Speech Pathology and Audiology Commons^™

Monitoring Spoken Language In Infants And Toddlers Who Are Deaf Or Hard Of Hearing Using The Lena Developmental Snapshot, Monika-Maria Oster, Kimberly A. Peters

Journal of Early Hearing Detection and Intervention

Purpose: This retrospective analysis evaluates the Developmental Snapshot as a language monitoring tool for infants and toddlers with bilateral hearing loss who use listening and spoken language.

Method: Data were obtained from the educational and clinical records of 147 children with bilateral hearing loss. For each child, the LENA (Language ENvironment Analysis) Developmental Snapshot, a standardized online language assessment that relies on parent report, had been completed at least once. When available, scores from other standardized language assessments (PLS-5, CDI, and DAYC-2) were also obtained.

Results: LENA Developmental Snapshot standard scores were characterized by high variability and mean scores in …

A Survey Study On Physiological Hearing Assessment Practice In The Usa, Malina Mangrum, Hasan Saleh, Sangamanatha Ankmnal Ankmnal Veeranna, Kimberly Ward, Charles G. Marx

Journal of Early Hearing Detection and Intervention

Background: In the United States, limited information exists regarding the physiological measures and testing parameters used in infant hearing assessments. To address this gap, we conducted a nationwide survey to identify the types of physiological tests and procedures currently employed by audiologists.

Method: A structured survey was distributed to audiologists across the country to gather information about the auditory tests and recording parameters used in infant hearing evaluations.

Results: Most respondents reported using Auditory Brainstem Responses (ABRs) to estimate infant hearing thresholds, primarily relying on traditional stimuli rather than chirp stimuli. The Auditory Steady-State Response (ASSR) was not widely used …

Effects Of Cross-Curricular Instruction On Clinical Education Outcomes For Speech-Language Pathology Graduate Students, Michele Dacy, Kimberly Smith

Journal on Empowering Teaching Excellence

Access the online Pressbooks version of this article here.

Cross-curricular instruction is the process of combining information from two or more subjects within a single discipline in order to help students integrate the knowledge and skills they learn from separate courses. The purpose of this study was to examine how cross-curricular instruction impacted speech-language pathology (SLP) graduate students' knowledge, confidence, and clinical skills related to the assessment of patients with co-occurring diagnoses of dementia and dysphagia. Twenty-three SLP master's students completed a questionnaire before and after receiving cross-curricular instruction on how to assess dysphagia in persons with dementia. The questionnaire …

Evidence-Based Practice In Speech-Language Pathology: Creating Effective Therapy Materials, Avalee Dunkley

Undergraduate Honors Capstone Projects

Evidence-based practice is a fairly new topic in speech-language pathology, gaining traction among professionals in the field in the last twenty years. Evidence-based practice is the integration of high-quality research, patient cultural and social values, and clinician expertise to treat a patient. Patients are more likely to progress when these three factors are combined. This paper explores four areas of speech-language pathology that are commonly treated in school-aged children: speech sound disorders, language disorders, social communication disorders, and the use of augmentative and alternative communication. Each section gives a summary of the disorder and how the disorder can be treated …

Patterns Of Acquisition For /ɹ/ Across Phonetic Contexts, Hailey Nielson

All Graduate Reports and Creative Projects, Fall 2023 to Present

Purpose: 

This study examined longitudinal changes in /ɹ/ production (i.e., the “r” sound) among 14 children aged five to seven at risk for persistent speech sound disorders (SSDs). Children at risk for SSDs show slower or atypical development of /ɹ/, yet little is known about which early patterns predict persistent difficulty, making it difficult for clinicians to prioritize caseloads and provide timely intervention. Using perceptual accuracy ratings across varied /ɹ/ contexts, we modeled growth in /ɹ/ accuracy across different word contexts and evaluated the extent to which early accuracy and changes in /ɹ/production predicted mastery at age seven.

