Speech Pathology and Audiology Commons^™

Brief Report: A Mobile Application To Treat Prosodic Deficits In Autism Spectrum Disorder And Other Communication Impairments: A Pilot Study, Elizabeth Schoen Simmons, Rhea Paul, Frederick Shic

Communication Disorders Faculty Publications

This study examined the acceptability of a mobile application, SpeechPrompts, designed to treat prosodic disorders in children with ASD and other communication impairments. Ten speech-language pathologists (SLPs) in public schools and 40 of their students, 5-19 years with prosody deficits participated. Students received treatment with the software over eight weeks. Pre- and post-treatment speech samples and student engagement data were collected. Feedback on the utility of the software was also obtained. SLPs implemented the software with their students in an authentic education setting. Student engagement ratings indicated students' attention to the software was maintained during treatment. Although more testing is …

The Use Of Mobile Technology In The Treatment Of Prosodic Deficits In Autism Spectrum Disorders, Elizabeth Schoen Simmons, Rhea Paul, Frederick Shic

Communication Disorders Faculty Publications

Objectives: The purpose of this study is to assess the feasibility and preliminary utility of an application, SpeechPrompts, for iOS devices in the treatment of prosodic disorders in school-age children with ASD.

Structural And Functional Vocal Fold Epithelial Integrity Following Injury, Ciara Leydon, Mitsuyoshi Imaizumi, David T. Yang, Susan L. Thibeault, Marvin Fried

Communication Disorders Faculty Publications

Objectives/Hypothesis: An intact epithelium is an important part of vocal fold defense. Damage to the epithelium can compromise vocal fold homeostasis and protection of the host tissue from viral and bacterial invasion. Elucidating the effects of damage on epithelial architectural and barrier integrity provides insight into the role of epithelium in protecting vocal folds. Using an animal model, we evaluated the time course of structural and functional epithelial restoration following injury. Study Design: Prospective, controlled animal study. Methods: Forty rats underwent surgery to remove vocal fold mucosa unilaterally. Larynges were harvested at five time intervals between 3 to 90 days …

Enhanced Maternal Origin Of The 22q11.2 Deletion In Velocardiofacial And Digeorge Syndromes, Maria Delio, Tingwei Guo, Donna Mcdonald-Mcginn, Elaine Zackai, Sean Herman, Mark Kaminetzky, Anne Marie Higgins, Karlene Coleman, Carolyn Chow, Maria Jalbrzikowski, Carrie E. Bearden, Alice Bailey, Anders Vangkilde, Line Olsen, Charlotte Olesen, Flemming Skovby, Thomas M. Werge, Ludivine Templin, Tiffany Busa, Nicole Philip, Ann Swillen, Joris R. Vermeesch, Koen Devriendt, Maude Schneider, Sophie Dahoun, Stephen Eliez, Kelly Schoch, Stephen R. Hooper, Vandana Shashi, Joy Samanich, Robert Marion, Therese Van Amelsvoort, Erik Boot, Petra Klaassen, Sasja N. Duijiff, Jacob Vorstman, Tracy Yuen, Candice Silversides, Eva Chow, Anne S. Bassett, Amos Frisch, Abraham Weizman, Doron Gothelf, Maria Niarchou, Marianne Van Den Bree, Michael J. Owen, Damian Heine Suñer, Jordi Rosell Andreo, Marco Armando, Stefano Vicari, Maria Christina Digilio, Adam Auton, Wendy R. Kates, Tao Wang, Robert J. Shprintzen, Beverly Emanuel, Bernice Morrow

Communication Disorders Faculty Publications

Velocardiofacial and DiGeorge syndromes, also known as 22q11.2 deletion syndrome (22q11DS), are congenital-anomaly disorders caused by a de novo hemizygous 22q11.2 deletion mediated by meiotic nonallelic homologous recombination events between low-copy repeats, also known as segmental duplications. Although previous studies exist, each was of small size, and it remains to be determined whether there are parent-of-origin biases for the de novo 22q11.2 deletion. To address this question, we genotyped a total of 389 DNA samples from 22q11DS-affected families. A total of 219 (56%) individuals with 22q11DS had maternal origin and 170 (44%) had paternal origin of the de novo deletion, …

Rhea Paul Joins Shu’S New Speech-Language Pathology Master’S Program, Rhea Paul

Rhea Paul

No abstract provided.

