Department: Allied Health Sciences: Communication Sciences and Disorders ![[clear]](close-x.png "Remove this limiter")
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1.
Anderson, Jill M.
Lateralization Effects of Brainstem Responses and Middle Latency Responses to a Complex Tone and Speech Syllable.
Degree: PhD, Allied Health Sciences: Communication Sciences and Disorders, 2011, University of Cincinnati
► Background: Previous human auditory brainstem response (ABR) studies have suggested that the…
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▼ Background: Previous human auditory brainstem response (ABR) studies have suggested that the right ear auditory network preferentially processes a spectrotemporally complex speech syllable and the left ear auditory network preferentially processes temporally devoid spectral stimuli. Human cortical studies also suggest lateralization effects to spectral versus temporal stimuli. However, it remains unclear if the reported brainstem lateralization effects may be due to the spectrotemporal content or the higher order lexical content of the evoking speech stimulus. Also, the lateralization effects observed at the cortical level in late evoked auditory potentials are based upon responses obtained well after the stimulus has arrived to the auditory cortices (~100 ms). Lateralization effects to spectrotemporally complex stimuli are unknown upon first arrival to the auditory cortices or in the auditory middle latency Pa response which occurs approximately 30 ms post-stimulus. Purpose: The purpose of this study was to gain a better understanding of how the human auditory processing system encodes spectrotemporally complex acoustic stimuli from subcortical levels to first arrival at the bilateral cortices. Research Design: This study is a comparative analysis of both brainstem frequency following responses (FFRs) and cortical auditory middle latency responses (AMLRs) to spectrotemporally complex speech and spectrally complex nonspeech stimuli evoked from right and left ear stimulation in normal hearing adult females. Study Sample: ABR and AMLR responses elicited by a spectrotemporally complex speech stimulus /da/ and a spectrally complex nonspeech stimulus were obtained in a group of twenty right-handed normal hearing adult females. Data Collection and Analysis: Electrophysiological brainstem FFRs and AMLRs were recorded using a 40 ms synthesized speech syllable /da/ presented both forwards and backwards in addition to a 40 ms complex tone. Monaural ipsilateral FFRs and AMLRs were obtained with insert earphones at an intensity of 80 dB SPL. Results: There were no significant differences in the right or left ear evoked FFRs to the complex tone or the speech stimulus played either forwards or backwards. However, the left ear AMLRs to the speech syllable played both in the forwards and backwards mode were significantly earlier than those obtained from the right ear. Conclusions: The results from this study do not support previous findings of a subcortical right ear advantage (REA) for any portion of the synthetic syllable /da/ and suggest that the subcortical neural network does not preferentially process short duration spectrotemporally complex acoustic stimuli differently based upon the spectral, temporal or lexical content of the stimulus. However, the AMLR results suggest that the neural mechanisms generating the AMLR Pa response react earlier to the speech syllable played both forwards or backwards during left ear stimulation. It may be deduced that the earlier Pa responses to left ear stimulation are due to the prosodic acoustic features of both the forwards and backwards syllable that are absent in the spectrally complex tone.
Advisors/Committee Members: Zhang, Fawen.
Subjects: Audiology
Keywords: Speech evoked auditory middle latency responses; Speech evoked auditory brainstem responses; Auditory middle latency responses to a complex tone; Frequency following responses; Lateralization to prosodic acoustic features
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2.
Back Froehlich, Lisa A.
A Collaborative Procedure to Support Teacher Adherence to Reading Comprehension Intervention and Its Effect on Student Outcomes.
