Communication Sciences and Disorders Commons^™

Fall Risk In Community-Dwelling Adults: A Comparison Of English And Spanish-Speaking Individuals, Jesus D. Gomez

Dissertations, 2020-current

Falls are a leading cause of injury-related mortality among middle-aged and older adults. Although vestibular dysfunction, hearing loss, behavioral factors, and social determinants of health have been associated with increased fall risk, few studies have examined these relationships. Furthermore, limited research in audiology and vestibular science has investigated fall-risk vulnerability among Spanish-speaking individuals.

This study aimed to: (1) estimate the prevalence of fall risk among community-dwelling adults and compare prevalence between English-speaking and Spanish-speaking participants; (2) assess the prevalence of previously undiagnosed benign paroxysmal positional vertigo (BPPV) and compare prevalence between language groups; and (3) develop predictive models of fall …

A Measure Of Spatial Orientation In Healthy Adults, Lauren Maloney

Dissertations, 2020-current

Spatial orientation is essential for effective navigation and movement, relying on the integration of sensory inputs from systems such as proprioception, vision, audition, and the vestibular system. The vestibular system, responsible for detecting rotational and linear movements, plays a crucial role in maintaining balance and spatial awareness. However, its specific influence on spatial orientation remains underexplored. This study investigates how vestibular input influences spatial orientation accuracy by examining participants' ability to estimate angular displacement during rotational stimuli. Twenty participants underwent testing using a rotational chair, with stimuli at varying rotational amplitudes (5-400 degrees). Along with their perceived angular displacement (i.e. …

The Effect Of Head Coverings On Directional Microphone Performance, Mariam Mohamed

Dissertations, 2020-current

Background: Directional microphones in hearing aids are a well-established strategy for enhancing speech intelligibility in background noise. While previous studies have examined the effects of hair, spectacles, and earmold venting, no systematic research has addressed whether head coverings, commonly worn for cultural, religious, or personal reasons, affect directional performance.

Objective: This study aimed to determine whether a thin cotton head covering alters the directivity index (DI) of premium receiver-in-canal hearing aids from four leading manufacturers, using laboratory-controlled conditions. 

Methods: A Knowles Electronics Manikin for Acoustic Research (KEMAR) was positioned within a sound-treated room to measure DI for both omnidirectional and …

Novel Paradigm For Assessing Vestibular Perception In Children, Nicole Kirk, Nicole Kirk

Dissertations, 2020-current

While objective vestibular reflexive testing has been heavily researched, there are few studies analyzing subjective vestibular perception and to date no progress has been reported on motion perception in children. It is unknown if children perceive motion like adults creating a need for research comparing these age groups for thorough clinical profiles. This study adapted an adult psychophysics protocol for school-aged children and collected data on ten typically developing children and ten healthy adults. Participants rotated at various peak velocities and frequencies in a rotary chair and were asked to report their spatial orientation (i.e., how far around they rotated) …

Family Quality Of Life And Infant Language Development: A Pilot Study Of Infants Without A History Of Chronic Otitis Media, Aubreigh Cartwright

Dissertations, 2020-current

Chronic otitis media (COM) is a condition associated with hearing fluctuations, recurrent medical interventions, and speech-language concerns. While the audiological impacts for children are well documented, there is less research pertaining to parents’ and caregivers’ experiences. The goal of the overall line of inquiry was to examine the impact of chronic otitis media on parent and caregiver quality of life. Parents and caregivers of ten typically developing infants from six to twelve months of age without COM were administered parent-proxy instruments to determine quality of life, as well as expressive and receptive lexicon. The parents were administered a family intake …

How Audiologists Are Using Adapted Cognitive Behavioral Therapy For Tinnitus Management: A Preliminary Study, Katherine Mary Mueller

Dissertations, 2020-current

Audiologists interact with patients reporting bothersome tinnitus frequently, however there is no standardized protocol to follow when treating/counseling these patients. Cognitive Behavioral Therapy (CBT) is highly researched and has been proven to alleviate bothersome tinnitus symptoms, yet audiologists are not clinically trained in this tinnitus management. Specific forms of CBT that were analyzed in this study include Attention Shifting, Neurophysiological Education, and Progressive Muscle Relaxations. This study surveyed current audiologists to determine how they are using adapted CBT techniques (aCBTt) for tinnitus management. This questionnaire aimed to investigate a) the effect of audiologists’ practice duration on their frequency to recommend …

