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

Communication Sciences and Disorders Faculty Articles and Research

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 …

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

Faculty Publications

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 …

Comprehensive, Multidisciplinary Care For Fragile X-Associated Tremor/Ataxia Syndrome, James A. Bourgeois, Andrea Schneider, Jessica Klusek Ph.D., Ccc-Slp, Thomas R. Christensen, Ellie Levin, Kendall Gardner, Ariel A. Jacobi, Randy J. Hagerman

Faculty Publications

Objective: 

The authors reviewed the pathophysiology, clinical genetics, phenotype, and comprehensive clinical management of Fragile X-associated Tremor/Ataxia Syndrome (FXTAS), a neurodegenerative disorder affecting FMR1 premutation carriers (55–200 CCG repeats).

Participants: 

A multispecialty and multidisciplinary team of authors with backgrounds in psychiatry, pediatrics, clinical psychology, speech and language pathology, and neurosciences.

Evidence: 

Review of English language sources on the clinical phenomenology, genetics, pathophysiology, and clinical management of FXTAS from 2001 (the original report) through 2025, with emphasis on the general medical, psychiatric, and neurological features of FXTAS and its multispecialty and multidisciplinary clinical management.

Consensus process:

All authors contributed to the …

Remote Language Assessment In School-Age Children With Phelan–Mcdermid Syndrome And Genotype–Phenotype Correlation, Sarah Quadri-Valverde, Jessica Klusek Ph.D., Ccc-Slp, Linda D. Ward, Diana Ivankovic, Nancy Powers, Vijay Shankar, Rachel A. Lyman, Trudy F.C. Mackay, William Bridges, Katy Phelan, Chris Rogers, Luigi Boccuto, Sara M. Sarasua

Faculty Publications

People with Phelan–McDermid syndrome (PMS) have reduced speech and language abilities, yet little research has profiled the communication abilities in this population. The purpose of this study was threefold: identifying the language and communication profiles of school-aged children with PMS, identifying genetic contributions to language and communication abilities, and determining the feasibility of remote data collection for research purposes. A speech language pathologist used standardized assessments and direct evaluations by video conferencing to evaluate language and communication abilities. Sixteen children and adolescents were evaluated: 5 with SHANK3 pathogenic variants, 9 with 22q13 deletions including SHANK3 (PMS-SHANK3 related), and 2 …

Assessing Misidentification Potential When Using Percent Developmental Delay As An Early Intervention Eligibility Criterion, Allison Gladfelter, Sarah Thomas, Christine Nguyen, Sarah O'Connor

CISLL Publications

Purpose:

Method:

Revisiting A Service-Learning Component In Aac Coursework: Design, Logistics, And Practical Challenges, Juhi Kidwai, Mohammad Al Rjoob, Maria Claudia Franca, Valerie E. Boyer

Teaching and Learning in Communication Sciences & Disorders

This scholarly teaching manuscript describes the design, implementation, and challenges of integrating a service-learning component into a graduate-level augmentative and alternative communication (AAC) course within a Communication Disorders and Sciences (CDS) program. The project sought to bridge academic instruction with real-world application while addressing unmet service needs in local schools. The 16-week course was divided into an eight-week didactic phase followed by an eight-week field-based practicum. Graduate students were paired with school-based speech-language pathologists (SLPs) in a rural, midwestern special education cooperative district, to support children using AAC. Implementation included a pre-semester needs assessment, collaborative student–SLP matching, structured orientation, weekly …

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 Through Disruption: Trauma-Informed, Community-Engaged Learning In A Graduate Csd Course, Teresa L. Boggs

Teaching and Learning in Communication Sciences & Disorders

This article explores how a graduate course in communication sciences and disorders (CSD) was rapidly redesigned in response to a natural disaster to integrate trauma-informed and community-engaged learning. Following Hurricane Helene’s impact on Appalachian communities, a standard literature review assignment was transformed into a collaborative project where students created low-cost, developmentally appropriate language-learning kits for young children affected by the storm. Grounded in adult learning theory, trauma-responsive pedagogy, and high-impact educational practices, the revised course structure enabled students to apply clinical knowledge in real time while supporting families in crisis. Outcomes included increased student engagement, empathy, and professional competency. The …