Degree: PhD, Allied Health Sciences: Communication Sciences and Disorders, 2011, University of Cincinnati
► Response to Intervention (RtI) is a multi-tiered approach to provide evidence-based instruction…
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▼ Response to Intervention (RtI) is a multi-tiered approach to provide evidence-based instruction to all students. Within a RtI paradigm, teachers and other professionals collaborate to design interventions for students who are at-risk for a learning disability. Despite the widespread use of RtI pardigms in educational settings, few studies have documented the efficacy of collaboration and teacher follow-through in intervention planning. This study examined support for children requiring Tier 2 interventions, which address at-risk students and are typically conducted in the regular classroom. Specifically, the purpose of this study was to determine whether reading comprehension interventions could be delivered in a systematic, collaborative procedure involving performance feedback meetings. A SLP collaborated with the teacher in grades 2, 3, 4, and 5 to develop the interventions and trained the teacher to use them. The study measured the percentage of intervention steps adhered to by the teachers, teachers’ attitudes toward the interventions, and the impact on student outcomes. Using a multiple baseline across subjects design, this study found that the performance feedback meetings supported teacher adherence to the intervention in 50% of the teacher subjects. All teachers’ adherence to the intervention improved from teacher training to performance feedback meeting phases. A t-test for related measures revealed that with 99% confidence, the intervention positively impacted student grades. One implication is that a collaborative framework can support the precise implementation of reading comprehension interventions in the classroom which ultimately can improve student outcomes.
Advisors/Committee Members: Creaghead, Nancy.
Subjects: Special Education
Keywords: Response to Intervention; Reading Comprhension Intervention; Collaboration; Performance Feedback; Academic Interventions
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3.
Bandaranayake, Dakshika W.
An Auditory-Perceptual Intervention Program for Fricatives: Effects and Implications for Toddlers without Fricatives.
Degree: PhD, Allied Health Sciences: Communication Sciences and Disorders, 2012, University of Cincinnati
► Purpose: Fricatives are a class of sounds that is considered difficult to…
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▼ Purpose: Fricatives are a class of sounds that is considered difficult to produce, and are generally developed later than stops, nasals and glides in speech sound development. Current understanding of fricative development suggests that children who develop fricatives at an early age may have better expressive language skills than children who do not develop fricatives early. The purpose of this study was to investigate the changes in fricative production, overall consonant production, and vocabulary growth in a group of toddlers who participated in a short-term, intensive auditory-perceptual intervention program. Methods: The study sample consisted of eight typically developing 18-month-old toddlers with half (n=4) in the treatment group and half (n=4) on the control group. Each toddler in both groups was visited 3 days a week for a period of 3 weeks. During each visit, a 15-minute session with a book-reading activity with a specially designed book and a play activity using selected toys and a play-script was conducted. The treatment group toddlers participated in an auditory-perceptual intervention with the book and the script designed to provide stimulation for the sounds /s/ and /z/. The control group toddlers participated in similar activities, however with materials designed to avoid stimulation of /s/ and /z/ sounds. Children’s performance was assessed with speech samples and the vocabulary scores obtained at pre-treatment, post-treatment, and when the child reached 20 months of age (follow-up). A speech sample was also collected from each child before every treatment session. The assessment data were statistically analyzed to look at the differences in speech sound production and vocabulary over time for both groups of toddlers. Results: The number of fricative /s/ and /z/ productions, number of fricatives, number of fricative types, percentage of fricative types and vocabulary raw scores significantly changed over time for toddlers of both groups combined from pre-treatment to post-treatment and/or follow-up sessions. No significant group effects or interactions between group and time were found for any of the outcome measures. Individual data revealed that 7/8 participants produced fricatives and all 8 of the toddlers increased their vocabulary raw scores from pre-treatment to post-treatment and/or follow-up session. Conclusions: All toddlers enrolled in the intervention completed the intervention as planned. Fricative production and overall vocabulary changed over the study period of 2 months (between 18-20 months) for toddlers of both groups, regardless of stimulated for fricatives or not. There is no evidence from this study that targeting fricatives using an auditory-perceptual method was helpful in phonological and vocabulary development. The lack of differences between the groups suggests that general language stimulation rather than specific fricative stimulation may result in the development of fricatives. Hence, early intervention programs with more general rather than specific stimulation may be appropriate and beneficial for toddlers identified with or at-risk for speech and language delay. The evidence that toddlers as young as 18 months of age are able to participate in a structured intervention program suggests that such programs might be viable for children who are at risk for speech and language delay.
Advisors/Committee Members: Creaghead, Nancy.
