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2017

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Articles 181 - 210 of 260

Full-Text Articles in Communication Sciences and Disorders

Speech-Language Pathology Graduate Students' Perceptions Of Cultural Competency Experiences, Ragen Elizabeth Bray Jan 2017

Speech-Language Pathology Graduate Students' Perceptions Of Cultural Competency Experiences, Ragen Elizabeth Bray

Student Theses and Dissertations

This study utilized a 19-item survey to investigate whether graduate SLP students understand the spectrum of skills necessary to become “culturally competent,” and to assess the number and types of formal and informal activities used to achieve cultural competency instruction in the speech-language pathology curriculum. Graduate students enrolled in five accredited graduate programs for Communication Disorders in the state of Arkansas responded to the survey. Overall, results indicated that accredited university speech-language pathology programs in Arkansas are attempting to implement opportunities for expanding cultural awareness and sensitivity for their students. However, the results from the survey indicate that these programs …


Perceptions Of Nonclinical Competencies As An Organizational Response: Exploring The Influence Of Institutional. Task Environments, Organizational Factors And Interorganizational Relationships On Educators' And Employers' Perceptions Of Nonclinical Competencies In Newly Graduated Speech Pathologists, Paula H. Boaz Jan 2017

Perceptions Of Nonclinical Competencies As An Organizational Response: Exploring The Influence Of Institutional. Task Environments, Organizational Factors And Interorganizational Relationships On Educators' And Employers' Perceptions Of Nonclinical Competencies In Newly Graduated Speech Pathologists, Paula H. Boaz

Theses and Dissertations

The qualitative comparative case study had as its purpose to explore perceptions of nonclinical competencies as viewed through the lens of organizational theroy, vis-a-vis the perceptions of educators and employers and the environmental pressures placed on them through institutional and task environments, by organizational factors, and through interorganizational relationships. Knowledge and abilitites which are not clinical in nature, yet are essential in professional postitons, are termed nonclinical competencies. The literature on organizational theory and nonclinical competency in speech pathology was reviewed. A conceptual framework was developed from reviews of the related literature and was used as a guide to the …


The Influence Of Literacy Intervention On Mathematics Performance, Twana R. Watkins Jan 2017

The Influence Of Literacy Intervention On Mathematics Performance, Twana R. Watkins

Student Theses and Dissertations

The purpose of this study was to investigate whether participation in an after-school literacy program utilizing the Barton Reading & Spelling System® (BRSS; Barton, 2000; Barton, 2002) would significantly affect mathematics skills as measured by total mathematics scores on a state-mandated testing assessment. The study consisted of 38 age- and gender-balanced participants categorized into an experimental or control group based on participation in the after-school program. Independent samples t tests and a paired samples t test were used to analyze test score differences for the first (Year 1) and second (Year 2) testing opportunities after exposure to the BRSS program. …


Evidence-Based Multifactorial Assessment Of Preschool-Age Children Who Stutter., Victoria Tumanova, Chagit E. Clark, Dahye Choi Jan 2017

Evidence-Based Multifactorial Assessment Of Preschool-Age Children Who Stutter., Victoria Tumanova, Chagit E. Clark, Dahye Choi

Communication Sciences and Disorders - All Scholarship

This review summarizes extant findings supporting multifactorial models of stuttering within the context of preschool-age stuttering assessment. Evidence is given for a number of speech-language and associated factors/domains to consider when evaluating young children who stutter. Selected factors are presented in two parts: (1) Caregiver Interview and (2) Direct Child Assessment. Factors addressed during caregiver interviews include: gender, time since and age at stuttering onset, family history of stuttering, caregivers’ perception/concerns about stuttering, and temperament. Factors addressed during direct child assessments include: stuttering behaviors, speech-associated attitudes/awareness, speech rate, as well as speech sound and language development. Interactions/relations among factors are …


Combined Aphasia And Apraxia Of Speech Treatment (Caast): Systematic Replications In The Development Of A Novel Treatment, Julie L. Wambaugh, Sandra Wright, Shannon C. Mauszycki, Christina Nessler, Dallin Bailey Jan 2017

Combined Aphasia And Apraxia Of Speech Treatment (Caast): Systematic Replications In The Development Of A Novel Treatment, Julie L. Wambaugh, Sandra Wright, Shannon C. Mauszycki, Christina Nessler, Dallin Bailey

Faculty Publications

Purpose: The purpose of this investigation was to examine the effects of a modified version of a newly developed therapy for aphasia and acquired apraxia of speech (AOS), Combined Aphasia and Apraxia of Speech Treatment (CAAST).

