Medicine and Health Sciences Commons^™

“Your Legs Don’T Look All That Good” An Analysis Of Impoliteness And Politeness In Individuals With Traumatic Brain Injuries In The Workplace, Grace Kozal

Theses and Dissertations--Communication Sciences and Disorders

Background: Social communication disorders are a common outcome from traumatic brain injury (TBI). This social communication disorder can be seen through impolite speech acts during conversation. While politeness is a social norm for workplace discourse, instances of impoliteness may have poor consequences. This research explores the use of impoliteness in persons with TBI within computer generated work-based conditions.

Methods: Language samples from the Voicemail Elicitation Task (VET) and Feedback/Advice Spoken Task (FAST) were transcribed word-for-word. Transcripts from all 62 participants were coded for impoliteness using a developed Impoliteness Codebook and were analyzed to identify significant differences in the number of …

Understanding The Effects Of Hormone Treatments On The Transgender Singer: A Pedagogical Study And Voice Studio Guide, Erin M. Hannon

Theses and Dissertations--Music

Transitioning from one gender to another can be an arduous and emotionally charged experience, accompanied by many physical and mental transformations. The journey of self-discovery and vocal explorations is both unique and deeply personal. Modifications that emerge in an individual's vocal characteristics have a profound influence on their capacity to communicate and express themselves.

Transgender vocal students and professional singers must navigate the delicate balance between their vocal and gender identities while considering the possible risks of Gender Affirming Hormone Therapy. Though these therapies may significantly alter one's appearance and overall well-being, they are also capable of causing notable declines …

Scoping Review On Eye-Gaze As An Access Method For Augmentative And Alternative Communication, Sara Elise Craig

Theses and Dissertations--Communication Sciences and Disorders

Background: Eye-gaze is an access method used for people with severe motor impairments to communicate when other access methods for augmentative and alternative communication (AAC) are not feasible. The purpose of this research was to conduct a scoping review on eye-gaze as an access technique for AAC. This scoping review uses Light’s communicative competences (i.e., linguistic, operational, social, and strategic) as a framework to analyze recent literature.

Methods: Five databases were searched to find relevant articles that considered eye-gaze as an access method for communicative purposes. Results were charted and analyzed to determine which, if any, communicative competences and associated …

Learner Outcomes From An Echo In Augmentative And Alternative Communication, Lillie Reinhart

Theses and Dissertations--Communication Sciences and Disorders

Background: Students with complex communication needs (CCN) rely on the use of augmentative and alternative communication (AAC) to support their communication; however, many students are leaving high school without an effective form of communication. To build capacity and increase school professionals’ knowledge and self-efficacy in AAC, this thesis used an adaptation of Project ECHO (Extension for Community Healthcare Outcomes) for use with AAC.

Methods: Using a post then pre-retrospective survey, participants self-reported changes in knowledge, confidence, and overall satisfaction with ECHO sessions. Paired sample t-tests assessed participant-reported change in knowledge. Frequency counts were used to analyze responses about confidence and …

Patient And Therapist Perceptions Of Respiratory Functioning Due To Spinal Cord Injury: Implications For Music Therapists, A'Marie Dotson

Theses and Dissertations--Music

Decreased respiratory functioning is a common symptom of spinal cord injury (SCI) and can impact individuals’ personal, professional, and social lives. In spite of this, researchers have not explored the use of music in the lives of individuals with SCIs or music’s role in their healthcare professionals’ treatment plans to improve respiratory functioning. The purpose of this qualitative study was to better understand how decreased respiratory functioning affects individuals with SCIs and healthcare professionals through a multiple case study design. Participants were two individuals with SCIs and three healthcare professionals (physical therapist, recreational therapist, and music therapist) who worked with …

Remote Supported Communication For Adults With Chronic Aphasia: A Serendipitous Study, Allie Hopper

Theses and Dissertations--Communication Sciences and Disorders

Supported communication is defined as anything that improves access to or participation in communication events or activities (King, Simmons-Mackie, & Beukelman, 2012). This thesis describes the results of a study that took place when a training program to provide graduate students in Communication Sciences and Disorders (CSD) with “hands on” experience in providing supported communication to persons with chronic aphasia (PWA) was interrupted by the outbreak of Coronavirus-19 and switched to a remote delivery format to fulfil service and training obligations to the PWA and the CSD graduate students respectively. The study (1) describes the actions taken to covert a …

Cognitive Abilities In Hearing Loss: Perceived And Performance Abilities Of Adults Related To Attention, Memory, And Social Cognition, Karah Gottschalk

Theses and Dissertations--Gerontology

Hearing loss is the most common sensory deficit noted in aging adults. It is commonly known to reduce an individual’s ability to detect, identify, and localize sounds and speech and to cause issues in communication. However, there are other less commonly discussed impacts that hearing loss has beyond the auditory system. Literature suggests a correlation between hearing loss and cognition in aging adults. Similar to hearing loss, the domains of cognition experience performance and functional changes across the life span. In an aging adult, changes related to cognition are also suggested to be associated with hearing loss. This study aimed …

