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2016
A Sensory Integration Program Versus Escape Extinction in Pediatric Feeding Disorders
Published Year: 2016 Program: Doctor of Speech Language Pathology
Bellom-Rohrbacher, Kristen H.
The purpose of this investigation was to determine if the use of sensory integration plus positive reinforcement would be more beneficial than the use of escape extinction plus positive reinforcement to increase overall acceptance of food and decrease negative mealtime behaviors in preschoolers with pediatric feeding disorders. Two preschool males participated in this investigation. The behavior being measured included the percentage of acceptance of undesired foods, duration of negative mealtime behaviors and the percentage of following sensory demands. The investigation took place at a pediatric multidisciplinary clinic in Bronx, New York. The investigation employed an alternating treatment design. Ultimately, the participants demonstrated positive changes in both conditions compared to the baseline. Both participants experienced higher acceptance of undesired foods in the escape extinction condition, and a decrease in negative mealtime behaviors, however, with several spikes and variability throughout. In the sensory integration condition, both participants experienced an increase in acceptance by the end of the investigation with very low negative mealtime behaviors. These findings support previous studies, which indicate that the use of sensory integration plus positive reinforcement is beneficial in treating children with pediatric feeding disorders to improve acceptance and decrease negative mealtime behaviors. This research also indicates the need for continued research with this population.
Effectiveness of Therapy Conducted with a Tablet Application on Individuals with Memory Impairment
Published Year: 2016 Program: Doctor of Speech Language Pathology
Galic, Meggan E.
The overall purpose of this research was to determine if individuals with dementia would benefit from cognitive/memory therapy interventions being provided by a tablet-based application. Two individuals with dementia participated in this research. The behaviors measured included overall cognitive function that was measured with a pre and post-test of cognition. In addition, percentages obtained on a memory task via a tablet-based therapy application were documented daily for each participant. The research was completed at a 120-bed skilled nursing facility in Houston, Texas. The design utilized for this research was a changing criterion design. Overall, in Phase A of the therapy intervention, both participants demonstrated positive changes. In Phase B when the therapy task became more difficult, the participants did not show a statistically significant difference between Phases A and Phase B, which was expected due to the increasing difficulty with the task. Both participants demonstrated positive statistically significant changes from the pre-test at the beginning of the therapy intervention to the post-test at the completion of the therapy intervention. These findings agree with previous studies that suggest there is evidence that individuals with dementia can demonstrate new learning. This research indicates the need for continued research in individuals with dementia.
Effect of Structured Training on Graduate Student Self-Efficacy in Medical Settings
Published Year: 2016 Program: Doctor of Speech Language Pathology
Heape, Amber Berry
Medical offsite placements for graduate students in communication sciences and disorders (CSD) are increasingly difficult for speech-language pathology (SLP) programs to attain. Some suggest that may be, in part, due to the perception of student ambiguity, clinical skill deficits, and poor overall self-efficacy (Brown, 2007). This leads to difficulty for universities, which are required to provide diverse clinical placements prior to graduation. The purpose of this investigation was to determine the effect of structured training on the self-efficacy of graduate students in medical settings, in order to determine if training would have a significant effect on selfefficacy. Most empirical research supports a relationship between self-efficacy and performance. Although much remains to be learned about self-efficacy, evidence now available in healthcare sciences suggests that it is possible to teach strategies to improve self-efficacious behavior (Bobo et al, 2012). Stress was also rated as a component of self-efficacy. This study used a single subject (small n) comparison design with A, B, and C phases. After baseline, the primary intervention phase (training) was measured, then the secondary intervention phase (medical offsite) to see the effects on self-reported efficacy ratings of students. Five of six participants in this investigation demonstrated significant improvement in self-efficacy levels after the provision of a structured training program. Pre-placement self-efficacy was increased, as well maintenance or further improvement during offsite placements. The potential implications of this type of structured training could theoretically change the focus of university courses in clinical methodology and theory, or warrant preplacement workshops to achieve the desired improvement.
Keywords: self-efficacy, medical, graduate student, training
Effect of Video Modeling with Picture Exchange Communication on Spontaneous Requesting in Children with Autism
Published Year: 2016 Program: Doctor of Speech Language Pathology
La Bella, Renee
Children with autism present with unique communication needs. The children who are nonverbal present speech-language pathologists with the challenge of finding and establishing an effective means of communication, often in the form of an augmentative and alternative communication (AAC) system. This investigation explored the use of video modeling (VM) for training three 6 year-old children with autism to use the Picture Exchange Communication System (PECS) to spontaneously request highly desired items. An alternating treatment research investigation was conducted by alternating two intervention conditions, PECS alone and PECS with VM. Each child received 10 sessions of each condition with no more than two consecutive sessions of the same condition. The dependent variable was the percentage of correct picture exchanges out of 10-20 opportunities. A correct trial involved the participant picking up the picture, reaching for the communication partner, and releasing the picture into the communication partner’s hand without prompting from the silent trainer at any stage of the exchange. Event recording took place at each session and the percentages of non-overlapping data (PND) and slopes were calculated for each participant. Both intervention types (i.e., PECS alone and PECS with VM) resulted in increases in the number of independent requesting for all three participants. There was an increase in levels from stable baselines with no spontaneous picture exchanges to 35-53% with PECS only and 40-58% with PECS and VM. Two participants performed 60% of the paired sessions better when the PECS was paired with the VM versus with the PECS only sessions. One participant performed 70% of the PECS only sessions better than the PECS with VM sessions. The slopes led to different insights than the PND. This investigation supported previous literature. However, results have limited generalization due to the small sample size and decreased interest in the videos for two of the participants.
Effect of Multiple Oppositions Approach on Intervention Progress for Speech Sound Disorders
Published Year: 2016 Program: Doctor of Speech Language Pathology
Lewis, Christine Richard
Speech sound disorder (SSD) is the most common diagnosis made by speech-language pathologists with a pediatric caseload (ASHA, 2014). An estimated 2% to 25% of children ages 5 to 7 years have a SSD diagnosis (Law, Boyle, Harris, Harkness, & Nye, 2000). This investigation examined the effects of the multiple oppositions therapy approach, contrastive method of phonological intervention administered by a speech-language pathologist to children with moderate-to-severe phonological disorders. Previous investigations supports that children with moderate-to-severe phonological disorders benefit from the multiple oppositions approach (Cathelle & Ruscello, 2004; Liles & Williams, 2006; Williams 2000a, 2000b). Multiple oppositions approach has been introduced and researched in recent years showing an efficient and effective way to remediate moderate-to-severe phonological disorders through contrasting multiple sounds simultaneously (Williams, 2000). Unlike other phonological treatment methods, the multiple opposition approach homonymy is a central theoretical tenant (Williams, 2010). The purpose of this research investigation is (a) to confirm previous claims regarding the effectiveness of the use of the multiple oppositions approach for improving sound errors with children with SSD, and (b) to improve understanding of the importance of the proper phonological analysis and selecting appropriate sound targets. A single-subject A-B research design was used to determine the effectiveness of the multiple oppositions approach. Research was conducted using three preschool age participants in the public school setting. The data were analyzed using visual inspection and the Two Standard Deviation Band method. The results revealed slight improvement in production of speech sound targets in all participants.
Keywords: speech sound disorder, phonological treatments, multiple opposition approach, minimal pairs
Effect of Phonemic Awareness Training on Phonemic Awareness and Oral Reading Fluency
Published Year: 2016 Program: Doctor of Speech Language Pathology
Means, Ebony Thompson
Studies evaluating the acquisition of phonemic awareness and learning to decode print have typically focused on preschool and primary school years. There is limited research of phonemic awareness skills in language-impaired readers post-elementary (Scarborough et al., 1998; Swanson, 2008; Ukrainetz, Cooney, Dyer, Kysar, & Harris, 2000). There are several studies that evaluate the benefit and efficacy of phonemic training with individuals who are hard of hearing, limited English learners, and primary age students (Castles, Wilson, & Coltheart, 2011; Krashen, 1999; Messier & Jackson, 2014); however, limited research is available on the efficacy of phonemic awareness training with secondary age students who continue to exhibit poor phonemic awareness and reading disability. A single subject A-B design was conducted to determine the effectiveness of explicit phonemic awareness training to improve adolescent students phonemic awareness deficits who are struggling readers and the ability to improve phonemic blending and segmenting skills, and reading fluency. The investigation included three adolescent students who completed eight intervention sessions. The baseline and 45-minute intervention sessions took place in a middle school in South Carolina. Ability to segment and blend sounds was assessed at each baseline session and at the beginning of each intervention session. The data were analyzed by a visual inspection and Two Standard Deviation Band method. The outcomes revealed improvement in percentage of accuracy in completion of phonemic awareness tasks for all participants, indicating that explicit phonemic awareness training had a positive effect on phonemic awareness skills and a slight increase in reading fluency words read per minute.
Keywords: phonemic awareness, segmentation, phonemic blending, reading, literacy program
Author has declined to share this capstone.
Effects of Spaced Retrieval Training and External Memory Aids on Individuals with Dysphagia and Dementia
Published Year: 2016 Program: Doctor of Speech Language Pathology
Mentor, Kennetha Sheeti’La
Two adults with dementia and dysphagia were taught to recall a compensatory swallow strategy using the spaced retrieval training method combined with external memory aids. Ten intervention sessions were administered over a four-week period with two weeks of baseline sessions with external memory aids only. On each trial, participants were provided a 5×8 note card with the compensatory swallow strategy and asked to recall a compensatory strategy by verbally responding to the question and executing the compensatory swallow strategy at increasingly longer retention intervals up to 3 minutes. Results yielded a positive effect of spaced-retrieval training combined with external memory aids for recall of compensatory swallow strategies. Both participants were able to recall the compensatory swallow strategy over longer periods of time across training sessions. These data provided initial evidence that spaced-retrieval training combined with external memory aids can aid individuals with dementia and dysphagia in recall of compensatory swallow strategies.
Keywords: dysphagia, dementia, spaced retrieval training, external memory aids
Effect of the Earobics Computerized Literacy Program on Segmentation Performance in Young Children
Published Year: 2016 Program: Doctor of Speech Language Pathology
Parker, Elizabeth D.
A single subject A-B design was conducted to determine the effect of the Earobics Computerized Literacy Program on ability of kindergarten children to segment sounds in words. Earobics was invented as supplementary literacy program to increase reading skills by focusing on phonological awareness abilities. The investigation included seven kindergarten children. The baseline and intervention sessions took place in a small elementary school in New Mexico. Six of the participants were able to activity participate in the investigation and were provided 12 intervention sessions. The participants were randomly assigned to one of two baseline phases: a three-data-point baseline or a sixdata-point baseline. Ability to segment sounds was assessed at each baseline session and at the beginning of each intervention session. The data were analyzed by a visual inspection, Binomial Test, and Two Standard Deviation Method. The data demonstrated significance for a positive change from baseline to intervention; in addition, it demonstrated that the variation of change was due to a special cause. These results indicated that the Earobics Literacy Program had a positive effect on the segmenting skills for the kindergarten children in this investigation. Segmenting involves only one area of phonological awareness and future research should expand to include additional areas of phonological awareness.
Keywords: phonological awareness, segmentation, reading, literacy program
Effect of Interactive Metronome on Understanding Spoken Language in Adults with Auditory Comprehension Impairments
Published Year: 2016 Program: Doctor of Speech Language Pathology
Peterson, Susie Bartolome
The ability to understand spoken language involves mechanisms beyond the linguistic level of comprehension. People with acquired auditory comprehension impairments due to a brain injury have differences in neural speed and timing that impair their ability to comprehend. This single subject research study investigated the effect of Interactive Metronome (IM) on processing and understanding spoken language that varied by length, complexity and/or speech rate, on different modalities that demonstrate comprehension (writing to dictation, repetition, following spoken commands and identifying the written word), and on the speed of response for following commands. In this A-B-A design, 15 sessions of IM training were provided to a 55-year-old male participant, 3 years post CVA with persisting symptoms of mild receptive aphasia and mild anomia, and was evaluated to have concomitant acquired auditory processing disorder. Results found improvement in auditory processing and comprehension in each of the modalities, in understanding spoken words with increased complexity and length, an improvement in temporal processing, and in the ability to comprehend faster rates of speech, as well as in faster abilities to respond to spoken commands. Findings contribute to the research that positive improvements in timing and synchronicity improve auditory processing and comprehension.
The Effect of Instruction Using the Expanding Expression Tool on the Number and Type of Attributes in Verbal Descriptions Produced by Children with Language Impairment
Published Year: 2016 Program: Doctor of Speech Language Pathology
Rau, Elaine
Verbal descriptions are important for academic success and are included in the 2010 Common Core State Standards; however, children with language impairment (LI) often have limitations in this area. The Expanding Expression Tool™ (EET) is a multisensory program designed to teach children with LI a conceptual strategy to produce comprehensive verbal or written descriptions. The EET learning tool is a toy made of large, color-coded beads on a thick cord. Users are taught a chant in which each colored bead corresponds to a specific component of a comprehensive description. Instruction is supported by a variety of color-coded materials, worksheets, and suggested activities. The effects of the EET program on the verbal descriptions produced by two children with LI were investigated using a single case research design. The participants were two boys, ages 6.7 and 9.9 years respectively. Each received 15 half-hour sessions of instruction in the EET program. The dependent variable was a probe, adapted from an investigation by Dudek (2014) to elicit verbal descriptions of six common nouns, administered at the beginning of each session. Responses to the six nouns were scored using rubrics adapted from Dudek; these scores were averaged to yield a Giving Verbal Descriptions score for each probe. Results indicated that the positive changes in each participant’s scores from baseline to completion of the intervention were significant and reflected an increase in the number and type of attributes produced by both participants.
The Effect of Real-Time Feedback Using a Smartwatch on the Clinical Behavior of Novice Student Clinicians
Published Year: 2016 Program: Doctor of Speech Language Pathology
Scott, Courtney G.
There is an identified need to investigate supervisory instructional practices that can effectively manage the cognitive load and needs of student clinicians (SCs) during various stages of clinical development (Young, Van Merrienboer, Durning, & Ten Cate, 2014). This investigation aimed to study an interactive, technology-based method for providing feedback to promote the transfer of knowledge from clinical supervisors to SCs. A substantial body of empirical evidence supports the use of Bluetooth technology to provide real-time feedback during clinical sessions, known as “bug-in-the-ear” (BITe) feedback (Gallant & Thyer, 1 989; Goodman, Brady, Duffy, Scott, & Pollard, 2008; Rock et al., 2009; Rosenberg, 2006; Scheeler & Lee, 2002). The use of computer monitors to provide real-time written feedback, referred to as “bug-in-the-eye” (BITi) feedback, recently emerged in the literature with preliminary evidence to support its effectiveness (Carmel, Villatte, Rosenthal, Chalker & Comtois, 2015; Weck, 2015). All participants in this investigation were students enrolled in a clinical practicum at an American Speech-Language-Hearing Association (ASHA) accredited communication disorders and sciences (CDS) program housed within a state-funded university in the midwestern United States. This investigation employed a single subject, sequential A-B design with two participants to observe the effects of implementing real-time feedback using a smartwatch on the clinical behavior of SCs. The use of a smartwatch to deliver real-time BITi feedback has not been previously considered for BITi feedback. A celeration trend line, descriptive statistics and a stability band were used to analyze the data by slope, trend and variability (Gast & Ledford, 2014). Results demonstrated a significant correlative relationship between BITi feedback with a smartwatch and an increase in positive clinical behaviors.
Keywords: Clinical feedback, speech-language pathology, real-time, smartwatch
The Effect of Rapid Syllable Transition Treatment on Childhood Apraxia of Speech
Published Year: 2016 Program: Doctor of Speech Language Pathology
Shigetomi-Toyama, Sandra C.
In the literature, there are various treatments for children with childhood apraxia of speech (CAS) but few discuss treating CAS with a concomitant disorder. CAS can be a challenging disorder to treat and likely to be seen in conjunction with a disorder like autism spectrum disorder (ASD) (Tierney et al., 2015) thus making the treatment more challenging. The purpose of this case study was to evaluate the efficacy of an evidence-based instructional program for CAS, Rapid Syllable Transition (ReST) treatment using the principles of motor learning (PML), and determine if the program would increase natural sounding speech in a boy eight years old with dual diagnoses of mild ASD and moderate CAS by improving the ability to vary the prosodic contours with appropriate intonation and rate in three-to-four syllable pseudo words and generalizing that ability to real words. The treatment, in this A-B single subject design, was intensive in both production (>75) and session frequency (four times per week for 3 weeks). The outcome revealed improvement in the ability to produce variable stress patterns with appropriate rate in three and four syllable pseudo words. Treatment effects generalized to untreated multisyllabic real words. The results supported the use of ReST to address speech naturalness in a child with dual diagnoses of ASD and CAS. Adherence to the PML appear to be a positive component to this approach.
Keywords: speech disorder, autism spectrum disorder, prosody, principles of motor learning, generalization, pseudo words, speech naturalness
A Comparison of Traditional Phonetic Placement-Production in Electropalatograpy: Performance of School-Age Children with Persistent Speech Disorder
Published Year: 2016 Program: Doctor of Speech Language Pathology
Sims, Niqueka S.
Pascoe, Stackhouse, and Wells (2006) define persisting speech difficulties (PSD) as “… difficulties in the normal development of speech that do not resolve as the child matures or even after they receive specific help for these problems (p. 2).” Lohman, Fucci, and Marinellie (2001), indicated that in traditional articulation therapy, children are given verbal instruction to improve sound production by altering lingual positioning in the oral cavity; however, some children may not conceptually understand verbal instruction alone and may require additional types of feedback (Ruscello, 1995). This additional feedback could be visual, because visual feedback may facilitate correct placement, thereby aiding correct speech production. One form of visual bio-feedback is electropalatography (EPG) is a computerized bio-feedback system that tracks and visually displays tongue-to-palate contact by use of a pseudo-palate. This investigation sought to determine the effectiveness of traditional phonetic placement articulation therapy as compared to electropalatography for increasing correct production of target phonemes in school age children with a persistent speech sound disorder. The investigation was an experimental single-subject mixed method A-B-A-B and B-A-B-A design, with six participants. The outcomes revealed improvement in percentage of accuracy for all participants, indicating that electropalatography had a positive effect on treating phoneme errors.
Keywords: electropalatography, articulation, articulation disorder, speech disorder, persistent speech disorder, smart palate
The Effects of Neuromuscular Electrical Stimulation and Traditional Dysphagia Treatments on Swallow Initiation Times in Individuals with Oral-Pharyngeal Dysphagia Secondary to Stroke
Published Year: 2016 Program: Doctor of Speech Language Pathology
Staley Sr., Carlos
Recent investigations have posited that greater than 42% of individuals who have experienced stroke have been diagnosed with dysphagia (Crisan, Shaban, Boehme, Dubin, Jeungling, Schulter, Albright, Beasley, & Schild-Martin, 2013). In addition, these individuals have required either short term or long term interventions to compensate for the various levels of dysphagia they have experienced. Traditional interventions for the various phases of dysphagia (swallow dysfunction) have consisted of oral motor exercises (e.g., oral-labial and tongue resistance exercises), compensatory swallow strategies (e.g., Mendelsohn Maneuver), diet modifications, and airway protections (Heijen, Speyer, Baijens, & Bogaardt, 2012). Most recently, neuromuscular electrical stimulation (NMES), has appeared as an adjunctive intervention for dysphagia resulting from various diagnoses including stroke. This modality involves electrical stimulation of the various muscles involved in swallowing. The NMES modality has not been without controversy and there are those who believe that NMES is not beneficial for treatment of dysphagia of any kind (Biber & Barrera, 2012). The purpose of this investigation was to determine the effect of NMES, when combined with traditional dysphagia interventions, on swallow initiation duration of individuals with stroke and subsequent oral/pharyngeal dysphagia characterized by delayed swallow initiation. The single subject (small n) design was utilized with an A (baseline) and a B (intervention) phase. Traditional dysphagia treatments (oral motor movements, e.g. tongue protrusion and lateralization) were utilized during Phase A of the investigation. NMES was added and utilized simultaneously with the traditional treatments within the intervention phase (Phase B) of the investigation to determine if this combination of interventions had an effect on the targeted swallow initiation duration. A speech language pathologist (SLP) collected the pre-treatment and post-treatment swallow initiation times of the participants during each phase of the investigation. Results of the one participant who completed the investigation revealed that while the traditional dysphagia intervention positively impacted the swallow initiation durations of this individual, there was a statistically significant positive impact on the swallow initiation durations of this same participant when NMES was utilized simultaneously with the traditional dysphagia therapeutic approach within the intervention phase. The potential implications of this investigation are that it provides additional information for future research that may further confirm that NMES is a relevant mode of treatment, and should therefore be considered a viable recommendation for intervention of dysphagia in patients with dysphagia secondary to stroke.
Keywords: neuromuscular electrical stimulation (NMES), dysphagia, oral motor exercises
Occupational Therapy
Published Year: 2016 Program: Doctor of Speech Language Pathology
Tutten, Pam
This capstone project is about expanding occupational therapy (OT) to include its origins of occupation, within the domain of work, and in the context of a national outpatient rehabilitation company. One of the goals of the Centennial Vision is to “deepen participants’ personal resolve to shape our common future”. This capstone project is an expression of that resolve. The author will educate corporate leadership of ABC Company as to why occupational therapy is principally qualified as a profession to enhance client participation in the roles and routines of the workplace. Evidence of the contribution of OT to the literature surrounding work practice will support this case. In addition, the educational foundation established by the Accreditation Council of Occupational Therapy Education, will demonstrate that OT graduates bear the qualifications necessary to contribute to the development and implementation of work programs at entry level. Finally, identification of OT in the domain od work as established in the Occupational Therapy Practice Framework: Domain and Process, 3rd edition, will further validate the inclusion of OT in work related programs. The goal of this program proposal is to influence corporate management to decide that OT is not only appropriate but also essential for inclusion in work program development and implementation. A secondary goal of this proposal is to advocate for the formation of an OT director position to facilitate that involvement.
A Guide for First-Time Parents Through the Lens of an Occupational Therapist
Published Year: 2016 Program: Doctor of Speech Language Pathology
Wong, Katti
Welcoming an infant into a family is a very overwhelming and exciting experience for mothers and fathers. This transition is life-changing, especially for first-time parents. There is a lot of information available in our society leading up to the birth about getting through pregnancy, the pain and options for labor and delivery, and what equipment a family should have at home in preparation for the infant’s arrival. However, once the infant is home, how to you help him or her grow and develop in a nurturing environment? This manuscript focuses on the following three main topics: the roles of being mothers and fathers, the importance of play for infants, and the support of infant motor development. This transition is a hectic experience for many families, therefore the goal of this manuscript is to decrease stress and increase confidence so that families can focus on meaningful participation in everyday activities. Educating parents with knowledge in these areas of infant development may support quality family time, overall self-confidence as parents, and knowledge on development. Hopefully, readers will use this manuscript as a stepping stone to initiate and further develop parenting skills.
2017
The Effect of a Sensory-Motor Approach to Feeding in Children with Pediatric Dysphagia
Published Year: 2017 Program: Doctor of Speech Language Pathology
Bell, Joy
The purpose of this investigation was to determine the efficacy of a sensory- motor approach to feeding in children with pediatric dysphagia. Two preschool males participated in this investigation. One of the participants withdrew from the investigation during the initial intervention phase due to an illness not related to the investigation. Inclusion criterion included diagnoses of oral-pharyngeal dysphagia, neurological and/or genetic disorder, postural control (with or without seating adaptive equipment), and the ability to follow two step commands and understand the words open, close, bite, chew, and swallow as determined by a speech-language screening. Exclusion criterion were children with food aversions due to a sensory feeding disorder without oral-motor weakness or coordination impairments, and children deemed unsafe to consume solids per pre-test swallowing and feeding exam results conducted one week prior to the investigation by the speech-language pathologist. The investigation was held at a speech therapy clinic in Lincolnton, NC. Therapy was held during lunchtime three sessions a week for 4 weeks with 30 minutes per session. An Oral-Motor Feeding Assessment was conducted pre- and post- treatment. The Independent variable was the chewing hierarchy-modified (level 3) and food weight consumed was measured as the dependent variable. The design utilized in the investigation was an ABAB design. Overall, the participant demonstrated positive changes during the intervention phases compared to baseline. A slight improvement in food consumption was also observed during the withdrawal phase of the investigation. This improvement appeared to be due to carryover of a learned skill as evidenced by the observance of the participant executing the learned technique independently during this phase. These findings support previous studies, which suggested that the use of a sensory-motor approach might be beneficial in improving swallow function and food consumption in children with pediatric dysphagia. Based on this research, further investigative studies are warranted to analyze the impact of a sensory-motor approach to feeding with the pediatric population.
The Effect of a Holistic Treatment Program on Remediation of Phonological Errors in a Preschool Child
Published Year: 2017 Program: Doctor of Speech Language Pathology
Bennett, Lauren S.
A distinctive feature approach to intervention is a treatment technique that targets phonemes absent in a child’s sound inventory, generally focusing on sound substitutions. Comprehension of phonemic contrasts are indicative of phonological complexity; therefore, children that present with phonological disorders are less aware of these contrasts, hindering speech sound development. A preschool-aged child was provided with instruction using a holistic distinctive features program that targeted final consonants. An AB, single subject design was used across eight sessions and measured improvement on presence of final consonants throughout various word lists. The participant engaged in a multi-step process including: auditory discrimination, practice, participant teaching, and elicitation. Results indicated that this contrastive intervention approach aided in increased inclusion of final consonants and suppressing the phonological process of final consonant deletion.
Keywords: Final consonant deletion, phonological process, distinctive features
Effect of the Developmental Language Preschool Therapy Approach for Preschool Students with Language Disorders
Published Year: 2017 Program: Doctor of Speech Language Pathology
Buchheit, Amanda
Approximately 8% of preschool students have speech and language difficulties. A significant portion of these preschool students will present with a diagnosis of a primary speech and language disorder. This single subject research study investigated the effectiveness of the Developmental Language Preschool Therapy Approach (DLPTA) for students identified with receptive and expressive language disorders, specifically measuring the participants’ progress in the areas of rate of spontaneous verbalizations, utterance length (e.g., mean length of utterance), and expressive vocabulary growth (e.g., Type Token Ratio). In this A-B design, 20 sessions of DLPTA were provided to three preschool participants, ranging from 3-years, 4 months to 4years, 4-months old, with a mixed receptive-expressive language disorder. Results indicated that the DLPTA indicated statistically and clinically significant increases in spontaneous verbalizations and mean length of utterance (e.g., phrase length) for Participants One, Two and Three. The DLPTA indicated a clinically significant impact on Type Token Ratio for Participants One, Two and Three. In addition, increases were noted in the total number of different words and total number of words that Participants One, Two and Three used. Additionally, expansions were noted in the grammatical tenses, question asking and use of wh-words used by all three participants. Qualitatively, parents reported a decrease in participant tantrum behavior and parent frustration and increases in the ability to understand their child, engage in a reciprocal conversation, and an increase in quality of life due to the DLPTA.
