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Impact Of Explicit Whole Class Oral Narrative Intervention On Oral And Written Language In Grade 1 Students, Diya Nair Aug 2024

Impact Of Explicit Whole Class Oral Narrative Intervention On Oral And Written Language In Grade 1 Students, Diya Nair

Electronic Thesis and Dissertation Repository

Oral language is one skill known to support written language development. Story-telling or narrative skills are important oral language skills that have been found to improve with explicit teaching and predict academic outcomes. This study investigated impact of the oral narrative intervention on the oral and written language skills of first-grade children. In a cross-over design with 63 participants from two schools, whole class intervention in one class per school was conducted in twelve 25–30-minute sessions over three weeks either during phase 1 or phase 2 of the study while the other class in each school completed their business-as-usual curriculum. …


Effects Of Age On The Adult Peripheral Auditory System, Faraz Masheghati Aug 2024

Effects Of Age On The Adult Peripheral Auditory System, Faraz Masheghati

Electronic Thesis and Dissertation Repository

Age-related changes in the auditory nerve and brainstem function were studied using electrocochleography (ECochG) and auditory brainstem responses (ABR) in young and old adult age groups. Isolating the effects of aging from lifetime ototoxic exposures such as noise is challenging. For this reason, only participants with normal audiograms were studied. Extended high frequency thresholds and distortion product otoacoustic emissions (DPOAEs) were also measured. Results reveal significant age-related differences. Older adults exhibit longer ECochG AP and ABR wave I and V latencies compared to younger adults, while the amplitude of these components, and the ECochG SP latency and amplitudes were unaffected …


Validation Of A Virtual Auditory Space, And Its Use To Investigate How Pitch And Spatial Cues Contribute To Perceptual Segregation Of Auditory Streams, Nima Zargarnezhad Jan 2024

Validation Of A Virtual Auditory Space, And Its Use To Investigate How Pitch And Spatial Cues Contribute To Perceptual Segregation Of Auditory Streams, Nima Zargarnezhad

Electronic Thesis and Dissertation Repository

The human auditory system can decompose complex sound mixtures into distinct perceptual auditory objects through a process (or processes) known as Auditory Scene Analysis. Pitch and spatial cues are among the sound attributes known to influence sequential streaming (Plack 2018). In this project, the fidelity of a virtual acoustic space (the Audio Dome) in reproducing precisely located sound sources with a 9th-order ambisonics algorithm was validated. The estimated horizontal Minimum Audible Angles aligned with previously reported values (Mills 1958) homogeneously across the space, and a robust low-frequency presentation was identified. Then, the Audio Dome was utilized to test …


The Roles Of Vestibular And Proprioceptive Signals In Updating Spatial Selective Auditory Attention During Head Motion, Erisa Davoudi Aug 2023

The Roles Of Vestibular And Proprioceptive Signals In Updating Spatial Selective Auditory Attention During Head Motion, Erisa Davoudi

Electronic Thesis and Dissertation Repository

Spatial Selective Auditory Attention (SSAA) allows individuals to attend to a desired sound’s location in an acoustically rich environment. This research project explored the compensatory updating of SSAA focus during head movements and the roles of vestibular, proprioceptive, and visual self-motion signals in this process. A behavioural auditory selective attention task was conducted with and without visual cues and in three different motion conditions that manipulated the availability of vestibular and proprioceptive signals: Static (no updating required), Active head rotation (vestibular and proprioceptive signals available), and Passive whole-body rotation (only vestibular signals available). The findings suggest that listeners do appropriately …


Loudness Matching In Individuals With Parkinson’S Disease And Hypophonia, Catherine Johnson Aug 2023

Loudness Matching In Individuals With Parkinson’S Disease And Hypophonia, Catherine Johnson

Electronic Thesis and Dissertation Repository

The purpose of the present study was to investigate speech loudness perception in 15 individuals with Parkinson’s disease (IWPD) and hypophonia (reduced speech intensity) and 15 healthy control (HC) participants. A loudness matching procedure was used to examine conditions involving speech loudness targets presented at various levels (60 to 80dB SPL). The loudness response conditions included manually controlled audio playback of external speech, self-vocalized speech, amplified self-speech, and speech projected to a distance of 2 meters. For most of the loudness matching conditions, the PD group did not demonstrate the predicted deficit in loudness matching. In some loudness matching conditions, …


