The purpose of the study was to evaluate the effectiveness of teaching a picture communication system to students with moderate to severe disabilities using the PECS Phase III application. A multiple probe across participants design was used to conduct the study and evaluate the effectiveness of the training on the PECS Phase III application. The results of the study demonstrated that teaching a picture communication system on an augmentative and alternative communication device is effective in the school setting with young adults with moderate and severe disabilities.

The purpose of this study was to determine the effects of QR code (quick reference) linked video-based instruction (VBI) on daily vocational skills for students with moderate to severe disabilities (MSD). A multiple probe across participants was used to evaluate the effectiveness of VBI accessed through scanning a QR code. During technology training a system of least prompts was used to teach students to unlock the iPod, scan the QR code, press play, and press pause between each step of the task; after reaching mastery, students entered into the intervention condition (VBI). During VBI an immediate change in level was observed across three particpants. This study found a functional relationship between VBI and the completion of vocational tasks.

This study examines the connection between curriculum, transition, and employment for individuals with moderate to severe disabilities. Employment for individuals with moderate to severe disabilities remains historically low. Results pointed to a need for increased coherence among transition planning, secondary school curriculum foci, and employers. Many factors influence successful post school employment outcomes for individuals with disabilities. These factors include expectations of the individual and family, individual adaptive behaviors, skill level and lack of knowledge by potential employers of individuals with disabilities. This study sought to understand the following questions: a) in what ways are curricular approaches, transition services, and employer requirements for individuals with moderate to severe intellectual disabilities interconnected? b) What factors affect employment for individuals with moderate to severe disabilities? c) In what ways do curricular approaches and transition services impact post school outcomes for individuals with moderate to severe ID? Connecting curriculum and transition directly to the needs of employers is imperative in understanding the effects both have on post school employment outcomes for individuals with disabilities.

This course is part of the Nancy McKinley Lecture Series, Aligning Literacy Instruction to Standards for Students with Moderate-to-Severe Disabilities (Including Autism), and is presented in partnership with University of Wisconsin-Eau Claire. This course will provide attendees with best practices to teach grade aligned middle and high school English/Language Arts (ELA) content. The best practices highlighted have been derived from rigorous studies conducted with a wide range of students with moderate to severe intellectual disabilities and autism.

No description available.

This pilot study sought to develop and evaluate the use of a treatment package that included systematic and direct instruction on acquisition of literacy skills aligned with middle school English/Language Arts standards for students with moderate to severe disabilities, including autism. Participants included five teachers and 15 middle school students with moderate to severe disabilities who were primarily served in a self-contained setting. A one-group, nonrandomized, pre-posttest design was implemented to measure vocabulary, comprehen- sion of familiar text and unfamiliar text, poetry, research, and writing skills. Results indicated significant gains in vocabulary and comprehension of familiar text. Limitations, implications, and the need for future research are discussed.

Conventional hearing aid circuitry is often unable to provide children with hearing loss with sufficient high frequency information in order to develop adequate oral language skills due to the risk of acoustic feedback and the narrower frequency spectrum of conventional amplification. The purpose of this study was to investigate word recognition abilities of children with moderate-to-severe hearing loss using hearing aids with linear frequency transposition. Seven children with moderate-to-severe sensorineural hearing loss between the ages of 5 years 0 months and 7 years 11 months were selected for the participant group. Word recognition assessments were first performed with the participants using their own previous generation digital signal processing hearing aids. Twenty-five-word lists from the Word Intelligibility by Picture Identification (WIPI) test were presented to the participants in three test conditions, namely: at 55 dB HL in quiet, 55 dB HL with a +5 dB signal-to-noise ratio (SNR) and at 35 dB HL. The participants were then fitted with an ISP-based hearing aid without linear frequency transposition, and the word recognition assessments were repeated with different WIPI word lists under the same conditions as the first assessment. Linear frequency transposition was then activated in the ISP-based hearing aid and different WIPI word lists were presented once more under identical conditions as the previous assessments. A 12-day acclimatization period was allowed between assessments, and all fittings were verified according to the DSL v5 fitting algorithm. Results indicated a significant increase of more than 12% in word recognition score for some of the participants when they used the ISP-based hearing aid with linear frequency transposition. A significant decrease was also seen for some of the participants when they used the ISP-based hearing aid with linear frequency transposition, but all participants presented with better word recognition scores when they used the ISP-based hearing aids without linear frequency transposition compared to their previous generation digital signal processing hearing aids. This study has shown that linear frequency transposition may improve the word recognition skills of some children with moderate-to-severe sensorineural hearing loss, and more research is needed to explore the criteria that can be used to determine candidacy for linear frequency transposition. / Dissertation (MCommunication Pathology)--University of Pretoria, 2010. / Speech-Language Pathology and Audiology / Unrestricted