Methods: 

Longitudinal …

Challenging Myths In Speech-Language Pathology: A Scientific Review Of Augmentative And Alternative Communication (Aac) Use, Bilingualism, And Late Talking, Mariah Morris

Undergraduate Honors Capstone Projects

Persistent myths within the field of speech-language pathology continue to influence clinical decision-making and contribute to biases experienced by both providers and clients. This scientific review examines common misconceptions surrounding late talking, bilingualism, and augmentative and alternative communication (AAC) by evaluating current evidence-based research. Specifically, this review addresses three central questions: Do children outgrow late talking? Does bilingualism cause language delay in children? Does AAC hinder speech development? 

An analysis of multiple peer-reviewed studies revealed little statistical support for the belief that bilingualism or AAC use causes language delays. Instead, research indicates that factors such as limited access to language-rich …

The Influence Of Early Detection And Intervention Providers' Actions And Communication On Parental Emotions And Early Intervention Engagement After A Child Is Diagnosed With Hearing Loss: A Scoping Review, Charlene M. Watson, D. Ellen Rick, Jillian Ingratta, Patti-Jo Sullivan, Xurong Zhao, Sheila Moodie

Journal of Early Hearing Detection and Intervention

Despite well-intentioned early hearing detection and intervention (EHDI) programs, parents receiving a newborn hearing loss diagnosis often experience distress, uncertainty, and fear, which can impact their readiness to engage in early intervention. The communication and support provided by clinicians in early hearing detection and intervention play a critical role in helping families navigate emotions, overcome barriers, and actively participate in EHDI programs. The purpose of this scoping review is to advance our knowledge of the following: For parents who have a newborn newly diagnosed with hearing loss, how do the actions/behaviors and communication (or lack thereof) of EHDI providers influence …

Fine And Gross Motor Skills Assessment, From A Caregiver's Perspective, In Children With Hearing Loss Using A Modified Ages And Stages Questionnaire (Asq-3), Steven M. Doettl, Patrick N. Plyler, Erin Plyler, Kelly R. Yeager, Leeann Hutker, Ginger Tallmadge, Aspen Gutknecht, Amy Becker

Journal of Early Hearing Detection and Intervention

Purpose: The purpose of this study was to determine if there is a significant difference on ASQ-3 (Ages and Stages Questionnaire version 3) Gross (ASQ G) and Fine (ASQ F) Motor scores between children with sensorineural hearing loss (SNHL) and children with normal hearing.

Methods: Data was gathered from the ASQ-3 as reported by parents/caregivers of 61 children (28 normal hearing children and 33 children with SNHL) ages 6-36 months. Results were averaged across the participants for both groups. Independent sample t-Tests were used to assess for any statistically significant difference in the ASQ scores between groups. Chi-square analysis …

From Policy To Practice In Deaf Education: American Sign Language And Spoken English Outcomes Of Deaf And Hard Of Hearing Children In Kansas, Jena Mcdaniel, Shreyas Teegala, Rebecca Maloney, Angie Walker, Mary S. Dietrich, Matthew L. Hall, Leah C. Geer, Julie Bustos

Journal of Early Hearing Detection and Intervention

Purpose: In the context of the recent expectation for state Early Hearing Detection and Intervention programs to track language milestones of deaf and hard of hearing (DHH) children, we examine how to leverage statewide assessment programs for improving language outcomes of DHH children. We present the degree to which DHH children in Kansas are meeting their language milestones for American Sign Language (ASL) and English and the influence of two measurement features.

