Communication Sciences and Disorders Commons^™

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 …

Effect Of Clinical Expertise On Efficacy Of Vocal Function Exercises In Individuals With Typical Voice, Maria H. Bane, Vrushali Angadi, Richard D. Andreatta, Joseph C. Stemple

Communication Sciences and Disorders Faculty Publications

Objectives/Hypothesis: To determine the effect of clinical expertise on efficacy of Vocal Function Exercises (VFEs) as measured by change in percent of maximum phonation time goal attained. The hypothesis was that clinical expertise would result in greater increases in percent of maximum phonation time goal attained.

Study Design: Randomized controlled trial.

Methods: A convenience sample of 19 individuals with typical voice was recruited in a university academic clinic setting. All participants completed baseline assessment and 17 completed all study procedures. Participants were randomized to receive VFEs from an expert voice clinician with more than 40 years’ experience (expert group (EG)) …

Belting In Musical Theatre: Vocal Pathologies, Injuries, And Pedagogical Implications, Kaylee Piatt

Theses and Dissertations--Music

Belting has become one of the most defining and contested vocal styles in contemporary musical theatre. Valued for its dramatic immediacy, speech-like intensity, and ability to cut through amplified orchestration, belting is frequently associated with heightened injury risk and pedagogical controversy. This thesis examines the relationship between belting, vocal pathology, and pedagogy through an interdisciplinary lens that integrates voice science, clinical literature, and professional performance practice. Rather than framing belting as an inherently harmful or stylistically aberrant technique, this study conceptualizes belting as a functional vocal coordination shaped by physiological mechanisms, cumulative vocal load, and occupational demands.

Drawing on existing …

Clinicians Perspective On The Implementation Of Person-Centered Care In Persons With Aphasia, Carmen S. Alderman

Theses and Dissertations--Communication Sciences and Disorders

This paper examines speech-language pathologist perspective on implementing person-centered care for persons with aphasia. Person-centered care is based on the social model, which emphasizes the importance of including the client. The survey addressed clinicians’ use of person-centered care related to collaborative goal setting and treatment planning, as well as facilitators and barriers to implementing person-centered care for individuals with aphasia based on the view of practicing clinicians across a variety of settings. The results indicated most speech-language pathologists have heard of person-centered care, understand the importance of involving clients in goal setting, ask clients about their preferences when setting goals, …

Examining The Relationship Between Cognitive Auditory Processing And Sex Hormones, Trey A. Cline

Theses and Dissertations--Gerontology

Estrogen and progesterone have demonstrated modulatory effects on central auditory nervous system (CANS) function. Post-menopausal females often present to audiology clinics with complaints of difficulty hearing in background noise. However, these individuals often have normal peripheral hearing sensitivity on standard audiometry. Previous studies using the auditory brainstem response (ABR) in post-menopausal females demonstrated longer response latencies compared to their premenopausal counterparts, suggesting that sound does not transmit through the CANS as efficiently. However, to date, the available literature focused on sex hormones and the CANS relies mainly on objective measures, predominantly the ABR. The ABR reflects physiologic function through the …

Practicing Clinicians' Views Of The Life Participation Approach To Aphasia Therapy, Stephanie H. Mays

Theses and Dissertations--Communication Sciences and Disorders

The Life Participation Approach to Aphasia therapy (LPAA) aligns with a person-centered, functional approach to speech therapy. Past research has demonstrated that persons with aphasia (PWA) benefit from this approach and prefer it when compared to the traditional medical model to therapy. However, a disconnect between PWA preferences and SLP treatment approaches in therapy persists. This study aims to identify both barriers and facilitators that SLPs face when implementing LPAA. Five CCC-SLPs practicing in the state of KY with experience working with PWA were recruited as participants. Participants were placed into two focus groups, with each group meeting for 2-3 …

“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 …

Key To Success: A Comprehensive Examination Of Support Personnel In School-Based Speech-Language Telepractice, Hannah Douglass

Theses and Dissertations--Rehabilitation Sciences

In the school setting, the telepractice team primarily consists of the clinician and a support person known as a telefacilitator. Though telepractice is an accepted method for delivering school-based speech-language therapy, many barriers to the integration of telepractice as routine care persist. A major barrier is clinicians' acceptance of telehealth. However, there has been limited investigation of factors that influence clinician acceptance. Another barrier is related to support personnel. Telefacilitators have been shown to be an integral part of the telepractice program. Yet there are significant gaps in knowledge regarding the roles and responsibilities, staffing and management, and barriers/facilitators to …

