized treatment plans that promote sustained strategy use. To better support the everyday needs of individuals with mild neurocognitive disorder and to inform clinicians who are developing interventions, the current dissertation includes four paper that examine a functional framework for external memory aid assessment and intervention. The first paper examined a group intervention teaching three types of external memory aids on functional strategy use, perceived strategy use, and cognitive skills. The second paper identified individual preferences for experiences with external memory aids during and following intervention. The third paper examined individual changes in functional and perceived strategy use following a group-based intervention teaching external memory aids. Lastly, the fourth paper examined the content validity and internal structure of the Functional External Memory Aid Tool: a measure that explores external memory aid use with simulated everyday tasks. By understanding the weaknesses in currently used assessment and intervention practices and the unique preferences of clients, this multi-manuscript dissertation aims to enhance the immediate and long-term needs of individuals with mild neurocognitive disorder.

A large body of research relates families’ socioeconomic status (SES) to child language development (Hoff & Tian, 2005). Results from these studies indicate preschoolers from low SES backgrounds may have underdeveloped linguistic foundations required for future academic success (Sirin, 2005; Lacouri & Tissington, 2011). These differences have been said to create a 30 million word-gap between the language experiences of low and middle to high SES children by the age of 3 years. Thus, children who come from lower SES backgrounds often lack the vocabulary knowledge used in school and in textbooks (Hart & Risley, 1995). One index of SES is parental level of education, specifically maternal education (Hoff & Tien, 2005). The current study compared the language processes related to word knowledge of 17 preschoolers who live in lower maternal education attainment (LEA) homes and 17 preschoolers who live in higher maternal education attainment (HEA) homes. An event related potential (ERP) thought to index semantic congruity and comprehension monitoring, the N400, was used. Preschoolers listened to nouns and verbs presented aurally that matched or mismatched with pictures to understand how preschoolers from varying SES backgrounds process linguistic stimuli. Additionally, participants completed an Auditory Oddball Paradigm, or tone judgment task, to evaluate how preschoolers categorized and judged non-linguistic stimuli (e.g., standard and target pure tones). Tone judgment results revealed a Group x region midline interaction, indicating that the groups may recruit different neural resources to judge tones. The noun picture task results indicated that the HEA group processed familiar object labels more robustly and quicker than the LEA group. N400 results did not differ for the verb picture task. These results may indicate that both groups require more neural resources to process action labels and that perhaps verbs represent a higher level of linguistic complexity for young children. These results provide preliminary evidence of neural linguistic processing differences between preschoolers from varying socioeconomic backgrounds. Because of the lack of minimal differences on associated behavioral measures of language, one may speculate that ERP underpinnings as exemplified in the current study may hold promise for identifying subtle underlying differences in the processing of language among preschoolers

Treatment for adulthood stuttering traditionally focuses on some combination of stuttering management and fluency management and may also target emotional and cognitive reactions to stuttering. However, long-term gains are often limited, and there is a need for continued development of approaches for mitigating impacts of stuttering. We know of no evidence-based therapy approaches designed to target functional communication in adults who stutter (AWS), despite widespread interest in improving functional communication in members of this speaker group. Script training is an intervention approach designed to improve accuracy and automaticity in functional communication. Script training was originally designed for use with adults with aphasia and was also recently applied successfully with adults with apraxia of speech. The aim of this study was to determine effects of script training in AWS. Three males participated, one who stuttered mildly, one moderately, and one severely. Using a single-subject, multiple-baseline design, treatment and maintenance performance was compared to baseline performance on three dependent variables: Script accuracy, percentage of syllables stuttered, and speaking rate. Results indicate that script training may benefit AWS. Script accuracy increased and percentage of syllables stuttered decreased in all three individuals. Speaking rate increased for one participant, whose pre-treatment stuttering was rated as mild in severity. All participants reported a self-perceived increase in confidence communicating. These effects indicate that additional research is warranted to continue investigating effects of script training in people who stutter.

