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This study explored the feasibility of using test translation to adapt a standard English vocabulary test for Zulu speakers. It was motivated by the difficulties associated with assessing speakers of the African languages, in the absence of Zulu speech-language therapists and Zulu assessment tools. The adaptation process in the present study began with a direct translation of the PPVT-R into Zulu by twenty Zulu university students. Based on the degree of consensus on translations and judgements of cultural appropriacy (using the committee approach), items were selected for the purposes of pilot testing of the translations on 107 Zulu pupils from six to eleven years, in the study area. The results of the first pilot study revealed that it was not feasible to standardise the first translated version of the test, as only seventeen percent of the items were found suitable for inclusion in a normative study. Further test development using translations from twenty educators, their judgements of cultural appropriacy of stimuli as well as application of the back translation test to determine semantic equivalence of translations resulted in the development of a revised translated version of the PPVT-R, consisting of mUltiple translations for some items. This was administered to 544, six to eleven year old Zulu children. The results of the second pilot study revealed that only 31.2% of the translations administered were appropriate for the purposes of developing norms, across all the age groups tested, with 80% of these translations applicable for six and seven year old Zulu children only. Therefore, the translated version of the PPVT-R, despite modifications, showed significantly reduced applicability for Zulu speakers. Using the information derived from the present study a test comprising thirty six Zulu words has been compiled for the purposes of screening the receptive vocabulary skills of six and seven year old Zulu children in the study area. The findings of the study confirmed the difficulties in using test translation as a procedural option in adapting a test for Zulu children; implications, further modifications and investigations are suggested in this regard. / Thesis (M.Sc.)-University of Durban-Westville, 1994.

The purpose of this single-subject case study was to determine if vocal changes can be used to implicate deceit based on a suspect’s involuntary vocal responses when placed in a high stress situation such as being interrogated for a crime. This study also identified justification for the use of SLPs in the criminal justice system for the purpose of voice analysis. 10 truthful and 10 deceitful statements were analyzed from a suspect charged with the crime of murder using the voice analysis software Praat to determine differences in vocal attributes with varying speech characteristics. These statements were analyzed in the areas of intensity, hesitations/pausing, speech rate, and disfluencies. It was found that changes in maximum intensity and total number of words per statement implicate that a person is being deceitful.

Purpose: Evidence for the multiple oppositions intervention approach indicates it should be delivered 3 times weekly; however, this high dose frequency is not provided by many speech-language pathologists worldwide. This study investigated whether parents could be involved in delivering phonological intervention to fulfill this intensity shortfall. Method: Five children with moderate-to-severe phonological impairment aged 3;3–5;11 (years;months) and 1 of their parents participated in this study using a multiplebaseline across participants design. Participants attended one 60-min clinic-based session per week for 8 weeks, and parents completed home practice 2 times per week over this period after receiving training. Parents also attended a 60-min training session prior to commencing intervention. Results: All children showed a treatment effect to treated words. Three of the 5 children demonstrated a large effect size for generalization to nontreatment words, with 1 child demonstrating a moderate effect and 1 child demonstrating no effect. However, all children showed qualitative changes to their speech system. Three of the 5 children experienced significant changes to communicative participation. Measures of treatment fidelity indicated that parents were able to competently deliver the intervention both within the clinic and at home. Conclusions: Combined parent-and speech-language pathologist–delivered multiple oppositions intervention is effective for some children with moderate-to-severe phonological impairment. The findings indicate that parents can be trained to competently and confidently deliver phonological intervention. Further evidence is needed to identify optimal child and parent characteristics most suited to this modified service delivery approach.

Background: Patients often report that living with a condition such as tinnitus can be debilitating, worrying, and frustrating. Efficient ways to foster management strategies for individuals with tinnitus and promoting tinnitus self-efficacy are needed. Internet-based cognitive behavioral therapy (ICBT) for tinnitus shows promise as an evidence-based intervention in Europe, but is not available in the United States. The aim of this pilot study was to evaluate the feasibility of an ICBT intervention for tinnitus in the United States. Method: This study reports the Phase 1 trial intended to support implementation of a larger randomized clinical trial (RCT) comparing ICBT to a weekly monitoring group. As a pilot study, a single-group pretest–posttest design was used to determine outcome potential, recruitment strategy, retention, and adherence rates of ICBT for tinnitus. The primary outcome was a change in tinnitus distress. Secondary outcome measures included measures of anxiety, depression, insomnia, tinnitus cognitions, hearing-related difficulties, and quality of life. Results: Of the 42 screened participants, nine did not meet the inclusion criteria and six withdrew. There were 27 participants who completed the intervention, with a mean age of 55.48 (± 9.9) years. Feasibility was established, as a large pretest–posttest effect size of d = 1.6 was found for tinnitus severity. Large pretest–posttest effect sizes were also found for tinnitus cognitions and hearing-related effects, and a medium effect was found for insomnia and quality of life. Treatment adherence varied with a retention rate of 85% (n = 23) at post-intervention assessment and 67% (n = 18) for the follow-up assessment. Conclusions: This pilot study supported the feasibility of ICBT for tinnitus in the United States. Ways of improving intervention retention and recruitment rates need to be explored in future ICBT studies. Protocol refinements that were identified will be implemented prior to further RCTs to investigate the efficacy of ICBT for tinnitus in the United States.

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This dissertation explored new ways of evaluating outcomes for preschoolers with communication disorders. It identified a need to evaluate outcomes as they relate to a child’s communicative participation and provided initial models for doing this. Chapter 1 provides the context for the dissertation, discussing the theoretical framework used, the literature on communicative participation outcomes, and Ontario’s Preschool Speech and Language Program (PSLP) and its program evaluation project (the setting for the studies presented in Chapters 4 & 5). Chapter 2 is a scoping review of the literature exploring the ways in which outcomes for preschoolers with communication disorders have been evaluated. It identifies a gap in the literature related to participation-based outcomes, and thus the need for the work presented in Chapters 4 and 5. Chapter 3 presents further evidence of both construct and predictive validity of the Communication Function Classification System (CFCS), the classification tool used for PSLP program evaluation. This tool was previously validated for use with children with Cerebral Palsy, and this study provides evidence of its validity with other groups of children. Chapter 4 explored communicative participation outcomes for preschoolers accessing PSLP services by developing growth curves that predict development of preschoolers’ communicative participation skills. The models provide a first look at the growth of those skills, and show that all children make meaningful change regardless of their communicative function. Chapter 5 added meaningful predictor variables (based on available data) to the previously defined growth curves (Chapter 4) and identified both demographic and intervention-specific variables that were predictive of growth. Predictors varied by level of communicative function, a new insight in the field. This work has clinical implications both within and beyond the PSLP. Chapter 6 discusses the clinical and research implications of this dissertation work as well as ideas for future directions of my research. / Thesis / Doctor of Philosophy (PhD) / The work presented in this dissertation explored participation-based outcomes for preschoolers with communication disorders. First, by completing a scoping review, I identified the need to explore participation-based outcomes for preschoolers with communication disorders. Participation-based outcomes are important and meaningful for families, but are not typically used in speech-language research or practice. I next modelled the development of communicative participation skills (how a child uses his/her communication to engage) for preschoolers with speech and language delays who were accessing services in Ontario’s Preschool Speech and Language Program (PSLP). Following this I identified both demographic and intervention-based predictors of that communicative ‘growth’. Development was modelled separately for children in five levels of communicative function using a reliable classification tool that I validated for use with this general community-based population. This work addresses a major gap in the speech-language literature and has important implications for clinicians, administrators and policy makers in the PSLP and beyond.