Method: Four speakers with chronic AOS and aphasia received CAAST in the context of multiple baseline designs. Dependent variables included language measures (i.e. production of correct information units (CIUs)) and speech production measures (i.e. speech intelligibility and percent correct consonants (PCC) in sentence repetition).

Result: Three of the participants demonstrated improved CIU production with treated picture sets and two also demonstrated generalization to untreated …


Finding The Experts In The Crowd: Validity And Reliability Of Crowdsourced Measures Of Children’S Gradient Speech Contrasts, Daphna Harel, Elaine Hitchcock, Daniel Szeredi, José Ortiz, Tara Mcallister Byun Jan 2017

Finding The Experts In The Crowd: Validity And Reliability Of Crowdsourced Measures Of Children’S Gradient Speech Contrasts, Daphna Harel, Elaine Hitchcock, Daniel Szeredi, José Ortiz, Tara Mcallister Byun

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Perceptual ratings aggregated across multiple nonexpert listeners can be used to measure covert contrast in child speech. Online crowdsourcing provides access to a large pool of raters, but for practical purposes, researchers may wish to use smaller samples. The ratings obtained from these smaller samples may not maintain the high levels of validity seen in larger samples. This study aims to measure the validity and reliability of crowdsourced continuous ratings of child speech, obtained through Visual Analog Scaling, and to identify ways to improve these measurements. We first assess overall validity and interrater reliability for measurements obtained from a large …


Knowledge And Perception Of Speech-Language Pathologists By Allied Health Personnel In The Acute Care Hospital Setting, Elizabeth E. King Jan 2017

Knowledge And Perception Of Speech-Language Pathologists By Allied Health Personnel In The Acute Care Hospital Setting, Elizabeth E. King

Merge

No abstract provided.


Sources And Content Of Popular Online Videos About Autism Spectrum Disorders, Betty Kollia, Margaret T. Kamowski-Shakibai, Corey H. Basch, Ashley Clark Jan 2017

Sources And Content Of Popular Online Videos About Autism Spectrum Disorders, Betty Kollia, Margaret T. Kamowski-Shakibai, Corey H. Basch, Ashley Clark

Communication Sciences and Disorders: Faculty Publications

Background: Our study aimed to determine source of upload and content portrayed in the 100 most-viewed videos on autism spectrum disorders (ASDs) on the video sharing public forum, YouTube. ASDs have become highly prevalent in the last decade, arousing a significant response from the media and psycho-educational health professions. Utilization of and reliance on social media for information on health matters has also proliferated. Some suggest that online videos could promote early detection (and intervention) of ASD by prompting caregivers to seek guidance. However, the usefulness of the available videos is unclear. Methods: The 100 most popular YouTube videos were …


The Ability To Critically Evaluate Research Literature In Speech-Language Pathology, David Gregorio Jan 2017

The Ability To Critically Evaluate Research Literature In Speech-Language Pathology, David Gregorio

Electronic Theses and Dissertations

Research in Speech-Language Pathology provides the basis for understanding how and to what degree therapeutic techniques and interventions affect the health and quality of life of individuals with communication disorders. Across numerous fields of healthcare, research serves just as important a function and is used to guide the practices of professionals across the public health sector. Several disciplines, including chiropracty, nursing, and physical therapy, rely on the implementation of Evidence-Based Practice (EBP) to ensure that the process of rehabilitation and the techniques employed therein are carried out though the synthesis of best clinical judgment, empirical evidence, and patient values. The …


Working Memory And Language Learning: A Review, Lisa Archibald, Lisa Archibald Jan 2017

