Medicine and Health Sciences Commons^™

Increasing Pediatric Hearing Aid Use: Considerations For Clinical Practice, Karen Muñoz, Kali Markle, Guadalupe G. San Miguel, Michael P. Twohig

Communicative Disorders and Deaf Education Faculty Publications

Purpose: Hearing aid use can be variable for young children, and inconsistent wear time can undermine spoken language development. This study explored the effectiveness of hearing aid data logging (DL) awareness and coaching sessions on increasing hours of hearing aid use. We also collected qualitative data on challenges participants experienced managing hearing aid use.

Method: We used a single-subject design that included three conditions, during a 6-week period, in the same order for each participant. Condition A was baseline, Condition B was DL monitoring alone, and Condition C was remote coaching calls plus DL monitoring.

Results: Hours of hearing aid …

Hearing Care And Management Priority Among Parents Of Children With Down Syndrome: A Grounded Theory, John J. Whicker, Karen F. Muñoz, Nicole J. Pearson, Trenton J. Landon, Lauri H. Nelson, Karl R. White, Michael P. Twohig

Communicative Disorders and Deaf Education Faculty Publications

Objective: This study qualitatively explored the factors that influence how parents of children who are Deaf or hard-of-hearing with Down syndrome prioritize hearing care and management and developed an associated theory to explain that priority.

Design: Grounded theory was used for the purposes of this qualitative study. Data were collected using in-depth interviews which were analyzed using a three-tiered qualitative coding process.

Study Sample: Eighteen mothers of children who are Deaf or hard-of-hearing with Down syndrome participated in this study.

Results: The higher the extent of engaged professional support, perception of benefit for child, parent activation, and family engagement, the …

An Exploration Of Automated Narrative Analysis Via Machine Learning, Sharad Jones, Carly Fox, Sandra Laing Gillam, Ronald B. Gillam

Communicative Disorders and Deaf Education Faculty Publications

The accuracy of four machine learning methods in predicting narrative macrostructure scores was compared to scores obtained by human raters utilizing a criterion-referenced progress monitoring rubric. The machine learning methods that were explored covered methods that utilized hand-engineered features, as well as those that learn directly from the raw text. The predictive models were trained on a corpus of 414 narratives from a normative sample of school-aged children (5;0-9;11) who were given a standardized measure of narrative proficiency. Performance was measured using Quadratic Weighted Kappa, a metric of inter-rater reliability. The results indicated that one model, BERT, not only achieved …

A Comparison Of The Storage-Only Deficit And Joint Mechanism Deficit Hypotheses Of The Verbal Working Memory Storage Capacity Limitation Of Children With Developmental Language Disorder, James W. Montgomery, Ronald B. Gillam, Julia L. Evans, Sarah Schwartz, Jamison D. Fargo

Communicative Disorders and Deaf Education Faculty Publications

Purpose: The storage-only deficit and joint mechanism deficit hypotheses are two possible explanations of the verbal working memory (vWM) storage capacity limitation of school-age children with developmental language disorder (DLD). We assessed the merits of each hypothesis in a large group of children with DLD and a group of same-age typically developing (TD) children.

Method: Participants were 117 children with DLD and 117 propensity-matched TD children 7-11 years of age. Children completed tasks indexing vWM capacity, verbal short-term storage, sustained attention, attention switching, and lexical long-term memory (LTM).

Results: For the DLD group, all of the mechanisms jointly explained 26.5% …

Individualized Frequency Importance Functions For Listeners With Sensorineural Hearing Loss, Sarah E. Yoho Leopold, Adam K. Bosen

Communicative Disorders and Deaf Education Faculty Publications

The Speech Intelligibility Index includes a series of frequency importance functions for calculating the estimated intelligibility of speech under various conditions. Until recently, techniques to derive frequency importance required averaging data over a group of listeners, thus hindering the ability to observe individual differences due to factors such as hearing loss. In the current study, the “random combination strategy” [Bosen and Chatterjee (2016). J. Acoust. Soc. Am. 140, 3718–3727] was used to derive frequency importance functions for individual hearing-impaired listeners, and normal-hearing participants for comparison. Functions were measured by filtering sentences to contain only random subsets of frequency bands …

Parent Challenges, Perspectives And Experiences Caring For Children Who Are Deaf Or Hard-Of-Hearing With Other Disabilities: A Comprehensive Review, John J. Whicker, Karen F. Muñoz, Lauri H. Nelson

Communicative Disorders and Deaf Education Faculty Publications

Objective: The purpose of this literature review was to explore parent challenges in caring for children who are deaf or hard of hearing with other disabilities and discuss implications for audiologists related to supporting families.

