Communication Sciences and Disorders Commons^™

The Implementation Of The Therapeutic Alliance In Aphasia Rehabilitation Research: A Narrative Review, Shelby Swiercz

Honors Theses

Background: The therapeutic alliance (TA), defined as the collaborative relationship between clinician and client, is widely recognized as a key factor influencing rehabilitation outcomes. However, within aphasia rehabilitation, its role remains underexplored and inconsistently measured

Methods: This narrative review examined peer-reviewed studies published between 1990 and 2025 that focused on adult aphasia rehabilitation and addressed the client-clinician relationship. Studies were identified through database searches, including PubMed, CINAHL, ComDisDome, EBSCO, and Google Scholar, and analyzed using thematic analysis.

Results: Most of the studies employed qualitative methodologies, particularly thematic analysis and semi-structured interviews, to explore patient and clinician perspectives. The therapeutic alliance …

Benefits And Barriers: Csd Faculty Attitudes Toward Student Accommodations, Erika Squires, Lori A. Pakulski, Celeste Domsch

Teaching and Learning in Communication Sciences & Disorders

Purpose: Academic accommodations in Communication Sciences and Disorders (CSD) have been explored via university websites and surveys of clinical educators, but little is known about CSD faculty attitudes toward accommodations in higher education. This study explored the types of accommodations faculty report and the benefits and barriers they encounter in doing so.

Method: A cross-sectional, mixed-methods study design was used to survey CSD faculty and instructors about the types of accommodations used by CSD students and the benefits and barriers associated with accommodations. Descriptive statistics were used to summarize participants’ responses. Qualitative analyses were used to identify themes on benefits …

Suena Como Nosotros: A Spanish-English Storybook For Growing Voices, Stephanie Czajka

Undergraduate Theses

The purpose of this project is to address the lack of speech therapy resources available to bilingual Spanish-English-speaking children between the ages of four to six. It will target common speech and language difficulties observed in children during the critical language development period, between the ages of four and six. This book will provide an accessible, culturally relevant speech therapy resource that can be used in the comfort of the home. Through the creation of this book, equity in healthcare access will be promoted, and bilingual pride and identity will be supported. The objectives of this project include designing and …

Interprofessional Collaboration: A Functional Vestibular Screening Framework For Children With Hearing Loss, Corinne Marascio

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Introduction: The vestibular system is comprised of five organs located in the inner ear that support balance, coordination, and spatial awareness (Cleveland Clinic, 2024). Due to the proximity of the hearing and vestibular organs, children with hearing loss are at an increased risk for vestibular dysfunction (Cushing & Papsin, 2018; Kelly et al., 2021). Early recognition and treatment of vestibular disorders via vestibular rehabilitation therapy can support healthy development throughout childhood (Monshizadeh et al., 2022; Wrobel et al., 2020). While vestibular assessment falls within the audiological scope of practice, barriers preclude routine screening of vestibular deficits in pediatric patients with …

Transcranial Alternating Current Stimulation As An Adjuvant For Nonfluent Aphasia: A Proof-Of-Concept Study, Lynsey M. Keator, Lisa Johnson, Roger Newman-Norlund, Kyler Spell, Samaneh Nemati, Leigh Ann Spell, Dirk B. Den Ouden, Christopher Rorden, Julius Fridriksson

Department of Speech-Language Pathology Faculty Papers

Effective rehabilitation tools are essential for improving language outcomes in chronic aphasia. Speech entrainment is a behavioral treatment that has shown promise in enhancing speech output in nonfluent aphasia, potentially by acting as an external mechanism to synchronize anterior and posterior language regions in the left hemisphere. Transcranial alternating current stimulation has been hypothesized to enhance functional connectivity between brain regions by amplifying endogenous oscillations. This proof-of-concept study explored whether high-definition tACS (HD-tACS) could improve speech fluency in nonfluent aphasia when paired with speech entrainment. In a double-blind, pseudorandomized study, 1 mA of HD-tACS at 7 Hz was applied to …