Management Of Topic In The Spoken Discourse Of Persons Living With Mild Cognitive Impairment And Alzheimer’S Dementia, Sydney A. Difruscia Jul 2023

Management Of Topic In The Spoken Discourse Of Persons Living With Mild Cognitive Impairment And Alzheimer’S Dementia, Sydney A. Difruscia

Electronic Thesis and Dissertation Repository

Analyses of elicited spoken discourse can identify mild cognitive impairment (MCI) and Alzheimer’s dementia (AD). Topic management, one feature of discourse defined as acts that maintain or terminate an established topic, can be measured via global coherence measures. Little is known, however, about whether analyses of topic management can distinguish spoken discourse performances of persons living with MCI (PLwMCI) vs. persons living with AD (PLwAD). The current study investigated whether there are differences in topic management in the spoken discourse performances of PLwMCI vs. PLwAD. Analyses were conducted on 120 transcripts of spoken sequenced story picture descriptions of PLwMCI (n=83) …


Engaging Clinicians To Develop A Meaningful Digital Outcome Measurement Tool To Improve Implementation Of The Focus On The Outcomes Of Communication Under Six (Focus), Boshra Bahrami Jun 2023

Engaging Clinicians To Develop A Meaningful Digital Outcome Measurement Tool To Improve Implementation Of The Focus On The Outcomes Of Communication Under Six (Focus), Boshra Bahrami

Electronic Thesis and Dissertation Repository

This study engaged speech-language pathologists who were familiar with an existing participation-focused paper-based outcome measure called the Focus on the Outcomes of Communication Under Six (FOCUS-34) to understand their current experiences using the tool and identify their recommendations for how a digital solution could improve their ability to use its data clinically. SLPs were actively involved in the early stages of the digital FOCUS-34 development to ensure its clinical utility and support its future implementation in clinical practice. Twenty-three speech-language pathologists participated in virtual focus groups that were run in groups of four or five. Focus groups lasted 60 minutes, …


Exploring Collaboration And Evidence-Based Practice In Speech-Language Pathology, Alyssa K. Kuiack Mar 2023

Exploring Collaboration And Evidence-Based Practice In Speech-Language Pathology, Alyssa K. Kuiack

Electronic Thesis and Dissertation Repository

Evidence-based practice refers to an integration between one’s clinical expertise developed through professional development and previous experience, the most current and valid scientific evidence and the unique needs of a particular clinical setting. Recently, there has been a growing expectation of speech-language pathologists to engage in the evidence-based practice process despite awareness that real-world implementation is a complex task. Implementation strategies may be helpful in moving complicated research findings into clinical practice, but there is little research examining the practical use of these strategies. The current dissertation examines how four different implementation strategies, explored through two case studies, can be …


Development Of Psychoacoustic Screening Tests For Hearing Assessments, Minh Vu Duong Aug 2022

Development Of Psychoacoustic Screening Tests For Hearing Assessments, Minh Vu Duong

Electronic Thesis and Dissertation Repository

The evaluation of suprathreshold listening abilities in audiological assessment is often minimized despite the valuable insight it produces about auditory discrimination skills. These capabilities can be assessed from psychoacoustic tests. However, measuring these abilities requires a significant amount of time. Therefore, screening tests were developed for frequency discrimination, gap detection, and amplitude modulation tests to identify individuals for whom these skills are most likely to be useful. The purpose of this project was to determine the ability of this screening tool to predict good performers and determine who is likely to have reduced skills and require full threshold assessment. Thirty …


Myeloarchitectonic Maps Of Cat Auditory Cortex, Austin Robertson Aug 2022

Myeloarchitectonic Maps Of Cat Auditory Cortex, Austin Robertson

Electronic Thesis and Dissertation Repository

The cerebral cortex contains myriad cortical areas that differ in structure, function, and connectivity. Current methods of delineating cortical structures and their subregions are insufficient for in vivo applications, either being highly invasive or requiring a detailed knowledge of a region’s tuning properties. To address this, we seek to establish a structural biomarker capable of delineating the cortex that possesses a non-invasive correlate. We explore myelin as a potential candidate by evaluating its efficacy in parcellating the feline auditory cortex through the generation of depthwise myelin density profiles for each of the 13 auditory cortical subregions. Our analyses revealed significant …


User Preferences For Hearing Aid Features: Outcomes, Concepts, And Test Construction, Hasan Saleh Jul 2022

User Preferences For Hearing Aid Features: Outcomes, Concepts, And Test Construction, Hasan Saleh

Electronic Thesis and Dissertation Repository

Modern hearing aids can vary in both digital signal processing (DSP) and non-signal processing (non-DSP) features. The complexity and availability of these features can differ at opposite ends of the technology spectrum, potentially influencing aided benefit and preference. Furthermore, the amount of feature choices in modern hearing aids has led to increasing complexity in the selection process.