Subjects: Speech Therapy
Keywords: Fricatives; Toddlers; Intervention; Speech sounds; Vocabulary; Speech and language
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4.
Beerman, Kathryn B.S.
The Occurrence of Vowel Errors Across Age Groups in Childhood Apraxia of Speech.
Degree: MA, Allied Health Sciences: Communication Sciences and Disorders, 2011, University of Cincinnati
► The purpose of this study was to determine if there are differences…
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▼ The purpose of this study was to determine if there are differences in the number of vowel errors across age groups in children diagnosed with childhood apraxia of speech. The study retrospectively examined the clinical database from the Cincinnati Children’s Hospital Medical Center Interdisciplinary Apraxia Clinic. The participants were divided into three groups: toddler, preschool, and school age. Vowel errors were counted using the raw scores on three sections of the Kauffman Speech Praxis Test: pure vowels, vowel-to-vowel movement and consonant-to-vowel movement. It was found that age did not play a significant role in the number of vowel errors present across the age groups.
Advisors/Committee Members: Prendeville, Jo-Anne.
Subjects: Speech Therapy
Keywords: Apraxia; Vowel Errors; Childhood Apraxia of Speech; Vowel errors across age groups
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5.
Flynn, Allison R. B.S.
The Relationship among Oral Motor, Fine Motor, Simple, and Complex Speech Skills in Childhood Apraxia of Speech.
Degree: MA, Allied Health Sciences: Communication Sciences and Disorders, 2011, University of Cincinnati
► Childhood apraxia of speech (CAS) is a controversial and greatly debated diagnosis…
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▼ Childhood apraxia of speech (CAS) is a controversial and greatly debated diagnosis in the area of pediatric speech sound disorders. Currently there is a lack of understanding of the etiology of the disorder and disagreement over the core deficits. Deficits in oral motor and fine motor praxis are commonly reported in the literature in association with childhood apraxia of speech (ASHA, 2007; Dewey, 1995; Maassen, 2002; Newmeyer et al., 2007); however, they are not validated in the research. While there are reported relationships between oral motor, fine motor, and speech praxis, the role of these relationships is yet to be determined. This study aims to provide evidence regarding the relationships between the oral-motor, fine-motor and speech skills of children with CAS. Subjects in this study were seen in the interdisciplinary apraxia clinic at Cincinnati Children’s Hospital Medical Center. To be included in the study the subjects had to be 2 to 5 years of age at the time of evaluation, receive a clinical diagnosis of childhood apraxia of speech (CAS), have a standard receptive language score greater than or equal to 85 to rule out receptive language deficits, and have received the Kaufman Speech Praxis Test. Subjects were excluded if they had a known neurological or developmental disorder or a known hearing loss. Pearson correlations were run, using IBM SPSS© Statistics 19 software, to determine the relationships among the standard scores of the oral movement, simple phonemic and syllabic level, and complex phonemic and syllabic level parts of the KSPT and the fine-motor quotient of the PDMS-2. A statistically significant moderate correlation (r=.523; p=.001) was found between the KSPT oral-motor standard scores and the PDMS-2 fine-motor quotients. There were no other statistically significant correlations within the data. The lack of a significant relationship between speech and non-speech motor control further supports current research that they are unique and independent of one another (Green, Moore, & Reilly, 2002; Moore & Ruark, 1996; Ruark & Moore, 1997; Steeve, Moore, Green, Reilly, & Ruark McMurtrey, 2008; Wilson, et al., 2008). Although oral-motor and fine-motor skills are commonly cited as diagnostic indicators for CAS, these data indicate there is no significant relationship between these skills and speech abilities. Furthermore, the results indicate that a child may have good oral and fine motor skills and still have significant deficits in their speech praxis at both the simple and complex levels. Clinically this indicates that when oral and fine motor deficits are involved with CAS it may be indicative of a global dyspraxia. The results also indicate that some level of speech is required to evaluate and confirm a diagnosis of CAS. These findings further support evidence against the use of non-speech oral motor exercises to improve speech skills (Bunton, 2008; Lof & Watson, 2008; Ruscello, 2008).