From Answers To Understanding: Bridging The Gap Between Multiple-Choice And Open-Ended Questions, Kathleen A. Siren

Teaching and Learning in Communication Sciences & Disorders

Assessment is central to effective teaching, and the structure of exam questions significantly influences both learning and instruction. Multiple-choice (MCQ) and short-answer (SAQ) questions are widely used and frequently studied, each offering distinct advantages and limitations for formative and summative assessment. This study examined a modified multiple-choice format, multiple-choice questions with explanation (MCQwE), for which students selected an answer and briefly explained their reasoning. Designed to combine the efficiency of MCQs with the diagnostic value of open-ended responses, MCQwE were implemented in an undergraduate speech science course and compared to traditional MCQs and SAQs in terms of student performance. Findings …

Teaching Students To Identify And Adjust Linguistic Bias In Speech-Language Pathology Clinical Writing, Ann K. Holland, Mary Riotte, Abby "Po Jung" Lee, Angela Ayre, Sarah Friel, Mirza J. Lugo-Neris, Laura L. Wolford

Teaching and Learning in Communication Sciences & Disorders

Biased and stigmatizing language is pervasive in healthcare records and has negative effects on clients’ care. While some research has studied how medical students may be taught to reduce stigmatizing language in their writing, the impacts of such trainings on clinical writing are rarely directly assessed, and little has been done to address this problem in speech-language pathology (SLP). This study assessed how a training module on biased language in clinical writing impacted SLP masters students’ ability to identify and correct stigmatizing language in a clinical report. Across two years, 120 students took part in this module. During the second …

Diagnostic Trends And Service Enhancements In Deaf Mental Health: A Longitudinal Analysis, Kent Schafer, Steve Hamerdinger, Frank Wu, Rie Sakai Bizmark, Charlene Crump

JADARA

A longitudinal study investigated mental health diagnostic trends and patterns among Deaf and Hearing individuals using a comprehensive dataset from Alabama Department of Mental Health spanning 2004-2024 (Deaf=4,547; Hearing=2,056,188). Chi-square analysis revealed significant proportional differences in diagnoses between the groups. Deaf individuals showed significantly higher proportions of psychotic (12.93% vs. 8.33% Hearing), mood (20.76% vs. 18.84% Hearing), and personality (0.58% vs. 0.43% Hearing) disorders. These findings suggest that increased access to specialized and competent mental health services for individuals who are Deaf, particularly following the increase of staffing patterns for the Office of Deaf Services in 2015,contributed to more accurate …

An Exploratory Bayesian Network Analysis Of Weight And Feeding Outcomes In 6-Month-Old Infants With Complex Congenital Heart Disease, Amy Delaney, Mary Taylor, Julie Ann Lavoie, Roger Brown, Karen Pridhame

Speech Pathology and Audiology Faculty Research and Publications

Purpose: We aimed to explore with a Bayesian network how clinically important factors related to feeding infants with complex congenital heart disease (CCHD) are associated with each other and influence feeding outcomes. Our goal was to raise questions for further study.

Method: This descriptive study included data from 19 infants on severity of neonatal illness, early oral-motor (OM) and swallowing skills, feeding patterns, liquid and solid intake, and weight-for-age at 2 and 6 months. Bayesian network analysis was used to estimate the conditional probabilities of these variables in relation to each other and predict the 6-month weight-for-age z score and …

Exploring Adolescent Hearing Aid Usage And Appearance Of Psychiatric Symptoms In Adolescents Using Hearql-28 Surveys, Courtney J. Austin, Dylan Chan

MEDI 9331 Scholarly Activities Clinical Years

Approximately 2% of DHH people in need of mental health services actually receive these services. Among pediatric hearing loss populations, co-occurring cognitive and physical impairments are risk factors for poor mental health status. Due to language barriers and isolation, more children with hearing loss do not have access to mental health services. Cochlear implants have been shown to improve mental health status among the DHH population. Current literature focuses on the mental health status of children with cochlear implants, with little focus on hearing aid users. Using HEAR28 data and surveys, we can quantify the incidence of psychiatric symptoms among …