The first aim of this dissertation was to investigate the aided benefit and preference differences between premium and entry-level hearing aids, and to investigate the drivers of any preference differences. No significant differences were found between the entry-level and premium hearing aids in …


Language-Based Strategies That Support Person-Centered Communication In Formal Home Care Interactions With Persons Living With Dementia, Reanne G. Mundadan Jun 2022

Language-Based Strategies That Support Person-Centered Communication In Formal Home Care Interactions With Persons Living With Dementia, Reanne G. Mundadan

Electronic Thesis and Dissertation Repository

Background. Several studies recommend language-based strategies for communication with persons living with dementia. Language-based strategies improve coherence, clarity, reciprocity, and continuity of interactions. Person-centered communication (PCC) strategies are the gold standard, including facilitation, recognition, validation, and negotiation. Only one study has examined the overlap between language-based strategies and PCC in long-term care. Little is known about which language-based strategies support PCC in home care. Accordingly, this study investigated the overlap between language-based strategies and PCC in home care interactions. Method. Conversation analysis of 30 audio-recorded routine care interactions between home care workers and persons living with dementia was conducted. The …


Practice-Based Research In Speech-Language Pathology, Meghan Vollebregt Apr 2022

Practice-Based Research In Speech-Language Pathology, Meghan Vollebregt

Electronic Thesis and Dissertation Repository

Practice-based research is an active and collaborative approach to clinical research that minimizes the research-practice gap. Practice-based research involves collecting data in practice to answer questions that arise from clinical practice. The findings from this research then inform future practices. Though over the past two decades there has been a significant increase in knowledge translation activities, especially the use of collaborative partnerships, the integration of these practices in speech-language pathology is in its infancy. In this thesis, I investigate the role of practice-based research in speech-language pathology. In Chapter 2, I first examine the current role of practice-based research in …


Approaches To Examining The Role Of Auditory Evoked Potentials In Early Language Development, Alyssa Janes Jan 2022

Approaches To Examining The Role Of Auditory Evoked Potentials In Early Language Development, Alyssa Janes

Electronic Thesis and Dissertation Repository

Previous research has suggested a relationship between auditory evoked potentials (AEPs) and spoken language proficiency, but their interactions during the earliest stages of development are not well understood. AEP-Age, an index that estimates the maturity of a child’s AEP relative to same-aged peers, has been effective in investigating this relationship in school-aged children, but has yet to be applied to younger populations. This thesis includes two Stage 1 Manuscripts (Registered Reports) for future studies to (a) assess the utility of AEP-Age to predict chronological age and language ability in 18-48-month-old children, and (b) investigate the relationship between AEP-Age and …


The Role Of Working Memory And Linguistic Knowledge On Language Performance, Theresa Ai Vy Pham Nov 2021

The Role Of Working Memory And Linguistic Knowledge On Language Performance, Theresa Ai Vy Pham

Electronic Thesis and Dissertation Repository

The language system is highly flexible and draws on distinct but interconnected cognitive mechanisms, including verbal working memory and long-term linguistic knowledge. Verbal working memory is the ability to manipulate verbal information in mind. Long-term linguistic knowledge refers to our knowledge of the language (i.e., phonology, semantics, syntax), stored in long-term memory. The close interaction between verbal working memory and linguistic knowledge highlights a pressing need to investigate the construct of verbal working memory, its separability and its relationship with linguistic knowledge. To understand the way working memory influences and interacts with language abilities in children and adults, I ask …


Typical And Atypical Development Of Compensation To Altered Auditory Feedback, Caitlin E. Coughler Aug 2021

Typical And Atypical Development Of Compensation To Altered Auditory Feedback, Caitlin E. Coughler