Working Memory And Language Learning: A Review, Lisa Archibald, Lisa Archibald

Communication Sciences and Disorders Publications

Children with speech, language, and communication needs (SLCN) form a highly heterogeneous group including those with an unexplained delay in language development known as specific language impairment (SLI). There is growing recognition that multiple mechanisms underlie the range of profiles observed in these children. Broadly speaking, both the domain-general executive attentional system known as working memory and domain-specific linguistic processing have been implicated in children with SLI. It has been challenging to tease apart these influences, however, due to the symbiotic relationship between working memory and language learning. For example, working memory limits might constrain the linguistic detail encoded whereas …


Do Bilingual Speakers Shift Fundamental Frequency Based On Language Acquisition Or Language Dominance?, Nydia Abigail Mendez Jan 2017

Do Bilingual Speakers Shift Fundamental Frequency Based On Language Acquisition Or Language Dominance?, Nydia Abigail Mendez

ETD Archive

As Spanish-English bilingual speakers continue becoming a growing part of the population in the United States it is essential to investigate their acoustic measures. The purpose of this study was to investigate a possible shift in fundamental frequency (F0) measures in bilingual speakers, and it sought to determine whether that shift was based on language acquisition or language dominance. Eleven Spanish-English bilinguals were asked to complete the following tasks 1) answer the Language Experience and Proficiency Questionnaire (LEAP-Q) 2) complete 3 Spanish and 3 English category fluency trials by naming words belonging to a category (e.g. animals), each one minute …


An Ableist Society: What Does Disability Look Like?, Maricela Paramo Jan 2017

An Ableist Society: What Does Disability Look Like?, Maricela Paramo

Nebraska College Preparatory Academy: Senior Capstone Projects

One out of every five adults in the United States has a disability. That is about 63.976 million people, yet, ableism is a common type of discrimination. This paper is an attempt to create awareness of ableism and its negative effects by providing testimonies and methods that will help people with disabilities live a life without prejudice.

The United States is nowhere close to being an ableist free society and it will remain this way until people stop using ableist language as an insult or to mock someone, until mocking the disabled is not a media entertainment, until public figures …


Assessment With Children Who Need Augmentative And Alternative Communication (Aac): Clinical Decisions Of Aac Specialists, Shelley Lund, Wendy Quach, Kristy S. E. Weissling, Miechelle L. Mckelvey, Aimee R. Dietz Jan 2017

Assessment With Children Who Need Augmentative And Alternative Communication (Aac): Clinical Decisions Of Aac Specialists, Shelley Lund, Wendy Quach, Kristy S. E. Weissling, Miechelle L. Mckelvey, Aimee R. Dietz

Department of Special Education and Communication Disorders: Faculty Publications

Purpose

The purpose of this study was to explore how speech-language pathologists (SLPs) who are augmentative and alternative communication (AAC) specialists approach the assessment process for 2 case studies, 1 child with cerebral palsy and 1 with autism spectrum disorder. The aim of the study was to answer the following questions: (a) How do clinicians with expertise approach the AAC assessment process for children with developmental disabilities? (b) Can any initial hypothesis be drawn about how SLPs approach the assessment of children with motor versus social interactive deficits?

Method

This study used a phenomenological qualitative design. The researchers conducted 2 …


Effects Of Collaboration Between Speech-Language Pathologists And Third-Grade Teachers On Student Vocabulary Outcomes, Mary Mitchell Jan 2017

Effects Of Collaboration Between Speech-Language Pathologists And Third-Grade Teachers On Student Vocabulary Outcomes, Mary Mitchell

Electronic Theses and Dissertations

A persistent literacy crisis continues to be reflected in international (Organisation for Economic Co-operation and Development [OECD], 2013), national (National Center for Education Statistics [NCES], 2015), and local literacy outcome data. Educators, including speech-language pathologists (SLPs), are called upon to collaborate to support students who struggle with academic language/literacy. However, few studies have operationally defined collaboration and investigated the effects of collaboration on student achievement. As a result, there is insufficient guidance for educators about ways to design, implement, and assess the effectiveness of collaboration models, defined in terms of their effects on student outcomes. There were two main objectives …


The Psychosocial Effects Of Aphasia On The Caregiver, Lauren A. Ferrara Jan 2017

The Psychosocial Effects Of Aphasia On The Caregiver, Lauren A. Ferrara

Honors Undergraduate Theses

Studies have investigated the physical and emotional wellbeing of family members and spouses who care for persons with stroke (Bakas, et al. 2006). Literature shows burden of care is high in role reversal and depression is frequent. Variables that affect the caregiver burden with persons with aphasia (PWA) have not been identified prior to this study. Results from caregiver interviews found six themes, some which have not been identified prior, such as feelings of optimism.