Advisors/Committee Members: Creaghead, Nancy.
Subjects: Speech Therapy
Keywords: Childhood Apraxia of Speech; Fine motor; Oral motor; Speech
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6.
Gottliebson, Renee O.
Efficacy of Cool-Down Exercises In the Practice Regimen of Elite Singers.
Degree: PhD, Allied Health Sciences: Communication Sciences and Disorders, 2011, University of Cincinnati
► Cool-down exercises are routinely prescribed for singers, yet few data exist about…
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▼ Cool-down exercises are routinely prescribed for singers, yet few data exist about the efficacy of active recovery or cooling down of the vocal mechanism. The purpose of the present study was to compare three aspects of vocal function after using different recovery methods following rigorous voice use. Vocal function was assessed using (1) phonation threshold pressure (PTP); (2) acoustic measures (accuracy of tone production, duration of notes and duration of intervals between notes); and (3) measures of subjective perception: perceived phonatory effort (PPE) and Singing Voice Handicap Index (SVHI). Data were collected after 10-minutes of cool-down exercises, complete voice rest, and conversation immediately following a 50-minute voice lesson. Data were collected again 12-24 hours later. Participants included actively performing elite singers (7 women, 2 men) enrolled in the graduate program (M.M., D.M.A.) at the University of Cincinnati’s College-Conservatory of Music. While it was expected that PTP estimates after cool downs would be significantly lower than baselines and the other conditions, it turns out that PTP estimates after cool downs were significantly higher at the 80% level of the pitch range. Statistically significant correlations between PTP estimates and PPE scores were found when comparing levels of the participants’ pitch ranges (10%, 20%, 80%). Mean PPE scores were highest at the 80% level of the pitch range. The acoustic measures yielded variable results. Cool-down exercises did not result in significantly more accurate tone production and shorter staccato note duration and duration of intervals between staccato notes as compared to baselines and recovery conditions. Instead, participants demonstrated greater accuracy of tone production during baselines and lesser accuracy after voice rest. Staccato notes were significantly shorter in duration after the conversation condition as compared to voice rest. Duration between staccato notes was significantly shorter 12-24 hours after voice rest compared to baselines and the other follow-up conditions. SVHI mean scores were higher during baselines than after the recovery conditions and during follow-up sessions. Statistical significance is noted in comparison of mean SVHI scores 12-24 hours after cool downs (overall lowest mean score) and baselines. The relationship between vocal cool downs and their aerodynamic and acoustic effects remains unclear. What was found was that perhaps the perceived benefit of vocal cool downs is not apparent immediately after their use, but is evident 12-24 hours later. While it appears that conversation may be an acceptable form of active vocal recovery, cool-down exercises may be most beneficial as they raise a conscious awareness of optimum, resonant voice use which may carryover into conversational speech. Future research may benefit from examination of long-term use of vocal cool-down exercises in subsequent vocal performance.
Advisors/Committee Members: Kelchner, Lisa.
Subjects: Speech Therapy
Keywords: cool-down exercises; vocal recovery; phonation threshold pressure; perceived phonatory effort; singing voice handicap index; tone accuracy
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7.
Hayes, Danielle J.
Assessing Vocabulary in Context Using Graduated Prompting.