Le traumatisme craniocérébral (TCC) est la première cause d’invalidité chez les jeunes adultes qui entrent dans leurs années les plus productives, affectant significativement leur qualité de vie. Le TCC modéré à grave s’accompagne de dommages neuroanatomiques considérables et de conséquences neurologiques, cognitives, et sociales qui persistent à long terme, et notamment de troubles de l’éveil et du sommeil qui sont parmi les séquelles les plus communes, invalidantes et persistantes. Conséquemment, l’objectif global de cette thèse était d’investiguer comment le TCC modéré à grave affecte le sommeil subséquent pendant l’hospitalisation aigüe et à long terme, et d’évaluer comment ce sommeil subséquent affecte la récupération à la suite du TCC. Pour ce faire, nous avons usé de méthodes quantitatives, incluant la polysomnographie, afin de mesurer précisément le sommeil du stade aigu au stade chronique à la suite du TCC, ainsi que dans différents groupes contrôles hospitalisés ou non. De plus, ces mesures ont été combinées à des méthodes de neuroimagerie, notamment l’imagerie par tenseur de diffusion, ainsi qu’à diverses mesures cliniques et neuropsychologiques. Aux chapitres un et deux, un survol de la littérature pertinente à cette thèse sera d’abord présenté, abordant des concepts ayant trait au sommeil et au TCC. Les questions qui demeurent dans la littérature ainsi que les objectifs spécifiques de cette thèse seront également abordés en détail. Au chapitre trois, le sommeil au stade aigu du TCC et son association avec la fonction cognitive seront abordés au travers d’un article empirique. Puisque le TCC représente une perturbation importante pour le cerveau, spécialement au stade aigu, et que la majorité des patients ayant subi un TCC développeront des déficits cognitifs persistants, ce chapitre vise à caractériser objectivement le sommeil des patients ayant subi un TCC modéré à grave pendant leur hospitalisation aigüe, et à évaluer comment ce sommeil est associé à la cognition des années plus tard. Dans ce chapitre, nous avons d’abord démontré grâce à la polysomnographie que le TCC causait des altérations importantes du sommeil pendant l’hospitalisation aigüe, qui étaient caractérisées par un sommeil plus fragmenté et une plus grande quantité de sommeil lent profond. Nous avons ensuite démontré que ces altérations étaient associées avec la cognition des années plus tard, en accord avec le rôle attendu du sommeil dans la récupération neurologique à la suite du TCC. Ce chapitre suggère non seulement que le TCC soit directement impliqué dans l’altération du sommeil suivant la blessure, mais aussi que le sommeil subséquent puisse être un marqueur précoce ou un promoteur de la récupération cognitive à long terme, soulignant l’importance de monitorer le sommeil à la suite du TCC. Aux chapitres quatre et cinq, le sommeil au stade chronique du TCC et son association avec les dommages neuroanatomiques seront abordés au travers de deux articles empiriques. Puisque qu’il est difficile d’expliquer les plaintes chroniques de mauvaise qualité de sommeil et d’éveil par l’architecture du sommeil des patients ayant subi un TCC, et que la microarchitecture du sommeil, qui dépend fortement des réseaux étendus de matière blanche, n’a que très peu été étudiée, ces chapitres visent à caractériser la microarchitecture du sommeil des patients ayant subi un TCC modéré à grave au stade chronique, et d’investiguer comment cette microarchitecture est associée à la détérioration attendue de la matière blanche. Dans ces chapitres, nous avons démontré que les fuseaux de sommeil et les oscillations lentes n’étaient que très peu altérés au stade chronique du TCC, soulignant leur surprenante résilience, et que contrairement à nos hypothèses, ceux-ci ne sont probablement pas directement impliqués dans les troubles de sommeil et de l’éveil persistants rapportés à la suite du TCC. D’un autre côté, nous avons également démontré que la synchronisation des oscillations lentes était fortement associée à la détérioration massive de matière blanche présente chez ces patients, supportant l’hypothèse qu’il existe une forte pression homéostatique de sommeil et un besoin de sommeil augmenté qui persistent au stade chronique. Cette thèse a contribué à élucider comment le TCC affecte le sommeil à court et à long terme suivant la blessure, ainsi que l’effet du sommeil pendant l’hospitalisation aigüe sur l’évolution cognitive qui s’ensuit à long-terme. / Traumatic brain injuries are the first cause of disability among young adults. This is notable considering they are entering their most productive years, significantly altering their quality of life. Moderate to severe TBI are accompanied by considerable neuroanatomical damage and neurological, cognitive, and social consequences that can persist over several years, and notably sleep-wake disturbances which are among the most common, debilitating, and persistent sequelae. Thus, the global objective of this thesis was to investigate how moderate to severe TBI affects sleep during acute hospitalization and in the long-term, and to evaluate how post-injury sleep affects recovery following TBI. To achieve this goal, we used quantitative methods, including polysomnography, to precisely measure sleep in the acute and chronic stages of TBI, and in both hospitalized and not hospitalized control groups. In addition, these measures were combined to neuroimaging methods, notably diffusion tensor imaging, and to various clinical and neuropsychological measures. In chapters one and two, an overview of the relevant literature will first be presented, touching on concepts related to sleep and TBI. Current gaps in the literature and the thesis objectives will also be detailed. In chapter three, sleep in the acute stage of TBI and its association with cognitive function will be addressed. Because TBI represents a major disruption to the brain, especially in the acute stage, and because most patients with TBI exhibit persistent cognitive deficits, this chapter aims to objectively characterize sleep during acute hospitalization following moderate to severe TBI, and to explore how sleep is associated with cognition years later. In this chapter, we first showed with polysomnography that TBI caused significant disruptions of sleep during acute hospitalization, which were characterized by a more fragmented sleep and more slow-wave sleep. We then showed that these alterations were associated with cognition years later, in line with the expected role of sleep in neurological recovery. This chapter suggests that the TBI itself is directly involved in sleep disruption following the injury, and that subsequent sleep may be an early marker or a promoter of long-term cognitive recovery, highlighting the importance of monitoring sleep following TBI. In chapters four and five, sleep in the chronic stage of TBI and its association with neuroanatomical damage is addressed. Because chronic sleep-wake complaints are not accounted for by sleep architecture following TBI, and that sleep microarchitecture, which relies on a structural backbone of white matter networks, has rarely been studied, these chapters aim to characterize sleep microarchitecture in the chronic stage following moderate to severe TBI, and to investigate how this microarchitecture is associated with the expected white matter deterioration. In these chapters, we showed that sleep spindles and slow waves were only minimally altered in the chronic stage following TBI, highlighting their surprising resilience to injury, and that contrary to our hypotheses, these sleep oscillations are probably not directly involved in the persistent sleep-wake disturbances reported following TBI. On the other hand, we also showed that slow wave synchrony was strongly associated with the massive white matter deterioration observed in these patients, supporting the hypothesis of elevated homeostatic sleep pressure and heightened need for sleep persisting in the chronic stage. This thesis contributed to elucidating how TBI affects short and long-term sleep following injury, as well as the effect of sleep during acute hospitalization on long-term cognitive outcomes.