Acoustic And Perceptual Measurements Of Prosody Production On The Profiling Elements Of Prosodic Systems In Children By Children With Autism Spectrum Disorders, Joshua John Diehl, Rhea Paul

Communication Disorders Faculty Publications

Prosody production atypicalities are a feature of autism spectrum disorders (ASDs), but behavioral measures of performance have failed to provide detail on the properties of these deficits. We used acoustic measures of prosody to compare children with ASDs to age-matched groups with learning disabilities and typically developing peers. Overall, the group with ASD had longer utterance durations on multiple subtests on a test of prosodic abilities, and both the ASD and learning disabilities groups had higher pitch ranges and pitch variance than the typically developing group on one subtest. Acoustic differences were present even when the prosody was used correctly.These …

Comparing Spoken Language Treatments For Minimally Verbal Preschoolers With Autism Spectrum Disorders, Rhea Paul, Daniel Campbell, Kimberly Gilbert, Ioanna Tsiouri

Communication Disorders Faculty Publications

Preschoolers with severe autism and minimal speech were assigned either a discrete trial or a naturalistic language treatment, and parents of all participants also received parent responsiveness training. After 12 weeks, both groups showed comparable improvement in number of spoken words produced, on average. Approximately half the children in each group achieved benchmarks for the first stage of functional spoken language development, as defined by Tager-Flusberg et al. (J Speech Lang Hear Res, 52: 643–652, 2009). Analyses of moderators of treatment suggest that joint attention moderates response to both treatments, and children with better receptive language pre-treatment do better with …

Cortical Gyrification In Velo-Cardio-Facial (22q11.2 Deletion) Syndrome: A Longitudinal Study, Arun Kunwar, Seethalakshmi Ramanathan, Joshua Nelson, Kevin M. Antshel, Wanda Fremont, Anne Marie Higgins, Robert J. Shprintzen, Wendy R. Kates

Communication Disorders Faculty Publications

Introduction: Velo-cardio-facial syndrome (VCFS) has been identified as an important risk factor for psychoses, with up to 32% of individuals with VCFS developing a psychotic illness. Individuals with VCFS thus form a unique group to identify and explore early symptoms and biological correlates of psychosis. In this study, we examined if cortical gyrification pattern, i.e. gyrification index (GI) can be a potential neurobiological marker for psychosis.

Method: GIs of 91 individuals with VCFS were compared with 29 siblings and 54 controls. Further, 58 participants with VCFS, 21 siblings and 18 normal controls were followed up after 3 years and longitudinal …

Enhancing The Application And Evaluation Of A Discrete Trial Intervention Package For Eliciting First Words In Preverbal Preschoolers With Asd, Ioanna Tsiouri, Elizabeth Schoen Simmons, Rhea Paul

Communication Disorders Faculty Publications

This study evaluates the effectiveness of an intervention package including a discrete trial program (Rapid Motor Imitation Antecedent Training (Tsiouri and Greer, J Behav Educat 12:185–206, 2003) combined with parent education for eliciting first words in children with ASD who had little or no spoken language. Evaluation of the approach includes specific intervention targets and functional spoken language outcomes (Tager-Flusberg et al., J Speech Lang Hear Res 52:643–652, 2009). Results suggest that RMIA, with parent training, catalyzes development of verbal imitation and production for some children. Three of five participants acquired word production within the DTT framework and achieved milestones …

Acoustic Differences In The Imitation Of Prosodic Patterns In Children With Autism Spectrum Disorders, Joshua J. Diehl, Rhea Paul