Method: Performance on the ASL/English Language Milestones for 198 children who were DHH (aged 1 to 8) was analyzed for attainment of age-expected language skills and …

The Radical Middle: Caregiver Beliefs About Language Access For Deaf And Hard Of Hearing Children, Monica Zmudzinski, Krystal L. Werfel

Journal of Early Hearing Detection and Intervention

The purpose of this study was to explore the communication choices of caregivers of deaf or hard of hearing (DHH) children. Specifically, we explored what communication options caregivers were presented with, identify what factors impacted a caregiver’s decision to pursue spoken language, and identify what barriers exist to learning sign language. We conducted semi-structured interviews with 20 caregivers of DHH children who had decision making power at the time of their child’s diagnosis. Transcripts were coded using an inductive approach with triangulation between authors. Many families reported that minimal to no information was provided about communication options at the time …

Evaluating Preschoolers Who Are Deaf/Hard Of Hearing Using Listening And Spoken Language To Determine Special Education Eligibility, Kameron C. Carden, R. A. Mcwilliam

Journal of Early Hearing Detection and Intervention

The aim of this study was to increase understanding of evaluation practices used when determining special education eligibility for preschoolers who are deaf/hard of hearing (DHH) using listening and spoken language (LSL), particularly during the early intervention to preschool transition. Specifically, we explored alignment of school-based practices with recommended practices from the National Association of State Directors of Special Education (NASDSE, 2018). An online survey was distributed to school-based special educators, including speech-language pathologists (SLPs), special education teachers, and teachers of the deaf within the United States that included a) evaluation practices, b) eligibility requirements, and c) practice demographics. Participant …

The Follow-Up Gap: Racial Disproportionality And Social Determinants Of Health In New Jersey’S Hearing Detection And Intervention Program, Maryrose Mcinerney, Wendy Zeitlin

Journal of Early Hearing Detection and Intervention

Objectives. To assess how race/ethnicity and social determinants of health are related to loss to follow-up (LTF) from NJ’s Early Hearing Detection and Intervention (EHDI) program.

Methods. All infants born in NJ between June 2015 and June 2017 referring for additional hearing healthcare after hospital discharge were considered for inclusion in this study. The sample consisted of 4,141 babies, 10.7% of which received no follow-up care. Step-wise multi-level logistic regression was used to determine how race/ethnicity, family-level, and community-level social determinants of health (SDOH) were predictive of LTF.

Results. In each model, the odds of being LTF were significantly higher …

Spatial Training For Children With Suspected Auditory Processing Disorder: A Random Control Trial, Taylor Delao

Student Research Symposium

Auditory Processing Disorder (APD), defined here as a deficit in the way sounds are analyzed by the brain, has remained a controversial topic within audiology for decades.

A Novel Method For Deriving The Binaural Interaction Component And Its Association With Spatial Listening Ability In Adults, Kate M. Fisher, Marlana J. Petersen, Mindee Anderson, Annika P. Williams

Student Research Symposium

• Spatial listening helps children detect and focus on specific sounds in noisy environments.
• Classrooms require filtering relevant speech (e.g., teacher's voice) from background noise, which is challenging without strong spatial listening skills.

Recognizing Individual Variability In Misophonia: Identifying Symptom-Based Subgroups With Gaussian Mixture Modeling, Mercedes G. Woolley, Amanda M. Ramos, Emily M. Bowers, Karen Muñoz, Julie M. Petersen, Michael P. Twohig

Psychology Student Research

Misophonia is characterized by intense emotional and physiological reactions to everyday sounds such as chewing and tapping. While previous researchers have focused on defining and characterizing the disorder, limited attention has been given to the variability in symptom presentations across individuals. In this study, we sought to identify distinct subgroups of individuals with misophonia by applying a Gaussian finite mixture model to explore the heterogeneity of symptom profiles. Sixty treatment-seeking participants completed the Duke Misophonia Interview, which assessed the presence and severity of various behavioral, affective, and cognitive symptoms. Items from this measure served as model indicators. Two clusters were …

Assessment Of Auditory Conditions In Misophonia Treatment Research: A Scoping Review, Karen F. Muñoz, Doris Velasquez, Makara Humes, Diana Ortiz, Michael P. Twohig

Communicative Disorders and Deaf Education Faculty Publications

Objective: To identify treatment research that used a behavioral approach to treat misophonia as the primary focus of treatment, and the audiological testing included in the research.

Design: Scoping literature review completed in February 2023 and updated in March 2024.