The primary goal of this study was to develop a preliminary tool to determine caregivers’ needs regarding the management of a person with a traumatic brain injury (TBI), during the acute rehabilitation period. The potential impact of TBI on family dynamics, interpersonal relationships and functional independence is well documented.To facilitate achievement of the main goal this study was divided into two phases. In the first phase, caregivers’ needs were determined by means of both qualitative and quantitative measurements in the form of structured and unstructured observations, the implementation of a “Needs Questionnaire”, a focus group and semi-structured interviews. The results obtained during this phase indicated that caregivers have needs for support from professionals and the community, as well as needs regarding the general management of the person with a TBI and the management of the potential communication difficulties associated with TBI. Based on these needs, a preliminary tool, namely the “Needs questionnaire for caregivers of a person with a traumatic brain injury”, was developed. During the second phase of the study, this tool was administered to caregivers of individuals with TBI before and after the presentation of a workshop to determine whether there is a change in caregivers’ needs once they have received information. A pretest-posttest, experimental design was thus implemented during the second phase of this study. Although further research is required for the qualitative and quantitative validation of this tool, the use of this tool has implications for providing a better understanding of caregivers’ needs during the acute rehabilitation period after TBI. The results of this study further emphasize that improved service delivery in the South African context is reliant on the early identification, by the professional team, of the needs that caregivers of individuals with TBI have. / Dissertation (M (Communication Pathology))--University of Pretoria, 2007. / Speech-Language Pathology and Audiology / unrestricted