Effects of Teaching Parents to Respond to Their Child’s Communicative Intents
Published Year: 2017 Program: Doctor of Speech Language Pathology
Cantu, Marisa
Eighty-five percent of a child’s brain growth occurs during the first three years of age (Bruner, Floyd, & Copeman, 2005). It is important that children with a developmental delay such as a language disorder be seen early to take advantage of the brain maturation. Early childhood intervention programs provide professional services to parents and children in naturalistic environments to increase the child’s communication using a variety of methods. In this investigation, the methods used were a combination of prelinguistic milieu teaching (PMT) and responsive interaction (RI), to determine the effects of a parent-training program on the parent’s verbal responses to the expressions of the child’s communicative intent, and determine if this program influenced the child’s language development. Results indicated that with an educationally rich environment, parent education, and coaching, the mother (JD) was able to increase her verbal responses to her child’s (TC) communicative intents. At baseline, JD’s verbal response rate of improvement was 0x, meaning there was no improvement in her verbal responses over these three session. When treatment was implemented, JD’s rate of improvement was 5.6x, indicating she began increasing her verbal responses after the treatment was introduced. At the maintenance phase, JD demonstrated another rate of improvement of 1.5x over these three sessions indicating that JD was able to maintain what she had learned and continued to improve. Absolute level of change between adjacent conditions and percent of nonoverlapping data (PND) indicated that from baseline to treatment, JD improved 5percentile points in absolute level of change with a PND of 75%. From treatment to maintenance, there was a 2-percentile point improvement in the absolute level of change with a PND of 33%. The child (TC) was also able to increase her receptive and expressive standard scores on the Developmental Assessment of Young Children 2nd edition in pre and post testing. TC’s standard scores in pre and post testing were greater than 22 points in receptive language (25 points), expressive language (33 points), and overall communication (26 points).
Keywords: prelinguistic milieu teaching, responsive interaction, early intervention, language, brain, developmental delay, communicative intents, normal development
The Use of Palin Parent-Child Interaction Therapy with Spanish-Speaking Children Who Stutter
Published Year: 2017 Program: Doctor of Speech Language Pathology
Carlo, Edna J.
This is a single-subject research study exploring the use of Palin Parent-Child Interaction Therapy with a Spanish-speaking child who stuttered. Both parents participated with their son in the indirect component of the therapy Program. Results indicated no changes in the level of stuttering frequency from baseline to intervention with the father. In contrast, changes seen with the mother reflect that treatment had an impact on the outcome response in this case. The study also adds findings about changes in the parents’ rating of (a) impact of stuttering on the child, (b) stuttering severity and parental concern, and (c) parents’ knowledge and confidence in dealing with stuttering. Individual variations are also discussed. Considerations for the cultural and linguistic adaption and application of an indirect intervention program for preschool children who stutter are proposed.
The Effect of Minimal Contrast Therapy on the Speech Perception of English Language Learners (ELLs) From Low Socioeconomic Status (SES) Households
Published Year: 2017 Program: Doctor of Speech Language Pathology
Colon, Marina M.
English Language Learners (ELLs) are a population at risk for lower literacy skills and are at an even greater risk when they are from low socioeconomic status (SES) households. Research suggests that the speech perception of Spanish speaking ELLs is immature when it comes to English only vowels sounds, which may be a factor contributing to lower literacy skills. Three participants, ages 4;0-4;11 from a Headstart preschool program who are ELLs from bilingual Spanish-speaking low socioeconomic households, took part in this study. A screener was utilized to identify the children that do not perceive the non-native English vowel target /æ/. The participants were seen together in a group as they would be seen in a Tier 2 RTI setting. The intervention continued for ten sessions. Intervention sessions were comprised of three tasks; (1) actively listening to non-native /æ/ stimuli, (2) actively listening to /æ/ and its minimal contrast /ɒ/ immediately following to attempt to discriminate between the two stimuli, and (3) actively listening to combinations of the two sounds and determine if the sounds are the same or different. All three participants showed increased speech perception of the nonnative English vowel phoneme /æ/ after receiving an intervention of minimal contrast therapy.
Effectiveness of an Instructional Treatment Model for Spanish Verbal Morphology in Spanish Speaking Preschoolers
Published Year: 2017 Program: Doctor of Speech Language Pathology
Cruz, Gloriana
Verbs are the most important part of speech in a sentence that describes action. They conjugate in three primary tenses (a) present, (b) past, and (c) future. In the Spanish language, the infinite form of the verb occurs in three different endings (a) ar; (b) er; (c) ir. Verb conjugation is a challenge for any new student of the Spanish language, especially for preschoolers who struggle to understand the underlying grammar concepts. Because this subject is of basic importance in the academic context, it requires an in depth review with regular discussion and practice, particularly in the field of speech language pathology. Three participants aged 3.6 to 5.0. years who were Specific Language Impairment SLI exhibiting a deficit in verb conjugation, took part in this study. A screener was utilized to identify individuals with a verb conjugation deficit. The participants had individual sessions twice a week in ten intervention sessions. The intervention sessions include two tasks: (1) introduction of the verb concepts, and (2) interactive learning exercises. Results did not reveal an impact for the three participants who took part in this study. Nevertheless, this investigation supports the notion that children with SLI require more frequent presentations of stimuli to generalize the target verb.
Effect of Thickened Liquids on the Hydration and Quality of Life of Patients with Dysphagia
Published Year: 2017 Program: Doctor of Speech Language Pathology
Garcia, Nelia Vanessa
Thickened liquids are the most frequent intervention in the hospital to prevent aspiration in patients with dysphagia (swallowing difficulties) (Garcia & Chambers, 2010a; Robbins, Gangnon, Theis, Kays, Hewitt, & Hind, 2005), however, they are the least recommendation to be adhered to, with a 36% of adherence (Low, Wyles, Wilkinson, & Sainsbury, 2001). Poor compliance with the use of thickeners can result in malnutrition, dehydration, aspiration pneumonia, decreased quality of life (QOL), and even death (Garcia & Chambers, 2010a). Due to the absence of convincing scientific evidence on how to manage these issues and the need of healthcare professionals to emphasize not only longevity of life but also QOL, this investigation was designed. This study examined the effect of two types of thickeners on the fluid intake and QOL of patients with dysphagia in the acute care setting. This investigation was a single-subject alternating treatments design (Atr). Three participants, aged 61-75, with a diagnosis of oropharyngeal dysphagia were recruited in the acute care setting and completed a total of six treatment sessions. Results of this investigation revealed a higher fluid intake with powder thickened beverages (>324mL) than with pre-thickened beverages. The overall QOL revealed the same preference for the taste of both type of thickeners (mean score of 3.9), preference to the texture and thirst-quenching abilities of powder-thickened beverages (mean scores of 3.7 vs. 3.6 and 3.9 vs. 3.6, respectively), and predilection for the appearance of pre-thickened beverages (mean score of 3.8 vs. 3.6). These findings support existing research about decrease oral intake and discontent when consuming thickened liquids.
Keywords: powder-thickened beverages, xanthan gum thickeners, dehydration, swallowing problems
Author has declined to share this capstone.
Effects of an Individualized Staff Training Program on the Use of Communication Strategies with Adults with Developmental Disabilities
Published Year: 2017 Program: Doctor of Speech Language Pathology
Hawkins, Lourdes
A multiple probe design across participants was used to investigate the effects of individualized staff training on the use of non-verbal communication by staff at a day habilitation program for individuals with developmental disorders. Staff interactions were observed and analyzed to determine the frequency of non-verbal communication strategies prior to training, during the training phase and intermittently during the remainder of the investigation. Each training session was 15-minutes in length and occurred within the staff’s assigned work location. All staff were observed to increase their overall use of non-verbal communication strategies. Pre-post questionnaires revealed that staff felt comfortable communicating with the individuals they served. Post-questionnaire indicated that staff believed they would benefit from an annual training.
Effect of Prompts for Restructuring Oral Muscular Phonetic Targets (Prompt) on Compensatory Articulation in Children with Cleft Palate/Lip
Published Year: 2017 Program: Doctor of Speech Language Pathology
Herreras Mercado, Raul
The current investigation researched the effectiveness of the PROMPT method to address compensatory articulation errors in children with cleft palate. The investigation consisted of three participants (ages 4:4 to 12:8) born with bilateral complete cleft lip and palate. Participants underwent several reconstructive surgeries to repair their lips and palates. The PROMPT treatment was provided for 45 minutes three times a week for four weeks (three weeks for Participant 2) after stable data was obtained during three consecutive therapy sessions. Therapy sessions addressed anterior lingual speech motor phonemes across three tiers (syllable combination, initial and final position at words, and phrase levels). Direct visual observation of data obtained throughout this investigation indicate potential positive effects and significant correlation between improvements in sound production at different tiers and the implementation of the PROMPT technique. Speech intelligibility was judged by three blinded listeners who were unfamiliar with children with speech disorders and/or with cleft palate speech. All listeners identified and judged improvement in overall speech intelligibility over the course of this investigation. Listeners examined speech samples selected from sessions 3, 6, 9 and 12. The findings in this investigation provide a potential relationship on the effectiveness of the PROMPT method and attainment of accurate speech productions in children with cleft palate producing compensatory articulation errors, resulting in improvement in overall speech intelligibility.
Effects of Caregiver Training on the Use of an Aided Language Stimulation Program Using Speech-Generating Devices
Published Year: 2017 Program: Doctor of Speech Language Pathology
Hoy, Melissa
Aided language stimulation is an intervention strategy used with individuals who use augmentative and alternative communication (AAC). While the current literature supports the use of aided language stimulation when implemented by speech-language pathologists and educators, there is limited research to support the use of aided language stimulation by caregivers, especially when using dynamic display speech-generating devices (SGDs). The purpose of this investigation was to determine if teaching caregivers in the use of aided language stimulation would increase their ability to spontaneously model vocabulary with their children using AAC systems. Two caregivers were taught aided language stimulation during preferred activities with their children, measuring caregiver rate of spontaneously modeled opportunities using a dynamic display SGD. Results showed an increase in rate for both participants using a single-subject, changing criterion design. Data interpretations and directions for future research are discussed.
Keywords: augmentative and alternative communication, AAC, modeling, dynamic display, communication partner
Effect of CIAT II on Language Deficit for Individuals with Acute Aphasia
Published Year: 2017 Program: Doctor of Speech Language Pathology
Jackson, Regina
Constraint-Induced Aphasia Therapy (CIAT) has been found to be effective for treating persons with chronic aphasia (Pulvermüller et al., 2001). Modifications to the traditional activities of the CIAT protocol have been found to be successful using Constraint-Induced Aphasia Therapy Plus (CIAT II of CIAT-plus) (Johnson et al., 2014). Current literature lacks information on dosage parameters and feasibility of the CIAT protocol with caregiver participation in the acute phase of aphasia. The purpose of this investigation was to examine the effect of the CIAT II protocol on language deficits in individuals with acute aphasia. This investigation replicated portions of the Johnson et al. (2014) protocol for CIAT II provided in decreased intensity and dosage for persons with acute aphasia. Two participants ranging between 65 to 67 years-old and <12 months’ post stroke onset were recruited for this investigation. The participants received 1 ½ hours of CIAT II for 5 days/2 weeks. Participant A met criteria after five sessions showing no significant intervention effect. Participant B completed all 10 sessions with all data points falling outside the upper 2 SD band analysis indicating a significant intervention effect. Both participants were found to exhibit improvements on all pre- and posttest scores for the quality of life questionnaire, Western Aphasia Battery-Revised (WAB-R), and naming of non-target words. Participant A showed the greatest improvement on the WAB-R although no statistically significant treatment effect was identified. The results of this investigation indicate the CIAT II protocol as effective when provided in reduced dosage and intensity for persons with acute aphasia.
Keywords: aphasia, constraint-induced aphasia therapy plus, CIAT II, CIAT, CIAT Plus, acute stroke, language, naming
Use of the Multiple Oppositions Approach in Young Children with Moderate to Severe Phonological Disorders
Published Year: 2017 Program: Doctor of Speech Language Pathology
Jones, Shaverra Arnette
With the many treatment approaches available, deciding which treatment approach is most appropriate for a particular client may be difficult and will require speech-language pathologist awareness of the treatment options and ability to determine which options best serves that particular client’s severity of the phonological disorder. The multiple oppositions approach is a contrastive approach that simultaneously contrasts several target sounds to a comparison sound (Williams 1992, 200a, 200b: Bernthal & Bankson, 2004). This model typically targets the phoneme collapse and homonymy through the use of larger treatment sets (Williams, McCleod, & McClauley, 2010). The use of the larger sets of the multiple oppositions approach includes the child’s rule, or phoneme collapse more systematically when compared to other singular contrastive approaches (Williams, McCleod, & McClauley, 2010). Although there is literature that supports its effectiveness in the university clinics, documentation of its effectiveness in aa public elementary school setting is limited. Using a single subject multiple baseline design across participants, the present investigation investigated the effectiveness of the multiple oppositions approach in increasing accuracy in production of works for young children with moderate to severe phonological disorder s in a public elementary school setting. The investigation included two participants with a moderate to severe phonological disorder. Prior to baseline, comprehensive assessment of the student’s phonological abilities and language were obtains. Additional generalizations probes were collected prior to each session throughout the investigation. The Sessions lasted approximately 30 minutes in length and took place two times per week in the speech therapy room in a public elementary school setting. Boredom and frustration, when present was managed by variety, breaks, and positive feedback.
An Examination of the Effectiveness of a Dysphagia Screening Tool Training Program for Registered Dietitians Working with Stroke Patients
Published Year: 2017 Program: Doctor of Speech Language Pathology
Jordan, Toupazer L.
Dysphagia refers to difficulty swallowing and can be potentially life-threatening due to malnutrition, dehydration, aspiration pneumonia, and other complications, including death (Cichero, Heaton, & Bassett, 2009; Johnson, Brody, Marcus, &Touger-Decker, 2015). Proper identification of dysphagia ensures the correct and safe provision of foods and medications. When dysphagia is not recognized, it can result in aspiration of oral contents, which occurs in 15-30% of hospital patients (Cichero et al., 2009). The majority of these patients are aged 65 years and older (Cichero et al., 2009). Persons at greater risk for dysphagia in the hospital setting include those with surgery to the head or neck, progressive neurological conditions, head injury, respiratory disorders, radiation or chemotherapy to the head and neck, autoimmune disorders, cardiac surgery, and psychiatric conditions. Also, those who have suffered a stroke are at high risk of dysphagia (Cichero et al., 2009; Heiss, Goldberg, Dzarnoski, 2010). The consequences of dysphagia can be exacerbated in patients diagnosed with stroke (Massey & Jedlicka, 2002). Stroke diagnosed with dysphagia are more likely to develop other medical conditions and complications, or even death (Wirth, Smoliner, Jager, Warnecke, Leischker, & Dziewas, 2013). An effective dysphagia screening process may aid in the detection of dysphagia in stroke patients in the hospital setting. The National Stroke Foundation in Australia mandated that all stroke patients be screened for dysphagia within 24 hours of the stroke and before given oral intake (Cichero et al., 2009). The American Heart Association and the American Stroke Association have also included screening for dysphagia for stroke patients before administering any food, liquid, or medication (Daniels, Anderson, & Peterson, 2013). When dysphagia is detected early in stroke patients, it increases the likelihood of preventing complications such as aspiration and malnutrition and initiates the treatment process (Massey & Jedlicka, 2002). Screening for dysphagia has primarily been the responsibility of speech-language pathologists; however, researchers have called for training programs that include other staff, such as nurses and dietitians, in the screening process (Cichero et al., 2009; Johnson et al., 2015). This effort has been deemed an interprofessional approach so as to expedite patient referrals to the speech-language pathologist. However, these other healthcare professionals are not necessarily trained to screen for dysphagia; therefore, a need has arisen to develop effective training programs and screening tools to facilitate dysphagia screening by these personnel. As part of a health care team, dietitians can participate in the process of screening stroke patients for dysphagia. In order to do this effectively, they must have an effective screening tool and be trained on how to use the tool. In the proposed investigation, a researcher-developed dysphagia screening tool training program will be evaluated for effectiveness with registered dietitians to screen stroke patients.
Effect of Coaching on Early Childhood Education Staff in Implementing Expressive Language Strategies for Students with Autism Spectrum Disorder
Published Year: 2017 Program: Doctor of Speech Language Pathology
Le Gray, Jodi
Speech-Language Pathologists (SLPs) strive to provide evidence-based practices to elicit expressive language in young children with autism spectrum disorder. This single subject, multiple baseline across behaviors investigation was implemented to see if early childhood education (ECE) staff could use expressive language strategies with students with ASD following coaching. The intervention of coaching was defined to include teaching at the beginning of each intervention condition, as well as two weekly coaching cycles that included check-in, embedded practice, and planning. One participant was coached in three independent strategies and demonstrated that coaching produced significant changes in the use of each strategy with students with ASD. The percentage of nonoverlapping data (PND) when baseline conditions were compared to intervention conditions were 87.5% for following the child’s lead and 75% for matched turns and expansions. These findings demonstrate the ECE staff can be coached to implement expressive language strategies for students with ASD and may have future implications for SLP service delivery in educational settings.
Keywords: Preschool, Early Intervention Natural Environments
A Comparison on the Expanding Expression Tool and the iPad Application of Naming Therapy on the Vocabulary Skills of Elementary Students with Language Impairment
Published Year: 2017 Program: Doctor of Speech Language Pathology
Miley, Lauren Gongre
Vocabulary difficulties are common occurrences in individuals with identified language impairments; thus, it is important to implement evidence-based interventions that can improve these individuals’ vocabulary skills. This investigation compared two interventions, the Expanding Expression Tool™ (EET) and Naming Therapy application on the iPad, to determine which intervention was more effective for improving vocabulary skills. The EET is a mnemonic device that teaches individuals through visual, auditory, tactile, and kinesthetic strategies, which are designed to increase language skills, while the Naming Therapy application is used on an iPad and helps persons learn strategies to communicate thoughts and needs. The materials used in this study included both independent variables, the EET and the Naming Therapy application, iPad, visual timer on an iPhone, paper and pen for the scoring probes, 6×6 black and white picture cards, tape recorder, and Eetchy. Three participants, two males and one female, ranged in ages from 6:11 to 8:8 years old. The participants were seen individually for five 15-minute sessions per week. The dependent variable was the number of descriptors the participant could provide to define a vocabulary word. The investigation utilized an adapted alternating treatment research design and the data was collected in three phases: a) initial probe, b) intervention, and c) superior treatment phase. A trend line, descriptive statistics, and a stability band were used to analyze the data by slope, trend, and variability. The results of this study indicated that the EET is a more effective tool than the Naming Therapy application for improving vocabulary skills in individuals with language impairments.
An Inter-School Settings Pilot Study Regarding the Effects of Modified Regulated Breathing on Fluency of Students Who Stutter
Published Year: 2017 Program: Doctor of Speech Language Pathology
Ogundare, Adetutu A.
Successful fluency treatment requires speech-language pathologists (SLPs) to draw from other fields such as behavioral analysis, psychology, and physiology to increase understanding of this multi•faceted disorder. The modified regulated breathing (MRB) treatment, a stuttering intervention based on behavioral approaches, has yet to be thoroughly explored and utilized in the field of speech language pathology (SLP). Additionally, this treatment strategy has been suggested to be important for generalization and maintenance of stuttering treatment outcomes in schools. The purpose of this single subject, multiple baselines design investigation was to identify effective methods to promote fluency of people who stutter (PWS) across academic settings by facilitating increased respiration through MRB. This investigation aimed to explore methods of diversifying traditional fluency therapy by promoting fluency across different types of academic settings as a larger part of therapy treatment, and increase the confidence and educational performance of students with fluency disorders by making the classroom a more positive setting for them to grow. Additionally, this investigation aimed to explore further education of SLPs and teachers regarding fluency therapy delivery in the classroom. Instruction in MRB was provided to two male participants (P#l age 12:5; P#2 age 12:11) with diagnosed fluency disorders. Treatment was provided in three settings, as follows: (1) traditional speech therapy room with the SLP, (2) therapy room with an unfamiliar visitor, and (3) classroom. Results indicated that increasing respiratory coordination utilizing MRB decreased the percentage of stuttered syllables (percent SS) produced when speaking across settings, versus no intervention. These positive results validate the need for further investigation of the MRB treatment to increase the fluency of PWS in school settings.
Effect of Using Specific Parent Coaching of Milieu Strategies for Late Talkers in Naturalistic Settings on Parent and Child Outcomes
Published Year: 2017 Program: Doctor of Speech Language Pathology
Robinson, Kelly LaRue
Although it has not been researched with individuals who only have communication disorders, the coaching model described by Shelden and Rush (2008) is utilized to implement speech-language interventions in early intervention settings. This study evaluated using the Shelden and Rush (2008) coaching model to teach a parent to implement three milieu strategies to her late talking toddler in their natural environments. The milieu strategies included models, mand models, and time delays. The participant was given two different target words to implement across each session. The target words served as a measure of the child’s ability to learn structured word targets. Total words and total different words used by the child were also measured throughout the study. Parent attitudes about the perceptions of child communication needs and the use of coaching were also investigated during this study. This study was a single-subject, A-B design replicated across one parent/child dyad for 4 weeks. The use of the A-B design allowed an examination of the participant’s behaviors in clearly defined coaching conditions. Results indicated that the Shelden and Rush (2008) coaching model can be used to teach parent use of milieu strategies. Although the child did not use target words, there was an increase in the child’s total words and total different words from baseline. At the beginning of the study the child had one spoken word and by the end of the study, she had a total of six spoken words and two gestures. The parent became more aware of her child’s communication difficulties by the end of the study. Parent and child outcomes from this study will add to the growing body of research that supports the use of parent coaching to implement milieu strategies in naturalistic environments for late talking toddlers.
Keywords: Parent Coaching, late talkers, vocabulary, parent perceptions
The Effects of Storybook Sharing on Speech Sound Production
Published Year: 2017 Program: Doctor of Speech Language Pathology
San Miguel, Patricia Ana
A single-case A-B-A-B research design investigation explored the effects of storybook sharing on the production of the T/ (“sh”) phoneme in words among three preschool children with a current articulation or phonological process disorder diagnosis. Participants included two males and one female who had similar backgounds. Four specific storybooks were chosen for the high-frequency content of the T/ phoneme and were used sequentially during the intervention phases. Visual analysis data is provided through level, frend, slope, and the two-standard deviation band method. Results demonstrated that all participants improved from pre-test to 2nd post-test, seven weeks from the conclusion of the investigation. All showed on an average accelerated trend across data points during all intervention phases. Clinical implications include the use of a naturalistic and interactive activity such as storybook sharing in an academic, clinical (therapeutic), and home setting with the appropriate training on how to utilize the appropriate storybooks with high concentration of the phoneme to carefully plan the use of reinforcements throughout the task, to use appropriate prosody and inflection during the storytelling, and to choose a topic of story that is relevant to the child for an effective intervention.
Keywords: storybook sharing, reading, arüculation remediation, naturalistic approach
Effectiveness of a Computer Application on Declarative Memory in Persons with Dementia
Published Year: 2017 Program: Doctor of Speech Language Pathology
Stanley, Dawn Marie
Despite memory being the hallmark of dementia, there have been attempts to rehabilitate the deficit. The aim of this investigation was to examine the declarative memory system by determining the effectiveness of an iPad application, Constant Therapy. The primary goal of the face-matching task within the application was to train individuals with dementia to recognize facial features on unfamiliar faces. The face-matching task contained five levels of difficulty, in which the participants were expected to master each level with 70% accuracy. This investigation was conducted with two participants. Participant A was an 85-year old African American female with moderate dementia with session conducted at an adult daycare center and participant B was a 65-year-old African American fèmale with mild dementia with sessions conducted at her home. Participant A completed the face-matching task in two weeks, which consisted of nine sessions. Participant B completed the face-matching task in two weeks, which consisted of I I sessions. This research was conducted with the A — B design. The Saint Louis University Mental Status (SLUMS) Exam was administered prior to the investigation to determine the presence/absence of dementia. The Functional Assessment Staging Tool (FAST) was completed by caregivers to stage the dementia. Overall findings suggested that both participants demonstrated a decline in performance as the task difficulty increased.
Effects of Telepractice Versus Face-to-Face Phonemic Awareness Intervention with Head Start Preschoolers
Published Year: 2017 Program: Doctor of Speech Language Pathology
Storey, Pamela A.
Speech-language pathologists (SLP) have been slow to adopt Telepractice as a service delivery model, although it has been approved by the American Speech Language and Hearing Association (ASHA, 2013) and an evidence base is evident in the extant literature. Limited investigations exist studying phonemic awareness interventions provided via telepractice. Burgeoning evidence supports the notion that when phonemic awareness, known as the sensitivity to detect the smallest sound structure in language, is targeted in explicit, small group instruction during the preschool years, the likelihood of becoming a good reader increases (Dodd & Gillon, 2001; Koutsoftas, Harmon & Gray, 2009). However, underserved, at-risk for early literacy low SES Head Start preschoolers rarely receive these efficacious SLP interventions due to nation-wide SLP shortages. A four-participant Adapted Alternating Treatment Design investigation was completed with 4-year old Head Start preschoolers using a phonemic awareness intervention targeting CVC word initial phonemes (liquids, nasals, stops) to compare the efficacy and efficiency of Telepractice and Face-to-face models. Twice daily, 20-minute, alternating morning and afternoon sessions were conducted, with percent correct measures of matching pictures with the same initial phonemes in a CVC word within 5 seconds of a verbal antecedent. Results indicate the Telepractice magnitude of improvement matched or exceeded the Face-to-face service delivery model in this study. Thus, Telepractice is as equally efficacious and efficient as Face-to-face, when providing phonemic awareness interventions to the 4-year old Head Start preschoolers. Further research is warranted with larger groups of participants, participants with speech-language impairments and/or other disabilities, to generalize the findings to the greater preschool population.
Keywords: speech-language pathology, telepractice, early literacy, at-risk, phonemic awareness
Author has declined to share this capstone.