Stigma Predicts Participation And Autonomy In Chronic Vestibulopathy: An Explanatory Mixed Methods Study, Brandy L. Hollins

Dissertations, 2020-current

Many vestibular disorders are “invisible”, not widely recognized, and challenging for patients to describe. However, its impact is visible and leads to significant challenges. Research has shown that stigma associated with other chronic health conditions can detrimentally affect patient outcomes, suggesting a greater need in this area. The World Health Organization’s (WHO) International Classification of Functioning, Disability, and Health (ICF) elucidates the role of physical, social, and cultural factors in the manifestation of health conditions within a universal framework. A critical aspect of the ICF’s contextual factors for individuals with vestibular loss is societal perception. Few studies have reported stigmatization …

The Relationship Between The Vestibulo-Ocular Reflex And Vestibular Perception In Trained Dancers Using Sinusoidal Harmonic Acceleration Testing, Diana Trinidad

Dissertations, 2020-current

Early studies have found that engaging in vestibular training, such as dance, may result in enhanced VOR suppression and changes in vestibular perception (e.g., lower sensations of vertigo) attributed to top-down modulation of subcortical neuronal networks and changes in the cerebellum. Dancers use spotting techniques to help control dizziness which involve holding their gaze on a visual object at eye level as they turn. As a result of this training, dancers become habituated to vestibular stimuli leading to lower VOR responses and decreased sensations of vertigo. This study investigated the relationship between the vestibulo-ocular reflex (VOR) and vestibular perception in …

Intertrial Coherence As A Measure Of Synchrony In Ocular Vestibular Evoked Myogenic Potentials And The Effect Of Gaze Angle, Sydney Brown

Dissertations, 2020-current

Ocular vestibular evoked myogenic potentials (oVEMPs) are produced by highly synchronous bursts of extraocular muscle activity in response to stimuli. These responses reflect utricular function and can be recorded using surface electromyography electrodes. Traditional analysis of oVEMPs is limited to time-domain waveform measurements, such as amplitude and latency of response peaks. Objective synchrony-based measures have not yet been applied to the analysis of oVEMPs, particularly in the comparison of synchrony across gaze angles. We followed the new time-frequency method of analysis developed by Clinard et al. (2022) that was successfully applied to cervical VEMPs to quantify response synchrony. Air-conducted oVEMPs …

Establishing The Feasibility Of Sustained Sinusoidal Cervical Vestibular Evoked Myogenic Potentials In Young Adults, Ashton Fowlkes

Dissertations, 2020-current

Cervical vestibular evoked myogenic potentials (cVEMPs) are used in clinics and research to assess the function of primarily the saccule. cVEMPs are typically stimulated with transient clicks or tone bursts through air conduction and are recorded from the sternocleidomastoid (SCM) muscle. The SCM is contracted by turning the head either left or right. In this study, we used sustained sinusoidal bone conducted stimuli. Using this new stimulus method allowed us to look at the possibility of a sustained cVEMP response, compared to the typically recorded transient response, as well as analyze the amplitude and signal-to-noise ratio (SNR) of the responses. …

The Application Of Time-Frequency Analysis To Ocular Vestibular Evoked Myogenic Potentials, Hannah R. Richardson

Dissertations, 2020-current

Ocular vestibular evoked myogenic potentials (oVEMPs) are produced by highly synchronous bursts of extraocular muscle activity in response to bone or air-conducted stimuli. Surface electromyography (EMG) electrodes can be used to record these responses which reflect utricular function. The traditional analysis of oVEMPs has been limited to time-domain waveform measurements, such as amplitude and latency of response peaks.

Recently, a method grounded in synchrony-based time-frequency analysis was successfully applied to cervical vestibular evoked myogenic potentials (cVEMPs) by Clinard et al. (2022). This approach to VEMP analysis can be used as a means to differentiate synchrony from amplitude, quantifying how phase …

Are Hearing Aids Designed For All Parts Of The World? An Ecological Momentary Assessment Study, Preeti Pandey

Dissertations, 2020-current

The affordability of hearing aids (HA) is a significant barrier to ownership in low-and middle-income countries (WHO, 2021). Crowded living conditions in developing countries intensify the complexity of listening environments compared to developed nations. No existing literature compares the listening environment and HA outcomes using real-world measures across these regions. This study aims to 1) compare HA outcomes and listening environments between India and the USA, and 2) evaluate the benefit of premium HAs over basic HAs in both locations. In an observational, multi-location, single-blinded study, nineteen hearing aid users (mean age 69.6 years) participated. Ecological momentary assessments (EMA) were …