Seeing Voices: A Dynamic, Interprofessional Approach To Teaching Performing Arts And Speech-Language Pathology Students About Vocal Anatomy And Physiology, Deborah Hersh, Luzita Fereday, Fiona Palmer, David Hall, Pedro Amarante Andrade, Priscilla Cornelius, Charn Nang, Jane White

Research outputs 2022 to 2026

Objectives: Seeing Voices was an interprofessional, technology-enabled, large-scale, teaching and learning event developed to address the need to improve voice students’ knowledge of laryngeal anatomy and physiology toward understanding and maintaining vocal health. Seeing Voices trialed a novel interprofessional educational approach, collected both quantitative and qualitative data about student experiences of laryngostroboscopic examination, and built a databank of laryngeal recordings for future student learning. Methods: Seeing Voices involved two 3-hour seminars in a large, university lecture space, run by an interprofessional team (speech-language pathologists, vocal coach, Ear Nose and Throat consultant) with quality equipment projecting laryngeal images to large screens …

Counselors’ Experiences Of The Alliance In Videoconference Supervision: The Role Of Nonverbals, John E. Trenery, Azra Karajic Siwiec, Randall L. Astramovich

Journal of Counselor Preparation and Supervision

The role of nonverbal immediacy and intimacy in shaping the supervisory alliance during videoconference-based clinical supervision is understudied. Using a generic qualitative research design, data were collected from 15 practicing counselors through semi-structured interviews. Thematic analysis identified six primary themes, highlighting both the perceived barriers and the essential role of nonverbal cues, as well as the need for amplified behaviors in video-based interactions. The findings point to significant gaps in telesupervision training and introduce a novel framework to strengthen telepresence in videoconference supervision. This study offers actionable insight for educational institutions and governing bodies, emphasizing the importance of targeted curricula …

Caregivers' Experiences Of Assessment And Treatment For Their Child With Childhood Apraxia Of Speech: An International Questionnaire Study, Donna Claire Thomas, Maryane Gomez, Angela Muis, Nathan Trezise, Eliza Williamson, Julie Case, Elizabeth Murray, Maria Irene Grigos, Jenya Iuzzini-Seigel, Shelley L. Velleman

Speech Pathology and Audiology Faculty Research and Publications

Purpose: The aim of this study was to understand caregivers' preferences and experiences with diagnosis and treatment of childhood apraxia of speech (CAS).

Method: Caregivers of children with CAS completed a 70-item online survey that explored demographics, initial concerns, the CAS diagnostic process, speech therapy goals, and preferred and received speech therapy service delivery (session frequency, length, and context). Quantitative data were analyzed descriptively and with inferential statistics; qualitative data were analyzed using content analysis.

Results: One hundred sixty-one caregivers participated, mostly from the United States, Australia, and Canada. A total of 72% of caregivers had concerns about their child's …

Gender, And Socioeconomic Status In School-Based Speech-Language Pathology Decision-Making For Adolescents With Traumatic Brain Injury: A Critically Appraised Topic, Geneva Renee Toledo

Selected Full-Text Master Theses 2021-

Purpose: Adolescents are at greater risk for traumatic brain injury (TBI), and TBI-related symptoms may contribute to disciplinary actions that increase their risk of entering the school-toconfinement pipeline. Given the disproportionate representation of racially marginalized male adolescents within this pipeline, this critically appraised topic (CAT) examined how race, gender, and socioeconomic status may influence school-based speech-language pathology (SLP) services and clinical decision-making following TBI. Method: A structured search of five electronic databases was conducted to identify studies examining speech-language pathologists’ (SLPs’) clinical decision-making and management of adolescents with TBI in relation to race, gender, and socioeconomic status. Relevant studies were …

Single Intratympanic Injection Of Proprietary Brain-Derived Neurotrophic Factor (Oto-413) In Subjects With Speech-In-Noise Hearing Impairment: A Randomized, Dose Escalating, Double-Blind, Placebo-Controlled Phase 1/2 Study, Alan C. Foster, Jeffery J. Anderson, David R. Moore, Morgan Oktela Fuentes, Yiwei Wang, Peter G. Volsky, K. Paul Boyev, Victoria A. Sanchez

Department of Otolaryngology (ENT) Faculty Publications

Purpose

To evaluate the safety and tolerability and exploratory efficacy of OTO-413, an intratympanic-administered, sustained release formulation of brain-derived neurotrophic factor (BDNF) in a thermoreversible gel, in participants with speech-in-noise hearing difficulties.