Effect of a Therapy Dog on Communication and Quality of Life in Adults with Mild to Moderate Dementia
Published Year: 2017 Program: Doctor of Speech Language Pathology
Townsend, Dorothy A.
Nearly 5.4 million Americans are affected by dementia (Alzheimer’s Association, 2016). Memory loss, depression, and decreased quality of life often arise from changes in the person with dementia’s (PWD) ability to communicate (Acton et al., 2007). This leads to difficulties for caregivers to communicate with persons with dementia. The purpose of this investigation was to examine the use of dog-assisted therapy as a means for increasing communication by facilitating reminiscence in PWD in order to increase quality of life. Speech language pathologists may be able to implement a therapy dog program to maximize communication efficiency and maintain the PWD’s ability to direct their health care. The effect of dog assisted therapy for PWD has been examined in inpatient and long-term settings in the United States and internationally. Literature supports the link between dog assisted therapy and social communication across geographic areas (Boyer & Mundschenk, 2014; Greer et al., 2001). This study used a single subject (small n) ABAB research design to investigate if a functional relationship exited between reminiscence intervention without a therapy dog (Phase A1 and A2) and reminiscence intervention with a therapy dog (B1 and B2) for communication and quality of life for adults with mild to moderate dementia. Results of this investigation revealed increased overall self-perceived quality of life pre- and post-intervention, indicating that the use of a therapy dog and reminiscence therapy had a positive effect on cognitive disorders. Findings contribute to the existing research base that suggests the use of a therapy dog with reminiscence therapy improves communication and quality of life for PWD.
Key Words: speech therapy, animal assisted therapy, geriatrics, cognition
Effect of Music on Reading Comprehension in Patients with Aphasia
Published Year: 2017 Program: Doctor of Speech Language Pathology
Treichler, Jaqueline
This investigation extended findings from Sarkamo et al. (2008, 2010, 2014) and examined the evidence on emotion, music, and language to determine the most effective and efficient method for application to the rehabilitation of participants with aphasia secondary to left middle cerebral artery stroke. A single subject adapted alternating treatment design was used to compare two music conditions, using music with sung lyrics simultaneously with silent reading of the lyrics, and priming with music and sung lyrics followed by reading of the lyrics, with a control condition using reading lyrics without music. Findings, presented for a single participant, demonstrated that the simultaneous and priming conditions were equally effective and efficient. The two music conditions resulted in retention of the trained phrases four weeks later, but the control condition did not. Using the celebration trend split middle line method, findings were significant and resulted in improvement on six out of ten reading subtest outcome measures. The impact of this study was a behavioral demonstration of effectiveness and efficiency of therapy using music directed toward recovery of reading comprehension for this participant with aphasia. Retention of trained reading material was improved using this approach. Outcome measurements showed improvement generalized to untrained reading material. New materials were developed to increase options for treatment.
Keywords: aphasia, emotion, language, music, neuroplasticity, reading, stroke
Dog-Assisted Therapy
Published Year: 2017 Program: Doctor of Speech Language Pathology
Wersal, James
Clinicians are expected to do more with less whether that is researching, developing a program, or creating activities for clients. The capstone intent is to develop a template for clinicians to initiate a dog-assisted therapy program. The proposal will be best in accomplishing the intent by providing an evidence-based program. This proposal will identify several key concepts for successful development and maintenance of a dog-assisted therapy program. The program will equip the clinicians with facts on breeds, estimated financial investment, activities therapists can use with their clients, dog owner responsibilities, and the ability for long-term sustainability of a program throughout the lifespan of the dog. The program will provide a snapshot of the risks associated with program development, enabling the therapist to be informed before investing in this complementary intervention. By the end of this paper, the reader should feel competent and confident in intializing their dog-assisted therapy program to promote functional outcomes.
The Importance of Early Recognition, Education, and Treatment of Lymphedema
Published Year: 2017 Program: Doctor of Speech Language Pathology
Wilson, Elizabeth
The purpose of this program proposal is educating physicians on the importance of recognizing lymphedema and referring clients for early treatment with occupational therapists. This collaboration will enable clients to receive the best possible care while promoting health and well-being. Evidence-based practice is used to describe measurement systems and therapy options as well as to explore client perceptions of lymphedema management. Timely treatment has been proven to result in optimal outcomes with multiple interventions being used on clients. Numerous articles support early treatment of lymphedema to slow the progression of swelling in the affected body part. This program promotes the early-education of physicians so that they may recognize and treat lymphedema in order to slow progression and to prevent co-morbidities. Early treatment has the potential to decrease health care utilization and expenditures for those with lymphedema. Physicians recognizing early lymphedema and referring for treatment can increase patient satisfaction and improve their patients’ ability to participate in preferred occupations. Further research is needed to improve early access to lymphedema care. Educating physicians on certification in lymphedema treatment, bandaging, compression garments, and massage are included in this program proposal.
2018
Effect of Treatment Environment on the Adult Who Stutters
Published Year: 2018 Program: Doctor of Speech Language Pathology
Benge, Hannah Ruth
Research indicates that stuttering inherently affects an individual’s communication in social situations, yet no studies appear to have been done on the effect of environment on stuttering therapy. This study sought to investigate the effect of treatment environment on speech fluency and approach to communication behaviors of the adult who stutters. The three participants were adults with persistent developmental stuttering and an interest in improving their communication. An alternating treatment design was used to measure the effect of a traditional clinic environment as compared to community environments. Results indicated that the treatment was effective in reducing situational anxiety associated with stuttering in participants 1 and 2, but not for participant 3. The treatment package also produced positive benefits on multiple outcomes associated with approach to communication. Findings were mixed regarding which treatment setting was the most effective for adults who stutter.
Keywords: persistent developmental stuttering, anxiety, agency, psychosocial
Effects of Feeding Environment at a Skilled Nursing Facility on Degree of Signs and Symptoms of Aspiration and Meal Consumption Amounts in the Geriatric Population
Published Year: 2018 Program: Doctor of Speech Language Pathology
Bethard, K. R.
The aim of this study was to investigate the performance of participants in a skilled nursing facility in two different feeding environments in order to compare any differences in degree of signs and symptoms of aspiration or meal consumption amounts to extend current literature with respect to determining the most effective environment for mealtime performance for dysphagia intervention while ensuring beneficial mealtime outcomes by conducting dysphagia therapy in the best environment for patient performance. Three participants were asked to eat meals in their normal mealtime environment and in a private therapy space while being observed. Observed signs and symptoms of aspiration and meal consumption amounts were collected at each meal. Results from visual and statistical analyses concluded that the environmental intervention had a slight, negative effect on the percentage of meal consumption amounts with the environmental change to the therapy space consistently causing an initial decrease in meal consumption amounts when introduced but little to no effect on the number of signs and symptoms of aspiration. Due to these findings, current privacy regulations affecting where dysphagia therapy can be conducted should be called into question.
Effect of Explicit Storybook Instruction on Narrative Retell in African American Preschool Children
Published Year: 2018 Program: Doctor of Speech Language Pathology
Bridges, LaShawn Thomas
The overall purpose of this investigation was to determine the effect of a narrative retell intervention on African American preschool age children who need support in the area of story grammar elements. Two participants were taught explicit narrative retell instruction using the narrative intervention, Story Champs. Scoring was based upon the most meaningful story grammar parts: problem, attempt, consequence, and ending: however, character, setting, and, feeling were scored as well. Participants’ total score of story grammar elements was documented weekly via a tablet for digital scoring. This single subject multiple baseline design across participants investigation took place in a childcare care center in a metropolitan area in South Carolina. The sessions were held three times per week for a total of eight weeks with follow-up occurring after two weeks without intervention: sessions lasted approximately IS to 20 minutes in length. Results yielded a positive effect of the narrative retell instruction using story grammar elements for both participants. In Phase B, one participant displayed an average change across sessions of +1.1 points/elements, and the other participant displayed an average change across sessions of + 1.3 points/elements. Although both participants displayed a slight decline in the story grammar retell scores between Phase B and Phase C. the outcome of this investigation still indicates an effective intervention. These findings demonstrate that Story Champs appears to be an effective intervention tool to measure growth of African American preschoolers’ narrative skills.
Effect of Anomia Treatment Delivered Via Telepractice to Persons with Aphasia (PWA)
Published Year: 2018 Program: Doctor of Speech Language Pathology
Chaclas, Jeanne Elizabeth
Research targeting therapy over-a-distance through the use of technology, or telepractice, encompasses a wide range of communication disorders in adults and children; however, studies that examine online service delivery to individuals diagnosed with aphasia—a neurological disorder caused by damage to the portions of the brain that are responsible for language production or processing—are limited (NINDS, 2017). Unfortunately, once persons with aphasia (PWA) are homebound, the intensive rehabilitation required to restore language skills may not be realistic. As such, Internet technology has the promise of extending frequent treatment to stroke patients in their homes. The purpose of this investigation was to further the evidence base by investigating two evidence-based prompting techniques used in aphasia treatment—semantic versus phonological cueing—via telepractice to one participant. Accordingly, this investigation utilized a single-subject comparison design to measure picture naming accuracy. While the participant demonstrated a minimal increase in performance following baseline for both semantic cueing treatment (SCT) and phonological cueing treatment (PCT) approaches, there was a slightly higher level of accuracy following the PCT approach. In addition, improved response time was observed following intervention for both SCT and PCT.
Keywords: telehealth, telerehabilitation, videoconferencing, stroke
The Effects of Phonemic Awareness and Word Recognition Training on Oral Reading Fluency in Secondary School Students with Reading and Language Impairments
Published Year: 2018 Program: Doctor of Speech Language Pathology
Davis, Denise Faith
In recent years, the role and responsibilities of speech-language pathologists with regards to reading have expanded. There has been an impetus for speech-language pathologists to collaborate, advocate, assess, design programs, and provide reading intervention to students with language impairments (ASHA, 2010). This drive is due to the knowledge and skills that speech-language pathologists possess in the area of language development and its effect on reading. However, much of the research has focused on reading in preschool to elementary grades, with limited research of explicit training of basic reading skills in secondary students with language and reading impairments (Scarborough et al., 1989; Swanson, 2008). The purpose of this study was to determine if explicit training in sight word recognition and phonemic awareness affect oral reading fluency (ORF) skills in high school students with language impairments. The primary dependent variable was the measurement of ORF, determined by words read per minute and reading accuracy. The secondary dependent variables were the measurement of phonemic awareness in the areas of vowel blending, sound segmentation, and sound blending skills. The investigation was conducted over a four-week period, for 45 minutes each session, with an A-B single case research design. Participants were explicitly trained in two areas during each session and a skill was discontinued when the participant scored greater than 80% accuracy on probing over two consecutive sessions. The investigation was conducted in a high school setting, with four participants, all diagnosed with a specific learning disability, due to deficits in basic reading and math skills, as their primary disability. Participant A was a 16-year-old African American female with moderate speech-language disability secondary to her specific learning disability. Participant B was a 17-year-old Pacific Islander female, also diagnosed with a moderate speech-language impairment secondary to the specific learning disability. Participant C was a 15-year-old African American male who had a history of speech-language impairment and participant D was a 19-year-old White Hispanic male, who also had a history of speech-language impairment. Although both participant C and D were not currently receiving speech therapy services, both had a history of a moderate speech-language impairment in the area of language comprehension skills. Overall findings revealed increase in percent accuracy during oral reading fluency tasks, suggesting that explicit training in basic reading skills, both in sight words and phonemic awareness skills, may increase oral reading fluency skills in high school students with reading and language impairments.
Keywords: phonemic awareness, sound segmentation, phonemic blending, reading, adolescent language, reading impairments, language impairments, oral reading fluency, vowel blending
The Effect of the Semantic Feature Analysis on Action Word Retrieval in Individuals with Chronic Aphasia
Published Year: 2018 Program: Doctor of Speech Language Pathology
Edwards, Dianca
The purpose of this investigation was to examine the effectiveness of Semantic Feature Analysis (SFA) on action-word retrieval with individuals with chronic aphasia. The participants included three women with a history of chronic aphasia as the result of traumatic brain injury, cancer, and mild cognitive impairment. The participants were age 40-80, living at home with moderate to severe chronic aphasia verified by a score of 26-75 on the Western Aphasia Battery-Revised (WAB-R; Kertesz, 2007). The treatment took place in the homes of the three participants three times each week. Treatment consisted of convergent naming of 15 trained, functional action-word photographs without cues, followed by naming of the same untrained action-word photographs using the SFA cueing chart. Semantic feature analysis was applied in the context of a changing criterion research design with a single session baseline with four intervention phases followed by post-testing with the WAB-R (Kertesz, 2007) and all 30 baseline stimulus photographs (trained and untrained) to assess generalization skills following intervention, Results included an increase in naming of the trained words for two of the three participants. The results are consistent with previous research, that included positive results with the use of SFA with individuals with aphasia. Additional studies examining the effect of SFA using action words for individuals with chronic aphasia are warranted.
Keywords: aphasia, semantic feature analysis, action word retrieval
The Effect of Individual Short Duration, High Intensity Speech Therapy Sessions on Speech Production in Children Ages 5 to 12 Years Old with Mild to Moderate Speech Sound Disorders
Published Year: 2018 Program: Doctor of Speech Language Pathology
Ferguson, Ellen
Currently, there is no gold standard for the treatment of speech sound disorders (SSDs) in the school setting (Kamhi, 2006). Further research is needed on what treatments will remediate SSDs efficiently and effectively given educational settings’ limitations. Paramount among those limitations is the protection of time spent in academic instruction (Baker, 2012). Large caseloads and the use of low intensity, distributive practice service delivery can result in a student requiring many more hours in speech therapy services above the 17 hours that is reported by the American Speech-Language-Hearing Association’s National Outcomes Measurement System (NOMS) as being necessary to remediate a single sound error. Research in the areas of intensity, therapy approach, and scheduling are limited and lack agreement on the most efficient and effective approach to remediating SSDs in the public education setting. The purpose of this investigation was to evaluate the effect of using individual, short duration, speech therapy sessions for the remediation of the speech of children ages 5-12 with speech sound disorders. The participants’ Individual Education Plan (IEP) goals and service delivery frequency and duration were used to determine the phoneme to target during therapy and were adapted to increase the frequency and shorten the duration of the individual therapy sessions and maintain the service delivery duration dictated by the participants’ IEPs. The outcome revealed improvement in the production of the targeted phoneme at the word level. The results supported the use of short duration, intensive speech therapy sessions in two out of three participants to efficiently address the treatment of speech sound disorders in the educational setting. Maintaining the intensity of both number of repetitions and the number of treatment sessions per week were important components in remediation of a speech sound error at the word level.
Keywords: intensity, augmented feedback, principles of motor learning
Effect of Empty Set Approach on Fronting in Preschoolers with Severe Phonological Impairment
Published Year: 2018 Program: Doctor of Speech Language Pathology
Foggie, T.
In the literature, there are various treatments for children with speech sound disorders (SSD) but few discuss treating specific phonological interventions processing disorders with specific interventions. According to Allen (2013), phonological interventions are effective as gleaned from the narrative reviews of many evidenced based intervention approaches for children with SSD. Due to the lack of breadth in the number of studies being compared, there are few studies that show that one intervention approach is unequivocally superior to another with a particular client group (Baker & McLeod, 2011). Knowledge of optimal intervention intensity for each approach will be integral to any investigation. Phonological processes that occur in the early stages of normally developing children can signal a delay in development (Beers, 1992; DeBree, 2007; Mediavilla et al., 2002). Phonological processing disorders can be challenging to treat in preschoolers with severe phonological processing delay. There are several treatment approaches that have proven to improve the disorder, however; there are no recommendations for speech-language pathologists to treat a specific phonological process.The purpose of this project was to evaluate the efficacy of the empty set intervention approach on preschoolers with the phonological process fronting to determine an efficacious treatment for the treatment of fronting. This single case research design investigation focused on the empty set intervention approach and its effect on retention and generalization of targeted speech sounds. The treatment, in this A-B single-subject design, was intensive to both production (20+ prompt sets) and session frequency (three times per week for 3 weeks).The outcome revealed improvement in the ability to correctly produce initial /k/ and /g/ phonemes of words in preschoolers who present with a severe phonological process fronting. Treatment effects generalized to untreated phonemes and improvements were noted with unaffiliated sounds.The results supported the use of the empty set approach to address fronting in preschoolers with severe phonological processing disorder.
The Effect of Verbal and Written Directives on Listening and Reading Comprehension in High School Students with Down Syndrome
Published Year: 2018 Program: Doctor of Speech Language Pathology
Forman, D.
Students with Down syndrome demonstrate challenges executing directives secondary to their difficulties with communication. The deficits in reading and listening comprehension and memory have the most impact on the students’ ability to function daily. A potential solution would be to determine the best method of issuing directives so students can anticipate, comprehend, and complete any directives in a timely manner. Four participants were screened using the Eckwall/Shanker Reading Inventory and completed a ten-directive test with random directives selected from the pool used in the investigation. Following pre-determined criteria, two of four participants passed the screening. Both attend a high school in the Southeast and had a primary diagnosis of Down syndrome. Pseudonyms were issued to each participant to maintain privacy. “Katie” age 17 years and “Tyler” age 15 years. An alternating treatment design was utilized for this investigation. The participants were seen individually for 35 minutes twice weekly over 4 weeks. Over the eight sessions, the participants completed a 5-minute screening followed by alternating treatment of traditional reading and listening comprehension. One session utilized pencil and paper tasks and the other session that week utilized manipulatives. Data was accumulated for both the 5-minute testing sessions, and for the tasks associated with the intervention. Data from the first week indicated both participants scored higher than anticipated based on their prescreening performance. This may be attributed to the newness of the activity and/or participant enthusiasm for a change in routine tasks. While performance varied during subsequent sessions, the data illustrated a positive progression in four out of the six dependent variables during intervention. For the 5-minute screening, Katie demonstrated improvement in both oral and written directives while the trend for combination directives was unchanged. Adam demonstrated improvement in the combination directives, no change in oral, and decreased in written directives. Overall, the intervention provided a positive influence on participant success in following directives. The hypothesis of the investigation failed to show improvement on the combination of oral and written directives. One explanation could be the small sample size of two participants. Even though the testing and intervention sessions were conducted in a small room free of distractions, the busy high school environment containing constant personal interactions among students potentially impacted mood and behavior of the participants. There is limited information in the body of literature regarding this topic. This investigation indicates that with oral and written modalities, improvement can be made with reading and listening comprehension intervention. Further study in this area, with a larger participant base would be beneficial to increasing the amount of information available to those who work with this population.
Keywords: Down syndrome, directives, manipulatives, reading comprehension, listening comprehension
Comparison of Shaker Exercise and Chin Tuck Against Resistance Exercise in Healthy Pediatric Populations
Published Year: 2018 Program: Doctor of Speech Language Pathology
Fullman, Leah I.
The purpose of this study was to compare the intensity of suprahyoid muscle contractions for five healthy pediatric participants during two dysphagia exercises: the chin tuck against resistance (CTAR) and the Shaker. There is empirical support for the use of both exercises to strengthen suprahyoid muscles in adult populations; however, there is a marked lack of evidence for use in pediatric populations. In an alternating treatment design, the healthy pediatric participants performed both exercises and the intensity of suprahyoid muscle contraction was measured as peak microvolts using surface electromyography (sEMG). All participants exhibited higher mean and median values of suprahyoid muscle activation during the CTAR exercise when compared to the Shaker exercise. The percentage of non-overlapping data was 75%, demonstrating a meaningful treatment effect. Though these results were for a small number of healthy children, they may be advantageous in future research for children with dysphagia, in that the results may guide researchers in the selection of treatment exercises.
Keywords: pediatric, dysphagia, chin tuck against resistance, Shaker, surface electromyography
Effects of Using a Voice Treatment Program Including Home Practice Using Mobile Technology on Voice Feminization
Published Year: 2018 Program: Doctor of Speech Language Pathology
Hawley, Janet L.
Purpose: Motivated by practice and feedback principles of motor learning, an SLP and Mobile app (SAM) protocol for voice feminization was developed to minimize SLP’s role to one of supervision and professional guidance and maximize learning during independent practice outside the session. The purpose of the study was to evaluate the effectiveness and acceptability of the innovative service delivery method. Method: The study used a single-subject changing criterion design. Four trans women completed a 10-week SAM voice intervention program delivered via 30-minute weekly in-clinic sessions and a technology-supported home program. The program was client-centered and incorporated frequent practice with intermittent, knowledge-of-result feedback. Outcome measures included acoustic measures, self and listener ratings of voice femininity and naturalness, and a program evaluation questionnaire. Results: Average F0 of phrases and picture descriptions gradually increased into the feminine range for all participants. Self and listener ratings showed that the trans women were perceived to sound more feminine, yet still natural, following treatment. Participants found the in-clinic sessions useful, the app easy to use, and noted little fatigue or discomfort. Conclusions: The innovative and efficient SAM program for voice feminization was effective relative to the stated aims in terms of acoustic, perceptual and program evaluation measures. There is a need for further studies to elucidate the factors that were key to the success achieved in the current study.
Keywords: male to female transsexual, acoustic voice analysis, perceptual voice analysis, principles of motor learning
The Effect of Proloquo2Go® and Visual Communication Board on Improving Communication Among Older Adults with Expressive Aphasia
Published Year: 2018 Program: Doctor of Speech Language Pathology
Henderson, Jorri Duncan
Background: People with aphasia (PWA) who cannot meet their needs through natural speech alone can benefit from using an augmentative and alternative communication (AAC) device as support (Hux, Weissling, & Wallace, 2006). In structured settings, alternative modes of communication can assist individuals with moderate to severe aphasia (Garrett & Kimelman, 2000). Low and high technology are forms of AAC to help individuals with communication and language impairments. Learning how to use an AAC system can be difficult for people with aphasia, yet, with training, AAC can be used to effectively address deficits in spoken language comprehension and expression. Objective: The investigation’s purpose was to determine whether a low-tech (communication board) device compared to a high-tech (Proloquo2Go® text-to-speech voice on iPadTM device was more effective for functional communication for adults over the age of 50, diagnosed with expressive aphasia. Method: Two participants with severe non-fluent aphasia who were immediately post-stroke with lesion to the language-dominant hemisphere received six days of training with a communication board and Proloquo2Go software system on an iPad in an alternating treatment single case research design. The participants were taught 20 pictures on both AAC systems (ten pictures on each low and high-tech device) during speech therapy. The null hypothesis that there would be no difference in patients’ responding using functional words on an AAC device trained was rejected. A difference in performance was observed between the two devices. Results: Criterion score of 75% and/or higher was the goal intended to be met for each AAC system. Outcomes showed an increase in communication using both low and hi-tech AAC devices; however, Participant 1 achieved five points below the established criterion with a communication board, and Participant 2 met the criterion on the last treatment day using Proloquo2Go. Conclusions: Further investigation of AAC treatment during speech therapy rehabilitation is necessary. Future studies should control for participant age and device preference (i.e. low-tech versus high tech), with the current investigation indicating that the younger participant favored the iPad, whereas the older participant preferred the communication board. Both subjects demonstrated improvement although only Participant 2 met criterion.
Keywords: augmentative and alternative communication, AAC, cerebrovascular disease, high-tech, low-tech
Efficacy of Executive Function Training for Young People (Age 18-26) in Recovery from Opioid Use Disorder
Published Year: 2018 Program: Doctor of Speech Language Pathology
Jacobski, Barbara M.
A review of the literature supports the theory that individuals with opioid use disorder (OUD) frequently exhibit impaired skills in executive function (EF) which negatively impact treatment retention and efficacy. EF is a higher-level cognitive process that requires interconnected communication throughout the entire brain to function properly. Current research suggests metacognitive strategy instruction and skill generalization may be effective approaches to cognitive rehabilitation in the OUD population. The purpose of this study was to investigate the effect of a multifaceted EF training program for young people in recovery from OUD. Additionally, it is the investigator’s hypothesis that improved EF skills will decrease levels of depression, anxiety, and stress, which have been associated with limited EF skills (Werchan & Amso, 2017). Four young adults (ages18-26) in recovery from OUD were recruited from sober living homes. An A-B single case research design was used to determine if a metacognitive approach to EF skill development with an emphasis on generalization of skills would positively impact performance on measures of executive function and thereby decrease levels of depression, anxiety and stress. The participants completed 30-minute sessions of alternating EF remediation and skill generalization activities using RehaCom®, a computer-based cognitive rehabilitation program, that took place over 12 consecutive days. Visual analysis of the data revealed overall improved performance in EF skills as well as decreased levels of depression, stress, and anxiety. Participants indicated the program was helpful and useful in their recovery.
Keywords: cognitive rehabilitation, substance use disorder, depression, stress, anxiety, impairment, therapy, remediation, prefrontal cortex
The Effect of the Social Thinking Methodology for Improving the Ability to Sustain Social Interactions in Adolescents with Social Communication Challenges
Published Year: 2018 Program: Doctor of Speech Language Pathology
Johnson, Sherry Melissa
Adolescents with social communication challenges pose a challenge for clinicians and educators to find evidence-based interventions to support the social needs of their students (Lee et al., 2008; White, Keonig & Scahill, 2007). The existing research on elements of the Social Thinking® methodology has shown promising results. The purpose of this study was to investigate the effectiveness of the Social Thinking® Methodology for improving the ability to sustain social interactions in adolescents with social communication challenges. Two adolescents participated in this multiple baseline design across behaviors. The three dependent variables (DV) measured include the following: asking follow-up questions, adding-a-thought, and supporting comments. Results from the visual and statistical analyses showed an increase in each participant’s ability to sustain social interaction from pre-to-post intervention. Both participants self-reported varying perspectives of their ability to sustain social interactions.
Keywords: autism spectrum disorder (ASD), conversation, social cognition, social skills, Social Thinking
The Effects of Tongue Strengthening Exercises in Mild to Moderate Obstructive Sleep Apnea
Published Year: 2018 Program: Doctor of Speech Language Pathology
Kearney, Ann
The aim of this study was to investigate the effects of tongue strengthening exercises on participants with mild to moderate obstructive sleep apnea (OSA). Although there is evidence that myofunctional therapy can have an effect on OSA, isolated tongue strengthening exercises have not been studied. Two participants were asked to complete six weeks of tongue strengthening exercises and participate in a questionnaire and a home sleep study pre and post exercises. Results from the visual analysis concluded that the intervention had a positive therapeutic impact on home sleep study scores and surveys. These findings are limited given the number of participants.