Advancing Dysphagia Screening: A Comparison Of Patient-Reported Outcome Measures And Bolus-Driven Screenings In Aspiration Prediction, Arica Amie Rusco

Theses and Dissertations--Communication Sciences and Disorders

It is known that dysphagia impacts an individual’s health and quality of life. Due to this, early identification of dysphagia is crucial. There are many different dysphagia screening tools with no consensus. This study aimed to compare the two most frequently used dysphagia screenings, a patient-reported outcome measure (PROM), the EAT-10, and bolus-driven swallow screening, the Yale Swallow Protocol, to determine if one tool is superior in aspiration prediction on a videofluoroscopic swallow study (VFSS). This study also aimed to discover the best cutoff score on the EAT-10 for aspiration prediction. A total of 66 participants were recruited after physician …

The Effects Of Exercise-Based Voice Therapy On Swallowing Outcomes: A Pilot Study Framework, Jenna F. Johnson

Theses and Dissertations--Communication Sciences and Disorders

In a 2019 study analyzing dysphonic patients in relation to coexisting dysphagia, approximately 11.8% of clients receiving treatment for voice disorders reported difficulty swallowing. However, the literature exploring the use of voice exercises to improve swallow function is limited to a small amount of voice treatment approaches, which does not reflect the wide range of evidence-based treatment approaches that may be prescribed for treatment of one’s voice complaints. This project proposes a descriptive study that would identify if completion of prescribed voice therapy exercises has implications on swallowing function in clients with co-occurring voice and swallow impairments. A pilot study …

The Critical Need For Early Language Access For Deaf And Hard Of Hearing Children, Kinya D. Embry-Wright

Theses and Dissertations--Rehabilitation Sciences

According to the American Speech-Language-Hearing Association (ASHA), speech-language pathologists (SLPs) are referred to as the experts of communication (ASHA, n.d.) utilizing their specialized training, extensive education, and clinical expertise to work with individuals across the lifespan with a variety of different speech and language delays, disorders, and deficits. However, when working with deaf or hard of hearing (DHH) children, there is often precedent given to speech and listening (M. L. Hall et al., 2019). For example, ASHA only recently updated their DHH portal to include American Sign Language (ASL), though they still list it on some webpages as an Augmentative …

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 …

Developing Ecologically Valid Clinical Tools For Persons With Tbi: Understanding The Role And Impact Of Distractions, Deanna Pinnow

Theses and Dissertations--Rehabilitation Sciences

There is a critical need for the development of ecologically valid clinical tools to assess real-life cognitive functioning in persons impacted by traumatic brain injury (TBI). Chronic cognitive impairments that are exacerbated by distractions are one of the core factors contributing to poor home and community re-integration post injury. Simulation-based digital platforms (i.e., virtual reality, augmented reality, and mixed reality) have become potential solutions for eliciting real-world cognitive performance in clinical settings. Yet, there is a paucity of research investigating the role and impact of distractions on cognition. As a result, there is no clear framework of measuring distractions to …

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 …

Coordinated Speech Therapy, Physiotherapy, And Pharmaceutical Care Telehealth For People With Parkinson Disease In Rural Communities: An Exploratory, 8-Week Cohort Study For Feasibility, Safety, And Signal Of Efficacy, Mary Jo Cooley Hidecker, Merrill R. Landers, Annalisa Piccorelli, Erin Bush, Reshmi Singh

Communication Sciences and Disorders Faculty Publications

Introduction: The potential for coordinated, multidisciplinary telehealth to help connect people with Parkinson disease (PD) in rural areas to PD specialists is crucial in optimizing care. Therefore, this study aimed to test the feasibility, safety, and signal of efficacy of a coordinated telehealth program, consisting of speech therapy, physiotherapy, and pharmaceutical care, for people with PD living in some rural US communities.

Methods: Fifteen individuals with PD living in rural Wyoming and Nevada, USA, participated in this single-cohort, 8-week pilot study. Participants were assessed before and after 8 weeks of coordinated, one-on-one telehealth using the following outcomes: (1) …

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 …

Perceived Exercise Habits Of Individuals With Parkinson’S Disease Living In The Community, Jordana Lockwich, Kate Schwartzkopf-Phifer, Camille L. Skubik-Peplaski, Richard D. Andreatta, Patrick H. Kitzman

Communication Sciences and Disorders Faculty Publications

Context

Exercise has been shown to improve gait in individuals with Parkinson’s disease (PD). Stepping practice at higher intensity levels has been suggested as a beneficial treatment option to improve gait in the neurological population. Unfortunately, this mode is poorly understood and underutilized within the PD population. Information on what individuals with PD are doing for exercise would be beneficial to help tailor exercise programs to improve gait and provide exercise options in the community for intensity-based exercise.