The Advancement Of Voice Therapy And The Contribution Of Vocal Function Exercises, Sydney Barnett Jan 2017

The Advancement Of Voice Therapy And The Contribution Of Vocal Function Exercises, Sydney Barnett

Lewis Honors College Capstone Collection

The human voice can transmit multiple streams of information about a person including physical, emotional, and social state. Voice disorders can interfere with social relationships, work productivity, and ultimately, impair an individual’s image. Speech-language pathologists have developed several approaches to voice therapy over the past several decades. Vocal function exercises (VFE) are physiological in nature and aim to restore the balance between the three subsystems of vocal production: respiration, phonation, and resonance. With advancing technology and more sophisticated experiments, researchers have shown positive outcomes with VFE regimens in the normal voice population, superior voice population, and disordered voice population. Data …


Recovery From Diffuse Brain Injuries: Two Case Studies., Alejandro E. Brice, Roanne G. Brice Jan 2017

Recovery From Diffuse Brain Injuries: Two Case Studies., Alejandro E. Brice, Roanne G. Brice

USF St. Petersburg Campus Faculty Publications

Subarachnoid hemorrhages (SAHs) are grave medical emergencies, whereas 30–50% of all SAHs may ultimately result in death. Subarachnoid hemorrhages share many resemblances with other neurological traumas such as a cerebral vascular accident, meningitis, and/or traumatic brain injury. Autoimmune encephalopathies (AE) occur when human antibodies assault the body’s cell surfaces and/or synaptic proteins. Consequently, widespread nervous system and diffuse brain involvement may occur. With subarachnoid hemorrhages and autoimmune encephalopathies, multiple areas of cognition and language can be impaired. Case studies in communication sciences and disorders are underutilized, yet are important in evidenced‐based practice. Speech-language pathologists in medical settings have worked with …


The Effect Of Road Noise On Sound Pressure Levels And Preferred Listening Levels Using Personal Listening Devices, Hayley Himstedt Jan 2017

The Effect Of Road Noise On Sound Pressure Levels And Preferred Listening Levels Using Personal Listening Devices, Hayley Himstedt

Doctoral Dissertations

Using a PLD in an automobile introduces unique threats such as volume levels set at higher levels to reduce the masking effects of road noise that enters the automobile. Passengers enjoying prolonged PLD exposure may be at an increased risk of noise exposure or fluctuating sound pressure levels resulting in hearing loss. Historically, hazardous noise has been primarily associated with industrial/occupational activities; however, harmful noise from recreational activities is also prevalent. The Center for Disease Control (2015) lists turning down PLD volume as one of their top three methods for reducing the possibility of NIHL in children. Excessive listening level …


Executive Control Mechanisms In Bilingualism: Beyond Speed Of Processing, Klara Marton, Mira Goral, Luca Campanelli, Jungmee Yoon, Loraine K. Obler Jan 2017

Executive Control Mechanisms In Bilingualism: Beyond Speed Of Processing, Klara Marton, Mira Goral, Luca Campanelli, Jungmee Yoon, Loraine K. Obler

Publications and Research

The question of interest in this study was whether bilingual individuals show superior executive control compared to monolingual participants. Findings are mixed, with studies showing advantage, disadvantage, or no difference between bilingual and monolingual speakers. In this study, we used different experimental conditions to examine implicit learning, resistance to interference, monitoring, and switching, independently. In addition, we matched our monolingual and bilingual participants on baseline response time. Bilingual participants demonstrated faster implicit learning, greater resistance to interference, more efficient switching compared to monolingual participants. The groups did not differ in monitoring. In conclusion, depending on task complexity and on the …


Mandarin-English Bilinguals Process Lexical Tones In Newly Learned Words In Accordance With The Language Context, Carolyn Quam, Sarah C. Creel Jan 2017

Mandarin-English Bilinguals Process Lexical Tones In Newly Learned Words In Accordance With The Language Context, Carolyn Quam, Sarah C. Creel