Keywords: Obstructive sleep apnea, myofunctional therapy, tongue strengthening exercises, Iowa Oral Performance Instrument
The Effect of Treatment of the Empty Set on Consonant Production in Children
Published Year: 2018 Program: Doctor of Speech Language Pathology
Ledbetter, Sarah
The diagnosis of a speech sound disorder (SSD) in childhood may affect a child’s academic, social, and emotional development. Speech-language pathologists (SLPs) who work with children diagnosed with SSD must select treatment methods that are effective (Gierut, 1998). A phonological approach to treatment of SSDs addresses a child’s underlying phonological system (Bauman-Waengler, 2008; Fey, 1985). This investigation examined Treatment of the Empty Set and its effect on consonant production in children with moderate to severe SSDs. Previous research has demonstrated that treatment of the empty set is an effective contrast treatment for children with SSDs (Gierut, 1992). In this approach, the child is presented with sounds differing in voice, place, and manner, or in place and manner (Gierut, 1989). The sounds contrasted are never produced correctly in the child’s phonetic or phonemic inventory (Gierut, 1989). A multiple baseline across participants design was selected for this investigation and included three participants ranging from 4-years, 9-months to 6-years, 2-months. Following a stable baseline, Participant One entered into treatment of the empty set. Participants Two and Three began intervention at staggered intervals. The intervention took place two times per week over four weeks. Each participant received eight total 30-45 minute sessions of treatment of the empty set. Visual analysis of the data was conducted to determine the effect of the intervention on the production of two target consonants. Visual analysis of the data revealed no change in untreated words containing the target sound for two participants. One participant demonstrated a significant change in the production of one target sound between the baseline and intervention phase.
Keywords: Contrast Treatment, Maximal Opposition, Treatment of Empty Set
Effects of Lee Silverman Voice Treatment (LSVT LOUD®) with Spanish Speaking Population: An A-B-A Single Subject Research Design
Published Year: 2018 Program: Doctor of Speech Language Pathology
Ledée Lozada, Leslie
The majority of people with Parkinson’s disease (PD) experience speech and voice disorders at some point during the course of the disease; these deficits may impair their quality of life. Medical and surgical treatments alone have not sufficiently alleviated speech disorders for people with PD, and in some cases have exacerbated or resulted in voice and speech impairment. A speech treatment approach called Lee Silverman Voice Treatment (LSVT LOUD®) has generated efficacy data for successfully treating voice and speech disorder in this population. The LSVT LOUD targets vocal loudness as a means of increasing vocal effort and improving coordination across the subsystems of speech. LSVT LOUD is delivered in a high dose that consists of four consecutive, individual 1-hour treatment sessions per week for 4 weeks (i.e., 16 sessions in 1 month); daily homework practice is assigned. Research has documented that treatment results can last out to two years, making LSVT LOUD the “gold standard” in treating speech disorders for people with Parkinson’s disease. Despite the established efficacy of LSVT LOUD, treatment of speech and voice remains an unmet need for many individuals in Puerto Rico due to lack access of trained and certified clinicians and inability to travel outside the island to receive the services. The objective of this study is to assess the clinical effectiveness of LSVT LOUD in the Spanish speaking population of Puerto Rico for treating voice disorders associated with Parkinson’s disease. A pre-test-post-test design is applied to assess the effectiveness of LSVT LOUD for the improvement of vocal loudness in the Spanish speaking population diagnosed with Parkinson’s disease. This research will provide important information for clinicians about LSVT LOUD treatment efficacy in the Spanish speaking population diagnosed with Parkinson’s disease. The findings from this study will have an important implication for enhancing treatment accessibility for individuals with Parkinson’s disease who seek voice and speech treatment.
Keywords: Lee Silverman Voice Treatment, LSVT LOUD®, Parkinson’s disease, hypokinetic dysarthria, neural plasticity, speech and voice disorder, speech and voice treatment, evidence-based practice
Perceived Vocal Improvement Following Semi-Occluded Vocal Fold Exercises in Persons with Muscle Tension Dysphonia
Published Year: 2018 Program: Doctor of Speech Language Pathology
Lightcap, Renee E.
The purpose of this pilot study was to determine the most efficient method to treat muscle tension dysphonia: semi-occluded vocal fold (SOVT) exercises as compared vocal hygiene education (VH) in an alternating treatment design. Previous research has documented a reduction in laryngeal tension with improved mean phonation time, airflow production, and improved Voice Handicap Index (VHI) scores using SOVT exercises. Additional studies have demonstrated improved vocal quality using VH. The results of this pilot study are based on a single female participant, recruited from Madigan Army Medical Center, with muscle tension dysphonia treated with SOVT exercises to the effects of VH alone using pre- and post-measures of perceived vocal effort through utilization of a visual self-rating analog scale. The data for this study are limited but could suggest the implementation of both direct and indirect treatment may improve vocal function. Keywords: Muscle tension dysphonia, semi-occluded vocal track exercises, vocal hygiene, visual analog scale.
Evidenced Based Health Literacy Training Program for Speech Pathologists
Published Year: 2018 Program: Doctor of Speech Language Pathology
Marquis-Colvard, C.
This research focused on the gap between health literacy (HL) and speech-language pathologists’ (SLPs’) self-perception of their knowledge, confidence, and communication skills concerning HL. The theoretical basis of this investigation was to create an effective learning experience for SLPs that could change their mindset. The research strategies adopted were a 30-question pretest/ posttest design used to gauge participant knowledge before and after the intervention and a 10-question Likert-like survey used to measure the participants’ self-perception of HL knowledge, confidence, and communication skills. The research approaches utilized for this investigation were chosen to effectively integrate the different components of the study in a coherent and logical way, ensuring effective collection, measurement, and analysis of the data. The target population was speech-language pathology clinicians. The participants (N=2) were a sample representing the properties of a larger population (typical US SLPs), English speaking females, ages 27y & 57y, who had from 2 to 25 years of experience. Devices and materials used were a PowerPoint presentation, journal, and pencils for the participants, and daily curriculum outline handouts. The results of the 6-session intervention demonstrated that the clinicians appeared to have made improvements in their self-perception of HL knowledge, confidence, and communication skills. In conclusion, providing HL training has the potential of improving clinician perception of their health literacy confidence, communication skills, and knowledge. With HL training, clinicians may see the connection between their responsibilities and improving patient outcomes through the use of evidence-based approaches which could save time, save money, and empower patients to better manage their own health.
A Comparison of Treatment Frequency in Elementary Age School Children Diagnosed With Moderate to Severe Speech Sound Disorders
Published Year: 2018 Program: Doctor of Speech Language Pathology
Mathews, Shawna G.
Current literature indicates there is no gold standard for speech sound disorder (SSD) intervention to include frequency of intervention nor duration of the sessions within the public-school setting (Kamhi, 2006). Additional research is warranted in the area of frequency and intensity of delivery of services that could prove a more efficient model of delivery that is also more beneficial for the students involved. This investigation compared speech sound intervention provided weekly in less intensity, high frequency sessions with greater intensity, lower frequency sessions within the public-school setting. Participants recruited for the investigation met inclusion criteria of ages between the age 5-years 0-months and 8-years 1-months who had an eligibility and individualized education plan (IEP) for services for 60 minutes of speech-language services weekly. Additional inclusion criteria indicated a moderate-to-severe speech sound disorder without comorbid disorders, a positive hearing acuity screening and a primary language of English. An A-B-C-B-C design was used to compare session data from intervention provided five times per week for 12 minutes each session with sessions provided two times per week for 30 minutes each session. Data were collected the initiation of each session as participants named 20 randomly selected consonant-vowel-consonant (CVC) pictures specific to phoneme errors indicated in the most current special education IEP. During intervention, participants imitated productions by the interventionist in isolation, in CVC words and in patterned sentences. Four participants completed the investigation. Data analysis was conducted to determine the effect of the frequency and intensity of intervention provided upon the outcomes of the participant productions. Three of four participants showed positive trend in productions across the investigation. Of these four, two participants demonstrated significant increase in correct production and a greater rate of change of the targeted phonemes within the B-phrases of the investigation of five sessions of 12 minutes per week than the C-phases of two sessions of 30 minutes per week. The third participant indicated positive trend in outcomes across all phases with inconsistent patterns between the B-phases and C-phases. The fourth participant demonstrated a zero-celerating trend within the four phases of the investigation.
Keywords: Speech sound disorder, public school, intervention, frequency, intensity
The Effectiveness of Combining Neuro-Developmental Treatment and a Speech Systems Intervention Approach in the Treatment of Dysarthria in Children with Cerebral Palsy
Published Year: 2018 Program: Doctor of Speech Language Pathology
McDermott-Winter, Therese
Current research exploring treatment of dysarthria in children with diagnoses of cerebral palsy (CP) suggests the importance of prioritizing the respiratory system, rather than isolating treatment to the oral motor or articulatory system alone. The purpose of this investigation was to attempt replication of previous intervention targeting specific respiratory tasks (Speech Subsystems Treatment – SST) in intervention, followed by examination of the effectiveness in use of a more direct respiratory treatment in the use of a specifically developed Neuro-Developmental Treatment (NDT) protocol combined with the respiratory tasks of the SST protocol. Two five-year old participants with diagnoses of spastic/dystonic CP and associated dysarthria completed an intensive course of speech therapy in an investigation structured using single case research design (A1-B-A2-BC). Seven sessions of SST were presented, followed by a two-week no treatment period, and then combined SST/NDT for six therapy sessions. Data were collected regarding performance on respiratory/speech tasks, as well as intermittent measures of single word and connected speech intelligibility. A rating of postural control was also included in this investigation. Each participant responded positively to both the SST and NDT/SST combined treatment, with improved performance on the respiratory/speech tasks of coordination of respiration with phonation, duration of phonation, slowed rate of speech and appropriate pausing for breath. While variable changes in speech intelligibility were identified at the single word level, intelligibility of connected speech improved 15.5-20% over the course of the investigation. Following the combined NDT/SST phase, increased postural control in a seated position was also documented. Short intensive cycles of SST and NDT/SST combined were effective in improving respiratory control and coordination in children with CP/dysarthria, with functional improvement in speech intelligibility achieved.
The Effect of Neuromuscular Electrical Stimulation (NMES) on Dysphagia Severity and the Role of Surface Electromyography (sEMG) in the Assessment and Treatment of Idiopathic Parkinson’s Disease (IPD)
Published Year: 2018 Program: Doctor of Speech Language Pathology
Medved, Michaela A.
In the literature, there are various investigations assessing the effectiveness of the use of neuromuscular electrical stimulation (NMES) in diverse patient populations diagnosed with dysphagia. To date there is not an extensive amount of literature on the use of NMES in individuals diagnosed with Parkinson’s disease (PD). From the literature that is available few researchers utilized surface electromyography (sEMG) as an outcome measure. The purpose of this case study is to evaluate the efficacy of neuromuscular electrical stimulation (NMES) paired with active swallowing and traditional therapy, to assess if the intervention will result in greater muscle firing as measured by surface electromyography (sEMG) when compared to traditional swallowing therapy in isolation. The primary principle underlying the use of NMES dictates that electrical stimulation can enhance muscle functioning during active swallowing (Toyama et al., 2014), therefore this modality was paired with effortful swallowing and resistance-based exercises. The treatment, in the A-B-A single-subject design, was intensive both from an exercise physiology and session frequency standpoint (three times per week for eight weeks). The outcome revealed improvement in sEMG firing during the intervention phase which remained during withdrawal. Additionally, quality of life measurements, via the SWAL-QOL, improved. Treatment effects were generalized across both participants. The results support the use of NMES in conjunction with active swallowing to improve dysphagia and quality of life in individuals with Parkinson’s disease.
Keywords: dysphagia, neuromuscular electrical stimulation (NMES), Parkinson’s disease, surface electromyography (sEMG), SWAL-QOL, swallowing
The Effect of Anticipatory Coarticulation in Conjunction with Augmented Feedback on Production of Final /r/ Words in People with Speech Sound Disorders
Published Year: 2018 Program: Doctor of Speech Language Pathology
Moore, Dawn M.
In the literature, /r/ is well documented as the most difficult sound to treat (Byun & Hitchcock, 2012), yet the research devoted to the remediation of this sound is limited. Surveys of school-based clinicians reveal /r/ treatment to be eclectic (Lancaster, Keusch, Levin, Pring, & Martin, 2010), even though Ehern (2010) reports less efficacy using an eclectic approach versus a programed approach. The most recent research for /r/ focuses on the use of ultrasound and biofeedback, but the cost of these technologies prohibits their mainstream use for nearly all clinicians, especially in the schools. The purpose of this study was to evaluate the efficacy of using anticipatory coarticulation with augmented feedback to increase accuracy of final /r/ words in people with speech sound disorders (SSDs). Anticipatory coarticulation in this study involved the addition of the word red after every final /r/ word and then specific augmented feedback was given for the participant to correct their production. A single-subject ABAB withdrawal design was implemented to assess the accuracy of productions of final /r/ words with red in four participants, ranging in age from 8;0 to 13;6 with a diagnosis of SSD. The accuracy of anticipatory coarticulation paired with augmented feedback was assessed in real time by the clinician and two interobservers (IOs) who listened to the audio recordings of the participants’ productions. According to the results, the participants improved their final /r/ productions during intervention phases as a function of anticipatory coarticulation and augmented feedback while returning to baseline level during the withdrawal phase. The data offer preliminary support for the use of anticipatory coarticulation in therapy for final /r/ words. The need for continued research is discussed as are the benefits and limitations encountered using telepractice.
Keywords: articulation disorder, speech sound disorder, persistent speech sound disorder, rhotics, anticipatory coarticulation, telepractice
The Effects of Dialogic Reading on the Expressive Vocabulary of Children with Moderate to Severely Impaired Expressive Language Skills
Published Year: 2018 Program: Doctor of Speech Language Pathology
Ramsey, Wanda
The purpose of this study was to investigate the effects of dialogic reading on the expressive vocabulary skills of children with moderate to severe expressive language delays. Previous research has shown positive effects of dialogic reading on the language skills of children who are typically developing and on children who are at-risk for language delays. However, there is limited research indicating the effectiveness of dialogic reading on children with moderate to severely delayed language skills. The participants in this multiple baseline across participants designed study received four weeks of individual dialogic reading intervention which was intended to increase their expressive vocabulary skills of a near-transfer vocabulary word list. The results revealed that all three participants demonstrated a significant increase in expressive vocabulary of the near-transfer vocabulary list. Additionally, dialogic reading increased the mean length of utterance (MLU) of the participants, though to varying degrees. More improvement was noted in the MLU of the participant who was in the earlier stage of language development than the participants in the later stage of language development.
Keywords: dialogic reading, intervention, word knowledge, expressive language
Comparing the Effects of Phonemic Perceptual Training with Sensory Motor Therapy With and Without Tucker Signs in Children with Phonological Delays
Published Year: 2018 Program: Doctor of Speech Language Pathology
Sagett, Lindy L.
The purpose of this investigation was to compare the effects of traditional speech therapy with Tucker signs to traditional speech therapy alone on the accuracy of speech production of a five-year old child with a mild to moderate phonological delay. In the literature, phonological delays and disorders are intermingled, making it difficult to determine the most effective intervention. Visual and tactile cueing have been shown to be effective in treating moderate to severe phonological impairments. An alternating treatments design was used to determine if adding multimodality cueing to phonemic perceptual training and sensory motor therapy results in greater improvements in accuracy of speech production than traditional therapy alone. Results indicated the use of Tucker signs was more effective than traditional therapy alone in remediating a mild to moderate phonological delay, without motor deficits. Accuracy of /l/ increased by an average of three words per session following traditional therapy including Tucker signs, as opposed to an average increase of two words per session following traditional therapy without Tucker signs. Percent consonants correct (PCC) increased from 72% preinterventions to 79% post interventions. Results were encouraging but limited to one participant. Results suggest that the use of Tucker signs during speech therapy may improve accuracy of speech production and intelligibility and decrease duration of time enrolled in speech therapy. Remediating phonological delays may also minimize academic and social impact.
Keywords: phonological delay, speech therapy, visual kinesthetic cues, Tucker signs
Effects of Seat Surface Position on Breath Support in Children with Low Tone
Published Year: 2018 Program: Doctor of Speech Language Pathology
Schouten, L.
In the literature, there are various positioning guidelines for children with impaired respiratory issues and hypotonia, but few discuss the treatment of positioning with a Swiss ball or therapy ball. Respiratory issues can be a challenging disorder to remediate, and the benefits of incorporating different seating methods for children with disabilities who are unable to sit independently may not be adequate to meet their postural movement needs (Reid, 1996).
The purpose of this case study is to evaluate the efficacy of sitting on a Swiss ball, rather than traditional horizontal seating as a treatment method. The principles of neuroplasticity in respiratory control are incorporated in determining if sitting on a Swiss ball will increase respiration function for maximum phonation time in three children ages four through six with a diagnosis of mild to moderate hypotonia. The treatment, in this AB-A-B single-subject design, was intensive in both respiratory production and session frequency (four times per week for four weeks).
The outcome revealed improvement in maximum phonation time when seated on a Swiss ball. An increase in attention and a decrease in fatigue were secondary results. Treatment effects were generalized to increased maximum phonation time when seated on a bench.
The results support using a Swiss ball to address respiration during typical therapy sessions in children with mild to moderate hypotonia. Increased attention with decreased fatigue appeared to be a positive component to this approach.
The Effects of Constraint-Induced Language Therapy (CILT) Targeting Specific Semantic Categories in Individuals with Chronic Stroke-Induced Aphasia
Published Year: 2018 Program: Doctor of Speech Language Pathology
St. Julian-Ball, Renetta
Numerous studies show linguistic improvement in individuals with chronic strokeinduced aphasia following the implementation of constraint-induced language therapy (CILT) and therapies targeting semantic categories. However, there are currently no studies that investigate the effectiveness of CILT when comparing results for trained and untrained categories of words used in sentences. The purpose of the research study was to determine, in patients with chronic stroke-induced aphasia, if a modified version of CILT targeting semantic categories would increase sentence production for trained and untrained words within trained and untrained semantic categories. Two males with chronic aphasia following stroke who met inclusion and exclusion criteria participated in this investigation. The single participant research incorporated an ABABA design. Participants took part in two phases of CILT (8 sessions per phase) that focused on words selected from two semantic categories: kitchen items and foods. Sessions lasted 1.5 hours and were held four times a week for four weeks. The Western Aphasia Battery-R and Boston Naming Test were administered pre-and post-treatment. The independent variables were Constraint-Induced Language Therapy and semantic category of training stimuli. The dependent variables were the accuracy of sentence production and word retrieval for semantic category words and standardized test scores. Overall, the participants demonstrated positive changes in sentence production and word retrieval only following the second treatment phase. No consistent pattern of generalization was evident within and across semantic categories. The improvement following CILT appeared to be due to cumulative treatment intensity that affected both categories. These findings support previous studies, which suggested that the use of CILT treatment is beneficial in improving language functioning in individuals with chronic stroke-induced aphasia once a sufficient number of sessions has been completed. Based on the research, further investigation is warranted to analyze the impact of CILT for sentence production within trained and untrained semantic categories for individuals with chronic stroke induced aphasia.
Effect of Social Behavior Mapping on Increasing the Perspective Taking and Metacognition of Adolescents with Social Cognitive Learning Challenges
Published Year: 2018 Program: Doctor of Speech Language Pathology
Tappen, D.
Previous research on the components of the Social Thinking (ST) methodology has shown positive, but preliminary results. One treatment framework within the ST methodology found in both schools and clinics is called Social Behavior Mapping (SBM). While SBM was studied as part of an intervention package, no research to date has measured the effectiveness of SBM as a standalone intervention. The purpose of this investigation was to explore the effectiveness of using SBM as a teaching framework for increasing perspective taking and metacognitive abilities in adolescents with social learning challenges. Four adolescents with Attention Deficit Hyperactivity Disorder (ADHD) participated in this multiple baseline across participants design for a total of eight treatment sessions. Data included both continuous and pre and post measures, and social validity surveys from subjects and parents. The results indicated an increased perspective taking ability in two subjects, with one subject also showing significant increases in metacognitive ability. The remaining two subjects saw varying results, with behavior as a factor in their performance. Clinical implications for the use of SBM with different types of learners is discussed.
Keywords: ADHD, autism, Cognitive Behavior Therapy, social cognition, social skills, Social Behavior Mapping, Social Thinking, Theory of Mind
The Effect of CTAR Exercises for Dysphagia in Persons with Oculopharyngeal Muscular Dystrophy
Published Year: 2018 Program: Doctor of Speech Language Pathology
Torres, Kristen
Oculopharyngeal muscular dystrophy is a genetic disease, which causes weakness in the pharyngeal musculature and dysphagia. This investigation presents the relevant literature and describes the swallowing deficits. Four participants with OPMD completed this A-BA-B design study. Primary measures included duration and extent of UES opening, stasis in the valleculae and pyriform sinuses, hyolaryngeal excursion, strength of the chin tuck and tongue to palate pressure strength. Secondary measures included a qualitative measure of eating satisfaction, swallow capacity measured by the Timed Water Swallow, and IDDSI diet rating. Chin tuck against resistance exercises (CTAR) was used to improve swallow function with limited results. Implications for strength training for swallowing in this disease are discussed.
The Effect of Aided Language Stimulation on the Expression of Multi-Symbol Messages by Students in High School with Moderate Intellectual Impairment Who Use Augmentative and Alternative Communication
Published Year: 2018 Program: Doctor of Speech Language Pathology
Williamson, Jill
In the literature, there are many investigations pertaining to effective treatment for individuals with intellectual and speech-language impairment with an emphasis on aided language stimulation (ALS) and augmentative and alternative communication (AAC). Verbal speech of these individuals is often difficult to understand especially to unfamiliar listeners (Beck et al., 2009). Implementation of AAC through voice output communication systems with dynamic displays (Uliano et al., 2009) may be used in accordance with ALS pairing verbal language with symbols on AAC devices (Drager et al., 2006) to assist in improving the overall quality of communication. By using ALS, the goal is to increase the length of multi-symbol messages produced for persons who use AAC. There has been successful research on using AAC modeling on the expression of multi-symbol messages by preschoolers (Binger & Light, 2007). However, there appears to be limited research on individuals in the high school setting using ALS and the production of multi-symbol messages using AAC. The purpose of this investigation was to determine if the use of ALS increased the length of the multi-symbol messages produced by students in high school with a moderate intellectual impairment who use AAC. The treatment, in this Multiple Baseline Across Participants (MBAP) single subject design, involved both production: direct imitation of two-word phrases in an action + object structure during 20 trials per session and the frequency of sessions: two times per week for four weeks. The data were analyzed using visual analysis, slope analysis, percentage of nonoverlapping data, and the Two Standard Deviation Band Method. Three out of the four participants indicated a positive change between the baseline and intervention phase with intervention data increasing in comparison to the flat baseline data, upward trend and slope in a positive direction during the intervention phase, and high percentage (75%) of percentage of non-overlapping intervention data points in comparison to the baseline data. The results indicate a significant change from the baseline to the intervention phase. Data of the fourth participant revealed no change when the intervention was presented. The outcome of this study revealed the ability of three students to produce two-word phrases on their Proloqu02Go™ communication application to facilitate verbal communication within the context of this investigation. The results supported that ALS increased the length of multi-symbol messages produced in three out of four participants specific to this investigation.
The Effect of Tactile Cues on Sound Production in Preschoolers with Articulation Impairment Compared with Traditional Phonetic Therapy
Published Year: 2018 Program: Doctor of Speech Language Pathology
Wolff, Miranda
The purpose of this investigation was to explore the effects of tactile facial cues used within traditional phonetic articulation therapy approach for preschool aged children with moderate to severe speech sound (articulation) impairment. Previous research using motor based approaches utilizing tactile facial cues for articulation therapy has shown a positive effect on speech sound acquisition and generalization. The majority of these studies included children with significant articulation impairments including children with childhood apraxia of speech and cerebral palsy and targeted sounds in words and phrases. Studies utilizing tactile facial cues are also limited to a few specific programs and not integrated into a traditional phonetic articulation therapy approach used by many speech-language pathologists. There were three participants included in this multiple baseline across behavior study. Each participant received traditional phonetic articulation therapy approach during the baseline sessions. In the intervention phase, tactile facial cues were used when a target was in error. The overall results were mixed. Only two of the participants received tactile facial cues as the third participant reached criterion for all three targets in the baseline phase. Only a total of three out of nine targets reached the intervention phase, however, all three targets for all three participants did reach criterion. Targets improving in the baseline phase indicate the efficacy of a traditional phonetic articulation therapy approach in remediating articulation errors while improvements in the intervention phase indicate a possible benefit in using tactile facial cues when a target does not respond to a traditional phonetic articulation therapy approach alone.
2019
Effect of Lingual Strength Training on Tongue Pressure and Endurance in Adults with Early Stage Parkinson’s Disease
Published Year: 2019 Program: Doctor of Speech Language Pathology
Arends, J. G.
Parkinson’s disease (PD) affects approximately one percent of the world’s population, of which, 80 percent develop dysphagia – swallowing impairments – that may lead to aspiration pneumonia, a dominant cause of death (30 to 40 percent) in individuals with PD (Fernandes, SoCal, Schuh, & Rieder, 2015; Macleod, Taylor, & Counsell, 2014; Troche et al., 2014). Because preventive measures and early intervention are critical to preventing aspiration pneumonia, this research study investigated the use of lingual strengthening exercises using the Iowa Oral Performance Instrument (IOPI) as an intervention in early stage PD. Using an A-B-A single subject experimental design, two participants with early-stage Parkinson’s disease, a 50-year-old female and a 68-year-old male, completed intensive lingual exercise with the investigator targeting lingual pressure and lingual endurance using the IOPI Pro two times per week, and a home trainer IOPI daily on non-intervention days across four to eight weeks. Findings revealed a large variable range of baseline lingual strength prior to intervention, impacting post-treatment results, which did not reveal statistical significance for achieving maximum IOPI pressures or maximum endurance in seconds for Participant 1, but had statistical significance for maximum anterior and posterior IOPI pressures for Participant 2 before he withdrew from the study. Self-reported changes using the SWALQoL inventory yielded values that were not significant following use of the lingual strength exercises. These findings support continued investigation into use of the IOPI and IOPI home trainer as a potential intervention for improving lingual strength in adults with Parkinson’s disease.
Effect of Caregiver Coachin on Generalization of Language Faciliation Strategy Implementation in the Home Setting
Published Year: 2019 Program: Doctor of Speech Language Pathology
Berti, Meghan J.