Children with hearing loss have limited auditory access to their native language and struggle to develop appropriate language skills. These children consistently demonstrate less complex oral language output, smaller vocabulary inventories, and delays in overall communicative proficiency. With the extensive implications hearing loss has on language development, a child with hearing loss requires immediate access to appropriate and effective intervention to address deficits and curb long-term language delays. However, there is a paucity of research investigating the effects of various language intervention programs with children with hearing loss. Much of the existing research focuses on the consequences of a selected language modality or lacks the rigor needed to produce conclusive evidence. While it has not been extensively investigated with children with hearing loss, narrative language intervention has been effective at improving a number of language skills of children with a variety of disabilities and language needs. Therefore, the purpose of this study was to investigate the effect of narrative language intervention on the narrative retelling skills and vocabulary use of children with hearing loss. To do so, a multiple baseline research design and a repeated acquisition research design were implemented. Participants included two children ages 5 and 9 diagnosed with bilateral sensorineural hearing loss and fitted to an amplification device. Each child received weekly, individualized narrative language intervention with a focus on use of target vocabulary words. Both participants demonstrated weekly increases in narrative retell scores and repeated pre-test to post-test gains in the use of targeted vocabulary. Results suggest narrative language intervention improved the narrative retell ability and vocabulary use of children with hearing loss.

The purpose of this investigation was to measure the ability of young normal hearing listeners to perceive speech in the presence of a background noise which varies in the relative intensity of its semantic content. The Speech Perception in Noise test was mixed with a two-component competing noise complex in which the narrative-to- speech noise ratio varied in 2 dB increments from -2 dB Na/SpN to +8 dB Na/SpN. These stimuli were presented at an overall +8 dB signal-to-noise ratio to thirty young normal hearing adults through the soundfield system. The differences between the mean error scores and standard deviations for the low predictability sentences were found to be statistically significant at all Na/SpN ratios. No main effect was observed for the Na/SpN ratios on the high predictability sentences. Significant differences were also observed between the mean error scores and standard deviations of HP and LP pairs at each Na/SpN ratio. These data further revealed a systematic increase in LP mean error scores and standard deviations as a result of linear increases in the Na/SpN ratio. These results suggest that semantically loaded competing noise significantly influences the perception of primary messages as a direct function of the competition ratio.

The frequency and duration of six coverbal behaviors were examined in two experimental groups and one control group. Conversational samples of ten aphasic subjects, ten right hemisphere damaged (RHD) subjects, and ten matched, non-brain damaged (NBD) control subjects were scored for frequency and duration of eye contact, head nod, head shake, head tilt, smile and eyebrow raise. Only the frequency of smile was found to differ significantly; the RHD subjects smiled less often than either of the other two groups.

This investigation compared the auditory conceptualization ability (Lindamood and Lindamood, 1970) or vocal phonics (Van Riper, 1963) of third grade students with and without articulation deficits in an attempt to determine if a relationship exists between auditory conceptualization ability and articulation ability. The specific question posed was: Is there a statistically significant difference in auditory conceptualization ability between third grade children with various degrees of articulation deficits and third grade children without articulation deficits.

Focus has turned from emphasis on phonetic sound errors to phonologic rule systems in the study of articulation disorders. The current theory proposes that the phonological disorders which children experience are controlled by higher levels in the brain than those that control the motor functioning of the brain. The purpose of the present study was to compare the use of phonological processes by a group of school-age children with moderate to severe multiple articulation disorders (MAD) with developmental apraxia of speech (DAS) to the phonological processes used by those without developmental apraxia of speech. For the purposes of this study, those without DAS were classified as functional articulation disorder (FAD).