Speech and Hearing Sciences Faculty Publications and Presentations

Previous research has mainly considered the impact of tone-language experience on ability to discriminate linguistic pitch, but proficient bilingual listening requires differential processing of sound variation in each language context. Here, we ask whether Mandarin-English bilinguals, for whom pitch indicates word distinctions in one language but not the other, can process pitch differently in a Mandarin context vs. an English context. Across three eye-tracked word-learning experiments, results indicated that tone-intonation bilinguals process tone in accordance with the language context. In Experiment 1, 51 Mandarin-English bilinguals and 26 English speakers without tone experience were taught Mandarin-compatible novel words with tones. Mandarin-English …


Developing A Revised Performance-Perceptual Test Using Quick Speech-In-Noise Test Material, Matthew Wetmore, Hua Ou Jan 2017

Developing A Revised Performance-Perceptual Test Using Quick Speech-In-Noise Test Material, Matthew Wetmore, Hua Ou

AuD Capstone Projects - Communication Sciences and Disorders

Objective: Two audiometric speech measures have been recognized to be useful to predict hearing aid use success: the Quick Speech-in-Noise (QuickSIN) test and the Performance-Perceptual Test (PPT). The PPT involves using the same speech test material (Hearing In Noise Test; HINT) twice, to evaluate patients’ objective and subjective speech recognition performance in noise and the discrepancy between the two measures (Performance-Perceptual Discrepancy; PPDIS). Utilizing the QuickSIN with the PPT (Revised-PPT) may provide a clinician with two important pieces of information from one test to help predict hearing aid use success and the need for counseling. This study aimed 1) …


Incorporating Spanish Language Instruction Into Health Sciences Programs In A Hispanic-Serving Institution, Connie Summers, Vannesa Mueller, Celia Pechak, Jeri J. Sias Jan 2017

Incorporating Spanish Language Instruction Into Health Sciences Programs In A Hispanic-Serving Institution, Connie Summers, Vannesa Mueller, Celia Pechak, Jeri J. Sias

Faculty Publications

Patient-provider language discordance is a growing problem in health care among Spanish-speaking patients. To produce graduates capable of linguistically competent care, three university programs are incorporating Spanish language instruction into their curricula (pharmacy, physical therapy, and speech-language pathology). We review these three models of Spanish language training and summarize the lessons learned to date. Differences in the training models reflect fundamental differences regarding the use of spoken language in the disciplines.


Vocal Fry Use In Adult Female Speakers Exposed To Two Languages, Todd A. Gibson, Connie Summers, Sydney Walls Jan 2017

Vocal Fry Use In Adult Female Speakers Exposed To Two Languages, Todd A. Gibson, Connie Summers, Sydney Walls

Faculty Publications

Summary: Objective. Several studies have identified the widespread use of vocal fry among American women. Popular explanations for this phenomenon appeal to sociolinguistic purposes that likely take significant time for second language users to learn. The objective of this study was to determine if mere exposure to this vocal register, as opposed to nuanced sociolinguistic motivations, might explain its widespread use. Study Design. This study used multigroup within- and between-subjects design. Methods. Fifty-eight women from one of three language background groups (functionally monolingual in English, functionally monolingual in Spanish, and Spanish-English bilinguals) living in El Paso, Texas, repeated a list …


Perceptions Of Mentoring Slps And Clinical Fellows During The Clinical Fellowship, Maria Resendiz, Connie Summers, Roxanna Ruiz-Felter, Elizabeth Belasco, Katherine Fox Jan 2017

Perceptions Of Mentoring Slps And Clinical Fellows During The Clinical Fellowship, Maria Resendiz, Connie Summers, Roxanna Ruiz-Felter, Elizabeth Belasco, Katherine Fox

Faculty Publications

The clinical fellowship (CF) is completed by speech-language pathologists (SLPs) after graduating with a master’s degree. The clinical fellow is supervised by a mentoring SLP who meets the qualifications set forth by the American Speech-Language-Hearing Association (ASHA). The current study focused on differences and similarities in expectations during the CF by the mentoring SLP and clinical fellow. Participants were asked about knowledge and skills for which clinical fellows are evaluated at the end of the CF in the areas of assessment and treatment. Clinical fellows wanted more help with assessment and less assistance with treatment. Mentoring SLPs felt assistance was …