A non-concurrent multiple baseline across participants investigation was completed to assess independent caregiver use of three language facilitation strategies following structured caregiver coaching. The purpose of the study was to evaluate the effects of caregiver coaching on use of language facilitation strategies during daily routines in the home environment. The participants were caregivers whose children were receiving SLP services through the Missouri First Steps program. Caregivers with children age 23 months to 40 months who were diagnosed with expressive language delay participated in the study. Results showed an increase in frequency of caregiver use of all language facilitation strategies (self-talk, parallel-talk, and expansions) for all participants. All participants experienced a positive relative level of change (RLC) between the intervention and baseline phases along with a trend comparison from zero-celerating to accelerating and improved change in slope. The percentage of non-overlapping data (PND) was 100% for total use of language facilitation strategies for all participants when baseline and interventions were compared, suggesting caregivers in the home setting can be coached successfully to implement language facilitation strategies during daily routines. Future research could examine the effects of caregiver coaching with families of multiple cultures, increased duration of coaching, a larger variety of early childhood settings, and a larger diversity of caregivers (i.e., both sexes and varying ages) in an effort to expand generalization of the current investigation’s results.
Keywords: early intervention, caregiver coaching, expressive language development
Training the Communication Partners of Adults with Complex Communication Needs in Guatemala
Published Year: 2019 Program: Doctor of Speech Language Pathology
Blackwell, A.
The successful implementation of an augmentative and alternative communication (AAC) system often depends on the quality of the training of the communication partners. This single-subject, multiple-probe investigation was designed to determine whether using specific teaching strategies with the communication partners of adults with complex communication needs (CCN) in Guatemala would improve the quality of communicative interactions through the increased use of open-ended questions, expectant delay, and aided AAC modeling using a static visual screen display (VSD). The teaching intervention was implemented immediately before engaging in a naturalistic communication interaction, and included descriptive overview, instructor modeling, guided practice, and role plays. The intervention resulted in significant improvement in each of the three targeted behaviors for the communication partner. The percentage of nonoverlapping data (PND) when the baseline phases were compared to the intervention phases was 100% for all participants in all dependent variables. The findings demonstrated that the package of teaching methods can be effective in teaching individuals in a low and middle income (LAMI) country how to improve the quality of their communicative interactions with their adult relatives with CCN. The results have future implications for speech language pathologists (SLPs) providing services to families from different cultures and countries.
The Acquisition of Receptive Vocabulary When Taught with Errorless Learning in Young Children with Autism Spectrum Disorders
Published Year: 2019 Program: Doctor of Speech Language Pathology
Brumbaugh, K.
Receptive language skills are critical for social, educational, and language development. It is common for children with autism spectrum disorders (ASD) to have impaired receptive language skills when compared to typically developing peers. Errorless learning strategies are commonly used instructional approaches to maximize the positive reinforcement through correct responses and minimize the opportunity for error. The literature has documented the numerous types of errorless learning procedures, but few studies evaluate the effectiveness of these strategies on teaching receptive language skills in young children with ASD. This capstone investigated the effects of two errorless learning strategies (positional prompting and progressive time delay). The participants were four males ranging in age from two-years-old to seven-years-old with varying expressive and receptive communication skills. The results indicated those five sessions were insufficient for children with moderate-to-severe communication deficits to demonstrate mastery of vocabulary using positional prompting or progressive time delay only.
Effects of Vestibular Sensory Stimulation on Expressive Language and Attention in Children with Autism Spectrum Disorder
Published Year: 2019 Program: Doctor of Speech Language Pathology
Charthern, A.
Vestibular sensory stimulation (VSS; Ayers and Maillox, 1981) has been found to be effective in treating children for language development. Current literature lacks sufficient information on the effects of VSS on expressive language and attention in children diagnosed with autism spectrum disorder (ASD). The purpose of this investigation was to examine the effect of VSS on expressive language and attention to task in children with ASD. Three participants ranging between 9.0 to 14.0 years-old diagnosed with ASD were recruited for this investigation. The participants received 20-minute sessions for 4 days across 3 weeks with each participant receiving a minimum of five sessions including at least two intervention sessions. A multiple baseline across participants design was used for this investigation. After the baseline phase, each participant received five minutes of VSS at the beginning of each session. Participant A and Participant C met criteria of five spontaneous requests over their baseline mean of spontaneous requests after two sessions, and participant B met criteria after four sessions. All three participants’ data points fell outside the upper two standard deviation band analysis indicating a significant intervention effect on expressive language. Only participant B’s data presented with a significant difference on the data for attention to task. The results of this investigation appears to indicate VSS to be effective on expressive language for children with ASD. Further research is recommended in order to continue to find supporting evidence on the relationship between vestibular sensory stimulation and expressive language.
The Effect of Language-based, Narrative Intervention on African-American Prekindergarten Students
Published Year: 2019 Program: Doctor of Speech Language Pathology
Ellis, Shirley
Story comprehension skills are needed to answer questions about past, present and future narratives. It is a foundation for good story tellers and reading success. Terry et al. (2013) reported that little is known about the narrative skills of ethnically diverse students. The purpose of this investigation was to examine the effect of a narrative-based intervention called Story Champs (Spencer & Petersen, 2016) for African-American prekindergarten children who require assistance in story comprehension after listening to a pre-kindergarten-level story. This investigation used an A-B-A single-subject case design to determine if an individualized narrative intervention will influence story comprehension recall. It was hypothesized that providing a narrative-based intervention would increase story comprehension skills of African American pre-kindergarten students. Results revealed improved answers to Wh-question in all of the four participants aged 3.0 to 4.7. Where and why questions were most frequently answered correctly, while what will and were correctly answered least frequently.
Keywords: story grammar elements, Wh-questions, narratives
A Comparison of Semantic Interventions on Adolescents with ASD for Teaching Functional Language in a Naturalistic Environment
Published Year: 2019 Program: Doctor of Speech Language Pathology
Engelhardt, L. A. T.
The use of a naturalistic approaches that involve matching combinations of verbal words, pictures, and sight words in natural environments for children with autism spectrum disorder (ASD) having minimal language have been reported as a successful language intervention in the literature. This investigation compared two treatment approaches in three adolescents with ASD to determine which approach was most effective to teach five semantic concepts of common, functional words and simple phrases through the use of matching stimuli. This study was conducted within the context of an alternating treatment single case research design. Treatment A represented matched stimuli consisting of tangible objects or real actions combined with the verbal word(s) and printed word(s). Treatment B represented matching stimuli consisting of pictures of objects or real actions matched with the verbal word(s) and printed word(s). Semantic concept word sets were unique for each participant and determined by each parent based on their functional relevance in the home environment. The investigation was conducted in the home of each participant. Data were collected and reported on three male adolescents diagnosed with ASD having minimal language. Each participant was evaluated by the primary investigator using language sample analysis, behavioral observations, and parent interview. No other baseline measurements were obtained prior to initiating the teaching protocol due to the individualized nature of the teaching materials. Treatment A was alternated with treatment B over six weeks and measurements were recorded using interval recording. Each session began with 10 minutes of teaching five semantic concepts and ended with 10 minutes of assessment. Percent of non-overlapping data analysis favored Treatment B as having superiority to Treatment A for two of three participants, while slope analysis favored Treatment A as having superiority to Treatment B for two of three participants. Measurements prior to initiating the teaching protocol established that the participants had minimal language and no known semantic knowledge of the words and concepts that were presented in the investigation. All participants met a mastery level of all five semantic concepts by the end of the first half of the study or sixth session. Data trend and slope were plotted on line graphs for visual representation of intervention effect size. This study provides preliminary data in support of the potential benefits of using matched stimuli to teach semantic language to adolescents with ASD having minimal language.
The Effect of Inspiratory Muscle Training on Exercise-Induced Laryngeal Obstruction in Adolescent Athletes
Published Year: 2019 Program: Doctor of Speech Language Pathology
Gaylord, J. N.
Breathlessness or dyspnea is a primary characteristic of exercise-induced laryngeal obstruction (EILO) and prevents individuals from inhaling and exhaling without effort. The reduced ability to breathe then impacts their function in daily life and engagement in recreational activities. This single subject research study investigated the effect of inspiratory muscle training on maximum perceived breathlessness, maximum phonation time, duration of running, and quality of life regarding dyspnea with EILO in adolescent athletes. In this A-B-A design, five weeks of inspiratory muscle training was provided to five adolescent athletes, four females and one male, aged 10 to 16. Results showed a reduction in maximum perceived breathlessness as well as an increase in maximum phonation time. Participants rated their quality of life regarding their dyspnea during exercise as significantly improved on the Dyspnea Index. These findings contribute to the increasing body of literature investigating the use of alternative therapy strategies for treatment of exercise-induced laryngeal obstruction in adolescent athletes.
Effect of Psychometric Properties Education on SLP Diagnostic Tool Selection
Published Year: 2019 Program: Doctor of Speech Language Pathology
Girten, D. R.
The purpose of this investigation was to determine if education about the psychometric properties of assessment tools influences the selection of language assessment tools used in the evaluation of child language skills by speech-language pathologists (SLPs). This investigation also tracked SLP’s perception of their own knowledge and confidence in the diagnostic decision making process. This investigation used a single-subject case design with changing criterion to determine if SLPs would increase their tool selection and expand their variety of assessments as a result of the education on psychometric properties. It was hypothesized that increased knowledge and awareness of the psychometric properties of standardized language tools would affect the type and number of assessment tools used in child language assessments; however, results indicated that tool selection did not vary greatly but that positive changes were initiated by the participants with an accelerating slope of tool variation as the intervention progressed. Results also indicated that the participants improved their knowledge about psychometric properties, gained confidence with the measurements, and the participants started utilizing tools that they previously did not use to evaluate a child’s language skills.
The Effect of the Comfort Feeding only Strategy on the Immediate Behavior and Affet of Individuals with Terminal Cancer and Receiving Palliative Care
Published Year: 2019 Program: Doctor of Speech Language Pathology
James, Marissa
The act of providing and sharing food or nourishment to families and friends has been regarded as a way to signify love and support (Arenella, 2010). While receiving palliative care, individuals with terminal diseases might also benefit from continuing this act. The comfort feeding only strategy was developed as an alternative to tube feeding for terminally ill patients who want to continue to eat and drink while they undergo palliative care measures or the practice of providing comfort and support as patients near the end of their life (Brody, 2011). The literature has reported qualitative studies investigating the effect nutrition has on the quality of life and wellbeing of individuals with terminal diseases. However, research examining the effectiveness of the comfort feeding only strategy on the mood or emotions of individuals receiving palliative care is minimal. The aim of this study was to measure the effect of the comfort feeding only strategy on the immediate behavior (facial expressions, vocalization, and verbalizations) and positive affect of individuals with terminal cancer and receiving palliative care. Due to ethical components related to withholding a potentially beneficial treatment from individuals receiving palliative care, a B-A-B design was used to conduct this study. While adhering to specific inclusion criteria, three individuals with terminal cancer and admitted to an acute palliative care unit were enrolled in this study. Each subject participated in the comfort feeding only strategy and data were collected using an adapted version of the Positive and Negative Affect Schedule (PANAS) in addition to a behavior observation chart, which measured their immediate behavior and affect throughout each intervention and no intervention session. The results showed a significant change or increase in the participants’ observed positive behaviors and positive affect while they received the comfort feeding intervention.
Keywords: Palliative Care, wellbeing (behavior and affect), comfort feeding
The Effects of InferCabulary Web-Based Program on Receptive Vocabulary in Native American Children
Published Year: 2019 Program: Doctor of Speech Language Pathology
Lee, S.
The purpose of this investigation was to determine if Native American children with moderate to severe receptive vocabulary delays would benefit from the use of the web-based program InferCabulary as an effective approach to increase receptive vocabulary. The investigation took place in the computer lab at an elementary school on a Pueblo Reservation in New Mexico. A concurrent multiple baseline across participants, single case research design was used for this investigation. It included five Native American students between 7.0 and 8.11 years of age with moderate to severe receptive vocabulary delays. Four boys and one girl participated in the investigation and were provided 12 intervention sessions. The participants were randomly assigned for a staggered start of a two-data point baseline. Vocabulary knowledge for Tier 2 words was assessed at each baseline session and at the beginning of each intervention session. In addition, accuracy percentages obtained on a vocabulary task via a web-based application were documented for each participant. The data were analyzed by examining the level, trend, and stability of data assessed within and between conditions and the slope of the pretest accuracy and percent accuracy of the intervention phase. Also, to determine the significance of the change between the pretest and intervention phases, the two standard deviation band method and percentage of non-overlapping data were analyzed. Four out of five participants demonstrated positive statistically significant changes from the pre-test at the beginning of the therapy intervention to the post-test at the completion of the therapy intervention. These findings suggest that Native American children with moderate to severe vocabulary delays may demonstrate receptive vocabulary growth using InferCabulary. This research also indicates the need for continued research for this population.
How Morphological Awareness Affects the Spelling Skills of Struggling Readers
Published Year: 2019 Program: Doctor of Speech Language Pathology
Mandell, Angela
The purpose of this investigation was to determine if morphological awareness training affects the spelling skills of second grade students who struggle with reading. This fourweek investigation used a single-subject A-B-A case design to determine if improved awareness of affixes and the relations between base words and their derived forms would increase word-level spelling accuracy. It was hypothesized that improving the morphological awareness skills of young struggling readers would improve spelling accuracy. Results revealed improved word level spelling accuracy in three of the four participants. However, spelling accuracy of the isolated affixes showed greater improvements in spelling accuracy and there was an immediate and significant decrease in word-level spelling accuracy once the morphological knowledge was eliminated with the introduction of new affixes. Findings suggest that instruction of morphological awareness improves the spelling skills of students who struggle with reading.
Keywords: morphology, morphological awareness, morphological intervention, literacy, spelling
Comparison of Music and Television Viewing on Oral Intake in School-Aged Children
Published Year: 2019 Program: Doctor of Speech Language Pathology
Medina, Y.
Ambience plays a key role in feeding behaviors. The literature has been scarce and conflicting on the effects of environmental multisensory modalities on children to increase oral intake. The purpose of this investigation was to compare the effects of music and television stimuli on typical school aged children when eating. Using an alternating treatment design, the participants engaged in simultaneously eating Jell-O™ chocolate pudding while either watching a pre-selected video (The Muppet Show, Punky Brewster) or music stimulus (Linus and Lucy [Remastered]). Music and television demonstrated a PND of 100% with a significant change in oral intake from baseline to intervention. However, the music stimulus demonstrated greater increase in oral intake. Despite a small number of participants, the results of this study in conjunction with the literature support the need for further investigations to determine if the manipulation of ambient factors may be used therapeutically to enhance feeding outcomes in children with dysphagia.
Eliciting Lexical Categories Using the Expanding Expression Tool for Preschoolers
Published Year: 2019 Program: Doctor of Speech Language Pathology
Mentrasti, A. L.
Expressive language skills increase rapidly during the preschool years. For children with impaired language skills, expressing their ideas can be problematic, leading to frustration, classroom difficulties, and difficulty developing peer friendships. Providing language intervention using an innovative protocol, such as the Expanding Expression Tool (EET), enhances the development of vocabulary by teaching a framework of semantic language fundamentals. The purpose of this investigation was to determine the effects of teaching the structured protocol of the EET to preschool children with language delays. The protocol was taught during a verbal description task to elicit lexical categories (i.e., nouns, verbs, adjectives, and adverbs) across six treatment sessions. Four participants (ages 4;6-4;11 years) were enrolled from a therapeutic preschool setting and currently were receiving speech and language therapy. The results indicated that using the EET increased the production of lexical categories and the development of semantic skills for recalling salient characteristics of vocabulary targets. Implications for further research would be to employ speech-language pathologists to utilize this framework for teaching vocabulary and expansion of expressive language for writing and speaking to determine if the EET can be effective with diverse populations.
The Effect of Basic Concept Vocabulary on a Measure of Early Literacy in Students with Language Disorders in the Primary Grades
Published Year: 2019 Program: Doctor of Speech Language Pathology
Merrick, E.
Literacy is an essential skill for life, as well as an academic skill with a basis in language. Children who have language disorders face unique challenges in accessing literacy instruction when they have difficulty understanding the language concepts used in instruction. The purpose of this investigation was to explore whether early literacy performance as measured by the DIBELS FSF would significantly improve after participants received language therapy to remediate deficits in the basic concept vocabulary pair first/last, as compared to the baseline. This investigation used a single-case research design in the form of a multiple baseline across participants. Three participants with educationally relevant language deficits and Tier 3 reading support were recruited, and two participants completed the intervention addressing basic concept vocabulary. Both participants displayed statistically significant gains in scores on the DIBELS FSF following intervention as determined by the Two Standard Deviation Band method (Portney & Watkins, 2015); however, neither participant displayed a statistically significant gain in basic concept performance as measured by a researcher-made probe. The PND was 75% for the participant “Benjamin,” and 100% for the participant “Carlos.” These findings demonstrated that addressing basic concept vocabulary for children in the primary grades with language disorder and literacy needs may be beneficial in improving early literacy performance. Further research is needed to more thoroughly explore the relationship between basic concept vocabulary and early literacy performance.
The Effect of Music on Comprehension of Basic Concept Vocabulary Acquisition in Children with Receptive Language Impairments
Published Year: 2019 Program: Doctor of Speech Language Pathology
Milford, M.
Researchers have suggested a correlation between music and language development (Lamb & Gregory, 1993). Music can be used to engage children, foster communication and self-regulation, and enhance overall learning experiences. Music can also increase listening comprehension, expressive language, attention, and recall (Hill-Clarke & Robinson, 2003). The present investigation focused on the acquisition of spatial concepts, which helps children understand directions clearly and allows them to express their ideas to others. These concepts are also predictors for later success in math and reading. Research suggests that children with language delays who exhibit weaknesses in receptive vocabulary have difficulty learning new words and comprehending oral and written information (Neuman & Dwyer, 2009). The purpose of the investigation was to determine whether the use of music would increase the receptive vocabulary of spatial concepts in children with moderate to severe receptive language impairments compared with a non-music intervention. Visual analysis included assessing the level, trend, and stability of data within and between conditions, determining the slope and percentage of non-overlapping data (PND), and use of the two standard deviation band method. The investigation include three participants ranging from ages 5.6 to 6.0 years old with receptive language impairments. Two concepts were targeted in the investigation: in front and behind. An A-B single-subject experimental design was used to determine whether music improved the acquisition of spatial vocabulary, specifically for the concept: behind compared with non-music conditions. The participants completed ten, 30-minute sessions over a 4-week period. Visual analysis of the music intervention data revealed overall improved performance in comprehension of the spatial concept: behind. All of the participants demonstrated positive changes from pre-test to post-test scores on the concept behind. Intervention data from two participants demonstrated positive therapeutic results. These findings demonstrated that implementing musical activities to address spatial concept vocabulary for young children with receptive language impairments may be beneficial in improving vocabulary skills. Further exploration is needed in the use of evidence-based music interventions for treating young children with language delays specific to basic concepts. Explicit, evidence-based strategies are essential for children to expand vocabulary repertoire for academic success.
Comparing the Efficacy of Effortful Swallow and Sour Bolus on Swallowing Function in Acute Stroke Patients
Published Year: 2019 Program: Doctor of Speech Language Pathology
Moore, C.
The objective of this investigation was to determine the efficacy of combining the effortful swallow and sour bolus, in comparison to the effortful swallow alone, on the improvement of swallowing function in acute stroke patients. Three acute stroke patients participated in this investigation, which took place at a comprehensive stroke hospital in West Palm Beach, Florida. Using an alternating treatment design, the intervention of effortful swallow alone, combining effortful swallow and sour bolus, and a withholding of the two aforementioned study interventions (diet assessment alone) were used to examine their respective effect on swallowing function results as quantified by the Mann Assessment of Swallowing Abilities (MASA). All three participants experienced improved swallowing function with both the effortful swallow and combining the effortful swallow with a sour bolus. However, there is a larger improvement on swallowing function as quantified throughout the data analysis of swallowing function when the sour bolus and effortful swallow were combined; as compared to the effortful swallow alone. The literature supports both the effortful swallow and sour bolus independent of one another. However, this investigation exhibited the efficacy of the combination of these two interventions, as it achieved more efficient improvement of swallowing skills. This research should be further explored across other neurological impairments and related dysphagia.
The Effect of Simulation of Clinical Interview Skills of Speech-Language Pathology Students
Published Year: 2019 Program: Doctor of Speech Language Pathology
Nahrstedt, K. C.
A rise in the number of speech-language pathology graduate programs, as well as workload issues make it difficult for speech-language pathologists (SLPs) to supervise students in the field (Hill, Davidson, & Theodoros, 2010); graduate programs are finding it increasingly difficult to secure clinical practicum placements for their students. It is particularly challenging to find clinical internships in areas of low incidence practice, such as voice, fluency, and swallowing. While some practicum sites offer hands-on clinical experience, they do not all offer sufficient training or opportunities for the development of important professional skills, including building rapport, collecting case histories, and refining clinical interviewing skills.
Allied health science programs in universities, such as nursing programs, are regularly using simulation to provide rich learning opportunities as part of their clinical education for students. Simulation experiences have been shown to be superior to problem-based learning as an instructional method and can help to develop skills such as critical-thinking, clinical decisionmaking, and effective communication with patients and colleagues (Steadman et al., 2006). Speech-language pathology programs are beginning to use simulation experiences as an effective and valuable alternative method for bridging the gap between academic knowledge and clinical skills (Sheepway, Lincoln, & Togher, 2011), though more research is needed to determine the efficacy of these experiences. Although limited, there are studies in the field of speech-language pathology (Hill et al., 2010; Zraick, 2012) supporting the use of simulation for increasing confidence levels and preparedness in clinical placements, managing stress levels, and teaching clinical interviewing skills (Chipchase et al., 2012; Hill, Davidson, & Theodoros, 2015; Miles, Donaldson, & Friary, 2015).
This investigation employed a single subject A-B research design with four participants and hypothesized that the use of simulation with a standardized patient would increase the percentage of open-ended questions used by students in a clinical interview and improve overall clinical interviewing skills. Clinical interviewing skills were rated using the Standardized Patient Interview Rating Scale (SPIRS). A celeration trend line, descriptive statistics, percentage of nonoverlapping data, and the two standard deviation band method (Portney & Watkins, 2009) were used to analyze the data by slope, trend and variability (Gast & Ledford, 2014). An improvement of clinical interviewing skills was demonstrated by all participants; however, three of the four participants demonstrated only a slight change in level in a positive or therapeutic direction during the treatment phase. Three of the four participants exhibited an immediate increase in the use of open-ended questions during a clinical interview with a standardized patient. Though the findings of this investigation showed a correlation between simulation with a standardized patient and increasing open-ended questions and overall improvement of clinical interviewing skills, these results are preliminary and should not be used to make causal deductions.
The Effect of the Speech Assessment and Interactive Learning System (SAILS) Program on /r/ Productions in 4- to 5-Year-Old Students with Mild Articulation Delays
Published Year: 2019 Program: Doctor of Speech Language Pathology
Oetken, J.
Many children have speech sound errors that are present during the preschool years. Early intervention for the proper development of the speech sound system could be key to correcting errors before they interfere with the social or academic development of children; however, many children with mild speech sound errors do not qualify for speech-language services in the public educational system. Children in the preschool years may also benefit from auditory perceptual training in addition to skilled speech sound interventions to address mild speech production errors, such as misarticulations of the /r/ phoneme. There is a need to address this gap in the provision of services for children with mild speech sound errors. A protocol for early intervention of mild speech sound errors that examines the efficacy of auditory perceptual training is still needed.
This study investigated the effect of auditory perceptual training with the Speech Assessment and Interactive Learning System (SAILS) program on /r/ productions of 4- to 5-year-old students with mild articulation delays. The SAILS program was paired with intermittent production training sessions by a speech-language pathologist (SLP). Participants included three children aged 4- to 5-years old. This investigation was completed through a single subject staggered start A-B design. Although one participant showed a positive trend in /r/ production accuracy, auditory perceptual training results indicated a negative trend for two of the three participants. The use of the SAILS program paired with minimal production training of the /r/ phoneme did not show consistent improvements in the production of /r/ at the word level with children who had mild articulation delays. A variety of behavioral factors may have impacted these results, o more research is needed to determine the efficacy of auditory perceptual training with this population.
The Effectiveness of the Combination of Thermal Tactile Stimulation (TTS) and Neuromuscular Electrical Stimulation (NMES) on Improving Timing of the Swallow Compared to Thermal Tactile Stimulation Alone in Adults with Mild to Moderate Dysphagia Concomitant of Chronic Respiratory Failure
Published Year: 2019 Program: Doctor of Speech Language Pathology
Omine, R.
Dysphagia affects approximately 1 in 25 adults each year in the United States (Bhattacharyya, 2014). While there are several different approaches to treatment, whether it be rehabilitative or compensatory, understanding the underlying neurological impairment and medical conditions related to dysphagia is important for treatment considerations. Sensory stimulation, such as thermal tactile stimulation (TTS), is a common method of treatment that focuses on rubbing the faucial pillars for triggering the pharyngeal swallow more rapidly. Neuromuscular electrical stimulation (NMES) is a method of treatment that focuses on strengthening the swallow by muscle contraction through electrical currents (Lim et al., 2009). Prompt swallow initiation is important for decreasing risk of aspiration and premature spillage to the vallecula (Martin-Harris et al., 2007). The purpose of this investigation using an alternating treatment design, was to determine the effectiveness ofNMES when combined with TTS for improving swallow initiation time compared to the implementation of TTS alone among three adults with dysphagia concomitant of chronic respiratory failure who presented with a delayed swallow initiation of greater than three seconds. VitalStim was used as the NMES device and a chilled laryngeal mirror (-1 to 3 Celsius) was used for TTS. The Logemann four finger method in conjunction with a stopwatch were used to measure the swallow. Swallow initiation time was assessed at baseline and after each session of NMES with TTS and TTS alone. Each participant received two sessions a day, five days a week for two weeks, for a total of twenty sessions. The investigation’s results revealed that while all three participants demonstrated improved swallow initiation time, data from two out of the three participants did not support the hypothesis that there will be greater decreased swallow initiation time when NMES is combined with TTS.
The Effect of Contrastive Analysis on Codeswitching in African-American English Speaking Children to Improve Writing Skills
Published Year: 2019 Program: Doctor of Speech Language Pathology
Reid, Summer
It is estimated that more than half of African-American children in the United States speak African-American English (AAE) which may impact their use of Standard American English (SAE) and negatively affect their academic and future prospects. If they are not able to use the mainstream language (Johnson & Koonce, 201$: Mufwene. 1996: Normore, 2005; Teny, 2006). The purpose of this research study was to investigate the efficacy of providing intervention using contrastive analysis in order to offer AAE speakers the codeswitching benefit, without neglecting cultural affiliations, during writing tasks. In this single-subject multiple baseline design across participants, three elementary school male participants of African American descent, aged 9-10 with mild expressive language disorders and who have similar characteristics of AAE occurrences in SAE writing tasks, were provided with an intervention designed to examine learning of grammatical variances under contrastive analysis to improve codeswitching abilities. Data from the three participants demonstrated positive therapeutic results. The percent accuracy of AAE occurrences decreased from baseline once the intervention was introduced for all participants. findings contribute to the research that contrastive analysis aids AAE speakers to become consciously aware of grammatical differences between formal writing and informal writing. Future research should investigate how the intervention of contrastive analysis affects the standardized expressive language scores of students following longer periods of intervention during the school year.