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 …

A Multi-State Look Into Early Intervention Speech-Language Pathologists’ Confidence Identifying And Diagnosing Autism, Allison Gladfelter, Adelaide Parr, Anna Cannone, Sarah O'Connor

CISLL Publications

Purpose: Although autism can be reliably diagnosed by 18 months of age, long wait times and limited access to qualified providers prevent families from obtaining timely diagnostic services. Trained speech-language pathologists (SLPs) are qualified to diagnose autism, ideally as part of a multidisciplinary team. SLPs working on early intervention (EI) teams are well-situated to help close this diagnostic wait time gap. The purpose of this survey study was to explore EI SLPs’ experiences serving autistic children, confidence in identifying and diagnosing autism, and their perceptions of barriers or facilitators to diagnostic confidence and wait times.

Method: 287 EI SLPs from …

A Review Of Interaction Between Sleep Apnea And Apoe E4 On The Risk Of Dementia, Xiuhua Ding, Carol Watwood, Amit Patel, Krupa Hegde, Brooke Mahanna, Lindsey Escudero, Jean Neils-Strunjas Ph.D, Ccc-Slp

Faculty Publications

Dementia has a significant impact on individuals, families, communities, and the economy. Alzheimer’s disease (AD) accounts for 60–80% of dementia cases. The APOE e4 allele is well known as the primary genetic risk factor for AD and dementia. Studies have also shown that sleep apnea increases the risk of dementia. Some research further suggests a possible interaction between sleep apnea and the APOE in dementia development; however, this relationship remains unclear. The purpose of this study is to synthesize evidence from the existing literature and report findings on the relationship between APOE, sleep apnea, and dementia. A systematic search of …

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 …

Policy Considerations For Universal Congenital Cytomegalovirus Screening In Colorado: Insights From Minnesota’S Model, Elizabeth Wood

Doctoral Scholarly Projects & Capstones

Congenital cytomegalovirus (cCMV) is the most common congenital infection in developed countries and a leading non-genetic cause of sensorineural hearing loss (SNHL) and neurodevelopmental impairment in children. Despite its significant public health impact, newborn screening policies for cCMV remain inconsistent across the United States. Recent policy developments, including Minnesota’s implementation of universal newborn cCMV screening (2023) and Colorado’s adoption of an expanded-targeted screening approach (2025), have intensified discussion regarding optimal strategies for early detection and intervention. This narrative review synthesizes current evidence on the epidemiology, clinical manifestations, diagnostic methods, treatment options, and long-term outcomes of cCMV, with a particular focus …

Association Between Tinnitus And Angina Pectoris In U.S. Adults: Evidence From Nhanes 2009–2018, Mitra Britton, Ishan Sunilkumar Bhatt

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Background/Objectives: Tinnitus has been increasingly associated with cardiovascular disease, and recent phenome-wide analyses have identified angina pectoris as a condition linked to tinnitus. This study aimed to replicate and quantify the association between tinnitus and angina pectoris in a nationally representative U.S. adult sample using NHANES, while adjusting for key demographic, cardiovascular, and tinnitus-related risk factors. Methods: Using data from four NHANES cycles 2009–2018, a cross-sectional analysis was conducted, which included 9185 participants, and used multivariate logistic regression analyses to investigate the association between tinnitus and angina pectoris. Results: Among 9185 adults, angina was associated with higher odds of tinnitus …

Evaluation Of The Consistency Of A Speech Verification System With Human Raters In Early Literacy Screening Assessments, Yaacov Petscher, Jennifer O'Sullivan, Hugh W. Catts, Ashley Edwards, Lisa Fitton Ph.D., Ccc-Slp