Study Sample: Included studies provided a behavioral or audiological intervention for misophonia, were peer-reviewed, and published in English before February 29, 2024. Studies were excluded if a pharmacological treatment was provided, if misophonia was not the primary treatment target, or if assessment of misophonia severity was not a treatment outcome.

Results: Fifteen articles met the inclusion criteria. …

Factor Structure And Longitudinal Changes In Bilinguals’ Oral Narratives Production: Role Of Language Exposure, Language-Domain Proficiency, And Transfer, Joseph Hin Yan Lam, Molly Ann Leachman, Cecilia Del Carmen Perez, Amy S. Pratt, Elizabeth D. Peña, Lisa M. Bedore, Ronald B. Gillam

Communicative Disorders and Deaf Education Faculty Publications

This paper examined the interaction between narrative performance, language exposure, and standardized measures of morphosyntax and semantics, in bilingual children tested two times, 1 year apart. We aimed to 1) identify the factor structure of oral narrative measures, and 2) examine the direction and strength of the effects of (i) language exposure and (ii) the relationship between language domains and narrative production. A total of 143 Spanish (L1)-English (L2) bilingual children completed a battery of oral narrative and oral language proficiency assessments in Spanish and English at two time points (kindergarten and Grade 1). Factor analyses yielded an identical two-factor …

Improving Newborn Hearing Screening For Community Births: Update From The Michigan Midwives Newborn Hearing Screening Program, Shannon B. Palmer, Nan Asher, Gina Cooper

Journal of Early Hearing Detection and Intervention

Objectives. To determine the effectiveness of a hearing screening training program for midwives who attend community births.

Methods. The data for this study was obtained from the mandatory reporting data to the Michigan Early Hearing Detection and Intervention Program (MI EHDI). Data included the total births and screening rates of babies born at home or in a birthing center in Michigan in the years 2020 and 2021. There were 90 birth attendants who oversaw 2711 community births across the two study years.

Results. The results of this study found that having a midwife who possessed a hearing screening machine increased …

Supporting Entry-Level Speech-Language Pathologists Who Serve Children Who Are Deaf Or Hard-Of-Hearing In Early Intervention, Kristina Blaiser, Hannah Daw, Blair Richlin, Jenn Gallup

Journal of Early Hearing Detection and Intervention

The aim of this study was to increase understanding of what is considered key information for entry-level speech-language pathologists (SLPs) serving children who are DHH. Specifically, this study explored skills and strategies that could be integrated into SLP graduate curriculum to increase entry-level provider confidence and knowledge. An online survey was distributed to providers of the DHH within the United States and included a) key skills and strategies recommended for entry-level providers serving children who are DHH b) barriers experienced by entry-level providers and c) demographics. The skills and strategies that emerged as most important according to participants (n …

Documented Newborn Hearing Screenings In Florida Administrative Hospital Data: State Policy Compliance By Hospital Types, Teresa Anthony, Blake Barrett, Adam Brown, Jessica Ryan

Journal of Early Hearing Detection and Intervention

Purpose: Florida policy mandates newborn hearing screenings (NBHS) in hospitals. U.S. inpatient administrative hospital data reflects low rates of documented screenings. This analysis investigates inconsistencies between Florida policy and administrative records.

Method: Analysis of Florida statutory language was completed. Florida hospital administrative data was retrospectively analyzed using various statistical methods to explore differences in proportions of documented NBHS among distinct hospital types based on profit and teaching statuses.

Results: Florida mandate requires NBHS completion in the hospital prior to discharge from the birth facility or within 21 days after birth and allows for billing a third-party payer. …

Cost-Effectiveness Analysis: Automated Auditory Brainstem Response (Aabr) Diagnostic Test Compared To Transient Evoked Otoacoustic Emission Screening (Teoae) For Universal Newborn Hearing Screenings (Unhs) In High-Risk Neonates, Teresa Anthony, Troy Quast, Sarah Warren

Journal of Early Hearing Detection and Intervention

Purpose: Comorbidities and ototoxic medications increase risk of hearing loss (HL) in infants admitted to neonatal intensive care units (NICU; 6 per 1000 births) compared to well-babies (1.7 per 1000 births). For newborn hearing screening (NBHS), transient evoked otoacoustic emissions (TEOAE) testing is more efficient and less costly. Automated auditory brainstem response (aABR) testing yields higher sensitivity and specificity. This study will identify if aABR is cost-effective compared with TEOAE for NBHS in high-risk neonates.