The Effect of Systematic Narrative-Based Intervention on Generalization of Story Grammar Elements in Preschoolers with Autism Spectrum Disorder (ASD)
Published Year: 2019 Program: Doctor of Speech Language Pathology
Shawhan, M. M.
The purpose of this multiple baseline across participants investigation was to examine the effects of systematically scaffolded narrative-based intervention on the personally generated narratives of preschool-age children with autism spectrum disorder (ASD). The author sought to determine if story grammar elements (e.g., character, problem, feeling, action, ending) targeted within structured narrative retells would transfer to personally generated stories. Three preschool-aged children with ASD participated in narrative-based language intervention which included structured levels of cueing (e.g., pictures and icons only, verbal only). Measures were taken using a scoring rubric for narrative retells and personally generated narratives. Results yielded significant treatment effects for Participant A on both narrative retell and personally generated story measures. Time constraints limited the number of intervention sessions for the other two participants; however, Participant A did demonstrate an increase in story grammar element inclusion in narrative retells and personally generated stories. Generalization of elements targeted within narrative retells to personally generated stories may support the use of systematically scaffolded narrative intervention to address linguistic targets in a naturalistic context for preschool-aged children with ASD. Future research may address linguistic concepts targeted more effectively within the narrative framework and investigate what types of cueing that are most effective for achieving mastery of treatment targets.
Effect of Functional, Interactive Use of Written Words in the Preschool Population with Autism Spectrum Disorder on Whole-Word Literacy
Published Year: 2019 Program: Doctor of Speech Language Pathology
Skrobarczyk, Michelle Lee
This single-subject research investigation evaluated the effects of teaching preschool-aged children with autism spectrum disorder (ASD) to utilize whole, written words to request (mand) by completing sentences as augmentative and alternative communication (AAC). Five preschool males (aged 3;0-5;3) participated. Dependent variables included measures of whole-word literacy. Findings indicated that most participants were able to demonstrate functional, whole-world literacy to request. Identification tasks proved more difficult for participants to complete. Findings indicated that future research may evaluate interventions for literacy with the preschools ASD population. Findings indicate that functional measures of language and literacy may beneficial for preschoolers with ASD. Future research may refine the target population for this intervention. Teaching literacy to this population may provide an efficient and effective intervention, possibly improving readings comprehension difficulties that the population often encounters at later ages.
Keywords: autism, preschool, language, literacy, reading, AAC, functional, interactive, written words, whole word
Effectiveness of Repeat Visual Exposure as a Mechanism to Increase Food Selection and Preference for Fruits and Vegetables in School Age Children with Color Vision Deficiency
Published Year: 2019 Program: Doctor of Speech Language Pathology
Stimart, Cindy
The consumption of vegetables by school age children continues to be below national pediatric recommendations> Preference has been identified as the most important predictor of food intake. Therefore, identifying the most effective strategies are necessary to increase preferences for fruits and vegetables. Repeated exposures (RE) is a traditional, evidence-based method used to modify preferences. Recent research has demonstrated that repeated exposure to photos of food can increase acceptance. However, school age children diagnosed with color vision deficiency (CVD) have not been included in these research studies. Therefore, the effect of color on food selection in children with CVD remains unknown.
Three healthy school aged children diagnosed with CVD were included in an A-B research design with a pre- and post-test free eating task. During an intervention period of eight sessions, they had intensive, repeated visual exposure to pictures vegetables (V) and fruits (F) over a period of one week. Primary outcome measures were selection measured through (1) eye gaze collected via artificial intelligence (AI) Tobii Nano and (2) participant color and volume selection during the pre- and post-free eating task. After completion of the intervention, post-intervention data were collected from the children (three boys, age 13-17; SD ± 1.25). The repeated exposure intervention resulted in no change in selection of fruit and vegetables for individuals with CVD. The free eating task showed no change in food preference compared to baseline. However, two of three participants did trial a novel food during the post-test assessment. The findings of this preliminary study suggest that repeated visual exposure may not lead to alter food selection for individuals with CVD.
Positioning and Volume Consumption in Preterm Infants with Clinical Symptoms of Gastroesophageal Reflux Disease
Published Year: 2019 Program: Doctor of Speech Language Pathology
Triano, S.
Background: Gastroesophageal reflux occurs frequently in pre-term infants and results in longer hospital stays and greater expense. Aversive behaviors such as gagging, arching, and irritability are common and can interfere with the infant’s ability to consume the volume needed to meet nutritional needs. Non-pharmaceutical treatment approaches including positioning are recommended for the treatment of gastroesophageal reflux disease. Episodes of gastroesophageal reflux are dependent upon positioning, with fewer episodes occurring when infants are placed in a left sidelying position versus a semi-upright position.
Method: This study was conducted in an 84-bed, level III neonatal intensive care unit of a large, regional hospital in the southeastern United States. Three infants were enrolled in this study. There were two males and one female with an average birth age of 30.4 (+/- 4.1) weeks gestation. Age at time of investigation was 38.2 (+/- 3.5) weeks corrected gestation. A single neonatal certified speech language pathologist fed each infant for eight feeding sessions using an alternating design with randomization of feeding position. Two observers recorded all incidents of facial grimace, head/trunk rotation, lower extremity bracing, decrease in heart rate and oxygen desaturation. Trend, slope and percentage of non-overlapping data were calculated for each participant and compared across participants to determine inter-subject replication.
Results: Data were not supportive of positioning as an effective factor in volume consumption in preterm infants with clinical signs of GERD. In two of the three participants, percentage of non-overlapping data showed an equal degree of effectiveness for both the left sidelying position and the semi-upright position. Results do not support positioning as an effective factor in physiological stability during oral feeds in the population studied. No participants had an episode of decreased heart rate. One of three participants had a single episode of oxygen desaturation. The data for aversive behaviors did support positioning as an effective factor during oral feeds for preterm infants with clinical signs of GERD. The left sidelying position was shown to be superior in the reduction of the aversive behaviors defined in this study for all three participants.
Conclusion: Use of positioning may not be the definitive solution but evidence suggests that it may be beneficial while creating no harm. Implementation of a left sidelying position during oral feeds has no cost and requires no specialized skills, making it a safe and reasonable choice as an initial treatment intervention.
The Effect of Surface Electromyographic Biofeedback on Submental Muscle Amplitudes During Effortful Swallows
Published Year: 2019 Program: Doctor of Speech Language Pathology
Walker, Brigitta
Births, graduations, weddings, and funerals are all events around which the ingestion of food is a common denominator. But what happens when the ability to perform this seemingly safe act becomes a ruminative and dangerous activity? For the millions of individuals who experience difficulty swallowing each day, a biomechanical juxtaposition looms between swallowing safety and swallowing endangerment. Oropharyngeal dysphagia affects one in 25 individuals in the United States each year as a result of multiple medical diagnoses: stroke, head and neck cancer, neurodegenerative disorders, and gastroesophageal reflux disease (Bhattacharyya, 2014). Traditional treatment methods for the remediation of dysphagia include practice of swallow strengthening exercises, swallow maneuvers, pharyngeal stimulation techniques, diet consistency changes, and postural adjustments (Kiger, Brown, & Watkins, 2006). Non-traditional adjunctive treatments, such as surface electromyographic (sEMG)
biofeedback, have been more sporadically applied and underutilized due to lack of clinician training in swallowing application and decreased availability of equipment (Crary & Groher, 2000). Although principles of biofeedback have been used in physical therapy for over half a century to treat limb impairments and movement disorders (Giggins, Persson, & Caulfield, 2013), biofeedback’s emergence as a viable treatment option within the speech pathology discipline has been slower, spanning just a little more than the past two decades. Beginning with a case report by Bryant (1991) describing the positive outcome of biofeedback assisted dysphagia treatment in a patient exhibiting profound dysphagia, other researchers initiated a quest to formulate treatment protocols suitable for ameliorating swallowing dysfunction. The purpose of this investigation was to illuminate the impact of sEMG biofeedback on submental muscle activity during performance of the effortful swallow therapeutic technique.
An alternating treatment design was employed during this single subject research investigation to compare submental muscle peak amplitudes, demonstrating efficacy of visual biofeedback used with effortful swallow as compared to the use of the effortful swallow in the absence of visual feedback. Although conflicting outcomes on efficacy of sEMG biofeedback exist in current literature (Benfield, Everton, Bath, & England, 2018), the potential for positive therapeutic outcomes with the use of biofeedback-assisted dysphagia therapy is available. Results of this investigation revealed that data from three of four participants did not support the hypothesis that submental muscle peak amplitudes of effortful swallows performed with visual biofeedback were superior to effortful saliva swallows completed in the absence of visual biofeedback. Reasons for this finding are unknown, but could be attributed to participants mentally challenging themselves when performing effortful swallows in the blind. This data concurs with evidence reported by Benfield, Everton, Bath, and England (2018) that research supporting sEMG biofeedback in the treatment of dysphagia is inconclusive.
Keywords: surface electromyographic biofeedback, dysphagia, effortful swallow
2020
The Effect of a High Frequency Parent Training Program on Parent Gesture Usage in Young Children with Autism Spectrum Disorder
Published Year: 2020 Program: Doctor of Speech Language Pathology
Allen, Vonetta
Purpose: The American Pediatric Association estimates autism spectrum disorder (ASD) impacts approximately 1.7% of American children. Researchers suggest early intervention should include gesture usage to facilitate receptive and expressive language development. According to the American Speech-Language-Hearing Association, parental involvement is recommended for positive outcomes during the early intervention process. Method: A single subject, A-B design was utilized to measure the effects of a parent gesture training program for parents of young children with ASD. Three parents participated in the three-week investigation completing 10-11 sessions with eight of the sessions used for the intervention. Participant gesture usage frequency data were measured and analyzed during the baseline and intervention phase. Upon completing the baseline phase, participants completed 20-25 minutes of in-clinic training sessions including a screencast, parent feedback, active participant implementation, and a reflection component. Results: Participants increased gesture use across the intervention phase. The accelerating trend in the intervention data path with an increased average rate of change across intervention sessions of 0.64 to 0.93 would be indicative of a positive change in the number of gestures used by parents after implementation of the intervention. Statistical and clinical significance were observed across all participants. Discussion: The findings from this investigation supported a high frequency parent training program for increasing gesture use. With parent trainings focused on increased gesture usage during play and during daily activities, parents can utilize learned skills to provide intervention while knowing they are providing the therapeutic technique correctly and confidently. An increase in gesture use by parents support previous literature related to high frequency parent training programs involving parents of young children with ASD.
The Effect of Visual Cues on Individuals with Dementia and Dysphagia
Published Year: 2020 Program: Doctor of Speech Language Pathology
Battle, Porsche Brown
External visual aids, paired with additional modalities, have been examined as compensatory strategies in individuals with dementia and dysphagia (Benigas & Bourgeois, 2016; Bourgeois et al., 2003). There is currently a lack of evidence that assesses the effectiveness of a single visual aid in using compensatory strategies in individuals with dementia and dysphagia. This investigation used an A-B-A design to examine the effect of a visual aid; specifically, Strat Mats©, on the use of compensatory swallow strategy in individuals with dementia and dysphagia. Three participants ranging between 69 and 88 years-old diagnosed with mild to moderate dementia were recruited for this investigation. Participants received six to 24 sessions. Each participant received three sessions in the baseline phase, three to 18 sessions in the intervention phase, and three sessions in the withdrawal phase (Participant B and C only). Participant A was dismissed from the study after the third session in the intervention phase due to dismissal criteria reached (not referring to the Strat Mat within 10 minutes). Participant B met the intervention phase criterion after four sessions by producing lingual sweeps in three consecutive trials across three consecutive sessions. Participant C met the criteria after 18 sessions. Participants B and C had three sessions in the withdrawal phase and demonstrated a positive therapeutic response. The results of this investigation suggest that an external memory aid, such as a Strat Mat, may be an effective use of compensatory strategies in individuals with dementia and dysphagia. Further research is warranted to continue to find supporting evidence on the use of external visuals aids in dysphagia intervention.
Keywords: dementia, dysphagia, Strat Masts, compensatory swallow strategy, external visual aid
A Multimodal Intervention Approach to Treating Language Delays and Disorders in Toddlers
Published Year: 2020 Program: Doctor of Speech Language Pathology
Brown, Kaitlin
This study focused on increasing expressive communication skills in children with limited verbal output to allow for communication of basic wants and needs with parents and caregivers. There were three children ages 22-34 months enrolled in the study with a diagnosis of mild-moderate, moderate, or moderate-severe expressive language delay or mixed receptive-expressive language delay who produced fewer than 10 spoken words or signs. This study was a non-concurrent multiple baseline across participants, so the sessions were allocated according to the start of their intervention, which was randomly assigned. During the baseline and follow-up sessions, the children were exposed to labeling of toys and pictures of a pre-determined vocabulary list. The intervention sessions consisted of the speech-language pathologist modeling American Sign Language (ASL) signs and spoken words from the same pre-determined vocabulary list. Two of the three participants demonstrated an increase in expressive communication skills and were able to produce 10 to 22 signs and five to ten new single words. While the other participant did not demonstrate an increase in spoken communication, she was able to produce two signs at the completion of the study. The intervention of traditional spoken English models and American Sign Language (ASL) signs proved to be an effective method of treatment and all children demonstrated and increase in both signed and spoken vocabulary. While further research is necessary to solidify the current treatment, it demonstrated a strong basis for increasing overall expressive communication skills in preverbal and nonverbal children.
The Effectiveness of Tele-Coaching on Communcation Partner Strategies During Storybook Reading
Published Year: 2020 Program: Doctor of Speech Language Pathology
Chin, Cheri Dodge
Objective: The purpose of this study was to determine if parents can learn to implement communication partner strategies within the context of storybook reading through an online-only tele-coaching instructional method. The secondary aim of the study was to measure any change in children’s communicative acts when parents implemented communication strategies. Method: A multiple probe across participants single-case experimental design was used for this investigation. Participants included five participant dyads. Each dyad included a parent caregiver and child with complex communication needs. Tele-coaching began after a stable baseline was obtained using storybook reading interactions. The PI spent one instructional hour teaching parents how to implement read-ask-ask-prompt (RAAP) treatment for each storybook’s two-page spread. Data were collected on the correct implementation of the strategies and frequency of child communication acts. Results: All five parents demonstrated significant changes in the use of the strategies. The percentage of nonoverlapping data (PND) between baseline and intervention was 100% for all parent participants. One child participant demonstrated a significant change between baseline and intervention frequency of communicative acts (PND=100%). No other children demonstrated conclusive differences during the intervention as compared to baseline, although one child increased his frequency of communicative acts to 100% during a maintenance probe. Conclusion: This investigation supported previous research that parents can learn communication partner strategies through coaching. It further supported the use of video technology to provide instruction, which is useful for families unable to attend in-person sessions. The investigation did not support the use of the RAAP treatment to increase children’s use of communication acts; however, it was noted that there were only five intervention sessions, and more sessions may provide different results.
Keywords: augmentative and alternative communication, AAC, modeling, communication partner, aided language input, communication board
The Effect of Descriptive Teaching Methods Implemented During Group Shared Reading on the Comprehension of Picture Symbols by Children with Intellectual Disabilities in Grades K-2
Published Year: 2020 Program: Doctor of Speech Language Pathology
Christian, Sally Ann
The purpose of this investigation was to examine the effect of descriptive teaching methods implemented during classroom-based group shared reading on the comprehension of conceptually-referenced picture symbols by early elementary-age students with an intellectual disability. This case study investigation utilized a simple time series design with one participant who was learning to use an AAC core vocabulary set to enhance communications and support aided language development within the context of school. The participant met the criterion for mastery within seven sessions of intervention. The results of this investigation suggest that DTMs used during classroom-based group shared reading may be correlated with an increase in the number of conceptually-referenced core vocabulary picture symbols for which some individuals with an intellectual disability can demonstrate comprehension. Additional research is needed to replicate effects, investigate the effectiveness of the intervention with individuals with other diagnoses, as well as explore its use within other intervention contexts.
The Effect of Parent Training on the Use of Dialogic Reading Strategy in Young Children with Delayed Vocabulary Skills
Published Year: 2020 Program: Doctor of Speech Language Pathology
Critchlow, M.
The purpose of this study was to investigate the effects of a short parent training program in dialogic reading (DR) on the use of DR strategies during shared reading with young children with delayed vocabulary skills. Research has shown DR is an effective method for increasing child vocabulary skills in school-age children and that training parents in DR can be effective; however, there is limited research on training parents of young children to use DR strategies and few studies have focused on to what extent parent use of strategies can support increased child responses for children under the age of three. In this multiple baseline across participants study, parents were trained using a parent training video and received subsequent feedback in using strategies in the DR PEER sequence during shared reading. The results revealed that all three participants demonstrated significant change in strategy use from baseline to the intervention phase. Participants demonstrated varying increases in using each type of strategy. Participant children also demonstrated varying increases in the number of responses to strategy use.
Keywords: dialogic reading, parent training, intervention, vocabulary, contingent responses
The Effect of the QuestionIT Software Application on WH Question Comprehension in Children with Receptive Language Disorder
Published Year: 2020 Program: Doctor of Speech Language Pathology
Duncan, M. L.
Computer assisted instruction (CAI) has had mixed results in its effectiveness in treating children with receptive language disorders. Current literature lacks sufficient information on the effect of CAI on wh-question comprehension in children with receptive language disorders. The Purpose of this investigation was to examine the effect of CAI using the iPad application QuestionIt© in children with receptive language disorder. Three participants, ranging from 7 to 10 years of age diagnosed with receptive language disorders, were recruited for this investigation. The participants received 20-25-minute biweekly sessions over 2 to 5 weeks with each participant receiving at least four intervention sessions. A single-case A-B research design was used for this investigation. Each participant interacted with the QuestionIt© application for an average of 11 minutes at the beginning of each intervention session. Participant 1 and Participant 3 met criteria in response to wh-questions who, what, what doing, where, and when within the first four sessions and Participant 2 met criteria after 10 sessions. All three participants’ data points fell outside the upper two-standard deviation band limit indicating a significant effect on wh-question comprehension. The results of this investigation suggest Questionit© to be effective on wh-comprehension for school age children with receptive language disorder. Future research is needed to investigate the effectiveness of CAI software programs in the treatment of receptive language disorders. Key words: computer-based instruction, computer assisted instruction, wh-question comprehension, receptive language disorder, QuestionIt© iPad application.
The Effect of The Paired Stimuli Approach on Production Accuracy in Words for Students with Speech Sound Disorders
Published Year: 2020 Program: Doctor of Speech Language Pathology
Duncan, Aundra Janae
Communication disorders, namely speech sound disorders, are the most common disorders in the pediatric population across the United State. These disorders are characterized by the inability to produce age-appropriate sounds at various levels of difficulty, most noticeably in conversation. Children may exhibit deficits with groups of sounds – phonological process disorder – or with specific sounds – articulation disorder. These deficits can be attributed to a myriad of factors, such as gender, birth order, or hearing loss. Children with speech sound disorders are at an increased risk for experiencing anxiety, low self-esteem, and frustration secondary to difficulties with communicating effectively with both familiar and unfamiliar conversational partners. Additionally, these students’ academic and social functioning may be negatively impacted in the educational setting. As there are a number of potential negative adverse effects associated with having a speech sound disorder, seeking assistance from a speech language pathologist (SLP) is paramount. As experts in communication, these individuals are uniquely trained to eliminate or reduce the presence of articulation errors; by providing direct instruction, as well as strategies to teachers and family members, SLPs play a vital role in abating the aforementioned experiences had by school-age children. The paired stimuli approach, introduced in 1971 by John V Irwin and Alan J Weston, is one of many treatment methods available to SLPs. This intervention is based on the idea that the phonetic context of a sound plays a significant role in whether the sound is produced correctly or incorrectly. By identifying contexts in which sounds are produced correctly, skills can be generalized to misarticulated contexts while simultaneously promoting self-monitoring skills. Despite early investigations indicating favorable outcomes such as decreased therapy time and improved conversational intelligibility, the paired stimuli approach is one the least used treatment strategies among SLPs in the United States. This underutilization may be attributed to the paucity of research supporting the efficacy of this intervention; moreover, to date, the majority of investigations completed on the topic have involved one or both of the developers. This investigation seeks to provide current research on the efficacy of this treatment approach in children. As the paired stimuli approach addresses only the initial and final positions of words, the secondary purpose is to determine what impact this method has on the remediation of articulation errors in the medial position of words.
Improving Pragmatic Language Skills in Toddler with Autism Spectrum Disorder
Published Year: 2020 Program: Doctor of Speech Language Pathology
Festa, J. E.
This study compared the effectiveness of two different treatment protocols, discrete trial training (DTT) and a naturalistic developmental behavioral intervention (NDBI), on spontaneous use of trained words in four 2-to-3-year-old children with autism. All participants produced more words trained using a NDBI than those trained using DTT. Secondary data were collected on the effects of a multifaceted treatment combining DTT with a NDBI on receptive, expressive, and pragmatic language outcomes and joint attention skills. Outcomes were measured using standardized tests, the Receptive/Expressive Emergent Language Test—Third Edition, and the Language Use Inventory. Additional non-standardized measures collected were total number of utterances produced, number of trained utterances produced, and pragmatic use categories appearing in language samples during generalization probes. Participants made gains in total number of utterances produced and ability to respond to bids for joint attention. Two profiles of overall improvement emerged, with two participants improving their performance by at least 40% across the majority of measures, and two participants making smaller gains across a more limited number of measures. These differences in response to treatment suggest several areas for future study.
Effect of Spaced Retrieval Training on Individuals with Dementia and Dysphagia
Published Year: 2020 Program: Doctor of Speech Language Pathology
Footman, Chantanna L.
Spaced retrieval training has become an asset in assisting individuals with memory loss and improving cognitive-linguistic function. The vast amount of literature relating to spaced retrieval training is connected to memory recall and retention of functional information. Literature supporting spaced retrieval training to improve utilization of performance-based tasks is limited. This investigation used a changing criterion designed to examine the effect of spaced retrieval training on individuals with dementia and dysphagia when utilizing compensatory swallow strategies. Three participants ranging from ages 65-70 with the dual diagnosis of dementia and dysphagia were recruited. Participants received individualized therapy sessions twice per day for five days across four weeks in addition to three probe sessions one week post-intervention. All participants met the ceiling criterion of 16 minutes; however, only Participant 2 was able to execute the targeted compensatory swallow strategy during all three probe attempts. Participants 1 and 3 executed compensatory swallow strategy on two of three probe attempts. Results of this investigation suggest that spaced retrieval training may be effective on performance-based tasks for individuals with dementia and dysphagia. Due to the limited amount of existing literature, further research is recommended in order to support spaced retrieval training for performance-based tasks.
Effect of Aided Language Simulation of Core Vocabulary on Frequency of Utterances by School-Aged Children with Severe to Profound Communication Disorders Who Utilize Alternative Access Speech Generating Devices
Published Year: 2020 Program: Doctor of Speech Language Pathology
Ford, D.
Acquisition of language for individuals who utilize augmentative and alternative communication (AAC) can look different from children who speak, as children with communication disorders have limited modeling exposure of their expressive language systems (Sennott, Light, & McNaughton, 2016). Oftentimes, children with severe communication disorders experience a lack of congruence between their levels of input when compared to their expressive output of language (Smith & Grove 2003). The purpose of this investigation was to determine the effect of aided language stimulation of core vocabulary on individuals with sever to profound communication disorders who utilize alternative access speech-generating devices (SGDs). This investigation utilized a single-subject, multiple baseline across participants design. It was hypothesized that aided language stimulation of core vocabulary would increase the frequency of utterances of individuals with severe to profound communication disorders. Results revealed all three participants demonstrated an increase in utterances produced utilizing an SGD following aided language stimulation. Visual analysis was utilized to determine changed within and between adjacent conditions. The percentage of non-overlapping data (PND) and two standard deviation (SD) band method were calculated to determine the effect and significance of the intervention.
Keywords: alternative access, AAC, core vocabulary, aided language stimulation
Improving the Use of Grammatical Inflections Past Tense -ed and Third Person Singular -s in Children with Language Impairment
Published Year: 2020 Program: Doctor of Speech Language Pathology
Grimmett, K. Terese
Objective: The purpose of this study was to examine the impact of using implicit instruction with recast alone and recast with auditory bombardment to improve the use of grammatical inflections past tense – ed and third-person singular -s in children with language impairment. Method: This investigation consisted of three participants, ages 10-11, who presented with moderate to severe language disorders. A non-concurrent, multiple baseline across participants design was utilized. This investigation took place across three phases: baseline, pre-intervention, and intervention. In the pre-assessment, deficits in the use of inflections were determined by language sampling. During the baseline phase, treatment-evoked trials were initiated. Participants received recast for correct responses. In the treatment-evoked trials, there was no reinforcement or corrective feedback provided when the child responded appropriately. After the baseline phase, but before the intervention phase, the participants engaged in pre-intervention activities designed to introduce the concept of morphology, provide learning activities focused on identifying affixes and root words, and introducing the target inflections past tense -ed and third-person singular -s. Results: During the intervention phase, participants used their new knowledge and wordless picture scenes to assist in the production of sentences where target inflections were required. At the end of this five-week investigation, it was concluded that two of the three participants demonstrated progress that could be attributed to the onset of the intervention. Conclusion: One participant demonstrated improvement during the baseline phase, and that progress continued through the intervention phase. This improvement, however, could not be attributed to the intervention as a trend could not be established during the baseline phase; therefore, the improvement could be attributed to factors other than the initiation of the intervention. The results of this investigation suggest that the use of recast with auditory bombardment for improving the use of grammatical inflections past tense -ed and third-person singular was effective.
Effect of Dual-Task Training, Provided Via Telerehabilitation, On Vocal Intensity in People with Parkinson’s Disease
Published Year: 2020 Program: Doctor of Speech Language Pathology
Kalanz, Jenny R.