Faculty Publications

This study investigates the use of a speech verification system (SVS) technology, a form of automatic speech recognition (ASR), in the assessment of children's reading skills. Despite the growing integration of ASR systems in educational assessment, significant challenges persist, particularly due to the acoustic, pronunciation and dialectal variability inherent in children's speech. Our research evaluated the consistency between human rater (HR) and speech verification system (SVS) scores produced from SoapBox Labs across three linguistic tasks—phoneme blending, expressive vocabulary and word reading. Results reveal variability in agreement rates, with SVS showing lower consistency with human raters in phonologically complex tasks like …

Evaluation Of The Consistency Of A Speech Verification System With Human Raters In Early Literacy Screening Assessments, Yaacov Petscher, Jennifer O'Sullivan, Hugh W. Catts, Ashley Edwards, Lisa Fitton Ph.D., Ccc-Slp

Faculty Publications

This study investigates the use of a speech verification system (SVS) technology, a form of automatic speech recognition (ASR), in the assessment of children's reading skills. Despite the growing integration of ASR systems in educational assessment, significant challenges persist, particularly due to the acoustic, pronunciation and dialectal variability inherent in children's speech. Our research evaluated the consistency between human rater (HR) and speech verification system (SVS) scores produced from SoapBox Labs across three linguistic tasks—phoneme blending, expressive vocabulary and word reading. Results reveal variability in agreement rates, with SVS showing lower consistency with human raters in phonologically complex tasks like …

Collaborative Learning In Clinical Education As A Catalyst To Support Foundational Professional Competencies In Speech-Language Pathology: A Theoretical Framework, Lori-Ann Ferraro

Teaching and Learning in Communication Sciences & Disorders

As a part of every speech-language pathology graduate program in the US, clinical education is an integral and required element for both academic accreditation and the eventual clinical certification for students. Clinical education is significantly important when considering overall educational models because it is an aspect of a student’s education that contributes to their ability to make connections between what is learned in the classroom and its real-world clinical application while contributing to the acquisition of competencies. The 2:1 collaborative learning model is supported by sound learning theories and evidence from the literature. A theoretical framework was created to demonstrate …

Developing Critical Thinking Skills In Undergraduate Csd Students Through A Case Study Project, Lydia R. Kruse, Windi Krok

Teaching and Learning in Communication Sciences & Disorders

Critical thinking skills are crucial for Speech-Language Pathologists to effectively assess, diagnose, and treat communication disorders. However, the optimal timing for teaching these skills to future clinicians remains an open question. Most of the current research is focused on developing critical thinking skills in graduate students, though there is some evidence to suggest that students should be working to develop critical thinking skills during their undergraduate education. This work describes the critical thinking skills demonstrated by undergraduate students in a Communication Sciences and Disorders (CSD program) through a case study project, as well as their self-perceptions. Results indicate relative weakness …

Development And Impact Of A Review Course For The Praxis Examination In Speech- Language Pathology, Miriam Baigorri, George Pagano

Teaching and Learning in Communication Sciences & Disorders

Abstract

The Praxis II: Subject Assessment in Speech-Language Pathology is a required national examination for certification and licensure in the United States. However, disparities in pass rates, particularly among culturally and linguistically diverse (CLD) test takers, create barriers to professional entry. This study examines students' perceptions of the effectiveness of an Examination Preparation Course, designed to enhance student success through structured content review, practice exams, and test-taking strategies. A total of 70 graduates (2018–2023) who completed the course participated in an online survey assessing their demographics, perceptions of the course’s effectiveness, and confidence levels before and after taking the course. …

Behavioral Personal Protective Equipment And Staff Safety: A Pilot Study Evaluating Its Impact Among Speech-Language Pathologists, Jennifer J. Bekins