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, …

Legibility Of Communicative Writing And Drawing In Aphasia: Does The Orthographic Medium Matter?, Nicole Waugaman

Theses and Dissertations--Communication Sciences and Disorders

Expressive language difficulties are commonplace in aphasia and are often further complicated by co-occurring motor speech disoders. Therefore, many people with aphasia (PWA) are unable to meet all their communication needs by speaking, and they may compensate with the use of communicative writing and drawing. Communicative writing and drawing can be defined as preserved, but imperfect, orthographic skills that PWA use to compensate for expressive language deficits resulting from aphasic and/or motor speech difficulties. The purpose of this study was to determine if the orthographic medium used by a PWA to write and draw influenced the legibility of their writing …

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 …

Impact Of Nicu Design On Feeding-Related Outcomes In Preterm Infants, Emma Kate Calvert

Theses and Dissertations--Communication Sciences and Disorders

Many NICUs around the country are moving away from traditional open-bay designs in favor of single-family rooms (SFRs) as more is understood about the impact of the sensory environment on neurodevelopment in preterm infants. SFRs house one infant and their family for the length of the infant’s stay and are associated with improvements in numerous outcomes, including increased milk intake and weight gain and earlier transition to enteral feeding. Oral feeding remains a critical requirement for NICU discharge; however, the impact of NICU design on feeding outcomes remains unknown.

The purpose of this study was to compare feeding outcomes between …

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 …

The Impact Of Dysphagia And Gastrostomy On Quality Of Life In Caregivers Of Patients With Amyotrophic Lateral Sclerosis, Emily Clare Sither Goggin

Theses and Dissertations--Communication Sciences and Disorders

There is little research studying the relationship between caregiver quality of life and gastrostomy, a palliative intervention recommended to manage dysphagia and malnutrition in patients diagnosed with Amyotrophic Lateral Sclerosis (ALS). To facilitate a more comprehensive assessment of treatment effectiveness and to better guide patients and their families, this study investigated the relationship between gastrostomy, caregiver strain, and patient disease-related factors. Patients with bulbar-onset ALS and their caregivers were recruited regardless of their decision to accept or decline future gastrostomy. Caregivers completed the Modified Caregiver Strain Index (MCSI) to assess levels of caregiver strain as an index of quality of …

Effectiveness Of Prophylactic Lingual Strengthening Exercises For Patients With Head And Neck Cancer A Systematic Review, Cassidy Pickens

Theses and Dissertations--Communication Sciences and Disorders

Radiation treatment for head and neck cancer has devastating effects on swallowing ability. Prophylactic swallowing exercises are often recommended. However, the evidence for these exercises is equivocal and information regarding critical components of an exercise program is lacking. The purpose of this systematic review was to examine the evidence regarding lingual strengthening exercises as a component of a prophylactic swallowing program.

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. …

Vocal Function Exercises For Normal Voice: The Effects Of Maximally Sustained Phonation, Mariah Elaine Morton

Theses and Dissertations--Communication Sciences and Disorders

Vocal Function Exercises (VFEs) is a well-known treatment program that consists of four exercises, in which the first and fourth tasks require maximally sustained phonation. However, the active ingredients responsible for treatment efficacy are still unknown. The primary purpose of this investigation was the explore the effects of maximally sustained phonation on the VFE outcome measure of maximum phonation time (MPT) in individuals between the ages of 18-40 with normal voice. Participants were randomized into three experimental groups that completed VFEs for six weeks. The baseline group sustained tasks one and four for as long as was achieved at the …

A Pilot Investigation Of An Instrument For The Assessment Of Feeding Disorders In Children With Severe Disabilities, Annaliese E. Norris

Theses and Dissertations--Communication Sciences and Disorders

The purpose of this pilot investigation was to assess the inter-rater reliability of an expert-validated pediatric feeding assessment, designed for clinician use with children who have severe disabilities. The tool would ideally allow for standardization of the clinical mealtime assessment process.

A comprehensive review of available feeding instruments revealed that there is a need for an assessment tool for children with motor and developmentally based feeding problems.In response to this need, a new clinician administered instrument called the Mealtime Assessment Tool for Children (MATCH) was developed in order to guide the assessment of a child during a clinical meal.