Early identification of children with reading and learning problems seems imperative. By using early identification predictors, a high risk group of children with possible reading problems could be located. This would facilitate placement and appropriate educational strategies for this group of children. By proper placement and planning, educators then would be able to set up remedial and/or preventive programs for these children before the pattern of unsuccessful attempts and improper training becomes irreversible. This study was designed to determine if verbal sequencing ability was a valid predictor of reading ability for a group of 31 preschool children. Secondarily, the investigation attempted to determine whether such verbal sequencing ability was predictive of general academic ability for this group of children. Reliability of the Blakeley Verbal Sequencing Ability Tests was determined. Thirty one children who were originally tested for verbal sequencing ability in 1965 when they were five years old were located in the Portland Public Schools. The children. now 13 years old, were administered the Blakeley Verbal Sequencing Ability Tests and the Gilmore Oral Reading Test. Records of school achievement were obtained from each child's cumulative school file. A least squares linear regression equation was used to analyze the data obtained. When the predictive value of the original verbal sequencing score was studied in relation to reading accuracy, reading comprehension, and general academic achievement, results for the total group of 31 children were not promising. Verbal sequencing ability in preschool children, in general was not significantly predictive of reading accuracy, reading comprehension, and school achievement eight years later. Examination of the results obtained on the Blakeley Verbal Sequencing Ability by Blakeley and this investigator suggested that inter-examiner reliability is extremely high. The most significant finding of this study was found through a comparison of the results of the male and female groups. The original sequencing score was a much better predictor of reading ability and school achievement for 'the males. The correlations were higher in all three area: comparing original sequencing ability with reading accuracy, reading comprehension, and school achievement. This trend may indicate that the sequencing test was not discriminative enough for five year old females, due to the advanced rate of physical and neurological development at that age. More significantly, the children used in this follow-up study may not have been representative of the original group tested, due to problems in locating the original subjects.

A labeling variable suggested by Wendell Johnson's “diagnosogenic" theory of the onset of stuttering was included in this study of the disfluencies of normal speaking college students in order to explore further the hypothetical relationship between normal disfluency and the onset of stuttering. A total of 60 Ss were randomly assigned to the following groups, each containing 10 Ss: I. Labeling Chastisement plus Contingent “wrong;" II. Labeling Chastisement plus Yoked (non-contingent) "wrong;" III. Labeling Chastisement -No “wrong;" IV. No Labeling Chastisement Contingent "wrong;" V. No Labeling Chastisement -Yoked “wrong;” VI. No Labeling Chastisement -No "wrong” (control). All Ss read aloud for 23 minutes, a three minute Baseline Period in which no experimental manipulations were introduced, followed by a 20 minute Experimental Period. Following the Baseline PerIod, Ss in the three Labeling Chastisement Groups were chastised for "stuttering” and asked to try not to. During the Experimental Period, -Ss in the two Contingent "wrong" Groups were presented “wrong” immediately following a repetition or prolongation. A yoked design was used, which enabled the Ss in the Yoked "wrong” Groups to hear this same "wrong," though non-contingently throughout their reading. The results showed that neither the Labeling Chastisement procedure nor non-contingent (Yoked) “wrong” caused an increase in disfluencies as predicted. The Ss in the Contingent "wrong” Groups decreased disfluencies during the Experimental Period, supporting the results of earlier studies which had reported that response-contingent stimuli reduce the disfluencies of normal speakers, while non-response-contingent stimuli have no effect upon disfluencies. Although this observation is in direct opposition to many onset of stuttering theories which posit that stuttering originates, in part, when the normal disfluencies of children are punished by overly-critical parents, it was noted that several theoretically-important differences exist between normal speaking college students and young children learning to talk. Normal speaking adults have had many years of speaking experience, during which time they have developed large verbal repertoires, enabling them to replace an undesirable response (disfluency) with a more rewarding one (fluency); Young children, on the other hand, have not yet mastered the complex skills required to speak correctly, and are likely to have an extremely narrow range of verbal response alternatives. Consequently, these young children, because of their lack of a correct response, may be more likely than normal adult speakers to respond to the disapproval of their disfluencies by altering their behavior in a maladaptive manner. Some of the normal speakers in this study showed an extreme vulnerability to the experimental manipulations as well as anticipation of disapproval from the E. Anticipation of speech difficulty and vulnerability to environmental influences are two factors which some theorists feel play an important role in the onset of stuttering. However, the Ss in this study who showed these behaviors were able to speak fluently when under pressure from the E to do so. Because of the vast differences between normal speaking adults and young children learning to talk, it was suggested that further experimentation with normal speaking adults engaged in verbal tasks in hopes of gaining insight into the hypothetical relationship between normal disfluency and the onset of stuttering might prove fruitless. Two alternative approaches were suggested. First, detailed observations of the interactions between adults and children in natural settings would undoubtedly prove enlightening. The second suggested approach calls for the laboratory study of adults engaged in a non-verbal task which involves interactions and requires behaviors comparable to those involved in the learning of speech by young children. Nine variables were suggested which would provide an ideal paradigm for this type of study.