Methods

This was a single dose, dose-ascending, randomized, double-blind, Placebo-controlled Phase 1/2 study conducted at 7 enrolling clinical sites in the U.S. 110 participants (56% female) enrolled had self-reported speech-in-noise (SIN) difficulties that were confirmed by a SIN test and were randomized to OTO-413 or Placebo. OTO-413 dose range was escalated from 0.01 mg to 1.5 mg within 7 Cohorts. Safety evaluations included monitoring for treatment-emergent adverse events, …

Beyond Mean Length Of Utterance: Novel Measures For Characterizing The Spoken Language Of Autistic Children, Janine Mathee-Scott, Courtney E. Venker

Speech Pathology and Audiology Faculty Research and Publications

Purpose:

Mean length of utterance (MLU) is a common measure of expressive language complexity in young children, including autistic children. However, means, by nature, obscure some information about spread and variability in data. Thus, we aimed to examine a new approach to characterizing linguistic complexity in autistic children by investigating the validity of two novel measures—range of length of utterance (RLU), standard deviation of length of utterance (SDLU)—alongside established measures: MLU and total utterances (TU).

Method:

Participants were 40 autistic children (12 girls, 28 boys; M_age = 41.78 months). Children participated in 10-min, play-based language samples with their caregivers. …

How Autistic Children Define Novel And Real Words, Henry James Tomiser

Graduate Research Theses & Dissertations

Word knowledge is highly valuable to Autistic individuals, and although much research has characterized Autistic children’s vocabulary breadth (i.e., the number of lexical entries), less attention has been paid to vocabulary depth (i.e., the richness with which one understands a given word). In this exploratory post-hoc study, 11 Autistic children (one assigned female at birth) participated in novel and real word learning paradigms in which child-friendly referents were paired with CVCV word forms. Participants were then asked to provide open-ended definitions of the words. Definitions were parsed into meaningful subunits, or semantic features. Semantic features were coded by type of …

Guitar Amplifier Directivity, Rachel C. Edelman, Brian E. Anderson, Samuel D. Bellows, Timothy W. Leishman

Directivity

No abstract provided.

Modifiable Risk Factors And Hearing Loss: The National Health And Nutrition Examination Survey 1999–2020, Yulu Zheng, Tingting Li, Zhiyuan Wu, Yahong Zhu, Zheng Guo, Xingang Li

Research outputs 2022 to 2026

Objective: To explore the associations between major modifiable risk factors and hearing loss.

Methods: This serial cross-sectional study was conducted within the National Health and Nutrition Examination Survey 1999–2020 in the United States. Associations were assessed using modified Poisson regression and within-sample population attributable fraction (PAF).

Results: Eight thousand seven hundred and seventy adults aged 40–85 years were included in the analyses, the mean (SD) age was 58.0 (11.7) years, with 4002 men (45.6%). Hearing loss was associated with low educational attainment with prevalence ratio 1.23, 95% confidence interval (1.15, 1.31); low income 1.11 (1.04, 1.19); diabetes 1.10 (1.03, 1.18); …

Independence Of Spectral Contrast Effects Across Different Frequency Regions In Speech Perception, Christian E. Stilp, Matthew B. Winn