Communication Disorders Faculty Publications

In research, it has been difficult to characterize the prosodic production differences that have been observed clinically in autism spectrum disorders (ASD). Moreover, the nature of these differences has been particularly hard to identify. This study examined one possible contributor to these perceived differences: motor planning. We examined the ability of children and adolescents with ASD to imitate prosodic patterns in comparison to a group with learning disabilities (LD) and a typically developing (TD) comparison group. Overall, we found that both the ASD and LD groups were significantly worse at perceiving and imitating prosodic patterns than the TD comparison group. …

Proposed Program To Meet Urgent Need, Rhea Paul

Rhea Paul

No abstract provided.

Cleft Palate, Retrognathia And Congenital Heart Disease In Velo-Cardio-Facial Syndrome: A Phenotype Correlation Study, Marcia A. Friedman, Nathanial Miletta, Cheryl Roe, Dongliang Wang, Bernice Morrow, Wendy R. Kates, Anne Marie Higgins, Robert J. Shprintzen

Communication Disorders Faculty Publications

Objective: Velo-cardio-facial syndrome (VCFS) is caused by a microdeletion of approximately 40 genes from one copy of chromosome 22. Expression of the syndrome is a variable combination of over 190 phenotypic characteristics. As of yet, little is known about how these phenotypes correlate with one another or whether there are predictable patterns of expression. Two of the most common phenotypic categories, congenital heart disease and cleft palate, have been proposed to have a common genetic relationship to the deleted T-box 1 gene (TBX1). The purpose of this study is to determine if congenital heart disease and cleft palate are correlated …

Characterizing And Predicting Outcomes Of Communication Delays In Infants And Toddlers: Implications For Clinical Practice, Rhea Paul, Forma P. Roth

Communication Disorders Faculty Publications

Purpose: This article focuses on using currently available data to assist speech-language pathologists (SLPs) in making decisions regarding a child's eligibility and considerations for recommended "dosage" of early intervention (El) services. Method: Literature describing the characteristics of infants and toddlers who are likely recipients of El services was reviewed. Results: Current literature provides information that can be used to inform clinical decisions for infants and toddlers with established medical conditions, as well as those with risk factors, for oral language, communication, and subsequent literacy disabilities. This information is summarized. Conclusion: Extant literature suggests that El makes a critical difference in …

Sally J. Rogers And Geraldine Dawson: Review Of Early Start Denver Model For Young Children With Autism: Promoting Language, Learning And Engagement (Book Review), Rhea Paul

Communication Disorders Faculty Publications

Book review by Rhea Paul:

Rogers, Sally R. and Geraldine Dawson. Early Start Denver Model for Young Children with Autism: Promoting Language, Learning and Engagement. New York: Guilford Press, 2010. 9781606236321; 9781606234914 (pbk.)

Neuroanatomic Predictors To Prodromal Psychosis In Velocardiofacial Syndrome (22q11.2 Deletion Syndrome): A Longitudinal Study, Wendy R. Kates, Kevin M. Antshel, Stephen V. Faraone, Wanda Fremont, Anne Marie Higgins, Robert J. Shprintzen, Jo-Anna Botti, Lauren Kelchner, Christopher Mccarthy

Communication Disorders Faculty Publications

Background: Up to 30% of young adults with velocardiofacial syndrome (VCFS; 22q11.2 deletion syndrome) develop schizophrenia or psychosis. Identifying the neuroanatomic trajectories that increase risk for psychosis in youth with this genetic disorder is of great interest. Methods: We acquired high-resolution anatomic MR images and measures of psychiatric function on 72 youth with VCFS, 26 unaffected siblings and 24 age-matched community controls at two timepoints, between late childhood (mean age, 11.9 years) and mid-adolescence (mean age, 15.1 years). Results: With the exception of cranial gray matter and orbitofrontal prefrontal cortex, neuroanatomic trajectories in youth with VCFS were comparable to unaffected …