Design: A comprehensive literature review was conducted, and through qualitative analysis, emergent themes were identified, and a narrative summary generated.

Study sample: Nine research studies were included in this review. Combined, these studies reflect a sample of 111 children, 23 families and 41 parents.

Results: Three broad themes were identified, and include parent-reported challenges related to family, professional and child variables. Sub-themes were identified within …

Teaching Counseling Skills In Audiology Graduate Programs: Clinical Supervisors’ Perceptions And Practices, Karen F. Muñoz, Trenton J. Landon, Kim Corbin-Lewis

Communicative Disorders and Deaf Education Faculty Publications

Background: Counseling is a critical component within audiological service delivery. Partnering with patients to support them in learning to effectively cope with their hearing challenges is a key component in achieving desired outcomes. Even though there is agreement on the foundational role counseling plays in audiology service delivery, counseling instruction varies among audiology training programs.

Purpose: The purpose of this study was to investigate the perspectives and practices of supervisors in audiology graduate training programs related to mentoring students in the acquisition of counseling skills.

Research Design: A cross-sectional design was used; participants completed a self-report survey.

Study Sample: The …

Pull The Andon Rope On Working Memory Capacity Interventions Until We Know More, Sandra Laing Gillam, Sarai S. Holbrook, Jamie Mecham, Daylene Weller

Communicative Disorders and Deaf Education Faculty Publications

Purpose: The purpose of this article is to discuss the current state of interventions for improving working memory (WM) capacity language, and academic skills and to provide suggestions for speech language pathologists working with students who have WM capacity limitations.

Method: Meta-analyses, systematic reviews, randomized controlled trials and non-randomized comparison studies investigating the role of WM interventions for improving WM capacity language, and academic skills are reviewed. Strategies for improving WM are discussed.

Results: The use of interventions designed to improve WM capacity and other cognitive skills is currently not supported by the research. Direct working memory interventions should be …

Understanding Dysrhythmic Speech: When Rhythm Does Not Matter And Learning Does Not Happen, Stephanie A. Borrie, Kaitlin L. Lansford, Tyson S. Barrett

Communicative Disorders and Deaf Education Faculty Publications

A positive relationship between rhythm perception and improved understanding of a naturally dysrhythmic speech signal, ataxic dysarthria, has been previously reported [Borrie, Lansford, and Barrett. (2017). J. Speech Lang. Hear. Res. 60, 3110–3117]. The current follow-on investigation suggests that this relationship depends on the nature of the dysrhythmia. When the corrupted rhythm cues are relatively predictable, affording some learnable acoustic regularity, the relationship is replicated. However, this relationship is nonexistent, along with any intelligibility improvements, when the corrupted rhythm cues are unpredictable. Findings highlight a key role for rhythm perception and distributional regularities in adaptation to dysrhythmic speech.

Interpreting Mmse Performance In Highly Proficient Bilingual Spanish-English And Asian Indian-English Speakers: Demographic Adjustments, Item Analyses, And Supplemental Measures, Lisa H. Milman, Yasmeen Faroqi-Shah, Chris D. Corcoran, Deanna M. Damele

Communicative Disorders and Deaf Education Faculty Publications

Purpose: Performance on the Mini-Mental State Examination (MMSE), among the most widely used global screens of adult cognitive status, is affected by demographic variables including age, education, and ethnicity. This study extends prior research by examining the specific effects of bilingualism on MMSE performance.

Method: Sixty independent community-dwelling monolingual and bilingual adults were recruited from Eastern and Western regions of the United States in this cross-sectional group study. Independent sample t-tests were used to compare two bilingual groups (Spanish-English and Asian Indian-English) with matched monolingual speakers on the MMSE, demographically adjusted MMSE scores, MMSE item scores, and a nonverbal cognitive …

The Noise Susceptibility Of Various Speech Bands, Sarah E. Yoho Leopold, Frédéric Apoux, Eric W. Healy