Objective: This investigation used a single-subject, non-concurrent baseline design to examine the effect of dual-task training (DTT) on vocal intensity levels in three participants with hypophonia secondary to Parkinson’s disease. Method: Vocal intensity levels, measured in decibels (dB), were collected for each participant during a 15-sentence reading and concurrent motor-task. Sound pressure levels in three to seven baseline and 12 intervention sessions were graphed for visual analysis of the data. Three additional speech tasks were assessed in single-task (ST) and dual-task (DT) conditions pre- and post-intervention to measure the interference of a motor-task on vocal intensity (cost-effect). All sessions and data collection were completed via telerehabilitation. Results: All three participants exhibited stability in baseline (averages ranged from 65.3-68.7 dB), followed by an immediate therapeutic increase in volume upon introducing the intervention. Pre-intervention vocal intensity levels were below average but increased to within normal limits post-treatment for all participants. Cost-effect improved with averages in ST increasing between 2.9-18.0 dB and averages in DT increasing between 5.8-18.9 dB for all participants. Conclusion: Visual and data analysis suggested a correlation between DTT and increased vocal intensity. Post-treatment, all participants showed an increase in intensity levels across tasks and ST and DT environments. These results warrant further investigation of DTT for individuals with PD who frequently demonstrate reduced volume while participating in motor tasks.
The Effect of Dosage Changes Using Traditional Speech Therapy on Speech Sounds Disorders
Published Year: 2020 Program: Doctor of Speech Language Pathology
Kirkland, Sarabeth Roberson
Objective: According to American Speech-Language-Hearing Association (ASHA, 2015), up to 8% of children exhibit a communication disorder. In the field of speech language pathology, there is no gold standard used to treat communication disorders specific to a speech sound disorder (Kamhi, 2006). Continued research efforts are needed to analyze which treatments will most effectively remediate speech sound disorders (SSDs). According to ASHA’s National Outcomes Measurement System (NOMS), 17 hours is the average time reported to target and successfully improve a single sound error. Dosage and frequency are an essential component in the outcome measures of schoolbased therapy and treatment plans. Van Riper (1978) established the traditional therapy approach to articulation that focused on the child being able to demonstrate an increased frequency of the correct production of the sound in error in increasingly sophisticated contexts. The traditional approach is the most commonly used in the school setting, with 47% of SLPs treating preschool children between ages three and six in public school settings using the traditional articulation therapy approach to target SSDs (Brumbaugh & Smit, 2013). Methods: This investigation evaluated the effects of dosage when using a traditional approach to improve outcomes for children with SSDs aged 6:0 to 8:0 years. This investigation examined the effect of short, frequent (three, 10-minute sessions per week) therapy sessions using a traditional articulation therapy approach compared to longer (one 30-minute session per week) therapy sessions, on SSDs. A comparative AB singlesubject design was used to compare the two interventions used over six weeks. Results: Three participants were included in the investigation. All participants received a total of 12 sessions. Visual analysis of the data was conducted to determine the effect of the intervention on the production of two target sounds. Data analysis revealed increases in accuracy at each level for all participants during less frequent, longer sessions and more frequent, shorter sessions. Data revealed that during the shorter, more frequent sessions participants demonstrated greater gains in percent accuracy at the end of session nine compared to gains made over the three sessions during longer, less frequent sessions. Overall, there were varied results between the participants’ rate of change. Participant 1 and participant 2 had a more substantial rate of change during the shorter, more frequent sessions, while participant #3 remained constant between longer and shorter sessions. Conclusion: Previous research and investigations that relate primarily to dosage and frequency are limited. Continued research efforts are needed to analyze which treatments will remediate SSDs most effectively. Overall results of this investigation did support the claim by the primary investigator. It was found that results of short more frequent sessions revealed larger gains for participant 1, 2, and 3. All participants made more substantial and greater gains between the initial measurement of task accuracy and the final accuracy measured during short, more frequent sessions. The rate of change was significantly increased during production tasks during the shorter session condition for participant 1 and participant 2. Participant 3 had no change between shorter and longer condition sessions. Data revealed a greater impact of tasks accuracy was met during the short, more frequent delivery method.
Keywords: speech sound disorders, traditional articulation therapy, dosage, frequency
Effectiveness of Minimal Pairs Versus Maximal Pairs Approaches in Spanish Speaking Children with Phonological Disorders
Published Year: 2020 Program: Doctor of Speech Language Pathology
Marino, Analia
The American Community Survey (United States Census Bureau, 2017) revealed that 21.3% of individuals living in the United States speak a language other than English at home, being Spanish as the second most spoken language. Phonological disorders in children affect approximately 10% of the pediatric population; 80% of these children are diagnosed as severely delayed (National Institute on Deafness and Other Communication Disorders [NIDCD], 1994). The early clinical treatment of phonological repertoire and awareness of children avoid potential difficulties in other areas of development areas such as reading, writing, spelling, and mathematical abilities (Gierut, 1998). This investigation evaluated whether the use of minimal pairs or maximal pairs would bring greater improvement to the production of targeted phonemes in children aged 3:0 to 6:11 years.
An A1B A2C/ A1C A2B single-subject design was selected for this investigation and included three participants. All participants received a total of twelve 30-minute-sessions following the baseline phase (not including the second A phase): six sessions were dedicated to the minimal pairs and six sessions to the maximal pairs approachs. Visual analysis of the data revealed that the maximal pairs approach demonstrated a larger increase in the accuracy of targeted phonemes’ production compared to minimal pairs intervention.
Keywords: maximal pairs, minimal pairs, phonological disorders, speech sound disorders.
Author has declined to share this capstone.
Effects of Debriefing on Simulated Clinical Interview Performance of SLP Students
Published Year: 2020 Program: Doctor of Speech Language Pathology
Martin, Kenyan L.
Objective: This A-B-B’ single case research design with 10 participants sought to investigate the effects of debriefing on the clinical interview performance of speech-language pathology (SLP) students using the computer-based simulation platform, Simucase. Method: Participants completed the clinical interview portion (case history and collaborator sections) of each child case in Simucase (18 total cases). All investigation activities occured remotely, with participants virtually attending each session at scheduled times. Each session commenced with a pre-briefing video conference before transitioning to Simucase to complete the assigned case of the day. Simucase performance scores were the primary dependent variable collected in this study. Upon conclusion of the simulations during B and B’ phases, participants immediately transitioned back to the video conference for debriefing. Results: Participant performance was variable, but general trends were observed. Debriefing provided during the B phase did not have a positive impact on participant performance. A modified debriefing approach was implemented during the B’ phase, which included guided self-analysis of simulation score reports. This method of debriefing demonstrated some positive effects. Conclusion: SLP students benefit from debriefing that is specific and guided toward self-analysis and reflection. Additional research on this topic is needed to better understand how to implement simulations and debriefing to best support student learning.
Effect of Explicity Phonetic Awareness Training on Leading Performance in Young Bilingual Children
Published Year: 2020 Program: Doctor of Speech Language Pathology
Melendez, Lyanne
The purpose of this investigation was to determine the effect of explicit phonemic awareness training on phoneme blending skills in second-grade bilingual children presenting with decoding difficulties. The research design was a single-subject, A-B-A design, and it included a combination of face-to-face and virtual sessions. The virtual portion of the study was conducted as a result of government-mandated school closure due to the COVID-19 outbreak. Participants were determined eligible after pre-testing was performed, and inclusion criteria were taken under consideration. The intervention or B phase was initiated simultaneously to the three participants, followed by a withdrawal phase. Explicit phoneme blending training consisted of manipulation of magnetic color tiles that provided visual, auditory, and tactile stimulation to blends sounds into words. All three participants completed the study. An observable increase in phoneme blending skills after explicit training implementation was observed for all three participants, in accordance with the two-band standard deviation method (Portney & Watkins, 2014). Participants also showed improvement in decoding skills during post-testing activities as tested with the Acadience Oral Reading Fluency Assessment (Dynamic Assessment Group; 2011). Study procedures, limitations, and recommendations for future research are further discussed.
Keywords: phonemic awareness, phoneme blending skills, explicit phonemic awareness training, decoding
Tea Strategies for Tackling OCD
Published Year: 2020 Program: Doctor of Speech Language Pathology
Mulligan, Christine
The purpose of this capstone is to emphasize the difficulties children with obsessive-compulsive disorder (OCD) face by developing an educational program to support caregivers regarding the condition, its impact at home, and classroom, and provide strategies to support positive engagement in meaningful occupation contexts. OCD is a mental health disorder characterized by obsessions and compulsion, which has adverse effects on children’s daily activities and psychosocial skills. The manifestations of OCD impair a child’s occupations, and the effects of the disorder are not only undesirable but are challenging and increases the stress on families. An occupational therapist’s responsibility is to provide mental health services for individuals and integrate everyone involved with the child. The program aims to deliver therapeutic activities to caregivers and educators in eight weekly sessions, and address the challenges associated with OCD, reducing the stress on families and caregiver burden.
Vowel Centered Accent Modification in Mandarin Chinese Speaking Pilot Candidates
Published Year: 2020 Program: Doctor of Speech Language Pathology
Pierson, Katie Ruth
Objective: To determine the effectiveness of vowel centered accent modification (VCAM) on percent vowels correct in Mandarin-speaking Chinese pilot candidates at the word, phrase, and semi-structured speech levels to increase the likelihood of pilot candidates passing International Civil Aviation Organization’s (lCAO) Level 4 English Proficiency Requirement. Method: This was a single-subject changing criterion design with six participants. Three target vowels and one control vowel were selected for each participant. Mono and bisyllabic target words were selected from aviation textbooks recommended by the flight academy. Visual feedback and placement cues were provided to assist with each participant’s vowel productions. The Pierson Aviation English Questionnaire (PAEQ), a pre and post measure, was also administered. Results: All participants demonstrated gains in percent vowel correct (PVC) at the three levels of difficulty. All pilots reported decreased anxiety levels when speaking with native speakers, air traffic controllers, and flight instructors. All pilots reported increased self-confidence levels when using aviation phraseology and an increase in enjoyment when speaking English. Conclusion: This investigation was the first of its kind to evaluate the effectiveness of vowel centered accent modification in pilot candidates. It was also the first investigation to demonstrate the usefulness of skilled speech-language pathology intervention and the positive effect on improving intelligibility in second-language English speakers in aviation.
Keywords: vowel centered accent modification, accent modification, aviation, pilot, pilot candidates, speech-language pathology, spectrograms, traditional articulation therapy, Mandarin Chinese, English language leamer, English as a second language, changing criterion design, single-subject design, expanding the field
Author has declined to share this capstone.
Effectiveness of Oral Hygiene on Nutritional Intake Outcomes in Long-Term Care Residents
Published Year: 2020 Program: Doctor of Speech Language Pathology
Roverato, Shatheta Day
Objective: This study aimed to measure the nutritional intake of long-term care residents 65 years and older, after implementing a daily oral hygiene program to incorporate current literature with the esteem in determining the effectiveness of oral hygiene before meals. Method: An ABAB withdrawal single case research design was used. Ten participants from a long-term care facility were asked to allow a speech-language pathologist to brush their teeth two times per day before a meal. PI measured meal weight before and after intake. Results: All participants demonstrated stable baselines and therapeutic treatment effects. Overall, 80% of participants experienced a positive, accelerating data trend during the initial invention phase. Upon withdrawal of the intervention, 90% of the participants presented with a decelerating data trend. Once the intervention was reinstated, 100% of participants demonstrated in an accelerating data trend. The median for the percentage of non-overlapping data for A2 to B2 phases including all participants was 85%, which indicated a significant increase in the amount of food intake once the oral hygiene program was reinstated. The OHAT was used to measure oral hygiene levels before and after implementing a daily oral hygiene program, and each participant showed improvement. Conclusion: These results support literature recommendations for long-term care facilities to implement an oral hygiene program into daily functional task procedures to increase oral nutritional intake.
Keywords: oral hygiene, dysphagia, aspiration, meal intake, long-term care resident
The Effect of Melodic Intonation Therapy in Apraxia of Speech in Adults with Broca’s Aphasia
Published Year: 2020 Program: Doctor of Speech Language Pathology
Taylor, Tasha Marie
Melodic intonation therapy (MIT) is a structured aphasia treatment program that uses the musical elements of language to improve expressive language and language production in individuals with Broca’s aphasia. Aphasia is a neurogenic disorder caused by damage to the regions of the brain responsible for language, typically the left half of the brain. It is usually seen in individuals who have experienced strokes. Apraxia of speech (AOS), which often co-occurs with Broca’s aphasia, is a speech disorder in which an individual has difficulty producing correct and consistent speech. This study aimed to evaluate MIT’s effectiveness in improving speech intelligibility in individuals with AOS. Due to AOS being a key characteristic in Broca’s aphasia, MIT may be considered a vital treatment technique for individuals with AOS. Two participants with post-stroke aphasia underwent one-hour treatment sessions for 20 days, in a multiple baseline single-subject design. The PI assessed increases in word length, hesitancy (difficulty initiating utterances), articulatory precision, and the number of syllables correctly produced after each session. Results showed that MIT improved articulatory precision, syllable production, and word length. No significant change was measured with hesitancy. Results suggest that MIT could be effective for improving speech intelligibility in individuals with AOS.
Impact of Critical Thinking Training on Diagnostic Plan-Writing
Published Year: 2020 Program: Doctor of Speech Language Pathology
Thornburg, Bonnie J.
Critical thinking is a collection of many different types of defined and categorized skills, for example, analysis, interpretation, evaluation, and inference skills. This investigation focused on analysis, that is, the ability “To identify intended and actual inferential relationships among statements, questions, concepts, descriptions or other forms of representation intended to express beliefs, judgments, experiences, reasons, information, or opinions” (Facione, 1990, p. 9). Specific critical thinking training is more effective than implicit critical thinking instruction (Morris, et al., 2019). However, explicit teaching of critical thinking skills is not as effective as inherent, discipline-specific training *Grill et al., 2015). Case studies are an effective training method (Nadershahi et al., 2013). According to Gavett and Peaper (2007), the supervisor’s use of focused questioning can encourage supervisees to develop a disposition toward critical thinking. Gunter and LeJeune (2015) created a tool for assessing the level of critical thinking, the Critical Thinking Evaluation Matrix (CTEM). Method: Participants were clinical fellows, ages 22-30, who scored 15 or fewer points on Gunter and LeJeune’s (2015) CTEM administered during recruitment. Participants were recruited by presenting written information about the study to the content expert who e-mailed the information to colleagues who are currently mentoring clinical fellows. The study’s setting was the participants’ homes because they responded to e-mailed intervention modules and case studies. The design was an A-B design because the intervention, knowledge acquisition regarding analysis skills, is a non-reversible behavior, and inter-participant performance was assessed. During the baseline 1 phase, participants were provided with a prompt from Gunter and LeJeune’s Critical Thinking in Clinical Practice in Speech-Language Pathology and asked to develop a written diagnostic plan. During the intervention Phase, participants received an e-mailed case study, detailed analysis, and background information questions and were asked to provide answers to the question and develop a written diagnostic plan for the prompt. Upon returning the analysis and background knowledge questions and written diagnostic plan, two trained raters evaluated the answers to the questions and diagnostic plan using the CTEM (Gunter & LeJeune 2015). Results: Data during the baseline phase were stable for two out of the three participants. When the intervention was introduced, an immediate, deteriorating rend was demonstrated followed by a zero-celerating or accelerating trend for all participants. Discussion: Intervention using case studies and focused questioning was an effective method of improving clinical fellows’ critical thinking skills. Gunter and LeJeune’s (2015) CTEM was a valid measure of improvement in critical thinking skills. Validating a method to measure growth in critical thinking skills could give supervisors a tool to assess the clinical competence of clinical fellows more accurately and facilitate the selection of specific training needed.
The Effect of Neuromuscular Electrical Stimulation on Muscle Contraction of the Suprahyoid Muscles in Patients 65 Years and Older with Stroke Related Dysphagia
Published Year: 2020 Program: Doctor of Speech Language Pathology
Uitenham, K. A.
The purpose of this investigation is to explore the effects of neuromuscular electrical stimulation on the muscle contraction of the suprahyoid muscles in participants 65 years and older who have experienced a stroke and subsequent stroke-related dysphagia. A total of four participants completed the investigation. This single subject study utilized an ABA design and was conducted over a two-week period for each participant. During phase A participant baseline suprahyoid muscle contraction strength was measured utilizing surface electromyography (sEMG). Neuromuscular electrical stimulation (NMES) was administered to the submental region of each participant during the intervention phase (Phase B) over the course of ten sessions. Muscle contraction of the suprahyoid muscles was measured at the conclusion of each session (Phase A2) via sEMG. A Guardian Way trained speech-language pathologist (SLP) administered all NMES treatments and collected all data for the entire study. The results yielded trends for participant A as zero-celerating, participant B as accelerating, participant C as decelerating, and participant D as decelerating. This investigation concluded that there was not enough evidence to determine whether NMES had a direct or consistent effect on muscle contraction of the suprahyoid muscles in participants aged 65 years and older with stroke-related dysphagia. Results were not significant and support previous literature that additional research is necessary to reach a conclusive stance on this highly controversial topic.
Keywords: dysphagia, neuromuscular electrical stimulation, surface electromyography
The Effects of an Online, Asynchronous Mindfulness-Based Stress Reduction Intervention on the Symptoms of Compassion Fatigue in Medical Speech-Language Pathologists
Published Year: 2020 Program: Doctor of Speech Language Pathology
Williams, K.
The aim of this study was to investigate the effects of an online, asynchronous mindfulness-based stress reduction (MBSR) intervention on symptoms of compassion fatigue for medical speech-language pathologists (SLPs). Although there is evidence that modified versions of MBSR programs, such as online-delivery models, can reduce compassion fatigue symptoms among various healthcare providers, the population of speech-language pathology has not been studied previously. In this ABA, single subject research design, a recruitment of seven participants completed and eight-week online, asynchronous mindfulness-based stress reduction program. Participants were full-time employed medical speech-language pathologists holding Certificate of Clinical Competence and state licensure and reported average to high levels of perceived stress. The online, asynchronous MBSR program consisted of one to two-hour weekly modules on a given topic of mindfulness that was access online at the leisure of the participant and included practice application activities. Weekly measurements of compassion fatigue symptoms were collected via the Professional Quality of Life Scale, version 5 (ProQOL5). Results suggested an online, asynchronous MBSR program was effective at reducing compassion fatigue symptoms of both burnout and secondary traumatic stress for medical SLPs. These findings contribute to the body of literature investigating remediation strategies for various healthcare providers experiencing compassion fatigue.
Keywords: mindfulness-based stress reduction, speech-language pathologists, burnout, compassion fatigue
2021
Peer Model Social Outcomes Using the Peer-Mediated Intervention Stay-Play-Talk
Published Year: 2021 Program: Doctor of Speech Language Pathology
Almasi, Nancy P.
Objective: This investigation used a single-subject, multiple baseline across behaviors design to examine the effect of the peer-mediated intervention (PMI), Stay-Play-Talk (SPT), on social initiation in three peer model/play partner dyads enrolled in a district preschool. Method: Peer model social initiations were coded during a 10-minute center-time activity for play organizer statements, share offers, and offers of assistance. The number of occurrences of each behavior during baselin and intervention was graphed for visual analysis of data. Peer model and teacher perceptions of participating in SPT were measured through weekly Likert scales and a post-intervention questionnaire. Results: All three peer model participants exhibited and immediate therapeutic increase in the number of occurrences across all three social initiation behaviors following SPT training. Weighted Tau-U effect sizes demonstrated statistically significant increases in social initiation across all three peer models for play organizer statements, share offers, and offers of assistance compared to baseline. A weighted Tau-U effect size of .92 also demonstrated statistically significant increases in the number of verbalization in response to peer model initiations across all three play partners. Peer models and their teacher reported overall positive experiences participating in SPT intervention. Conclusions: Visual and data analysis suggested a correlation between SPT and increased social initiations and responses across three peer model/play partner dyads. These results further support the use of SPT as a PMI for preschoolers at risk for social language delays.
Effect of Phonological Awareness Focused Interventions on Phonological Errors and Phonemic Awareness in Young School-Age Children
Published Year: 2021 Program: Doctor of Speech Language Pathology
Alvis, Jewel
Objective: This investigation explored integrated phonological awareness intervention as a method to increase phonemic awareness skills of blending and segmenting, while remediating a targeted phonological error pattern. Method: A noncurrent multiple baseline single subject designed was replicated across three participants ranging in age from 5;2 to 6;7 with at least one phonological error pattern and below average phonological awareness skills. The independent variable of integrated phonological awareness intervention consisted of completing blending and segmenting activities using 20 trained words, with a dose of 70 to 100 productions of the targeted error pattern with each of the 10, 30-minute intervention sessions. Blending and segmenting tasks used magnetic blocks, picture cards, and whiteboard activities to practice the skills. Results: All three participants demonstrated improvements in the primary dependent variable of percent consonants correct for their targeted error pattern for trained words. Each participant also demonstrated improvements in percent phonemes correct (PPC) for both blending and segmenting trained words with their targeted error pattern. The participants all showed transfer of targeted skills to untrained words with their target error pattern and generalization of blending and segmenting to CVC words that did not contain their target error pattern in a pretest/posttest. Conclusion: Integrated phonological awareness intervention was an effective method of simultaneously improving speech production and the phonemic awareness skills of blending and segmenting for young, school-age children.
The Effect of Parent Training in Indirect Language Stimulation on Parent’s Behavior With Their Late Talkers During Play
Published Year: 2021 Program: Doctor of Speech Language Pathology
Axelman, Stacy
Objective: This investigation was conducted to evaluate the effect of training parents in indirect language stimulation on parent behavior with their late talking toddlers during play through telepractice. Method: An A-B design with follow up was selected for this investigation and included one participant. The independent variable was parent training through telepractice in the use of indirect language stimulation techniques. The primary dependent variable was the cumulative number of times the parent used ILS correctly during a 10-minute play session. Results: Visual analysis revealed an immediate positive therapeutic change for participant one and carryover during the follow up phase. Percentage of nonoverlapping data was 100% with all treatment data points falling outside the range of the baseline data points. A parent questionnaire administered pre and post training also suggested a shift in a parent’s understanding of adult communication behavior and its impact on late speaking toddlers. Conclusion: Results of this investigation supported the hypothesis that parents’ behavior will change positively when trained to use indirect language stimulation techniques during play with their late talking children.
The Efficacy of Phonological and Orthographic Intervention of the Fluency and Accuracy of Nonsense Word Reading
Published Year: 2021 Program: Doctor of Speech Language Pathology
Brummel, Amy Kathryn
Purpose: The purpose of this investigation was to examine the effect of a phonological and orthographic intervention on the nonsense word reading ability of three 6-9 year-old children. Method: The intervention consisted of reading word cards with repeated orthographic patterns and different initial phonemes, all with high neighborhood density and high phonotactic probability. The drill cards were read sequentially, then in a randomized order, three times a week for three weeks. The number of nonsense words read correctly in 30 seconds were measured during each session. Results: The phonoloigcal and orthographic intervention did not significantly increase the participants’ ability to read nonsense words; however, for all three participants, the intervention resulted in an accelerating trend when compared to the minimally accelerating, zerocelerating and decelerating trends observed baseline. Conclusion: Reading remediation requires long-term intervention; three weeks was not long enough to learn the skills required for reading success. The intervention slope values seen in this investigation demonstrated a slow accelerating trend, which may be useful as a prognostic indicator and aid in the development of reading fluency goals and benchmarks. Future research and limitations are discussed.
Modified Melodic Intonation Paired with Gestures for Improving Functional Communication in Aphasia
Published Year: 2021 Program: Doctor of Speech Language Pathology
Bullock, Fatima Q.
Communication, defined as the expression of the most basic to complex thoughts and ideas, is a vital component to human interactions. When a message is conveyed from one communication partner to another, it is typically delivered via verbal and non-verbal methods. When an individual experiences difficulty effectively or consistently expressing and or receiving communicative thoughts and ideas secondary to a left-sided hemorrhagic or non-hemorrhagic stroke, communicative breakdowns in expressive and receptive language occurs and is referred to as aphasia. Depending upon the severity of the language impairment, individuals with aphasia often rely on multimodal methods of communication, such as the use of hand gestures in conjunction with verbalization to express thoughts and ideas to compensate for language impairments. Melodic Intonation Therapy (MIT) along with modified versions of the technique, (Modified Melodic
Intonation Therapy-MMIT) are two commonly used interventions in the treatment of individuals with non-fluent aphasia (NFA). Given the number of individuals who sustain a stroke resulting in aphasia, there is a growing need to maximize communicative potential with the use of multimodality interventions. This investigation will explore the findings of three participants with chronic NFA’s to improve verbal communication skills with alternating modified approaches to the traditional MIT model.
Keywords: chronic stroke, non-fluent aphasia, pantomime gestures, modified melodic intonation therapy
The Effect of Kinesthetic Movements on Children with Speech Sound Disorders
Published Year: 2021 Program: Doctor of Speech Language Pathology
Dao, Kelcie L.
Objective: Speech sound disorders (SSDs) are very common in children ages 3 to 9 receiving speech services in the educational setting. There are few research articles on the effects of auditory, motor, and other multi-sensory treatments on the acquisition of speech sounds in children diagnosed with SSDs. While some research exists that supports the positive correlation between motor-based treatment and SSDs, there is a need for more research to examine the outcomes in children with SSDs in the educational setting. The combination of tactile-kinesthetic, visual, and verbal prompts proved to be very effective in increasing auditory and visual accuracy of speech sound errors. The purpose of this research study was to determine the effect of kinesthetic movements and the acquisition of speech sounds in error compared to the traditional approach. Method: Three participants ages 7 to 9 years old participated in a single-subject alternating treatment design to examine the efforts of kinesthetic movements on the acquisition of speech sounds. A total of 10 sessions were completed with all participants. The final two sessions were a maintenance phase. Results: Visual analysis was completed to determine which treatment was more effective. Two out of the three participants showed a greater slope with the traditional approach; however, greater accuracy of speech sounds was noted with two out of three participants utilizing kinesthetic movements. Conclusion: In conclusion, while some participants showed greater accuracy of speech sounds in error utilizing kinesthetic movements, more research is warranted to determine if kinesthetic movements can be used to generalized.