Methodology: Cost-effectiveness analysis was conducted from a healthcare system perspective. Prevalence and outcomes data for aABR, TEOAE, and auditory brainstem response (ABR) were obtained …

Diagnostic Overshadowing: A Delayed Diagnosis Of Autism Spectrum Disorder In A Deaf Child, Quynh-Chi Dang, Michael Hoffman, Rachel St. John

Journal of Early Hearing Detection and Intervention

Diagnostic overshadowing occurs when a patient with a pre-existing diagnosis presents with symptoms that are attributed to the diagnosis, but actually reflect a separate issue. This diagnostic overshadowing can lead to delays in diagnosis, as well as disparities in health care and outcomes. The following case will provide an example in which diagnostic overshadowing contributed to the delay of an autism diagnosis in a child who is deaf. With at least 40 to 50% of children who are deaf or hard of hearing having at least one co-existing medical/developmental condition, and the current prevalence of autism at 1 in 36 …

Understanding Barriers To Timely Enrollment Of Early Intervention Services For Children Who Are Deaf And Hard Of Hearing, Krystal L. Werfel, Eddie Okosi, Brittany Grey, Cora Swindale, Emily Lund

Journal of Early Hearing Detection and Intervention

Although the Joint Committee on Infant Hearing guidelines recommend that children who are deaf and hard of hearing should begin early intervention by six months of age, prior work has revealed a substantial percentage of children who receive a diagnosis of hearing loss by three months of age but do not enroll in early intervention by six months of age (Grey et al., 2022). To further understand barriers to enrollment in early intervention for these families, we completed qualitative semi-structured interviews with 10 caregivers of children who were diagnosed with hearing loss by three months of age but did not …

A Review Of Social Media Platforms Of State Early Hearing Detection And Intervention Programs In The United States, Rohit Ravi, Karl R. White

Journal of Early Hearing Detection and Intervention

Purpose: Social media tool is increasingly used to support good health practices. Almost every Early Hearing Detection and Intervention program has a website, and it would be useful to know how they are using social media. The aim of this article was to analyse how social media is being used by Early Hearing Detection & Intervention programs in the United States, as well as how frequently.

Method: The present study analysed existing social media handles of the Early Hearing Detection and Intervention programs. The search for social media accounts & data extraction was carried out between 1st January 2022 to …

Impact Of A Narrative Language Intervention On Language, Behavior, And Self-Concept Among Bilingual Children With Developmental Language Disorder, Nancy Tarshis Ma, Ms, Ccc-Slp, Kathleen Mcgrath Mss, Lsw, Ida Barresi Ma, Ccc-Slp, Risa Battino Ms, Ccc-Slp, Bcs-F, Sarah Henderson Msed, Ms, Ccc-Slp, Shankar Viswanathan Drph, Jee-Young Moon Phd, Karen Bonuck Phd

Developmental Disabilities Network Journal

The growing research on narrative interventions is promising but has gaps regarding cultural/linguistic diversity and outcomes beyond language. We evaluated whether a structured, oral narrative intervention affects narrative language, problem behaviors, and self-concept in a diverse group of children with developmental language disorder. A 10-session intervention was implemented within routine care. Baseline and follow-up data included: (a) Narrative recordings—coded by therapists using the CUBED Narrative Language Measure, (b) Child Behavior Checklist—a parent-reported behavioral assessment, and (c) the Piers-Harris Children’s Self-Concept Scale. Among the sample’s n = 33 children, aged 6-16, 55.6% were bilingual. Post intervention, participants’ narrative language scores improved …

A Systematic Review Of The Prevalence Of Late Identified Hearing Loss In Childhood, Karen Muñoz, Dylan Chan, Donald Goldberg, Diana Ortiz, Valerie James Abbott, Karl White

Communicative Disorders and Deaf Education Faculty Publications

Objectives

The objective of this systematic review was to assess the evidence about the prevalence of permanent hearing loss for children not identified from newborn hearing screening (NHS).