Bridging The Gap Between Clinical Practice And Evidence For Hyolaryngeal Excursion Assessment During A Clinical Swallow Evaluation, Kelsey Murray

Dissertations, 2020-current

This study investigated current practices of subjective hyolaryngeal excursion (sHLE) assessment during a clinical swallow evaluation (CSE) among speech-language pathologists (SLPs) using a survey-based approach. A sample of 77 SLPs in the United States completed an online survey rating their perceived importance and practice of sHLE assessment during a CSE. Additionally, the survey inquired about inferred interpretations from assessing sHLE. Results indicated a strong positive correlation between the rated importance of sHLE assessment and the reported frequency with which it is completed, r_s(46) = .720, p < .001. However, the findings also suggested that some SLPs are not assessing sHLE during a CSE. This offers valuable insight into the prevailing practices of HLE assessment among SLPs, considering the limited evidence for HLE assessment and interpretation. Interpretation and generalizations of the findings is limited due to the small sample size. Findings, however, do support the need for future research investigating the validity of sHLE assessment performed during a CSE, with the aim of providing evidence to guide clinical best practices.

Keywords: hyolaryngeal excursion, speech-language pathologist, clinical swallow evaluation, dysphagia, palpation

Abstract …

Exploring Counseling Self-Efficacy Development Among Graduate Speech-Language Pathology Students, Rebecca Jones

Dissertations, 2020-current

Two thematically linked studies are contained within this dissertation document, completed in partial fulfillment of the degree requirements for the Doctor of Philosophy, per the Communication Sciences and Disorders Ph.D. handbook, and in agreement with an advisory committee. These projects serve to advance the scholarship of teaching and learning in the areas of counseling skill development and therapeutic alliance building. The first study deals with the impact of a university-based caregiver coaching program on SLP graduate students' counseling self-efficacy (CSE) and their perceptions of therapeutic alliances with infant caregivers. A mixed-methods approach was employed utilizing reflexive thematic analysis (RTA) and …

The Effect Of Dance Training On The Vor During The Video Head Impulse Test, Miranda Scalzo

Dissertations, 2020-current

The vestibulo-ocular reflex (VOR) is essential to maintain clear vision during head movements and can be assessed through the head impulse paradigm (HIMP). The suppression head impulse paradigm (SHIMP) is used to quantify the ability to suppress the VOR. MacDougall et. al. (2016) demonstrated that SHIMP gain is decreased compared to HIMP gain values in healthy adults. Previous research has supported the idea that vestibular trained athletes, such as dancers, have an enhanced capability of suppressing the VOR than those without vestibular training. The objective of this study was to assess VOR suppression capabilities at increased velocities, similar to what …

“Neur-Aud-Diversity”: Young Adults With Adhd Are More Impulsive And Can Be Accurately Selected From Their Neurotypical Peers Using False Alarm Rates In Masked And Unmasked Auditory Tasks, Katelyn Hobbs

Dissertations, 2020-current

Objective diagnostic measures are desired for those with ADHD (attention deficit/hyperactivity disorder) to overcome current subjective measures. Listeners with ADHD are more impulsive than their neurotypical peers (those without a neurological disorder). Greater impulsivity can lead to lower thresholds on an informational masking task. It was hypothesized that people with ADHD would have lower thresholds on an informational masking task, however, no significant difference was found between the groups’ thresholds (t ₄₀=.49, p=.62, Cohen d=.16). A significant difference was found when comparing the initial false alarm rates from the long testing period with the final false alarm rates (p=.035, …

Assessing Trends In Cochlear Implant Recipients' Quality Of Life Score Over Time, Rebecca Civil

Dissertations, 2020-current

This study investigates changes in subjective health-related quality of life (HRQoL) among cochlear implant (CI) recipients over extended periods post-implantation. While existing literature primarily focuses on the initial or short-term improvements in QoL post-implantation compared to pre-implantation, this study looks into the stability and potential decline of QoL over time. Although the literature provides limited evidence on longitudinal trends in QoL among CI recipients over extended periods exceeding 12 months post-implantation, that limited evidence suggests a trend of decline in QoL scores, even as objective audiological measures tend to stay consistently high in the same population. Utilizing data from 25 …

