Medicine and Health Sciences Commons^™

Beyond The Treatment Protocol: Active Ingredients For Precision Voice Rehabilitation, Maria H. Bane

Theses and Dissertations--Rehabilitation Sciences

Despite the growing body of research demonstrating voice therapy efficacy, only 12 of 100 people referred to a speech-language pathologist (SLP) for a voice evaluation will successfully complete therapy. One possible reason for this discrepancy is that clinical laboratory and clinical outcomes studies have focused on if voice therapy works while failing to explain how voice therapy works. While the if question is important, the yes or no response this question generates is of limited utility when those referred for voice therapy fail to complete. Consequently, the how question, which concentrates on the mechanisms and processes underlying effective voice therapy, …

The Effects Of Three Service Delivery Models On Vocabulary Learning By Second-Grade Children, Laura Stone

Theses and Dissertations--Rehabilitation Sciences

Speech-Language Pathologists (SLPs) provide services to children in schools across the United States primarily in a direct small group service delivery model outside of the regular education classroom. To date little research exists to indicate that direct pull-out service delivery is an effective model in elementary schools for students requiring speech and language therapy. One area that has been studied is the effectiveness of vocabulary intervention among service delivery models. Preliminary findings suggest that students with language and literacy deficits learn vocabulary well within a regular education environment with SLP support. However, there is little consensus on how service delivery …

Using Transcranial Direct Current Stimulation To Improve Naming Ability In Post-Stroke Aphasia: Evaluating Evidence And Optimizing Outcomes, Mohammed Alharbi

Theses and Dissertations--Rehabilitation Sciences

Introduction. Aphasia is a devastating acquired language disorder that affects about one third of stroke survivors. Aphasia can severely affect quality of life and can be associated with economic burdens due to the need for long-term communication rehabilitation. Traditional aphasia therapies are known to be effective; however, progress is often slow and limited in severe cases – full restoration of communication abilities is rarely achieved. Thus, there is a critical need for therapeutic solutions that can reduce the associated burden of aphasia. Transcranial direct current stimulation (tDCS) is a non-invasive and inexpensive neuromodulation technique that has the potential to boost …

Experiences Of Adolescents In The General Education Setting Interacting With Peers With Intellectual Disability, Katie Goldey

Theses and Dissertations--Rehabilitation Sciences

Social interaction is critical to health, quality of life, and linguistic and cognitive development. However, young people with intellectual disabilities are unlikely to have equitable opportunities for social interaction. This may be particularly true of adolescents. This study used qualitative phenomenological methods to examine the lived experiences of students in the general education setting interacting with their peers with intellectual disability. Twenty participants engaged in one on one interviews with the author. Interviews were recorded, transcribed verbatim, and analyzed for overarching themes. Four main themes emerged from the data including: (1) Teens just don’t have many opportunities to interact with …

Growing Old As A Rock Star: A Four-Part Study Of The Aging Voice, Joanna Sloggy

Theses and Dissertations--Rehabilitation Sciences

This dissertation focuses on the aging voice - specifically the aging elite vocal athlete. It is comprised of four components; a series of research studies and a viewpoint piece designed to explore the awareness, struggles, and vocal compensations of aging singers dealing with age related vocal and performance problems. The overarching goal of these studies is to inform the development of a voice care protocol for the aging rock star to guide customized intervention for these elite vocal athletes that is focused on optimizing both vocal output and performance.

First, the dissertation introduces and identifies characteristics of the exceptional voice. …

Parent-Implemented Language Intervention With Young Children From Low-Ses Environments Who Have Language Impairment, Courtney Allison Hatcher

Theses and Dissertations--Rehabilitation Sciences

In this study, the author examined the effects of training four parents from low-socioeconomic environments to use Enhanced Milieu Teaching (EMT) with their young children with language impairment. The investigator used a modified Teach-Model-Coach-Review method to teach parents to use the following EMT strategies during 8-10 individualized, home-based sessions: matched turns, expansions, time delays and milieu teaching prompts. A single-case multiple-baseline design across-behaviors replicated across four parent/child dyads was used to evaluate the parents' use of the EMT strategies. Child language outcomes were also assessed using pre- and post-intervention language samples. All parents learned and demonstrated use of each language …

