Digitized by Kansas Correctional Industries

<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>

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.

The psycholinguistic model is a theoretical framework that details the speech processing system at various levels of input, storage, and output. In the case of a child with complex speech-language impairment, this study sought to determine if: (1) a psycholinguistic approach to assessment was effective in identifying the participant’s level(s) of speech and language deficit and (2) if intervention targeted to the identified level(s) of deficit was effective in treating the participant’s speech and language difficulties. First, a comprehensive battery of assessments was administered to identify the participant’s speech processing difficulties and relative strengths. Then, treatment was targeted to specific areas of deficit indicated by assessment. Results indicate that psycholinguistic assessment was effective in identifying the participant’s levels of breakdown in speech processing. Treatment results were variable, although considerable gains were made on primary objectives such as phonological awareness, reading and spelling, and speech production. Overall, findings suggest that a psycholinguistic approach may be appropriate for some children with complex speech-language impairment, although rapid gains may not be seen in each targeted area. / A Thesis submitted to the School of Communication Science and Disorders in partial fulfillment of the requirements for the degree of Master of Science. / Spring Semester 2017. / April 10, 2017. / literacy, psycholinguistics, speech and language therapy, speech processing, speech sound disorder / Includes bibliographical references. / Toby Macrae, Professor Directing Thesis; Erin Ingvalson, Committee Member; Kaitlin Lansford, Committee Member.

Thesis (Ph. D.)--Ohio State University, 1973. / Includes vita. Includes bibliographical references (leaves 149-153). Available online via OhioLINK's ETD Center.

<p> This study uses ultrasound to image onset velar stop consonant articulation in words. By examining tongue body placement, the extent of velar closure variation across vowel contexts provides for the measurement of anticipatory coarticulation while productions within the same vowel context provide measurement of extent of token-to-token variation. Articulate Assistant Advanced 2.0 software was used to semi-automatically generate midsagittal tongue contours at the initial point of maximum velar closure and was used to fit each contour to a curved spline. Patterns of lingual coarticulation and measures of speech motor stability, based on curve-to-curve distance (Zharkova, Hewlett, &amp; Hardcastle, 2011), are investigated to compare the speech of typically fluent speakers to the speech of people who stutter. Anticipatory coarticulation can be interpreted as a quantitative measure indicating the maturity of the speech motor system and its planning abilities. Token-to-token variability is examined from multiple velar vowel productions within the same vowel context, describing the accuracy of control, or stability, of velar closure gestures. Measures for both speaking groups are examined across the lifespan at stages during speech development, maturation, and aging. Results indicate an overall age effect, interpreted as refinement, with increased speech stability and progressively more segmental (less coarticulated) productions across the lifespan. A tendency toward decreased stability and more coarticulated speech was found for younger people who stutter, but this difference was small and absent among older adults. Outcomes of this study suggest the articulatory maturation trajectories of people who stutter may be delayed, but overall maturation of the speech mechanism is evident by older adulthood for typically fluent speakers and those who stutter. Applications to intervention are discussed in closing. </p>

<p> <i>Purpose:</i> The current study sought to investigate the relationship between two metrics of sentence intelligibility in adults with Parkinson&rsquo;s Disease (PD), Multiple Sclerosis (MS), and healthy controls. An objective measure of intelligibility, orthographic transcription, and a subjective measure of intelligibility, Visual Analog Scaling (VAS), were the two metrics of intelligibility examined. Areas of interest included 1) comparisons of the pattern of intelligibility change in transcription and VAS, 2) strength of the relationship between these two types of intelligibility measures, and 3) differences in intralistener and interlistener reliability between the two metrics. </p><p> <i>Methods:</i> 78 speakers and the speech samples reported in Tjaden, Sussman, and Wilding (2014) and Kuo, Tjaden, and Sussman (2014) were used in the current study. The pool of 78 speakers consisted of 32 healthy control speakers, 16 speakers with PD, and 30 speakers with MS. Speakers read Harvard Psychoacoustic Sentences in habitual, clear, fast, loud, and slow conditions. In Tjaden et al. (2014) and Kuo et al. (2014), 50 naive listeners used a VAS on a computer to estimate how much of the speaker&rsquo;s message was understood (e.g., from &lsquo;didn&rsquo;t understand anything&rsquo; to &lsquo;understand everything&rsquo;). In the current study, 50 naive listeners heard the same stimuli, but were instructed to type exactly what they heard. Responses were scored to obtain a percentage of key words transcribed correctly for each stimulus. Results from the current study were compared to results from the VAS task studies (Tjaden et al., 2014; Kuo et al., 2014) using descriptive statistics (e.g., mean, standard deviation, etc.), parametric statistics (e.g., multivariate linear model fit to the data in this repeated measured design), correlation analyses (e.g., between the two metrics), and metrics of reliability. </p><p> <i>Results and Discussion:</i> Results revealed that the pattern of transcription intelligibility scores was very similar to scaled intelligibility derived from VAS. However, transcription scores were higher in magnitude than the VAS scores. In addition, correlation analyses showed the two intelligibility measures were highly correlated. Last, both interlistener and intralistener reliability were marginally higher for the VAS reported in Tjaden et al. (2014) and Kuo et al. (2014) than for the transcription data in the current study. These results suggest that a less time-consuming task, such as the VAS task, may be a viable substitute for a more time-consuming transcription task when documenting intelligibility in a clinical population to obtain an overall metric of severity for tracking disease progression and/or treatment progress. </p>