Degree: PhD, Allied Health Sciences: Communication Sciences and Disorders, 2011, University of Cincinnati
► Graduated prompting is a method of dynamic assessment that is used to…
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▼ Graduated prompting is a method of dynamic assessment that is used to make predictions about a child’s response to intervention (Gutierrez-Clellan & Pena, 2001). The purpose of this study was to use graduated prompting to assess the word learning ability of low-income fourth grade students when given context clues during a reading task. Twenty-eight fourth grade students were administered the Expressive One Word Picture Vocabulary Test (EOWPVT; Brownell, 2000) and were placed into Pass (85 and higher) and Non-Pass (below 85) groups based on standard EOWPVT scores. The participants were administered the three phases of the Dynamic Assessment of Vocabulary in Context (DAVIC): 1) Pretest, 2) Graduated Prompting, and 3) Transfer task. Scores on the DAVIC phases were analyzed by group and by EOWPVT score. The frequency of responses at each prompt level was compared to EOWPVT score. DAVIC pretest and DAVIC transfer task scores were compared. There was no significant difference between the scores of the Pass group (M=67.00, SD=14.502) and scores of the Non Pass group (M=64.57, SD=9.525) on the DAVIC graduated prompting phase t(26)=.524, p=.605, d=.19. Scores on EOWPVT and DAVIC pretest scores were significantly correlated, r=.599, p=0.01. EOWPVT scores were significantly correlated with Prompt 1, r=.429, (p=0.05) and Prompt 3, r= -.376, (p=0.05). There was not a significant correlation r=.184 p=.184, between scores on the EOWPVT and DAVIC transfer task scores. The participants scored significantly higher on the transfer task (M=62.32, SD=10.61) than on the pretest (M=37.96, SD=5.87); t=-10.73, p=<.001, d=2.84. Results of this study suggested that when assessing a child’s vocabulary skills, Graduated Prompting may be more effective in determining a child’s abilities than a standardized assessment alone.
Advisors/Committee Members: Prendeville, Jo-Anne.
Subjects: Speech Therapy
Keywords: vocabulary; dynamic assessment; response to intervention; context clues; graduated prompting; word learning
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8.
Knollman-Porter, Kelly.
Intensive Auditory Comprehension Treatment for People with Severe Aphasia: Outcomes and Use of Self-Directed Strategies.
Degree: PhD, Allied Health Sciences: Communication Sciences and Disorders, 2012, University of Cincinnati
► The purpose of this study was to determine the efficacy of an…
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▼ The purpose of this study was to determine the efficacy of an intensive (2 hours/day, 5 days/week for 3 weeks) treatment protocol on individuals with severe, chronic speech perception or auditory comprehension deficits associated with aphasia. Two experiments were implemented to examine this purpose. Experiment I: Single Word Comprehension Approach (SWCA) established the effectiveness of an intensive treatment protocol on single word auditory comprehension (n = 6). Alternatively, Experiment II: Speech Perception Approach (SPA) examined the outcomes of an intensive treatment protocol on speech perception in individuals with profound global aphasia (n = 2). The researcher employed an ABA single subject design for both experiments, and examined the following variables: (1) changes in single word comprehension (SWCA) or speech perception (SPA); (2) the number of self-initiated requests for repetition and lip-reading cues; (3) the effectiveness of repetition and lip-reading cues; (4) the indirect effects of the protocols on verbal expression (SWCA – naming; SPA – repetition; Both – narrative skills); (5) and generalization to functional communication environments. Results revealed that all participants enrolled in the SWCA or SPA exhibited a lack of awareness regarding their comprehension impairment at the onset of treatment. Despite this reduced awareness, 7 of the 8 demonstrated a large effect on either single word comprehension or speech perception. A generalization effect to untrained stimuli was also exhibited by these participants. The use of repetition successfully improved speech perception and single word comprehension in all participants; however lip-reading was beneficial in only 1 of the 8 participants. An indirect effect on verbal expression naming ability was demonstrated by 5 of the 6 SWCA participants; this effect was not observed in the SPA participants. Carryover of these skills to functional communication situations was reported by one of the eight caregivers. These finding suggest that individuals with severe to profound, deficits have the potential for continued improvements in speech perception or auditory comprehension, even in the chronic stages of recovery. However, caregiver involvement, use of personally relevant stimuli and rehabilitation protocols designed to increase self-awareness of speech perception and single word comprehension impairments may be a crucial link to generalization of communication gains to functional situations with this population.
Advisors/Committee Members: Dietz, Aimee.
Subjects: Speech Therapy
Keywords: aphasia; severe auditory comprehension; severe speech perception; intensive treatment; repetition; lip-reading
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9.
Mashima, Pauline A.
The Use of Video-Teleconferencing to Deliver Voice Therapy At-A-Distance.