Out Of The Mouths Of Babes: Vocal Production In Infant Siblings Of Children With Asd, Rhea Paul, Yael Fuerst, Gordon Ramsay, Kasia Chawarska, Ami Klin

Communication Disorders Faculty Publications

Background: Younger siblings of children with autism spectrum disorders (ASD) are at higher risk for acquiring these disorders than the general population. Language development is usually delayed in children with ASD. The present study examines the development of pre-speech vocal behavior in infants at risk for ASD due to the presence of an older sibling with the disorder. Methods: Infants at high risk (HR) for ASD and those at low risk, without a diagnosed sibling (LR), were seen at 6, 9, and 12 months as part of a larger prospective study of risk for ASD in infant siblings. Standard clinical …

Infants At Risk For Asd Show Aberrant Preferences For Speech At Six To Nine Months, Rhea Paul, Gerald Mcroberts, Katyrzyna Chawarska

Communication Disorders Faculty Publications

Purpose: To examine auditory preferences for speech stimuli in infants at risk for Autism Spectrum Disorder due to the presence of a diagnosed sibling.

The Hypothesis Of Apraxia Of Speech In Children With Autism Spectrum Disorder, Lawrence D. Shriberg, Rhea Paul, Lois M. Black, Jan P. Van Santen

Communication Disorders Faculty Publications

In a sample of 46 children aged 4-7 years with Autism Spectrum Disorder (ASD) and intelligible speech, there was no statistical support for the hypothesis of concomitant Childhood Apraxia of Speech (CAS). Perceptual and acoustic measures of participants' speech, prosody, and voice were compared with data from 40 typically-developing children, 13 preschool children with Speech Delay, and 15 participants aged 5-49 years with CAS in neurogenetic disorders. Speech Delay and Speech Errors, respectively, were modestly and substantially more prevalent in participants with ASD than reported population estimates. Double dissociations in speech, prosody, and voice impairments in ASD were interpreted as …

Mapping Cortical Morphology In Youth With Velocardiofacial (22q11.2 Deletion) Syndrome, Wendy R. Kates, Ravi Bansal, Wanda Fremont, Xuejun Hao, Anne Marie Higgins, Jun Liu, Robert J. Shprintzen, Bradley S. Peterson

Communication Disorders Faculty Publications

Objective: Velo-cardio-facial syndrome (VCFS; 22q11.2 deletion syndrome) represents one of the highest known risk factors for schizophrenia. Insofar as up to thirty percent of individuals with this genetic disorder develop schizophrenia, VCFS constitutes a unique, etiologically homogeneous model for understanding the pathogenesis of schizophrenia.

Method: Using a longitudinal, case-control design, we acquired anatomic magnetic resonance images to investigate both cross-sectional and longitudinal alterations in surface cortical morphology in a cohort of adolescents with VCFS and age-matched typical controls. All participants were scanned at two time points.

Results: Relative to controls, youth with VCFS exhibited alterations in inferior frontal, dorsal frontal, …

The Neural Underpinnings Of Prosody In Autism, Inge-Marie Eigsti, Jillian Schuh, Einar Mencl, Robert T. Schultz, Rhea Paul

Communication Disorders Faculty Publications

This study examines the processing of prosodic cues to linguistic structure and to affect, drawing on fMRI and behavioral data from 16 high-functioning adolescents with autism spectrum disorders (ASD) and 11 typically developing controls. Stimuli were carefully matched on pitch, intensity, and duration, while varying systematically in conditions of affective prosody (angry versus neutral speech) and grammatical prosody (questions versus statement). To avoid conscious attention to prosody, which normalizes responses in young people with ASD, the implicit comprehension task directed attention to semantic aspects of the stimuli. Results showed that when perceiving prosodic cues, both affective and grammatical, activation of …

Eight Simple Rules For Talking With Preschoolers, Rhea Paul

Communication Disorders Faculty Publications

The article offers eight simple rules that teachers can use to help preschoolers build their vocabularies. It suggests teachers to talk with children to identify topics that interest them. It also recommends teachers to accompany all the routines and activities of the preschool day to enhance the language experience of children. Moreover, it proposes that open-ended questions invites preschoolers to offer lengthier and more detailed responses, thus stimulating their language growth.