The Effect Of Listening Level On Listening Effort: A Pupillometry Study, Noelle Elizabeth Steele

Dissertations, 2020-current

Listening in adverse conditions such as in the presence of background noise or at a low intensity level can require additional listening effort. While the relationship between signal to noise ratio and listening effort has been reported previously, there is a gap in the literature on the effect of listening at different levels on listening effort. In the present study, five young, normal-hearing listeners were tested for speech understanding at two presentation levels (35 dB and 65 dB) under three signal to noise ratio conditions (0, -3, and -6 dB). Peak pupil dilation was measured using a Tobii T60 XL …

Magnitude Estimations Of Angular Motion: Test-Retest Reliability, Elizabeth C. Pahygiannis

Dissertations, 2020-current

Dizziness and imbalance are one of the most common complaints of people 65 years and older, as it affects 20-30% of this population and puts one at a higher risk of falling (Iwasaki & Yamasoba, 2015). Vestibular impairments are identified through measures of vestibular reflexes such as the VOR. However, the extent of impairment observed through the VOR may not correlate with the patient’s perceptions of their symptoms (Kobel et al., 2021).A large portion of patients with vestibular symptoms cannot be diagnosed with the testing that is currently available (Agrawal et al., 2009). Magnitude estimation is a psychophysics technique used …

Assessing The Effects Of Emg Target Levels On Cvemp Thresholds, Melanie Johnson

Dissertations, 2020-current

Cervical vestibular evoked myogenic potentials (cVEMP) measure function of the saccule and inferior vestibular nerve by evoking inhibitory electromyogram (EMG) responses from the sternocleidomastoid muscle using short duration stimulation. Previous research has shown that cVEMP amplitude increases relative to EMG target level and latency remains constant, yet there is little to no research demonstrating the relationship between EMG target level and cVEMP threshold. The objective of this study is to determine the effects of EMG activation on cVEMP thresholds and assess whether patients who generate larger tonic EMG during cVEMP testing have lower cVEMP thresholds. cVEMPs were recorded in 20 …

“Neur-Aud-Diversity”: Assessing Adhd Through Speech-On-Speech Masking, Rebecca Hales

Dissertations, 2020-current

Attention deficit hyperactivity disorder (ADHD) is an executive functioning disorder which can be difficult to diagnose. The current diagnosis process relies on observations and subjective reports, resulting in individuals being misdiagnosed or have delays in receiving a proper diagnosis. Differences in auditory processing have been observed between neurotypical (NT) and ADHD individuals via neurophysiological measures, so this study aims to see if those differences can be translated into objectively measurable differences in more cost-effective behavioral measures.

While seated in front of an array of speakers, NT and ADHD participants were asked to listen for verbal directions to complete a task …

The Directional Effect Of Target Position On Spatial Selective Auditory Attention, Heesung Park

Dissertations, 2020-current

Spatial selective auditory attention plays a crucial role in listening in a mixture of competing speech sounds. Previous neuroimaging studies have reported alpha band neural activity modulated by auditory attention, along with the alpha lateralization corresponding to attentional focus. A greater cortical representation of the attended speech envelope compared to the ignored speech envelope was also found, a phenomenon known as 'neural speech tracking’. However, little is known about the neural activities when attentional focus is directed on speech sounds from behind the listener, even though understanding speech from behind is a common and essential aspect of daily life. The …

Reality Of Counseling In Pediatric Audiology Clinical Practice, Lara Leggio

Dissertations, 2020-current

The overwhelming nature of hearing loss identification often causes families to experience grief and confusion. Children as young as nine months old with severe hearing loss have the option to undergo cochlear implantation (CI) surgery with the hopes of restoring normal hearing. Pediatric audiologists accompany families through the identification of hearing loss and the learning process that coincides with this surgery. Despite knowledge that parents of children with communication disabilities will experience a sense of loss and have moderate to severe cyclic emotional reactions, little is known about how audiologists manage the emotional needs of families, if they feel prepared …

Assessing Word Recognition In Infants With A History Of Chronic Otitis Media, Sarah Wright