Degree: PhD, Allied Health Sciences: Communication Sciences and Disorders, 2011, University of Cincinnati
► Telehealth or telemedicine is the use of telecommunications technology to deliver health…
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▼ Telehealth or telemedicine is the use of telecommunications technology to deliver health care services at-a-distance. One of the most commonly recognized benefits of telehealth is improved access to services which includes the opportunity for patients to receive care that otherwise would not be available due to lack of specialists in a geographic area, distance from health care facilities, or lack of transportation. By eliminating geographic considerations, global delivery of health care is possible. One of the barriers to the deployment and widespread use of telehealth is the lack of evaluative data or evidence to prove that this innovative model of service delivery is as effective as the traditional in-person model of delivering health care. This study investigated the telehealth model of delivering speech-language pathology services at-a-distance. Pre-existing de-identified data were analyzed to describe the feasibility of, patient satisfaction with, and effectiveness of delivering voice therapy remotely using video-teleconferencing. The de-identified data were collected during the operationalization phase of a stepwise process to develop a telehealth vocal rehabilitation protocol. There were 31 participants in this study. Twelve participants in the control group received voice therapy in person at an urban medical center and 19 participants in the experimental telehealth group received voice therapy delivered via video-teleconferencing between the urban medical center and two remote sites: a rural satellite clinic and an overseas clinic. Comparisons of pre- and post-treatment data on: 1) patient self-rating on the Voice Handicap Index, 2) auditory-perceptual ratings of voice samples, 3) visual-perceptual ratings of video endoscopic laryngeal exams, and 4) noise-to-harmonic ratios indicated no significant differences between participants who received voice therapy in-person and participants who received therapy remotely via video-teleconferencing. Quantitative analyses of four treatment outcome measures support the effectiveness of delivering voice therapy at-a-distance using video-teleconferencing technology. Qualitative methods of evaluation were used to explore participants’ opinions and capture rich descriptions of their experiences with telehealth. Questionnaires and interviews focused on eliciting overall impressions including satisfaction with and comfort in receiving therapy remotely. Triangulation involved gathering accounts from participants in different roles and comparing results with different sources including existing literature and expert opinion. The following themes emerged from the data: benefits of telehealth (improved access to services, convenience, time savings, cost savings); clinical interactions via video-teleconferencing (initial approach and comfort level, therapy process, patient privacy and confidentiality, innovation); and response to telehealth services (comparing modes of receiving services, patient satisfaction, treatment outcomes). Based upon qualitative analysis of data, the telehealth vocal rehabilitation protocol appears to be: 1) feasible in terms of overcoming barriers to care, and 2) effective in terms of yielding desirable clinical outcomes. However, overcoming administrative, personnel, equipment, technical, workflow, and service delivery issues required time and effort to facilitate successful deployment.
Advisors/Committee Members: Kelchner, Lisa.
Subjects: Speech Therapy
Keywords: speech-language pathology; communication sciences and disorders; voice therapy; telehealth; telemedicine; telepractice
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10.
Pelatti, Christina Y.
Miscue Analysis of Students with Down Syndrome and Typically Developing Students with Reading Difficulties.
Degree: PhD, Allied Health Sciences: Communication Sciences and Disorders, 2010, University of Cincinnati
► Study of the language and literacy skills of individuals with Down syndrome…
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▼ Study of the language and literacy skills of individuals with Down syndrome (DS) has evolved over the past thirty years. Despite these advances, little research has explored the process of reading by incorporating an authentic text (i.e. storybook). This information is pertinent to assist in the understanding of language and literacy and the impact on intervention to ensure that individuals with DS receive appropriate access to knowledge and skills through reading. Therefore, the purpose of the current study was to determine if there were differences between two groups, individuals with DS and typically developing (TD) children with reading difficulties, while reading an authentic text and incorporating the reading tool, miscue analysis. Ten individuals with DS and nine TD children with reading difficulties participated in this study. Subjects qualified for this study based on raw scores from the Fluency subtests of the Gray Oral Reading Test—Fourth Edition (GORT-4), and TD children demonstrated reading abilities on the Fluency subtests that were at least one standard deviation below the average range for their age. Quantitative data from miscue analysis were analyzed using a logistic regression, and the data from miscue analysis as well as the oral retellings were analyzed qualitatively to further explore and describe these measures. Results from the statistical analysis revealed that unlike their reading-matched peers, participants with DS produced more overall miscues as well as those that did not maintain the author’s meaning, were not syntactically acceptable, and were less graphophonemically similar. The participants with DS self-corrected miscues less frequently than the TD group. Qualitative analysis revealed that participants in the DS group utilized reading strategies and cueing systems while reading; however, they were less sophisticated than the TD children with reading difficulties. Holistic analysis of the oral story retellings showed that the participants with DS produced primarily fragments, used fewer details, and had retellings that were judged to be more confusing than the TD participants. Clinical implications are discussed.