Electronic Thesis and Dissertation Repository

Auditory feedback, how we hear ourselves speak, plays an important role in the acquisition and maintenance of fluent speech. Although there is wide acceptance of the importance of auditory feedback control throughout development, little is known about how this develops or how the reliance on auditory feedback control may shift compared to other elements of speech motor control. This dissertation aimed to improve our understanding of the development of auditory feedback control and speech motor control in typically developing children and pediatric clinical populations through the exploration of responses to altered auditory feedback. In altered auditory feedback paradigms, small, often …


The Similarities And Differences Between Distortion-Product Otoacoustic Emission Testing Instruments And Accuracy Settings, Maximilian Tran-Luong Aug 2021

The Similarities And Differences Between Distortion-Product Otoacoustic Emission Testing Instruments And Accuracy Settings, Maximilian Tran-Luong

Electronic Thesis and Dissertation Repository

Advanced measures of the auditory system like otoacoustic emission (OAE) testing are essential for highlighting the subtle expressions of hearing loss if clinical care is to remain up to date with current scientific knowledge. The purpose of this study was to compare distortion product OAE (DPOAE) testing across three different measurement systems (Interacoustic Titan, Bio-logic Scout and Vivosonic Integrity) to determine if there are differences in DPOAE testing. Secondly, the study will look to evaluate the effect if varying accuracy settings on DPOAE testing within the Integrity system. DPOAE tests evaluating levels, noise floor levels, probe fit check time and …


Developing A Spoken Language Outcome Monitoring Procedure For Early Hearing Detection And Intervention Programs, Olivia Daub Jul 2021

Developing A Spoken Language Outcome Monitoring Procedure For Early Hearing Detection And Intervention Programs, Olivia Daub

Electronic Thesis and Dissertation Repository

Early Hearing Detection and Intervention programs are associated with improved spoken language outcomes for children who are deaf/hard-of-hearing. Best practice recommendations call for regular spoken language outcome monitoring to support decision making for all stakeholders (families, audiologists, speech-language pathologists, and program managers).

Despite the clear calls for spoken language outcome monitoring, there is no peer-reviewed guidance as to how Early Hearing Detection and Intervention programs can best accomplish this monitoring. This dissertation evaluates the assumptions underlying spoken language outcome monitoring and contributes a new procedure developed for a Canadian Early Hearing Detection and Intervention program: the Ontario Infant Hearing Program. …


Speech Language Pathologists (Slps) Enactment Of Dysphagia Education And Counselling In Tbi Inpatient Rehabilitation., Stephanie Muir-Derbyshire Jul 2021

Speech Language Pathologists (Slps) Enactment Of Dysphagia Education And Counselling In Tbi Inpatient Rehabilitation., Stephanie Muir-Derbyshire

Electronic Thesis and Dissertation Repository

Abstract

Background

Traumatic brain injury (TBI) incidence rates are rising significantly across all age groups, often requiring complex and expensive medical care. Common causes of TBI include motor-vehicle accidents, violence, sport injuries and falls. For some individuals, inpatient rehabilitation (IPR) is used as a care pathway to provide intervention(s) for the physiological, psychological, neurobehavioural and cognitive-communication sequelae of a TBI.Many patients with a TBI will also experience dysphagia, an impairment or disorder of deglutition (swallowing). Dysphagia affects hydration, nutritional intake, respiration and can significantly impact an individual’s quality of life. It has been identified as a contributing factor in the …


Objective Measurement Optimization In Early Hearing Detection And Intervention, Matthew J. B. Urichuk Jul 2021

Objective Measurement Optimization In Early Hearing Detection And Intervention, Matthew J. B. Urichuk

Electronic Thesis and Dissertation Repository

Following the fitting of amplification devices, outcomes need to be evaluated to determine benefit of intervention. Objective measurements, which generally require rapid acoustic or electrophysiological measurement without active participation of the individual, are one subset of evaluation methods.

This thesis aimed to improve the reliability, accuracy, and efficiency of a subset of objective outcome measurements: the speech-evoked Envelope Following Response (EFR), and the wideband real-ear-to-coupler-difference (wRECD), which are used in hearing aid validation and verification respectively.