Speech Pathology and Audiology Faculty Research and Publications

Identification of speech sounds is influenced by spectral contrast effects (SCEs), the perceptual magnification of spectral differences between successive sounds. SCEs result in the categorization of a target sound being biased away from spectral properties in the preceding acoustic context. Given remarkable consistency in the magnitudes of these contrast effects within the same frequency region, it was hypothesized that they would also show stable relationships across different frequency regions. In this study, normal-hearing listeners’ phoneme categorization and contrast effects were assessed where phonetic contrasts were driven by changes in low-frequency F₁ (“big”-“beg” continuum), mid-frequency F₃ (“dot”-“got”), or high-frequency …

Exploring Tonal Focus: Qualitative Perspectives And Acoustic Correlates In Slps And Singers, Lily C. Carpenter

Theses and Dissertations--Communication Sciences and Disorders

Tonal focus is a complex construct that has variable definitions and interpretations across professions and within existing literature. Although tonal focus is widely described both clinically and pedagogically, both fields differ in their perspectives and goals related to the concept. This study aims to understand singers’ and speech language pathologists’ (SLP) conceptual perception and acoustic demonstration of tonal focus. Eleven SLPs and six singers were recruited to participate in the study. Participants completed an interview with the primary investigator and were recorded producing forward, neutral, and backward tonal focus in various contexts. Acoustic and qualitative analysis indicated that tonal focus …

Communication Sciences And Disorders Faculty Perspectives On Collaborating With Students As Instructional Partners, Bryanna Cosman

Master's Theses and Doctoral Dissertations

Student-faculty partnerships, such as instructional partnerships, have been shown to benefit both students and faculty members who engage in them. This form of collaboration does not commonly occur at public, comprehensive universities, especially in the field of communication sciences and disorders (CSD). The purpose of this study was to understand the perspectives of CSD faculty on collaborating with students as instructional partners (IP), as there is limited research on it. IPs are students who have successfully taken a class in the recent past, attend the course in a subsequent semester, and meet after each class with the professor to discuss …

Integrating Hippotherapy Into Interprofessional Aphasia Rehabilitation: A Feasibility Pilot Study, Bethany H. Wenger

Graduate Student Theses, Dissertations, & Professional Papers

Background and Significance: Stroke remains a leading cause of disability in the United States, affecting over 2.5 million individuals annually. Stroke-related motor and communication deficits often co-occur, increasing challenges for recovery, increasing social isolation, depression, and dependency. Hippotherapy has emerged as a novel treatment approach for neurorehabilitation; however, its application within interprofessional models for individuals with stroke-related motor and communication impairments remains underexplored. This study examines the feasibility, fidelity, and acceptability of an interprofessional intervention using hippotherapy for adults with chronic post-stroke aphasia, the purpose of which is to generate methodological guidance for future controlled trials.

Methods: A non-randomized, single-group …

Integrating Perspectives Of People With Aphasia: A Holistic Approach To Community Aphasia Groups Within An Intensive Comprehensive Aphasia Program, Mckinlee A. Mihelish

Graduate Student Theses, Dissertations, & Professional Papers

Introduction: People with aphasia (PWA) experience chronic communication deficits that impact daily life. Community Aphasia Groups (CAGs) are commonly used to address these challenges and have demonstrated psychosocial and communicative benefits; however, they lack standardized structure and are implemented with variability across settings. Additionally, much of the existing research focuses on group-level outcomes rather than participant-driven priorities, limiting clinicians’ ability to tailor interventions. This study examined what PWA want from CAG participation and how these priorities may change over time.

Methods: This quantitative study investigated priority changes among PWA participating in a CAG within a summer 2025 Intensive Comprehensive Aphasia …

The Effects Of Speak Out! On Hypokinetic Dysarthria In Individuals With Idiopathic Parkinson’S Disease, Linden King

Murray State Theses and Dissertations

The purpose of this single subject research study was to prove the efficacy of SPEAK OUT! therapy in improving loudness, rate of speech, and quality of life for individuals who have hypokinetic dysarthria due to Parkinson’s Disease. In this A-B-A design, five weeks of SPEAK OUT! therapy was provided twice a week to four individuals with a diagnosis of Parkinson’s disease. Results showed an increase in loudness in conversation and improved quality of life measured by statistical and visual analysis. These findings contribute to the research behind the use of SPEAK OUT! therapy for individuals with HKD due to PD.