Dissertations, 2020-current

Otitis media (OM) is a common ear-related disorder diagnosed in children that can cause a temporary conductive hearing loss. The fluctuating hearing loss may alter auditory processing which may interfere with language development while impacting quality of life for infants and their caregivers (Homøe et al., 2019). In several languages, eleven-month-old infants have shown a preference for familiar words over unfamiliar words using the head-turn preference paradigm. This study examines the effect of chronic OM on the preference for familiar or unfamiliar words in eleven-month-old infants. Fourteen eleven-month-old infants (mean age 344 days) with three or more diagnosed ear infections …

The Effect Of Microglial Cell Dysfunction On Multi-Modal Pre-Pulse Inhibition, Michelle Besser

Dissertations, 2020-current

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication, restricted behaviors, and executive functioning deficits. Mutations in fractalkine signaling, particularly in CX3CR1, in the brain have been linked to ASD and other neurodevelopmental disorders. This investigation examined wild-type mice and mice with one or two copies of mutated CX3CR1 and their uni-modal (auditory and somatosensory) and multi-modal (combined) pre-pulse inhibitions (PPI). PPI is an unconditioned response – a decrement in the acoustic startle reflex when the mouse detects a non-startling stimulus presented a few hundred ms before the startling sound. In this study, the …

Impact Of Diabetes Mellitus On Vestibular Function: A Scoping Review, Ellen M. Jones

Dissertations, 2020-current

Diabetes mellitus (DM) encompasses a group of metabolic diseases that result in high blood sugar (i.e., hyperglycemia). By 2030, it is anticipated that 578 million adults worldwide will have DM, with this number growing at a faster rate in developed areas of the world.^[27] If left uncontrolled, DM can cause considerable damage to several areas of the body, including the heart, kidneys, nerves, and ears. When focusing exclusively on the ears, there has been markedly less research on the vestibular system when compared to the auditory system, even though DM is a known risk factor for falling. The purpose …

Magnitude Estimates Of Angular Motion: Perception Of Speed And Spatial Orientation Across Visual And Vestibular Modalities, Erin Hernon

Dissertations, 2020-current

Both the vestibular system and optokinetic system generate conjugate eye movements in response to either movement of the head or movement of the visual surround. Both systems help to maintain gaze stability. While the VOR is most sensitive to input frequencies above .2 Hz, the optokinetic system helps maintain gaze stability at lower frequencies. Previous research on perceptual thresholds across the two sensory modalities shows that there are frequency-dependent differences between vestibular and visual perception. The purpose of this study is to extend previous vestibular psychophysics work by 1) comparing magnitude estimates from vestibular stimulation to visual stimulation across multiple …

Age-Related Decline In Neural Synchrony And The Ffr, Haley Szabo

Dissertations, 2020-current

It is a known phenomenon that speech understanding in background noise declines with advancing age. Although there is ample evidence of behavioral measures declining with age, there is less physiologic evidence. This study hypothesizes that the FFR will be degraded with advancing age, consistent with poorer phase locking. This is hypothesized to be present even in people with audiograms within normal limits. A second hypothesis is that middle-aged adults will have degraded neural representation as frequency increases, compared to a younger normal hearing group which will have better high frequency neural representation than the middle-aged group. Subjects were divided into …

Role Of Emg Monitoring On Cvemp Testing In Preschool Age Children, Brenna Murray

Dissertations, 2020-current

While cervical vestibular evoked myogenic potential (cVEMP) testing has largely been studied and practiced on the adult population, less is known about the best practices for performing cVEMPs on a pediatric population, especially in young children under the age of 5 years. Further, very young children (i.e., 2-3 years) often prefer to sit with their caregiver during the testing, yet there is very little data on how much electromyographic (EMG) activity a child generates if in a seated position as opposed to a supine position. The purpose of this study was to assess the role of EMG on cVEMP recordings …

The Relationship Between Quality Of Life Outcomes And Social Hearing For Cochlear Implant Recipients Using The Nciq And Pipsl, Bonnie A. Purtill

Dissertations, 2020-current

Unmanaged hearing loss can have profound cognitive, social, and emotional impacts on a person’s life. Cochlear implants improve functional skills such as auditory detection and speech discrimination, and have also been shown to improve quality of life. Health related quality of life (HRQoL) measures are a great tool to assess mental, physical, and social changes after cochlear implantation. While previous research has established improvement in HRQoL after cochlear implantation, there remains a lack of research evaluating long-term effects of cochlear implants for post-lingually and bilaterally deafened adults. Using a disease specific HRQoL questionnaire—Nijmegen Cochlear Implant Questionnaire (NCIQ) and a social …