Language Of Intervention In Bilingual Children With Autism Spectrum Disorders, Connie Summers, Vanessa Smith, Vannesa Mueller, Victoria Alexander, Amelie Muzza Jan 2017

Language Of Intervention In Bilingual Children With Autism Spectrum Disorders, Connie Summers, Vanessa Smith, Vannesa Mueller, Victoria Alexander, Amelie Muzza

Faculty Publications

Selecting the appropriate language of intervention for bilingual children with language impairment is difficult, especially for bilingual children with autism spectrum disorders (ASD) as their families are often encouraged by professionals to select one language only for communication. The limited evidence supports the use of bilingual language interventions when working with bilingual children with ASD. The current study sought to expand this limited work by presenting preliminary data of the effects of a bilingual and monolingual treatment condition on the language skills of two bilingual children with ASD (ages 3 and 5) using an alternating treatment, single-subject design. The two …


The Effects Of Stimulus Rate On Abr Morphology And Its Relationship To P1 Caep Responses And Auditory Speech Perception Outcomes In Children With Auditory Neuropathy Spectrum Disorder Evidence From Case Reports, Garrett Cardon, Rosemary J. Mcknight, Hannah Glick, Anu Sharma Jan 2017

The Effects Of Stimulus Rate On Abr Morphology And Its Relationship To P1 Caep Responses And Auditory Speech Perception Outcomes In Children With Auditory Neuropathy Spectrum Disorder Evidence From Case Reports, Garrett Cardon, Rosemary J. Mcknight, Hannah Glick, Anu Sharma

Faculty Publications

Objective: Auditory neuropathy spectrum disorder (ANSD) affects approximately 5–15% of children with sensorineural hearing loss (SNHL). ANSD is characterized by the presence of otoacoustic emissions (OAE) and an absent or abnormal auditory brainstem response (ABR). The purpose of this study was to investigate the prognostic value of slow-rate ABR in predicting the auditory cortical development and auditory speech perception outcomes in case studies of children with ANSD. Design: ABR waveform characteristics were collected at slow stimulation rates (5.1 clicks/second) and a fast stimulation rates (>11–31.1 clicks/second, rates typically used in a clinical setting) in three case reports of children …


Challenges To Augmentative And Alternative Communication Interventions With Autism Spectrum Disorder Students, Kristy Jane Singer-Macnair Jan 2017

Challenges To Augmentative And Alternative Communication Interventions With Autism Spectrum Disorder Students, Kristy Jane Singer-Macnair

Walden Dissertations and Doctoral Studies

Students with autism spectrum disorder (ASD) have challenges with communication, social interactions, and behavior, which can limit their functioning in school settings. They need to have functional communication skills to access the curriculum and have their needs met across all social environments. Special education teachers often experience barriers to successful implementation of augmentative and alternative communication (AAC) interventions appropriate for these students. The purpose of this case study was to understand how special education teachers experience AAC intervention processes, and illuminate the conditions for effective AAC implementation. A qualitative case study was conducted using interviews from 6 credentialed special education …


Graduate Bulletin, 2017-2018, Minnesota State University Moorhead Jan 2017

Graduate Bulletin, 2017-2018, Minnesota State University Moorhead

Graduate Bulletins (Catalogs)

No abstract provided.


Receptive And Expressive Single Word Vocabulary Errors Of Preschool Children With Developmental Disabilities, Juliana L. Hirn Jan 2017

Receptive And Expressive Single Word Vocabulary Errors Of Preschool Children With Developmental Disabilities, Juliana L. Hirn

Honors Undergraduate Theses

Vocabulary growth during the preschool years is critical for language development. Preschool children with developmental disabilities often have more difficulty with learning and developing language, therefore making more errors in vocabulary. It is important to recognize what type of errors children are demonstrating, especially as it relates to receptive and expressive language abilities. This study explores the error patterns preschool children with developmental disabilities make during receptive and expressive single word vocabulary tests. A secondary analysis of preexisting data was conducted from a sample of 68 preschool children with developmental disabilities ranging in severity. Based on a coding system developed …


Promotion Of Early Pediatric Hearing Detection Through Patient Navigation, Matthew L. Bush Jan 2017

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 …