Joint Decision-Making In Married Couples Affected By Aphasia, Ryan S. Husak

Theses and Dissertations--Rehabilitation Sciences

Background: Aphasia is an acquired language disorder, usually due to stroke, that affects the social functioning and the quality of life of the person with aphasia as well as the quality of life of his or her family and caregivers. Traditional aphasia therapy has tended to focus on decontextualized tasks and discrete elements of language functioning. The Life Participation Approach to Aphasia (LPAA) focuses on the collaborative nature of communication and addresses communication within personally relevant contexts. Joint decision-making is one type of social interaction that occurs frequently between married couples and has received considerable attention in the literature. …

Investigating The Efficacy Of Vocal Function Exercises In Improving Vocal Function In Adults Irradiated For Laryngeal Cancers: A Three Part Dissertation, Vrushali Angadi

Theses and Dissertations--Rehabilitation Sciences

Deterioration in voice quality following radiation therapy for the treatment of laryngeal cancers (LC) is well documented in literature. The majority of studies show that these voice problems are long term and in some cases permanent. Deterioration in voice quality, especially over a period of time could lead to significant communication difficulties in daily life or in some cases could even result in loss of profession. Despite the negative effects of radiation therapy on voice quality being well documented, few studies have focused on the efficacy of voice therapy in the irradiated LC population.

The purpose of this study was …

Vocalization Subsystem Responses To A Temporarily Induced Unilateral Vocal Fold Paralysis, Daniel J. Croake

Theses and Dissertations--Rehabilitation Sciences

Healthy voicing is thought to be dependent on a dynamic balance of three interactive subsystems: respiration, phonation, and resonance. Theoretically, multiple patterns of subsystem interactions likely underlie healthy voice production; however surprisingly little quantitative data exists defining the nature of these subsystem production patterns and interactions across individuals.

The central aim of this study was to quantify the interactions of the vocalization subsystems in a non-perturbed and perturbed condition (induced unilateral vocal fold paralysis) in 10 vocally healthy participants. Respiratory inductance plethysmography, laryngeal aerodynamics, and acoustic formant data were used to measure the proportional contributions of, and changes to, the …

Problem Solving Of Typically Developing Children On An Adaptation Of The Twenty Questions Task, Janice Carter Smith

Theses and Dissertations--Rehabilitation Sciences

This cross sectional study examined problem solving by typically developing children on the Rapid Assessment of Problem Solving test (RAPS). The RAPS, a modification of Mosher and Hornsby’s 20Q task, requires the examinee to solve three problems. Each problem involves asking yes/no questions to identify a target picture from a 32-picture array with as few questions as possible. Participants were 73 young (ages 7-9), 79 early adolescent (ages 10-13) and 77 adolescent (ages 14-17) children residing in Kentucky. Children were seen in the summer months and administered the RAPS on a single occasion, with 22 of the children being testing …

Perception And Use Of Communication Care Plans By Certified Nursing Assistants In Nursing Homes: The Role Of Professional Support, Christen G. Page

Theses and Dissertations--Rehabilitation Sciences

The majority of individuals in nursing homes have cognitive-communication impairments which impact quality of care because direct care providers, certified nursing assistants, (CNAs) are unsure how to respond to resident’s communication behaviors. One intervention that facilitates staff-resident communication in nursing homes is communication plans; however, the research to date about communication plans has not specifically involved CNAs.