Communicative Disorders and Deaf Education Faculty Publications

The degrading influence of noise on various critical bands of speech was assessed. A modified version of the compound method [Apoux and Healy (2012) J. Acoust. Soc. Am. 132, 1078–1087] was employed to establish this noise susceptibility for each speech band. Noise was added to the target speech band at various signal-to-noise ratios to determine the amount of noise required to reduce the contribution of that band by 50%. It was found that noise susceptibility is not equal across the speech spectrum, as is commonly assumed and incorporated into modern indexes. Instead, the signal-to-noise ratio required to equivalently impact …

Counseling In Audiology: Aud Students’ Perspectives And Experiences, John J. Whicker, Karen F. Muñoz, Jared C. Schultz

Communicative Disorders and Deaf Education Faculty Publications

Counseling in audiology is an important aspect of service delivery. How audiologists interact with patients and foster counseling relationships to help patients and families understand and live with hearing loss can impact outcomes of audiological interventions. Currently, variability exists in how graduate training programs are teaching counseling skills, and the extent to which counseling skills development is supported in clinical experiences is unclear. This article seeks to explore the perspectives related to the importance of counseling and counseling training experiences received through clinical instruction of Au.D. students beginning their final year of study, to identify where counseling training might be …

Counseling Skill Development In Audiology: Clinical Supervision Considerations, Karen F. Muñoz

Communicative Disorders and Deaf Education Faculty Publications

Audiologists play a critical role in supporting patients as they provide diagnostic information about their hearing and in the delivery of treatment services. Graduate training related to counseling, however, varies among programs in the extent students are prepared to engage effectively and intentionally with patients. Instruction is needed to provide students with a framework that supports their ability to learn and implement evidence-based counseling services. This article addresses the impact patients can experience when counseling gaps exist, shares clinical instruction strategies that can support students' acquisition of counseling skills, and discusses considerations for integration of counseling education into graduate training …

Combining Degradations: The Effect Of Background Noise On Intelligibility Of Disordered Speech, Sarah E. Yoho Leopold, Stephanie A. Borrie

Communicative Disorders and Deaf Education Faculty Publications

The effect of background noise on intelligibility of disordered speech was assessed. Speech-shaped noise was mixed with neurologically healthy (control) and disordered (dysarthric) speech at a series of signal-to-noise ratios. In addition, bandpass filtered control and dysarthric speech conditions were assessed to determine the effect of noise on both naturally and artificially degraded speech. While significant effects of both the amount of noise and the type of speech were revealed, no interaction between the two factors was observed, in either the broadband or filtered testing conditions. Thus, it appears that there is no multiplicative effect of the presence of background …

Do You Know If Your Clients Are Having Challenges Coping, Karen F. Muñoz, Hannah Mcleod, Cache Pitt, Elizabeth S. Preston, Tiffany Shelton, Michael P. Twohig

Communicative Disorders and Deaf Education Faculty Publications

Hearing loss is a common condition, yet, many adults who could benefit from amplification do not use their hearing aids, even though it could help them overcome negative consequences such as social withdrawal, loneliness, and depression. Equally concerning, hearing aid use is highly variable for young children, compromising speech and language developmental outcomes.

How clients are coping with emotional challenges may be a contributing factor to hearing aid usage, and such challenges may go undetected by audiologists. Depression and anxiety are common mental health conditions, and can interfere with effective healthcare management and treatment adherence; for example, when parents of …

Cultural Adaptation Of The Test Of Narrative Language (Tnl) Into Brazilian Portuguese, Natalia Freitas Rossi, Tâmara De Andrade Lindau, Ronald B. Gillam, Célia Maria Giacheti

Communicative Disorders and Deaf Education Faculty Publications

Purpose: To accomplish the translation and cultural adaptation of the Test of Narrative Language (TNL) into Brazilian Portuguese.

Methods: The TNL is a formal instrument which assesses narrative comprehension and oral narration of children between the ages of 5-0 and 11-11 (years-months). The TNL translation and adaptation process had the following steps: (1) translation into the target language; (2) summary of the translated versions; (3) back-translation; (4) checking of the conceptual, semantics and cultural equivalence process and (5) pilot study (56 children within the test age range and from both genders).