Design

Articles were grouped into three categories based on the methodological approach: (1) all participants received diagnostic testing, (2) otoacoustic emission (OAE) or pure tone screening was completed and those not passing were referred for a diagnostic test, and (3) data were retrieved from archival records. Study characteristics, prevalence, and contextual factors were synthesised and narratively described.

Study Sample

30 peer-reviewed articles.

Results

Prevalence of permanent hearing loss per 1,000 children ranged …

Hearing Loss And Cognitive Decline In The Aging Population: Emerging Perspectives In Audiology, Naveen K. Nagaraj

Communicative Disorders and Deaf Education Faculty Publications

In this perspective article, the author explores the connections between hearing loss, central auditory processing, and cognitive decline, offering insights into the complex dynamics at play. Drawing upon a range of studies, the relationship between age-related central auditory processing disorders and Alzheimer’s disease is discussed, with the aim of enhancing our understanding of these interconnected conditions. Highlighting the evolving significance of audiologists in the dual management of cognitive health and hearing impairments, the author focuses on their role in identifying early signs of cognitive impairment and evaluates various cognitive screening tools used in this context. The discussion extends to adaptations …

A Retrospective Analysis Of Hearing Screening Outcomes In Infants Whose Mothers Were Covid-19 Positive During Pregnancy, Sangamanatha Ankmnal Ankmnal Veeranna, Charles G. Marx, Hwanseok Choi, Clinton White, Kimberly Ward

Journal of Early Hearing Detection and Intervention

Background: This study examined hearing screening referral rates over a three-year period, including testing performed pre-pandemic (2019) and during the first two years (2020 and 2021) of the onset of the spread of COVID-19.

Methods: This study conducted a retrospective analysis of 8,130 hearing screening referral records from 2019 – 2021, obtained from a large regional level II trauma center. These records were generated from the universal hearing screening process which utilized automated auditory brainstem response devices.

Results: There was no significant change in the number of infants screened for hearing loss and hearing screening outcomes between the pre-pandemic and …

Factors Contributing To Late Identification Of Deaf/Hard Of Hearing Children In Louisiana, Danielle D. Mercer, Tri Tran, Dawne Mccabe, Terri Ibieta, Dana Hubbard

Journal of Early Hearing Detection and Intervention

To ensure children who are Deaf/Hard of Hearing (D/HH) receive supports they need to reach their full potential, it is imperative that they be identified as early as possible. Early Hearing Detection and Intervention benchmarks stipulate children who are D/HH be enrolled in early intervention no later than 6 months of age. A major barrier to early enrollment is late identification. We reviewed records of children identified as D/HH in Louisiana after 6 months of age for 2015-2020 birth cohorts to determine factors contributing to the late identification. Cases were examined in-depth after it was determined that a diagnosis was …

Increasing Pediatric Hearing Aid Use: Considerations For Clinical Practice, Karen Muñoz, Kali Markle, Guadalupe G. San Miguel, Michael P. Twohig

Communicative Disorders and Deaf Education Faculty Publications

Purpose: Hearing aid use can be variable for young children, and inconsistent wear time can undermine spoken language development. This study explored the effectiveness of hearing aid data logging (DL) awareness and coaching sessions on increasing hours of hearing aid use. We also collected qualitative data on challenges participants experienced managing hearing aid use.

Method: We used a single-subject design that included three conditions, during a 6-week period, in the same order for each participant. Condition A was baseline, Condition B was DL monitoring alone, and Condition C was remote coaching calls plus DL monitoring.

Results: Hours of hearing aid …