Prosodic Comparisons Between Speech And Music For Different Emotions, Reagan Brothers

Honors Projects

This study compares the prosodic acoustic characteristics between different emotional expressions in speech and clarinet playing and evaluates the similarities in prosody between these two domains. The prosodic features analyzed include pitch, loudness, and duration, which are the psychoacoustic terms referring to fundamental frequency [f_o], intensity, and rate of time. The American folksong “I’ve Been Working on the Railroad” was both spoken and performed with three emotions: neutral, sad, and happy. The first comparison was how each prosodic characteristic compared across the three different emotions within each domain, and then prosody was compared across the two domains …

A Clinical Training Program For Auditory-Perceptual Rating Of Connected Speech In Aphasia., Marianne Casilio, Manaswita Dutta, Katherine Bryan, Kelly Crouch, Zachary Dewall, Ilana Feld, Jennifer Kile, Keely Mcmahan, Jacqueline Samora, Kiiya Shibata, Stacey Steel, Multiple Additional Authors

Speech and Hearing Sciences Faculty Publications and Presentations

Although discourse analysis has been receiving growing interest among aphasia researchers and speech-language pathologists (SLPs), several key challenges, such as limited time, insufficient training, and a lack of accessible tools, preclude its practical application in clinical settings. To address these barriers, we developed and evaluated a clinical training program for Auditory-Perceptual Rating of Connected Speech in Aphasia (APROCSA; Casilio et al., 2019), a time-efficient and psychometrically robust transcriptionless system for quantifying a range of speech-language impairment features.

Exploring Future Educators’ Roles In Classroom Aac Use: Insight Into Knowledge, Skills, And Attitudes, Katrina M. King

Honors College Theses

The United States public school system requires the provision of a free and appropriate public education (FAPE) in the least restrictive environment (LRE) for qualifying students with disabilities (U.S. Department of Education, n.d.). Speech, language, and hearing related disabilities are among the qualifying categories (U.S. Department of Education, n.d.). Students with these disabilities may have complex communication needs (CCN), or significant limitations in their speech, language, and communication abilities (Communication Rights Australia, 2018). Augmentative and alternative communication (AAC), a type of assistive technology, offers support for these students, however, several barriers inhibit full communicative participation (American Speech-Language-Hearing Association [ASHA], n.d.-a). …

A Novel Method For Examining Autistic Children’S Comprehension Of Individual Words Produced Within Delayed Echolalia: A Proof-Of-Concept Pilot Study, Janine Mathee-Scott, Grace Corrigan, Emily Lorang, Zachary Hesse, Jennifer Johnson, Courtney E. Venker

Speech Pathology and Audiology Faculty Research and Publications

Delayed echolalia, or the repetition of previously heard speech, is often observed in the expressive language of autistic children. Relatively little is known about how the production of delayed echolalia fits within the overall picture of autistic children’s language ability, including receptive language. To date, no empirical studies have tested autistic children’s comprehension of individual words within their delayed echoes. The present study aimed to establish proof-of-concept for a novel method of examining children’s comprehension of individual words that they produce in their own delayed echoes. Using natural language sampling combined with parent report, we identified instances of delayed echolalia …

Too Loud To Ignore: Knowledge, Attitudes, And Practices Regarding Hearing Protection In Student Musicians And Ensemble Directors, Lucile Donald, Ashley G. Flagge

Ashley Flagge Publications

Musicians are at an elevated risk for noise-induced hearing loss (NIHL) due to repeated exposure to sound levels exceeding occupational safety guidelines. Although many strides have been made in educating music students on the potential dangers of noise exposure and the mitigating effects of hearing protection devices, the current attitudes on this topic among high school and college-level student musicians remain largely unknown. An electronic survey was administered to high school (n = 195) and university (n = 161)-level band students and ensemble directors (n = 15) regarding knowledge of noise/music-induced hearing loss (MIHL), personal practices with HPDs, and types …