Advisors/Committee Members: Creaghead, Nancy.
Subjects: Speech Therapy
Keywords: Down syndrome; miscue analysis; language development; oral story retellings
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11.
Riegler, Lindsay James.
Military On-Line Problem Solving Intervention (MOPS-VI).
Degree: PhD, Allied Health Sciences: Communication Sciences and Disorders, 2012, University of Cincinnati
► The present study reports the phase I findings from an innovative web-based…
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▼ The present study reports the phase I findings from an innovative web-based videophone treatment study designed to increase understanding of traumatic brain injury, and elicit problem solving skills for attention and memory impairment following mild TBI in returning veterans. The results support the feasibility of the approach and provide preliminary evidence of efficacy, defined as increased compliance and improvements in memory skills comparable to face-to-face treatment. The intervention utilized telehealth modalities to improve access to care and increase adherence to cognitive therapy. This is a matched pre/post design. The control group participants were veterans initially compliant with face-to-face cognitive therapy. The Military On-Line Problem Solving Videophone Intervention (MOPS-VI) participants were recruited from a group of veterans non-adherent to standard face-to-face cognitive therapy. Each MOPS-VI participant was provided a laptop computer, wireless internet and a videoconference phone for the duration of the intervention. Following baseline measures of executive dysfunction including: 1) The Test of Memory and Learning 2nd Edition, 2) The Test of Everyday Attention, 3) Behavioral Rating Inventory of Executive Function Adult Version, 4) Center of Epidemiological Depression Scale, and the 5) State/Trait Anxiety Inventory, veterans were trained how to access the on-line modules. Each module consisted of didactic information, veteran interviews providing personal accounts of struggles with executive dysfunction, and self-guided web exercises to help improve executive function skills. Upon completion of each of the six on-line modules, MOPS-VI participants participated in follow-up videophone sessions in an effort to generalize the content learned in the web-based modules. Results of a two way (pre vs. post assessments) x (standard vs. MOPS-VI) analysis of variance (ANOVA) indicated there was a significant pre-post assessment effect, F (1, 10) =50.38, p<.001, indicating that participants' memory improved after treatment for both MOPS-VI and standard treatment groups. There was no significant difference between face-to-face therapy and MOPS-VI therapy (F (1, 10) =0.39, p=.55) suggesting that MOPS-VI therapy is as effective as standard treatment and therefore is a strong alternative for face-to-face treatment. Although not statistically significant, the MOPS-VI intervention yielded similar results as standard therapy even when the MOPS-VI intervention was fewer months in duration. The results provide preliminary evidence that delivery of TBI telehealth intervention is feasible with this group and, for some patients, increase compliance. Further, the results suggest that the intervention is at least as effective as similarly organized face-to-face therapeutic intervention.
Advisors/Committee Members: Boyce, Suzanne.
Subjects: Speech Therapy
Keywords: Telehealth, Traumatic Brain Injury, Veteran, Cognition, Rehabilitation
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12.
Youssif, Mostafa A.
Vestibular Evoked Myogenic Potential (VEMP) in children with Enlarged Vestibular Aqueduct (EVA).