The speech-evoked EFR, a neural response reflecting phase-locked activity to the envelope of a speech stimulus, can be detected using a variety of statistical …


Modelling Loudness: Acoustic And Perceptual Correlates In The Context Of Hypophonia In Parkinson’S Disease, Daryn Amory Cushnie-Sparrow Jun 2021

Modelling Loudness: Acoustic And Perceptual Correlates In The Context Of Hypophonia In Parkinson’S Disease, Daryn Amory Cushnie-Sparrow

Electronic Thesis and Dissertation Repository

Hypophonia (quiet speech) is a common speech symptom associated with Parkinson’s disease (PD), and is associated with reduced intelligibility, communicative effectiveness, and communicative participation. Studies of hypophonia commonly employ average speech intensity as the primary dependent measure, which may not entirely capture loudness deficits. Loudness may also be affected by the frequency components of speech (i.e. spectral balance) and speech level variability. The present investigation examined relationships between perceived loudness and intelligibility with acoustic measures of loudness, speech intensity, and spectral distribution in individuals with hypophonia secondary to Parkinson’s disease (IWPDs) and neurologically healthy older adults (HOAs).

Samples of sentence …


The Relation Of Auditory Temporal Processing To Language Development And Other Cognitive Processes: Methodological And Conceptual Considerations, Rachael E. Smyth Feb 2021

The Relation Of Auditory Temporal Processing To Language Development And Other Cognitive Processes: Methodological And Conceptual Considerations, Rachael E. Smyth

Electronic Thesis and Dissertation Repository

Separate lines of research have demonstrated relations between auditory temporal processing and language ability and between information processing speed and intelligence. Because these processes have rarely been studied in the same sample, it is unclear how auditory temporal processing and information processing speed may operate together and how they may relate to cognitive functions including language. The overarching aim of this dissertation was to integrate these lines of research to better understand whether auditory temporal processing has a unique relation with language, or whether it relates more broadly to language and other cognitive functions as a part of global information …


Speech-Language Pathology Interventions And Ingredients That Support Social Communication And Language Of Preschoolers With Autism, Amanda Binns Feb 2021

Speech-Language Pathology Interventions And Ingredients That Support Social Communication And Language Of Preschoolers With Autism, Amanda Binns

Electronic Thesis and Dissertation Repository

One of the best predictors of long-term outcomes for autistic children is development of language and social communication skills. Therefore, it’s not surprising that speech and language therapy is one of the most frequently accessed interventions for children with suspected or diagnosed autism. From a public health and family well-being perspective, identifying effective social communication interventions and better understanding the specific components that contribute to their effectiveness is critical. However, there is a lack of clarity about the most effective interventions. This dissertation addressed this important topic through three studies.

Study 1 examined the literature on interventions provided by speech-language …


An Exploration Of Audiologists' Readiness To Adopt Connected Hearing Healthcare For Remote Hearing Aid Fitting, Luisa Natalia Perez Velez Nov 2020

An Exploration Of Audiologists' Readiness To Adopt Connected Hearing Healthcare For Remote Hearing Aid Fitting, Luisa Natalia Perez Velez

Electronic Thesis and Dissertation Repository

Background: Globally, the increasing prevalence of hearing loss and need for improved access to hearing healthcare services, highlights the growing need for alternative service delivery models. A Connected Health model emerges as a solution for this need, focusing on the use of telecommunication technologies. This model, extended to audiology, can help to better ‘connect’ a patient to their own care process and to their provider during audiological diagnostics, treatment, and management services, at a distance and in an effective and timely manner. The strong capacity for and underutilization of Connected Audiology within current aural (re)habilitation service models have led to …


Communicative Participation Outcomes Of Preschool Speech-Language Services: Opportunities, Challenges, And Solutions, Elaine Yuen Ling Kwok Jun 2020

Communicative Participation Outcomes Of Preschool Speech-Language Services: Opportunities, Challenges, And Solutions, Elaine Yuen Ling Kwok

Electronic Thesis and Dissertation Repository

It has been estimated that speech and language disorders impact as many as 15-22% of preschoolers. In Ontario, Canada, families who are concerned about their children’s speech, language, or communication skills can access publicly funded services through Ontario’s Preschool Speech and Language Program. In this program, speech-language pathologists provide assessments and early interventions to improve children’s communication skills and lessen the negative effect of communication delays on development. Since 2012, the Program mandated the use of an outcome measure, the Focus on the Outcomes of Communication Under Six® (FOCUS), but there has been inconsistent uptake among speech-language pathologists. Using a …