Results: The adapted version maintained the same structure as …

Monitoring Indicators Of Scholarly Language (Misl): A Progress-Monitoring Instrument For Measuring Narrative Discourse Skills, Sandra Laing Gillam, Ronald B. Gillam, Jamison D. Fargo, Abbie Olszewski, Hugo Segura

Communicative Disorders and Deaf Education Faculty Publications

The purpose of this study was to assess the basic psychometric properties of a progress-monitoring tool designed to measure narrative discourse skills in school-age children with language impairments (LI). A sample of 109 children with LI between the ages of 5 years 7 months and 9 years 9 months completed the Test of Narrative Language (TNL). The stories told in response to the alien picture prompt were transcribed and scored according to the TNL manual criteria and the criteria established for scoring the progress-monitoring tool, Monitoring Indicators of Scholarly Language (MISL). The MISL total score demonstrated acceptable levels of internal …

“Whatdunit?” Developmental Changes In Children's Syntactically Based Sentence Interpretation Abilities And Sensitivity To Word Order, James W. Montgomery, Julia L. Evans, Ronald B. Gillam, Alexander V. Sergeev, Mianisha C. Finney

Communicative Disorders and Deaf Education Faculty Publications

Aim 1 of this study was to examine the developmental changes in typically developing English-speaking children’s syntactically-based sentence interpretation abilities and sensitivity to word order. Aim 2 was to determine the psychometric standing of the novel sentence interpretation task developed for this study, as we wish to use it later with children with Specific Language Impairment (SLI). Children listened to semantically implausible sentences in which noun animacy and the natural affordance between the nouns were removed, thus controlling for event probability. Using this novel “whatdunit?” agent selection task, 256 children 7-11 years listened to two structures with canonical word order …

Disordered Speech Disrupts Conversational Entrainment: A Study Of Acoustic-Prosodic Entrainment And Communicative Success In Populations With Communication Challenges, Stephanie A. Borrie, Nichola Lubold, Heather Pon-Barry

Communicative Disorders and Deaf Education Faculty Publications

Conversational entrainment, a pervasive communication phenomenon in which dialogue partners adapt their behaviors to align more closely with one another, is considered essential for successful spoken interaction. While well-established in other disciplines, this phenomenon has received limited attention in the field of speech pathology and the study of communication breakdowns in clinical populations. The current study examined acoustic-prosodic entrainment, as well as a measure of communicative success, in three distinctly different dialogue groups: (i) healthy native vs. healthy native speakers (Control), (ii) healthy native vs. foreign-accented speakers (Accented), and (iii) healthy native vs. dysarthric speakers (Disordered). Dialogue group comparisons revealed …

Early Hearing Detection And Intervention: Diagnostic Hearing Assessment Practices, Karen F. Muñoz, Lauri H. Nelson, N. Goldgewicht, D. Odell

Communicative Disorders and Deaf Education Faculty Publications

Purpose

To gain an understanding of practice patterns for infant diagnostic hearing services at pediatric audiology facilities.

Method

The authors used a cross-sectional survey design. From August to November of 2009, surveys were mailed to 1,091 facilities in 28 states and the District of Columbia. One survey was completed per facility, and responses were anonymous.

Results

The return rate was 33% (356 surveys). The results revealed that the comprehensiveness of the test batteries used varied among facilities. Over half of the respondents, 146 (55%), reported using a limited test battery, 94 facilities reported using a comprehensive test battery but lacked …

Improving The Quality Of Early Hearing Detection And Intervention Services Through Physician Outreach, Karen F. Muñoz, L. Shisler, M. Moeller, K. White

Communicative Disorders and Deaf Education Faculty Publications

Physicians and other health-care providers should play a central role in helping families of children with permanent hearing loss receive timely and appropriate screening, diagnostic, and early intervention services. Because the technology and procedures for ensuring timely and appropriate services for infants and young children with hearing loss have changed so dramatically over the past 15 years, many health-care providers are not well informed about the best ways to provide effective services. Audiologists can help to ensure that physicians and other health-care providers are better informed about the services needed by infants and young children with hearing loss. This article …

What Is Rti And How Do I Fit In?, Sandra Laing Gillam

Communicative Disorders and Deaf Education Faculty Publications

Since 1977, most children with LD have been identified for services on the basis of an IQ-achievement discrepancy criterion. That is, children must be failing in one or two areas, significantly, even though they score well on an IQ measure in order to qualify for special education services. There are a number of problems with this practice, not the least of which being that many children with serious learning difficulties do not perform well on verbally loaded measures of IQ and do not qualify for comprehensive services designed for children who meet the discrepancy criteria. In addition, discrepancy criteria and …