Pacific Journal of Health

This retrospective, exploratory pilot study investigated the preliminary effects of a behavioral safety readiness protocol on speech-language pathologist (SLP) physical safety during outpatient care delivered at neurodevelopmental clinics within a single medical center. During the intervention phase, SLPs voluntarily wore Kevlar sleeves during all patient care interactions, tied long hair back, and maintained accessibility of nitrile gloves for use during behavioral escalations. The behavioral safety readiness protocol was reinforced by the safety slogan, “Sleeves On, Hair Back, Gloves in Pocket.” Safety event data from May – June 2023 and 2024 (pre-intervention periods) were compared with data from May – June …

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 …

Syllabus Design And Clinical Competency: A Review Of Dysphagia Training Graduate Speech-Language Pathology Programs Across North Carolina, R. Jordan Hazelwood, Kasey M. Clift, Paige H. Bradford

Appalachian Student Healthcare Research Review

Background

Despite the critical role of dysphagia management in speech-language pathology education, limited research has examined how graduate-level curriculum design and learning experiences influence clinical preparedness and competency development. The purpose of this study is to examine the relationships between instructor characteristics, syllabus design features, and the inclusion of dysphagia management competencies in graduate speech-language pathology (SLP) dysphagia course syllabi across North Carolina (NC).

Method

Instructor information and dysphagia syllabi from all accredited graduate SLP programs across NC were collected and rated. The New Dale-Chall Readability Calculator was used to evaluate syllabus readability and content complexity. The Four Dimensions of …

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 …

Humanity Is Evolving Its Consciousness: The Role Of Archetypal Energies As Guides During An Unfolding Weeding Out And Alignment Process, Carroy U. Ferguson

Psychology Faculty Publication Series

Humanity is evolving its consciousness at individual and collective levels.  Given these seemingly tumultuous times, as of this writing (January 2026), to make such a statement may sound like a strange thing to say.  However, I suggest that if you are alive today and if you are reading these words, these are the very times for which you were born—to assist Humanity as it evolves its consciousness with your unique gifts, whatever they may be.  That is, this period of our individual and collective human being-ness may be characterized as an unfolding period of weeding out and alignment with the …

The Impact Of Bilingual Home Literacy Practices On The Emergent Literacy Skills Of Hispanic Youth, Sophie Watkins Roberts

Student Theses and Dissertations

This study examined the impact of bilingual home literacy environments (HLEs) on the emergent literacy skills of Hispanic children enrolled in an after-school program in Jonesboro, Arkansas. Thirteen Spanish–English bilingual children in kindergarten through third grade and their parents participated. Parent-reported data were collected using an adapted Spanish–English Reading Questionnaire (SER-Q), and children’s literacy skills were assessed with the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) and the Spanish Reading Inventory–Second Edition (SRI-2). Descriptive and correlational analyses explored within- and cross-language relationships between HLE practices and early reading performance. Results indicated that even modest access to books and daily …

Communication Disorders Graduate Student: Perspective Of Voice, Maycie Brentney Terrell / Blankenship

Student Theses and Dissertations

This study examined the influence of training in SPEAK OUT!® on the perceptual ratings of voice and speech made by communication disorders (CD) graduate students. The purpose of this study was to investigate the influence of SPEAK OUT!® training by comparing those who have undergone SPEAK OUT!® training with those who have not. To address this, 36 participants who attend communication disorders graduate programs within the United States were recruited. Data were collected through a Qualtrics survey distributed via email and analyzed using the Statistical Package for the Social Sciences (SPSS). The findings indicate that perceptual ratings across most voice …

Band Directors: Risk Factors For Vocal Dysphonia, Brianna Bumpous

Student Theses and Dissertations

The voice is an extensively utilized tool for high school marching band directors, which places them at risk for vocal disorders due to the profession's demands. Responsibilities such as leading rehearsals, teaching instrumental techniques, and directing require extensive vocal use in acoustically challenging environments, including football fields, large open indoor practice areas, and loud acoustic spaces. Research exists regarding vocal health for teachers, coaches, and musicians, yet little research has been conducted for high school marching band directors. This non-experimental exploratory study aimed to analyze if high school marching band directors experience dysphonia due to their occupation and if female …