Rehabilitation Of Post-Stroke Aphasia In Ghana, Keren Sarpomaa Kankam May 2020

Rehabilitation Of Post-Stroke Aphasia In Ghana, Keren Sarpomaa Kankam

Electronic Thesis and Dissertation Repository

Aphasia is one of the most common consequences of stroke and affects the communication and social functioning of approximately 30-35% of stroke survivors. Despite the importance of speech-language pathology (SLP) services for individuals with post-stroke aphasia, aphasia rehabilitation services in sub-Saharan Africa are riddled with challenges. Through interviews, demographic information, and syllabi reviews, we examined the SLP assessment and treatment services available for individuals with post-stroke aphasia in Ghana and the challenges the stakeholder groups encounter in providing and identifying such services. Results of the study identified challenges with the current post-stroke aphasia services in Ghana, and thus the need …


Advanced Phenotyping Of Otosclerosis In An Ontario Population And Two Large Newfoundland Families, Matthew B. Lucas Apr 2020

Advanced Phenotyping Of Otosclerosis In An Ontario Population And Two Large Newfoundland Families, Matthew B. Lucas

Electronic Thesis and Dissertation Repository

Otosclerosis is a relatively common hearing loss disorder characterized by abnormal bone growth in the otic capsule leading to stapes fixation. In approximately half of cases, otosclerosis is inherited as an autosomal dominant trait. Typically, gene discovery efforts rely on surgical confirmation, audiometry and occasionally acoustic reflexes to identify affected cases of otosclerosis within families, requiring that the otosclerosis was at an advanced stage to be detected. This makes it difficult to identify individuals with early otosclerosis. The use of advanced phenotyping to identify cases of otosclerosis was tested in an Ontario otosclerotic population as well as in two large …


Construction And Preliminary Validation Of The Interrai 0-3 Developmental Domains, Jo Ann M. Iantosca Mar 2020

Construction And Preliminary Validation Of The Interrai 0-3 Developmental Domains, Jo Ann M. Iantosca

Electronic Thesis and Dissertation Repository

Background. With no standardized approach for early assessment of childhood development in Canada, and with a lack of a comprehensive assessment-to-intervention system that amalgamates social, psychiatric, medical, functional, psychological, and environmental constructs, the interRAI 0-3 was developed to support intervention efforts based on the needs of young children and their families. The interRAI 0-3 includes over 650 items that seek clinical information, developmental milestones, and context items regarding the family and social relationships surrounding the child. The newly developed interRAI 0-3 was most recently evaluated to examine the reliability and validity of the Expressive and Receptive Language and the Gross …


Objective Estimation Of Tracheoesophageal Speech Quality, Yousef S Ettomi Ali Dec 2019

Objective Estimation Of Tracheoesophageal Speech Quality, Yousef S Ettomi Ali

Electronic Thesis and Dissertation Repository

Speech quality estimation for pathological voices is becoming an increasingly important research topic. The assessment of the quality and the degree of severity of a disordered speech is important to the clinical treatment and rehabilitation of patients. In particular, patients who have undergone total laryngectomy (larynx removal) produce Tracheoesophageal (TE) speech. In this thesis, we study the problem of TE speech quality estimation using advanced signal processing approaches. Since it is not possible to have a reference (clean) signal corresponding to a given TE speech (disordered) signal, we investigate in particular the non-intrusive techniques (also called single-ended or blind approaches) …


Exploring The Temporal Variability Of Speech Intensity, Speech Intelligibility, And Communicative Participation In Individuals With Hypophonia And Parkinson’S Disease, Cynthia Mancinelli Nov 2019

Exploring The Temporal Variability Of Speech Intensity, Speech Intelligibility, And Communicative Participation In Individuals With Hypophonia And Parkinson’S Disease, Cynthia Mancinelli

Electronic Thesis and Dissertation Repository

Hypophonia, or reduced speech intensity, is frequently observed in individuals with Parkinson’s disease (PD). This speech deficit can impact speech intelligibility and communicative participation. However, there is little empirical evidence exploring the day-to-day variability of speech and communicative participation in individuals with PD. The purpose of this study is to investigate the temporal variability of acoustic and perceptual speech measures and psychosocial measures in individuals with hypophonia and PD. Additionally, this study seeks to examine the relationships among measures of speech intensity, speech intelligibility, self- and proxy-rated communicative participation, demographic factors, and non-speech factors. Twenty-three participants with PD, 23 primary …