The …

Professional Competencies For E-Helpers: A Telepractice Resource, Hannah M. Schlaak

Theses and Dissertations--Communication Sciences and Disorders

The primary purpose of this study was to craft and validate a set of core competencies necessary for an e-Helper to possess. A review of the literature guided the creation of the initial competencies. Following expert review, the competencies were revised and formatted into an online survey which was sent to respondents in four target groups: (a) school administrators who had adopted telepractice as a service delivery model; (b) SLPs experienced in telepractice within a school setting; (c) current e-Helpers, and (d) scholars experienced in telepractice. Sixty percent (21 out of 35) of the competencies were rated as “important” by …

Myosin-Xva Is Key Molecule In Establishing The Architecture Of Mechanosensory Stereocilia Bundles Of The Inner Ear Hair Cells, Shadan Hadi

Theses and Dissertations--Medical Sciences

Development of hair cell stereocilia bundles involves three stages: elongation, thickening, and supernumerary stereocilia retraction. Although Myo-XVa is known to be essential for stereocilia elongation, its role in retraction/thickening remains unknown. We quantified stereocilia numbers/diameters in shaker-2 mice (Myo15^sh2) that have deficiencies in “long” and “short” isoforms of myosin-XVa, and in mice lacking only the “long” myosin-XVa isoform (Myo15^ΔN). Our data showed that myosin-XVa is largely not involved in the developmental retraction of supernumerary stereocilia. In normal development, the diameters of the first (tallest)/second row stereocilia within a bundle are equal and grow simultaneously. …

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. …

Inter-Rater Reliability Of Diagnostic Language Testing Administered Via Telepractice, Sarah E. Adams

Theses and Dissertations--Communication Sciences and Disorders

Federal law mandates children with language disorders receive free and appropriate intervention. Diagnosis is the first step in the intervention continuum; however, children in rural America are underserved due to personnel shortages. Limited studies have demonstrated the reliability of language testing conducted via telepractice. Further research examining the reliability of language tests administered via telepractice is necessary. The purpose of this study was to assess inter-rater reliability of three language tests administered via telepractice.

Promotion Of Early Pediatric Hearing Detection Through Patient Navigation, Matthew L. Bush

Theses and Dissertations--Clinical and Translational Science

Congenital hearing loss is the most common neonatal sensory disorder and it is crucial to diagnose hearing loss as soon as possible after birth in order to facilitate rapid treatment. Universal standards of infant hearing healthcare dictate that infant hearing screening should be completed by one month of age and abnormal screening tests should be followed with definitive audiological testing by three months of age. Obtaining diagnostic testing can be complicated by limited access to care in rural areas, breakdowns in communication, lack of parental support, and poor coordination of care. There is no established method to address appointment non-adherence …

Vocal Function Exercises For Normal Voice: With And Without Semi-Occlusion, Megan Suzanne Brown

Theses and Dissertations--Communication Sciences and Disorders

The primary purpose of this investigation was to explore the effects of varying degrees of vocal tract semi-occlusion in Vocal Function Exercises (VFEs) on attainment of pre- established maximum phonation time (MPT) goals in individuals between the ages of 18 and 45 with normal voice. Individuals were randomized into three experimental groups: the traditional VFE with a semi-occluded vocal tract (SOVT), modified /o/ with partial occlusion, and modified /a/ without significant occlusion. For six weeks, the participants completed the four exercises two times each, twice daily on corresponding vocal tract postures assigned by group. Results indicated significant change in percent …

Singing Portuguese Nasal Vowels: Practical Strategies For Managing Nasality In Brazilian Art Songs, André Campelo

Theses and Dissertations--Music

The articulation of Portuguese nasalized vowels poses some articulatory problems accompanied by negative acoustic effects for the performance of Brazilian art songs. The main objective was to find strategies that permit the singer to conciliate an idiomatic pronunciation of these vowels with a well-balanced resonance, a desirable quality in classical singing. In order to devise these strategies, the author examined sources dealing with nasalized vowels from varied perspectives: acoustic properties of vowel nasalization, phonetic and phonological aspects ofBrazilian Portuguese (BP), historical views on nasality in singing, and recent vocal pedagogy research. In addition to the overall loss of sonority, the …

Vocal Function Exercises For Normal Voice: The Effects Of Varying Dosage, Maria H. Bane

Theses and Dissertations--Communication Sciences and Disorders

The primary purpose of this investigation was to explore the effects of variable doses of home practice Vocal Function Exercises (VFEs) on attainment of pre-established maximum phonation time (MPT) goals in individuals between the ages of 18 and 25 with normal voice. A secondary purpose was to monitor for potentially toxic effects of high doses of VFEs. Three experimental groups completed a six-week VFE protocol and practiced twice daily. The low dose group performed each exercise once, the traditional group twice, and the high dose group four times. Results indicated significant change in VFE MPT for all three groups and …

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 …

The Use Of Gesture In Self-Initiated Self-Repair Sequences By Persons With Non-Fluent Aphasia, Eleanor M. Feltner

Theses and Dissertations--Linguistics

This study examines the relationship between types of gestures and instances of self-initiated self-repair (SISR) used by persons with non-fluent aphasia (NFA), which is a type of aphasia characterized by stilted speech or signing (Papathanasiou et al., 2013), in interactions with clinicians. Conversation repairs in this study are assessed using the framework of Conversation Analysis (CA), which is an approach for describing, analyzing, and understanding social interaction (Sidnell, 2010). Previous linguistic studies have demonstrated a distinct preference for the use of gesture during a repair by persons with aphasia (Goodwin, 1995; Klippi, 2015; Wilkinson, 2013). This study draws more conclusive …