The purpose of this study, using a grounded theory qualitative approach, was to describe development, implementation and evaluation of communication care plans (CCPs) for residents with cognitive-communication impairments in nursing homes by CNAs who did and did not receive professional support. Communication care …

Effects Of An Online Training In The Ziggurat Model On The Autism Knowledge Of School-Based Speech-Language Pathologists (Slps), Wendy L. Wilkerson

Theses and Dissertations--Rehabilitation Sciences

Autism Spectrum Disorder (ASD) is a low-incidence disorder with high impacts on individuals, families, and society. School-based speech-language pathologists (SLPs) have tremendous responsibilities toward individuals with ASD, but pre-service SLPs are not adequately trained to fulfill these expectations. In order to reduce the widespread financial and social impact of ASD, school-based SLPs need to complete effective training to prepare them for the selection of established social-communication practices. One framework for the selection of individualized intervention is the Ziggurat Model (Aspy & Grossman, 2008). The following study used mixed methods to investigate the research question: “Does the ASD knowledge base of …

The Relationship Of Somatosensory Perception And Fine-Force Control In The Adult Human Orofacial System, Nicole M. Etter

Theses and Dissertations--Rehabilitation Sciences

The orofacial area stands apart from other body systems in that it possesses a unique performance anatomy whereby oral musculature inserts directly into the underlying cutaneous skin, allowing for the generation of complex three-dimensional deformations of the orofacial system. This anatomical substrate provides for the tight temporal synchrony between self-generated cutaneous somatosensation and oromotor control during functional behaviors in this region and provides the necessary feedback needed to learn and maintain skilled orofacial behaviors.

The Directions into Velocity of Articulators (DIVA) model highlights the importance of the bidirectional relationship between sensation and production in the orofacial region in children learning …

A Comparison Of Group Versus Individual Therapy On The Output Of Appropriate Utterances In A Six-Year-Old Girl With Autism: A Case Study, Mckinzie Craig Sheridan

Theses and Dissertations--Rehabilitation Sciences

Children with autism spectrum disorders typically experience language deficits in multiple areas, including form, content, and use. These children often receive speech therapy with individual sessions (one child and clinician), group sessions (several children), or a combination of both. Although research has deemed individual therapy successful, there is still debate regarding the success of group therapy, and there is virtually no literature examining a comparison between individual and group therapy. The current case-study investigated the relative effectiveness of individual versus group therapy for one six-year-old female with moderate autism spectrum disorder. The child underwent ten alternating therapy sessions of similar …

Rural Speech-Language Pathologists' Perceptions And Knowledge Of Emergent Literacy Instructional Practices: A Mixed Methods Study, Kellie C. Ellis

Theses and Dissertations--Rehabilitation Sciences

The acquisition of emergent literacy skills has become a prominent focus of early childhood education programs in recent years as research has demonstrated the significance of emergent literacy ability in the process of learning to read. The effectiveness of use of varied instructional techniques targeting the emergent literacy domains of phonological awareness, written language awareness, emergent writing, and oral language is well described in the literature. Consequently, educational service providers like speech-language pathologists are being called upon to assume roles in emergent literacy service provision. However, research has not fully explored the perceptions and knowledge speech-language pathologists possess of emergent …

Age, Attention, And Ots In A Constrained Vs Unconstrained Task, Courtney Leann Jensen

Theses and Dissertations--Rehabilitation Sciences

The discourse of older healthy adults is commonly described as lengthy and off-topic and thought to be associated with a general cognitive decline that occurs in healthy aging. This study investigated the overall decline in attention associated with healthy aging and its relationship to instances of off-topic speech (OTS) in a constrained and unconstrained language production task. Ninety cognitively healthy adults participated and comprised three age cohorts (40 – 75+). Participants completed cognitive measures of attention and two discourse tasks that included recounting personal events and describing a procedure. Older adults exhibited poorer scores on measures of selective and shifting …

Effects Of Response Elaboration Training On Sentence Production Of Persons With Chronic Agrammatic Aphasia, Ryan S. Husak

Theses and Dissertations--Rehabilitation Sciences

Purpose: Response Elaboration Training (RET) is a treatment program for increasing the amount of information contained in the speech of individuals with aphasia. This study employed a sentence production task (SPT) to examine whether RET will (1) generalize to a task not worked on in treatment and (2) affect syntactic performance.

Methods and Procedures: Three adults with chronic non-fluent Broca’s aphasia received RET in this prospective, repeated case study. The dependent variable was a SPT requiring the participant to put a verb in a sentence. Changes in the syntactic performance of the participant’s sentence productions were classified across …