22q11.2 Deletion Syndrome: Are Motor Deficits More Than Expected For Iq Level?, Nancy J. Roizen, Anne Marie Higgins, Kevin M. Antshel, Wanda Fremont, Robert J. Shprintzen, Wendy R. Kates

Communication Disorders Faculty Publications

To examine motor function in children with 22q11.2 deletion syndrome (22q11.2) and a Full Scale IQ (FSIQ) comparable control group. This study was part of a prospective study of neuropsychological function in children 9 to 15 years of age with 22q11.2 and community control subjects and included children from these two populations with comparable FSIQs. Verbal IQs on the WISC-R for 40 children with 22q11.2 (88.4) and 24 community control subjects (87.2) were not different (P=.563). However, the performance IQs were (22q11.2; 81.1 vs community controls; 89.3; P

Cervical Vascular And Upper Airway Asymmetry In Velo-Cardio-Facial Syndrome: Correlation Of Nasopharyngoscopy With Mra, Avi G. Oppenheimer, Susan Fulmer, Keivan Shifteh, Ja-Kwei Chang, Allan Brook, Alan L. Shanske, Robert J. Shprintzen

Communication Disorders Faculty Publications

Purpose

Velo-cardio-facial syndrome (VCFS), the most common genetic syndrome causing cleft palate, is associated with internal carotid and vertebral artery anomalies, as well as upper airway asymmetry. Medially displaced internal carotid arteries, often immediately submucosal, present a risk of vascular injury during pharyngeal flap surgery for velopharyngeal insufficiency (VPI). We evaluate the frequency and spectrum of cervical vascular anomalies in a large cohort of VCFS patients correlating MRA with nasopharyngolaryngoscopy in detecting at risk carotid arteries. Furthermore, we assess the relationship with respect to laterality between cervical vascular patterns and the asymmetric abnormalities of these subjects’ upper airways.

Methods

Cervical …

Cognitive And Psychiatric Predictors To Psychosis In Velocardiofacial Syndrome: A 3-Year Follow-Up Study, Kevin M. Antshel, Robert J. Shprintzen, Wanda Fremont, Anne Marie Higgins, Stephen V. Faraone, Wendy R. Kates

Communication Disorders Faculty Publications

Objective: To predict prodromal psychosis in adolescents with velocardiofacial syndrome (VCFS). Method: 70 youth with VCFS, 27 siblings of youth with VCFS and 25 community controls were followed from childhood (Mean age = 11.8 years) into mid-adolescence (mean age 15.0 years). Psychological tests measuring intelligence, academic achievement, learning/memory, attention and executive functioning as well as measures of parent and clinician ratings of child psychiatric functioning were completed at both time point. Results: Major depressive disorder, oppositional defiant disorder, and generalized anxiety disorder diagnoses increased in the VCFS sample. With very low false positive rates, the best predictor of adolescent prodromal …

Talk To Me: Issues In Acquiring Spoken Language For Young Children With Autism Spectrum Disorders, Rhea Paul

Communication Disorders Faculty Publications

Speech-language pathologists play a critical role in the treatment of children with autism spectrum disorders (ASD) because communication deficits are a primary component of both the diagnostic criteria and the focus of educational services for children with these conditions. Children with ASD almost always are delayed in speech acquisition (Tager-Flusberg, Paul, & Lord, 2005), as well as in other areas of communication. Lack of speech is often the most obvious symptom and greatest cause for concern of parents of toddlers who are eventually diagnosed with ASD, even though closer observation usually reveals additional problems.