Objective

To investigate the current exercise habits of individuals living with PD in the community aimed at improving walking and to understand …

Abnormal Nutritive Sucking As An Indicator Of Neonatal Brain Injury, Sabrina Shandley, Gilson J. Capilouto, Eleonora Tamilia, David M. Riley, Yvette R. Johnson, Christos Papadelis

Communication Sciences and Disorders Faculty Publications

A term neonate is born with the ability to suck; this neuronal network is already formed and functional by 28 weeks gestational age and continues to evolve into adulthood. Because of the necessity of acquiring nutrition, the complexity of the neuronal network needed to suck, and neuroplasticity in infancy, the skill of sucking has the unique ability to give insight into areas of the brain that may be damaged either during or before birth. Interpretation of the behaviors during sucking shows promise in guiding therapies and how to potentially repair the damage early in life, when neuroplasticity is high. Sucking …

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, …

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 …

Comparison Of Upper Extremity Function In Women With And Women Without A History Of Breast Cancer, Mary Insana Fisher, Gilson J. Capilouto, Terry Malone, Heather M. Bush, Timothy L. Uhl

Communication Sciences and Disorders Faculty Publications

Background

Breast cancer treatments often result in upper extremity functional limitations in both the short and long term. Current evidence makes comparisons against a baseline or contralateral limb, but does not consider changes in function associated with aging.

Objective

The objective of this study was to compare upper extremity function between women treated for breast cancer more than 12 months in the past and women without cancer.

Design

This was an observational cross-sectional study.

Methods

Women who were diagnosed with breast cancer and had a mean post-surgical treatment time of 51 months (range = 12–336 months) were compared with women …

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 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 …

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 …

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 …

Development Of A Non-Invasive Device For Swallow Screening In Patients At Risk Of Oropharyngeal Dysphagia: Results From A Prospective Exploratory Study, Catriona M. Steele, Rajat Mukherjee, Juha M. Kortelainen, Harri Pölönen, Michael Jedwab, Susan L. Brady, Kayla Brinkman Theimer, Susan Langmore, Luis F. Riquelme, Nancy B. Swigert, Philip M. Bath, Larry B. Goldstein, Richard L. Hughes, Dana Leifer, Kennedy R. Lees, Atte Meretoja, Natalia Muehlemann

Neurology Faculty Publications

Oropharyngeal dysphagia is prevalent in several at-risk populations, including post-stroke patients, patients in intensive care and the elderly. Dysphagia contributes to longer hospital stays and poor outcomes, including pneumonia. Early identification of dysphagia is recommended as part of the evaluation of at-risk patients, but available bedside screening tools perform inconsistently. In this study, we developed algorithms to detect swallowing impairment using a novel accelerometer-based dysphagia detection system (DDS). A sample of 344 individuals was enrolled across seven sites in the United States. Dual-axis accelerometry signals were collected prospectively with simultaneous videofluoroscopy (VFSS) during swallows of liquid barium stimuli in thin, …

Neurocognitive Basis Of Repetition Deficits In Primary Progressive Aphasia, Sladjana Lukic, Maria Luisa Mandelli, Ariane Welch, Kesshi Jordan, Wendy Shwe, John Neuhaus, Zachary Miller, H. Isabel Hubbard, Maya Henry, Bruce L. Miller, Nina F. Dronkers, Maria Luisa Gorno-Tempini

Communication Sciences and Disorders Faculty Publications

Previous studies indicate that repetition is affected in primary progressive aphasia (PPA), particularly in the logopenic variant, due to limited auditory-verbal short-term memory (avSTM). We tested repetition of phrases varied by length (short, long) and meaning (meaningful, non-meaningful) in 58 participants (22 logopenic, 19 nonfluent, and 17 semantic variants) and 21 healthy controls using a modified Bayles repetition test. We evaluated the relation between cortical thickness and repetition performance and whether sub-scores could discriminate PPA variants.

Logopenic participants showed impaired repetition across all phrases, specifically in repeating long phrases and any phrases that were non-meaningful. Nonfluent, semantic, and healthy control …