Degree: PhD, Allied Health Sciences: Communication Sciences and Disorders, 2012, University of Cincinnati
► Enlarged vestibular aqueduct (EVA) syndrome is considered one of the most common…
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▼ Enlarged vestibular aqueduct (EVA) syndrome is considered one of the most common congenital anomalies of the inner ear which is radiologically detectable and associated with hearing loss. It is a minor dysmorphology belonging to the family of Mondini dysplasias. Although there are many studies about the effect of EVA on audiological function, there are only a small number of studies on its effect on the vestibular system especially in children. In spite of the frequent studies emerging in the last few years which proved that vestibular disorders in children are not as rare as thought, the data about one of the most important tests in vestibular assessment, vestibular evoked myogenic potential (VEMP) test, and its response characteristics at different ages in children are scant. This study was designed to collect normative data for VEMP response parameters in children from the age of 3 to 12 years and to examine the effect of age on these parameters. The differences between VEMP responses in normal children and children with EVA were investigated in an attempt to evaluate the effect of EVA on the saccular function. The VEMP test was conducted on 39 normal children and on 28 children with EVA. The results revealed that P1 and N1 latencies in normal children are shorter than published normal latencies in adult. The VEMP response was absent in 10% of children with EVA. Moreover, there was a direct correlation between the vestibular aqueduct (VA) diameter and VEMP threshold. Based on these results, using a specific normative data for VEMP test in children is recommended when assessing the pediatric population. In addition, the saccular function should be investigated using VEMP test in children with EVA. However, further studies using other vestibular tests are recommended to investigate the effect of EVA on different vestibular functions.
Advisors/Committee Members: Keith, Robert.
Subjects: Audiology
Keywords: Enlarged vestibular aqueduct (EVA); vestibular evoked myogenic potential (VEMP); pediatric vestibular; vestibular
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13.
Zacharias, Stephanie R.
Middle and High School Teachers' Perceptions towards Adolescent Females with A Voice Disorder: A Handicap in the Classroom?.
Degree: PhD, Allied Health Sciences: Communication Sciences and Disorders, 2010, University of Cincinnati
► Advances in the diagnoses and treatment of pediatric voice disorders have evolved…
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▼ Advances in the diagnoses and treatment of pediatric voice disorders have evolved over the years, however little research has focused on the publics’ perceptions of individuals with a voice disorder. Establishing a better understanding of how the public perceives those with a voice disorder may provide increased insight into how the community’s views impact an individual with a voice disorder’s education, social and future outcomes. The primary aim of this study was to explore middle and high school teachers’ perceptions of personality traits and quality of life in female adolescents with varying degrees of voice disorders. A web-based survey using Quesitonpro.com was created to collect data. Four voice samples, which had been previously rated by two experienced speech-language pathologists using the Consensus Auditory-Perceptual Evaluation of Voice, were downloaded into the survey (normal, mild, moderate, severe). Thirty-two teachers answered 25 questions per voice related to personality traits (18 attributes) and quality of life (6 questions). Analyses of variance were used to compare means with post-hoc testing, using the Dunnett test, to determine significant differences between groups. Each survey (personality traits and quality of life) was analyzed separately. Data for each survey were analyzed in the following ways: normal voice compared to combined voice disordered groups, normal compared to individual voice disorder type, and across voice disordered severity type (mild, moderate, severe). The findings of the study indicate that personality traits and quality of life in adolescent females with moderate and severe voice disorders were rated more negatively by middle and high school teachers’ than those with a normal or mild voice disorder. Importantly, the more severe the voice disorder, the more negative ratings of personality traits and quality of life became. Findings suggest that adolescent female students with a moderate and severe voice disorder have a hidden handicap and are most at risk for academic, social, and vocational difficulties stemming from ones negative perceptions. Informing teachers, speech-language pathologists, patients, and families about the subtle biases and perceptions of teachers’ may improve education, social, and vocational outcomes. Furthermore, teaching self-advocacy may be necessary to help students with a voice disorder obtain an optimal educational experience.
Advisors/Committee Members: Kelchner, Lisa.
Subjects: Speech Therapy
Keywords: Voice disorder; Adolescent; Teachers' Perceptions
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