The Assessment And Treatment Of Prosodic Disorders And Neurological Theories Of Prosody, Joshua J. Diehl, Rhea Paul

Communication Disorders Faculty Publications

In this article, we comment on specific aspects of Peppe´ (Peppe´ , 2009). In particular, we address the assessment and treatment of prosody in clinical settings and discuss current theory on neurological models of prosody. We argue that in order for prosodic assessment instruments and treatment programs to be clinical effective, we need assessment instruments that: (1) have a representative normative comparison sample and strong psychometric properties; (2) are based on empirical information regarding the typical sequence of prosodic acquisition and are sensitive to developmental change; (3) meaningfully subcategorize various aspects of prosody; (4) use tasks that have ecological validity; …

Velopharyngeal Insufficiency: Diagnosis And Management, Robert J. Shprintzen, Eileen Marrinan

Communication Disorders Faculty Publications

Journal articles relevant to the diagnosis and treatment of velopharyngeal insufficiency were reviewed. All studies ascertained by PubMed search were included. Recent findings: Studies reported on the application of magnetic resonance scanning, reliability tests of the International Working Group diagnostic protocol, the use of nasometry, and techniques designed to assess the function of the velopharyngeal mechanism. Treatment studies focused on outcomes in small samples of cases and complication rates from pharyngeal flap. One study discussed ineffective speech therapy procedures. Summary: There were relatively few studies this past year. Those that were published were hindered by small and heterogeneous sample sizes …

Defining Spoken Language Benchmarks And Selecting Measures Of Expressive Language Development For Young Children With Autism Spectrum Disorders, Helen Tager-Flusberg, Sally Rogers, Judith Cooper, Rebecca Landa, Catherine Lord, Rhea Paul, Mabel Rice, Carol Stoel-Gammon, Amy Wetherby, Paul Yoder

Communication Disorders Faculty Publications

Purpose: The aims of this article are twofold: (a) to offer a set of recommended measures that can be used for evaluating the efficacy of interventions that target spoken language acquisition as part of treatment research studies or for use in applied settings and (b) to propose and define a common terminology for describing levels of spoken language ability in the expressive modality and to set benchmarks for determining a child's language level in order to establish a framework for comparing outcomes across intervention studies.
Method: The National Institute on Deafness and Other Communication Disorders assembled a group of researchers …

Velo-Cardio-Facial Syndrome, Doron Gothelf, Amos Frisch, Elena Michaelovsky, Abraham Weizman, Robert J. Shprintzen

Communication Disorders Faculty Publications

Velocardiofacial syndrome (VCFS), also known as DiGeorge, conotruncal anomaly face, and Cayler syndromes, is caused by a microdeletion in the long arm of Chromosome 22. We review the history of the syndrome from the first clinical reports almost half a century ago to the current intriguing molecular findings associating genes from the microdeletion region and the physical and neuropsychiatric phenotype of the syndrome. Velocardiofacial syndrome has a wide spectrum of more than 200 physical manifestations including palate and cardiac anomalies. Yet, the most challenging manifestations of VCFS are the learning disabilities and neuropsychiatric disorders. As VCFS is relatively common and …

Pragmatic Assessment In Autism Spectrum Disorders: A Comparison Of A Standard Measure With Parent Report, Brian Reichow, Shawn Salamack, Rhea Paul, Fred Volkmar, Ami Klin

Communication Disorders Faculty Publications

The purpose of this study was to investigate the concurrent validity of subtests on the Comprehensive Assessment of Spoken Language (CASL) by comparing them with the assessment of communication and social skills on the Vineland Adaptive Behavior Scales (Vineland). The participants were 35 children and adolescents with higher functioning autism spectrum disorders (ASD) who had received both the CASL and the Vineland. Results of the study suggest that the Pragmatic Judgment and Inferences subtests of the CASL appeared to document the difficulties that individuals with ASD had in adaptive use of language for communication.