The Effect of Binaural Auditory Beats on Anxiety During Mechanical Ventilation and Weaning
Published Year: 2021 Program: Doctor of Speech Language Pathology
Dolan, Kristin Charise
Hospitalizations are a source of anxiety further exacerbated with invasive, life-sustaining equipment such as mechanical ventilation (MV). The primary purpose of this investigation was to determine what effect listening to binaural auditory beats (BAB) would have on anxiety in critically ill adults dependent on MV. The A-B-A-B withdrawal design study enrolled a single participant from a Transitional Care Hospital. All investigation phases were completed over 13 days, including five baseline and five withdrawal sessions and 16 separate intervention sessions. Authentic 10 hertz (Hz) alpha frequency BAB were presented via stereo headphones for a 15 minute duration. Self-reported anxiety levels were collected using an electronic visual analog scale (eVAS). Changes in anxiety level from baseline to intervention transitioned from a contratherapeutic to a therapeutic trend. Withdrawal of the intervention resulted in a contratherapeutic trend but increased data variability and delayed latency of change. Reintroduction of the intervention resulted in a return to a therapeutic trend but continued data variability, including an unexpected immediate increase in anxiety level. Despite variable phase data and an insignificant treatment impact by two-standard deviation (2SD) band analysis, a positive therapeutic change in anxiety trends was appreciated during each intervention phase. There is merit realized in using BAB to affect self-reported anxiety. Future exploration, however, is warranted to augment the limited research currently available, including increased sample sizes, further modified homogenous populations, and improved guidelines to support dosing variability decisions.
The Effect of Parent Training Using EMT en Espanol (in Spanish) on the Ability of Monolingual Spanish-Speaking Parents to Use Matched Turns During Parent-Child Interactions
Published Year: 2021 Program: Doctor of Speech Language Pathology
Frey, Sandy
Objective: The Spanish-speaking population is rapidly growing and needs evidence-based interventions that work within the culture to promote language development in children with a language impairment or delay. The migrant Spanish-speaking population is a subculture that is rarely included in this type of research; therefore, it is unknown if evidence-based interventions that are effective in the Spanish-speaking population would be just as effective in the migrant population. Method: This single-subject investigation was implemented to determine if Enhanced Milieu Teaching in Spanish (EMT en Espanol) is effective in training Spanish-speaking migrant parents/caregivers in using matched turns when engaging in everyday activities with their children. Results: Statistical Process Control (SPC) identifies three common rules used to define the criteria for special cause; the data collected during the intervention phase of this investigation met two of the three common rules. This indicates a statistically significant increase in the number of matched turns when a parent/caregiver was educated on how to mirror and map their chlld’s interactions from baseline to the completion of the intervention. Conclusion: These findings demonstrate that a monolingual Spanish-speaking migrant parent is able to implement the matched turn strategies during daily interactions with their child when provided with the appropriate training in their native language.
The Effect of Addressing Food Overselectivity in Young Children Through the Delivery of Caregiver Training Via Telepractice
Published Year: 2021 Program: Doctor of Speech Language Pathology
Karouzakis, Kristina Marie
Objective: This investigation explored the effects of using caregiver training (CT) via telepractice to improve the caregiver’s use of specific verbal prompts during mealtimes. Method: An A-B design with follow-up was selected for this investigation and included two participants. The independent variable was caregiver training through telepractice to use specific verbal prompts with their children during mealtime. Caregivers were taught key phrases and language to use for creating a positive feeding experience. The dependent variable in this investigation was the mean number of times per minute a caregiver used a specific verbal prompt during mealtime or snack time. Results: Visual analysis revealed an immediate positive therapeutic change for all participants during the intervention phase. PND was 100% with all treatment data points falling outside of baseline data points. After the investigation was completed, caregiver perception of intervention and delivery service revealed that all participants ‘strongly agreed’ that they felt comfortable during the session and found the intervention to be a beneficial experience for them and their children. Also, the caregivers reported on the Ease of Use and Helpfulness of telepractice, and all participants ‘strongly agreed’ that telepractice was overall easy to use and helpful. Caregivers reported that telepractice was easier to use than face-to-face sessions. Conclusion: The results support the hypothesis that using telepractice to provide CT increased the number of times a caregiver used specific verbal prompts during mealtimes. Through analysis, the data demonstrated the positive impact that training had on each participant.
Effects of an Intensive Tongue Strengthening Program on Post-Glossectomy Swallow Function
Published Year: 2021 Program: Doctor of Speech Language Pathology
Kizner, Jennifer
People treated for tongue cancer with partial glossectomy, reconstruction, and postoperative chemoradiation often have oral dysphagia due to the significant changes to lingual anatomy affecting the oral phase of the swallow, specifically, bolus formation manipulation and oral transit. In this AB, criterion-changing, single-subject experimental design (SSED) study, three participants who were 4-20 months post-partial glossectomy, reconstruction, and chemoradiation treatment completed a daily intensive tongue strengthening protocol for five weeks using the Iowa Oral Performance Instrument (IOPI). The use of the IOPI involved visual feedback, and the participants had high adherence to the intensive daily lingual exercises. Post-intervention data, when compared to pre-intervention control data, revealed significant improvement in lingual strength (measured in kPa lingual pressures) and in the efficiency of food intake (as measured by an increase in grams of food eaten in a 15-minute time period). Participants in this study also reported a perceived improvement in their ability to eat more challenging foods, which may positively affect the overall quality of life post-cancer treatment. The results of this study indicate that a surgically resected and radiated tongue can be exercised, and a tongue strengthening exercise protocol could improve or impact the variety, efficiency, and amount of food consumed. Findings of this initial SSED add to the breadth of the literature regarding improvements in swallowing function through interventions that affect the overall quality of life post multimodal tongue cancer treatment.
Keywords: lingual pressures, swallowing, head and neck cancer, lingual SCC
The Effect of the Systematic Articulation Training Program Accessing Computers (SATPAC) Program Delivered Via Teletherapy on the Speech Production of Children Between the Ages of Six and Ten
Published Year: 2021 Program: Doctor of Speech Language Pathology
Landreth, Leann
Speech-Language Pathologists are responsible for remediating speech sound disorders in the most efficient and effective means to avoid their negative impact on classroom performance, literacy skills, social interactions, and vocational outcomes. As a results of the COVID-19 pandemic, SLPs need to identify effective therapy methods of telepractice. The Systematic Articulation Program Accessing Computers (SATPAC) utilizes multiple components of the principles of motor learning through nonsense words imitated to the beat of a metronome. Sacks et al. and Flipsen and Sacks report the effectiveness of the SATPAC program for remediating /r, s, z/. The purpose of this study was to determine the effectiveness of the SATPAC program via teletherapy. Other modifications of the original investigations included addressing the phoneme, using a different primary investigator (PI), and scheduling 20-to-30-minute sessions twice per week. The investigation utilized an A-B single-subject research design to assess the carryover of the target sound from the medial position of nonsense words to actual words. Once the participant obtained baseline stability, the PI initiated the intervention. The PI probed 20 randomized words at the beginning of each intervention session to monitor progress. The results indicated that the participant improved in the initial position of words from 0% to 80% accuracy over ten intervention sessions. The data offered preliminary support of the use tof SATPAC via teletherapy to remediate articulation errors in addition to /r, s, z/.
The Effect of Explicit Instruction on Executive Function Skills Via Telehealth in Adolescents with Specific Language Impairments
Published Year: 2021 Program: Doctor of Speech Language Pathology
Lawrence, Daria Darnae
Research targeting the improvement of executive function (EF) skills in children is varied, but studies examining improving EF in adolescents with specific language impairment (SLI) is scant. Speech-language pathologists (SLPs) are in need of evidence-based practice methods to support adolescents with SLIs in the development of EF skills. Furthermore, in the wake of events such as the COVID19 pandemic, SLPs need interventions that can be delivered via telehealth. As such, the use of Ward and Jacobsen’s Get Ready-Do-Done method shows promise for improving EF in adolescents with SLI delivered via telehealth. The purpose of this study was to further the evidence base for treating executive dysfunction (ED) in adolescents with SLI by using the Get Ready-Do-Done method delivered via telepractice to one participant. This investigation used a single-subject, AB design to measure the amount of time needed to plan and complete a structured, building task. The participant demonstrated minimial decrease in the amount of time needed to construct the figurine and a decrease in the amount of time needed to locate and place each piece on the figurine.
The Effect of An Explicit Literacy Intervention on Initial and Final Sound Segmentation Skills in Preschool Children
Published Year: 2021 Program: Doctor of Speech Language Pathology
Martin, Konya
Students with phonologically based speech sound disorders (SSD) are at a greater risk for phonological awareness (PA) deficits and later literacy concerns. PA develops in a sequential pattern before formal instruction. When delays in PA occur, intervention is warranted. Evidence-based PA interventions require structured approaches, multisensory methods, and references to the orthographic representations. The purpose of this investigation was to determine the impact of using the program Lively Letters (LL) when presented through telepractice on the ability of preschool students with phonologically-based SSD to segment the initial and final sounds in spoken words. The primary investigator conducted this A-B single-subject design with two participants intervening two times a week for 30-minute sessions for five weeks. The investigation outcomes revealed improvement in the PA skill of initial sound segmentation while also teaching articulatory placement for speech sounds,
The Effects of Parent Coaching Via Telepractice on the Duration and Frequency of Shared Book Reading with Children Who Are Late Talkers
Published Year: 2021 Program: Doctor of Speech Language Pathology
Mauldin, Glinda
Objective: This investigation was set up to determine if parents with limited knowledge, skills, and use of engagement strategies with preschool children identified as late talkers would increase shared book reading duration and frequency as a result of receiving parent coaching through telepractice. Method: A multiple baseline across participants design was selected for this investigation and 3 participants were enrolled. The independent variable was the teaching and coaching of parents through telepractice to implement engagement shared reading strategies. The primary dependent variable was shared book reading duration and the secondary dependent variable was shared book reading frequency. During the entirety of the investigation, the participants self-reported daity shared book reading duration and frequency via a provided reading log. Results: Visual analysis revealed positive therapeutic changes for all participants. The PND between the adjacent phases was 100% with all data points falling outside of the range of baseline data for all participants. The parent report also reported an increase in shared book reading frequency after the intervention. Conclusion: These findings demonstrate that parents with children who are late talkers can be coached through telepractice to increase engagement during share book reading resulting in increased shared book reading duration and frequency.
The Efficacy of TAGteach in the Treatment of Speech Sound Disorders in Children
Published Year: 2021 Program: Doctor of Speech Language Pathology
Palacios, Dan
Objective: The identification and resolution of speech sound disorders have long been one of the primary goals for speech-language pathologists, both in research and in the clinical setting. This investigation compares an acoustical guidance method, known as TAGteach, to traditional intervention for the treatment of speech sound disorder in school-aged children. Method: A single-subject adapted alternating treatment design was used during this investigation. Three participants with an identified speech sound disorder were recruited to participate. Each participant’s treatment alternated between TAGteach and traditional articulation designs. Accuracy of single-word speech targets on probe tasks were judged by two speech-language pathologists blind to the treatment condition. Results: A visual analysis of the data indicated that TAGteach produced an effect in two of the three participants, Despite some variability in the baseline data, the participants demonstrated an improvement in the level of their performance on the treatment probe following the introduction of the intervention. Conclusion: These results support the hypothesis that TAGteach is an effective intervention for the treatment of speech sound disorders in school-age children. Participants were able to improve their performance on the single-word treatment probe from baseline to treatment condition. Elements detailed in the manualized TAGteach, such as positive reinforcement and maintaining motivation, contribute to improved performance.
The Effects of AAC Aided Recasts via Telepractice on the Grammar of Children with Severe Language Disorders
Published Year: 2021 Program: Doctor of Speech Language Pathology
Panchik, Ann M.
This investigation attempted to identify if AAC aided recasts enhance grammatical acquisition for emerging morphosyntactic structures, including past tense verbs, question words, and question syntax. In a telepractice setting, during shared book reading, LAMP Words for Life@ was used to enhance recasts for four elementary-schoolage children with severe language impairments. A nonconcurrent A-B design with varying baseline lengths demonstrated a correlation between AAC aided recasts for three out of four participants. Visual analysis revealed therapeutic changes for Participants 2, 3, and 4 as more than two consecutive data points fell above the two-standard deviation (2SD) band of the baseline, percent non-overlapping data (PND) ranged between 50% and 80%, and the slopes of intervention trend lines ranged between 3.04 and 19. Social validity suggested moderate positive outcomes with a small amount of effort required from parents. Strong interobserver agreement and procedural fidelity supported internal validity despite the use of a quasi-experimental design.
Keywords: severe developmental language disorder, language therapy, expressive language therapy, LAMP Words for Life, explicit language intervention, specific language impairment
The Effects of Virtual Caregiver Coaching in Antigua and Barbuda on the Implementation of EMT Language Support Strategies in Naturalistic Environments
Published Year: 2021 Program: Doctor of Speech Language Pathology
Peters, Sensemillah Zakiya
Objective: The use of telepractice to provide allied health services has increased in recent years. Research in larger developed countries has shown that virtual caregiver coaching using language support strategies for children with language impairment to be effective, but there is no research using this service delivery model in smaller culturally diverse countries with limited speech and language resources. This investigation set out to determine the effectiveness of coaching caregivers in Antigua and Barbuda through telepractice to use EMT language support strategies throughout various activities of daily living with a child with language impairment. Method: A single-case multiple-baseline design was used with a single caregiver-child dyad to evaluate the caregiver’s use of EMT language support strategies. A modified version of the Teach-Model-Coach-Review method was used to teach the caregiver the language support strategies: environmental arrangement, matched turns, expansions, and time delay with milieu prompting, via virtual instruction. The caregiver attended sessions three times a week for up to 45 minutes for four weeks. Results: The reuslts of this study indicated a positive relationship between the intervention and caregiver use of strategies. The caregiver demonstrated increased responsiveness to the child’s communication attempts and exhibited the use of language support strategies across activities. Conclusion: Caregivers of children with language impairment can be taught and coached through telepractice to utilize language support strategies to facilitate language acquisition, language use and increase engagement and responsiveness.
Effectiveness of Visual-Acoustic Biofeedback in the Remediation of the Phoneme /r/
Published Year: 2021 Program: Doctor of Speech Language Pathology
Peterson, Laura
A reliable treatment method that successfully remediates /r/ errors in all children and adolescents is elusive. Speech-language pathologists (SLPs), who responded to Ruscello’s survey, conveyed the need for more effective treatment approaches to address the challenge of remediating residual speech sound errors, particularly /r/. In response to the appeal for innovative treatment, the present paper will investigate the remediation of the /r/ and other in individuals with residual speech sound errors, with a specific focus on treatment using visual-acoustic biofeedback versus traditional treatment using the Speech Therapist’s App for /r/ Treatment (staRt). All intervention utilized the Speech Therapist’s App for /r/ Treatment (staRt) in a single-case randomization design where participants received an equal number of biofeedback and non-biofeedback treatment sessions in a randomized order. The principal investigator (PI) provided intervention to four children, between 9 and ten years of age, with a residual speech sound error impacting /r/. The first question assessed effect sizes measuring the variation in accuracy from the pre-treatment baseline to the post-treatment maintenance phase, representing participants’ response to the overall treatment package. This response surpassed the smallest value to be considered clinically significant in all four participants. The second question used measures of short-term change to compare biofeedback versus traditional treatment conditions. One participant exhibited significantly larger gains in biofeedback than traditional treatment. No other participant showed a substantial difference between visual-acoustic biofeedback and traditional treatment.
Shared Story Reading in Students with Phonological Disorders and Poor Phonological Awareness
Published Year: 2021 Program: Doctor of Speech Language Pathology
Reading, Kourtney
Objective: The investigation was set up to determine if the intervention of shared story reading is effective in increasing phonological awareness skills of phonological segmentation and blending, while also remediating a phonological disorder by increasing percent of consonants correct. Method: A single-subject research A-B design was selected for this investigation with replication across four participants ranging in age from kindergarten to second grade. The independent variable of shared story reading (SSR) consisted of a story chosen based on one selected phonological process from inclusion criteria embedded with target words. Probe data were collected on the dependent variables of phonological segmentation, phonological blending, and percent consonants correct. SSR prompts were implemented using wh-questions, open-ended questions, utterance expansion, and word descriptions. Phoneme segmentation and blending tasks were modeled using tactile manipulatives of magnet blocks. No speech sound production cues were provided. After meeting baseline stability, the participants participated in 10 total intervention sessions, approximately 30minutes in length. Results: Out of the four participants, three participants demonstrated improvements in all three dependent variables from baseline. The fourth participant exhibited an increase in percent consonants correct and no change in phoneme segmentation and blending. Conclusion: Overall, the results confirm the hypothesis of this investigation indicating a positive effect of SSR on each of the three dependent variables of phoneme segmentation, phoneme blending, and percent consonants correct.
Keywords: shared story reading, percent consonants correct, phoneme segmentation, phoneme blending, phonological disorder, phonological awareness
The Effects of a Social-Emotional Learning Curriculum on Siblings of Children with Autism Spectrum Disorders Conducted Through Videoconferencing
Published Year: 2021 Program: Doctor of Speech Language Pathology
Rogers, Christina Bronwyn
A single-subject A-B design was conducted virtually to determine the effectiveness of an established social-emotional curriculum, Strong Kids™, on typically developing siblings of children with autism spectrum disorder (ASD). Published articles have shown Strong Kids™ to be effective for 94% of students in reducing their internalizing symptoms following the program (Gueldner et al., 2019). The majority of research has focused on students in mainstream classes altogether; however, none have studied typical siblings of children with ASD specifically. This study included five
siblings ages 9-10 who participated in the Strong Kids™ program twice weekly for 90 minutes over six weeks. Baseline data were recorded on three occasions before the introduction of the treatment. During the intervention phase, the participants answered 10 multiple-choice questions related to social-emotional knowledge before and after each session. Secondary measures, “Strong Kids™ Knowledge Test” and “Knowledge About Autism Scale” (KAAS), were also employed pre-and post-intervention. The data were analyzed by visual inspection, observing trend lines, slope, and baseline stability, as well as the percentage of non-overlapping data (PND) and two standard deviation method. The results indicate that all participants improved their skills
in either social-emotional knowledge or knowledge of autism or a combination of both, providing the potential for further investigation.
Keywords: typical siblings, social-emotional learning, autism spectrum disorder, teletherapy
Effect of the Expanding Expression Tool on Vocabulary Growth in Early Elementary Aged Students Living in Poverty
Published Year: 2021 Program: Doctor of Speech Language Pathology
Sharp, Sarah Elizabeth
Objective: With evidence supporting the need for a strong vocabulary to ensure academic success, children from low-SES homes often require additional support in the school environment to strengthen their vocabulary skills. Various intervention programs have been implemented across the country, but few of those programs have research to show efficacy when working with students from low-SES backgrounds. Through the use of a multi-sensory approach, the Expanding Expression Tool (EET) provides the child with a mnemonic device, along with visual and tactile information, to facilitate organization and retrieval of information about items described. Method: Using a single case research design, the effects of the EET were investigated by measuring the verbal descriptors produced by two children given to describe a target noun. The participants were a set of fraternal twins, one male and one female, aged 6 years, 10 months. Each received baseline and intervention sessions for 30-minutes, three times per week until criterion was met. The dependent variable was the number of verbal descriptors given to describe common nouns. Results: Using the 2 standard deviation method, data indicated that changes from baseline to the end of intervention showed a signficant increase in number of descriptors provided to describe a noun. Conclusion: Given instruction in the EET, children from low-SES background may increase vocabulary production in relation to descriptors of nouns.
Effects of Respiratory Exercise on Post-Stroke Cognition
Published Year: 2021 Program: Doctor of Speech Language Pathology
Sheldon, Melody L.
Evidence suggests that exercise improves cognition in stroke patients. The purpose of this investigation was to assess the effects of a self-administered respiratory exercise on cognition in individuals with chronic stroke. An AB single study design was implemented over an eight-week intervention phase using a respiratory exercise five days a week. The primary outcome measure examined memory (digit span backward) as this domain is sensitive to exercise-induced changes to cognition, and memory deficits are prevalent in cognitively impaired stroke patients. Secondary outcome measures included the domains of executive functions (verbal fluency), attention (color word interference), and respiratory capacity, an aspect of respiratory function, using spirometry. Analysis of the data indicated that individuals post stroke showed improvements in working memory, attention, and problem solving after playing the didgeridoo, a self-administered exercise that was cost-effective, accessible, and motivating. There were no appreciable changes to respiratory capacity.
Keywords: attention, color word, executive dysfunction, forced vital capacity, respiratory capacity, spirometry
Comparison of an Active Speech Approach to a Traditional Articulation Approach in Children with Speech Sound Disorders
Published Year: 2021 Program: Doctor of Speech Language Pathology
Stewart, Sandi K.
Objective: Evidence suggests that physical activity enhances learning, and currently there is a profusion of research confirming the correlation between movement and academic achievement. A comparison single-case design was implemented to determine if an active speech approach is more effective than a traditional articulation approach in remediating errored speech sounds. Method: Using a comparative single-subject design, the primary investigator recruited students between five and 10 year of age from a local elementary school in Utah. Three participants followed an A-B-C design, where A was the baseline phase, B was the traditional articulation approach, and C was the Active Speech Approach. Three participants followed an A-B-C design. A total of six students were identified for this 5-week investigation. The independent variables were the traditional articulation approach, a clinician-driven intervention that uses a seated hierarchical progression, and the Active Speech Approach, an innovative approach that utilizes gross motor movements during targeted speech sound drills. Results: All participants demonstrated a greater rate of change in the phase directly following the baseline phase, no matter the intervention employed. The results of this investigation indicated a stronger association between the traditional articulation approach and the change in behavior. Overall, participants one, three and four had greater slope values than the participants who initiated treatment with the Active Speech approach. Conclusion: Results confirm that all participants made significant improvements with their errored speech sound with both independent variables. While the Active Speech approach did not produce greater gains than a traditional articulation approach, the Active Speech approach did prove that participants made substantial gains while also being actively engaged.
The Effect of Gross Motor Movements Included in Concurrent Articulation Therapy
Published Year: 2021 Program: Doctor of Speech Language Pathology
Stout, Gwendolyn
Objective: Correct speech sound production is essential for communication. Literature suggests a connection between speech sound errors and gross motor diffficulties. This capstone project reports the results of a single-subject experimental design compaing the effectiveness of completing speech treatment alone and speech treatrment with associated gross motor movements for individuals with speech sound disorders. Method: An alternating treatment design was used. Two participants aged six- to eight-years, eleven-month-old (both male), engaged in concurrent articulation therapy with cross-crawl gross motor movements for one treatmet sound and without cross crawl movements for another target sound. The investigator collected data on the articulation accuracy on a ten-word probe at the end of each session. Results: Both treatments demonstrated an increase in articulation accuracy. However, articulation therapy with cross crawl motor movements demonstrated a greater slope and relative level of change for both participants. Conclusion: Results revealed that combining cross crawl gross motor movements into articulation therapy does not interfere with progress. Combining cross crawl movements in articulation therapy provided a steeper slope, thus indicating a faster change in accuracy for both participants.
Effect of Spaced Retrieval Training on the Ability to Recall Face-name Associations
Published Year: 2021 Program: Doctor of Speech Language Pathology
Throckmorton, Carissa
Objective: To examine the effects of spaced retrieval training (SRT) on the ability to recall face-name associations in those with mild to moderate dementia residing in a skilled nursing facility.
Method: This was a single-subject AB replication design with six participants. Three face-name associations of facility administrators were selected and administered in random order to teach each participant using SRT. Stimulus cards were presented, and responses were recorded using Tactus Therapy Spaced Retrieval Application. Criterion for mastery was the ability to recall the face-name association at 16-minutes across two consecutive sessions, and a maximum of 10 intervention sessions.
Results: All participants demonstrated gains in the ability to recall face-name associations. Five out of six participants met the mastery criterion for each face-name association.
Conclusion: Results confirm that all participants made improvements in the ability to recall the trained face-name associations as compared to their baseline. The results of this investigation indicated a stronger argument for the use of SRT in teaching and improving memory in individuals with dementia.
Keywords: spaced retrieval training, dementia, face-name associations, memory
The Effect of Myofascial Release on Cognitive Function
Published Year: 2021 Program: Doctor of Speech Language Pathology
VanEnkevort, Katherine S.
Objective: The objective of this study was to determine if myofascial release, performed on the head, neck, and face of nurses in skilled nursing facilities, affects cognitive function, specifically memory, and attention. Method: This was a single case research design, with myofascial release on the head, neck, and face as the independent, and five-word recall as the dependent variable. Results: The participant’s ability to recall five-word sequences improved during the intervention and withdrawal phases, compared to the baseline phase, in terms of overall accuracy, but also in the rate of response, which was not anticipated. Conclusion: Myofascial release appeared to have a direct effect on the immediate recall of five-word sequences.
The Effect of the Maximal Oppositions Approach on Children’s Speech Sound Learning Via Telepractice
Published Year: 2021 Program: Doctor of Speech Language Pathology
Voigt, Blair M.
Objective: The investigation evaluated the effect of the maximal oppositions approach on treated and untreated speech sounds when delivered via telelpractice. The primary dependent variable (DV) was percent accuracy of the treated sound. The secondary DVs measured generalization to untreated word positions and untreated sounds. Method: Two participants, ages 7;4 (P1) and 5;3 (P2), with severe SSDs received treatment in an A-B-A-B withdrawal design. P1 received two 20-minute sessions per week for 17 sessions, and P2 received two 15-minute sessions per week for eight sessions. The dose was 50 trials per session. Sessions occurred via telepractice. Results: P1’s treatment data revealed a stable baseline and accelerating trends only during treatment (B) phases. Upon withdrawal of the treatment (A2), data dropped in level and became zero-celerating, suggesting the maximal oppositions treatment was the cause for improvement in B1. P1 experienced a 40% gain from session four to session 17. In contrast, P2’s data trends were zero-celerating in all phases; P2’s treated sound did not improve. P2 did improve the accuracy of three untreated sounds 33%, while P1’s untreated sounds did not improve from pre- to post-investigation. Conclusion: Constrasting results between participants make conclusions difficult. The approach had a treatment effect on each participant, but in different areas. P1 improved accuracy on the treated sound; P2 improved accuracy on untreated sounds. Limitations and future directions for research are discussed.
The Effect of Explicit Grammar Instruction on the Reading Comprehension Skills of Late Elementary School Age Students with Language Deficits
Published Year: 2021 Program: Doctor of Speech Language Pathology
Warren-Ross, Naomi
The purpose of this investigation was to determine the effect of explicit grammar instruction on the reading comprehension skills of late elementary school students with language and/or reading weaknesses. Three late elementary school students participated in a nine-week changing criterion study using Shape Coding as the intervention. Grade-level morphosyntax skills were measured by morphosyntax identification activities. Grade-level text comprehension skills were measured by accurate responses to comprehension passage questions. Results of this study seemed to suggest that using Shape Coding as an intervention showed a therapeutic effect on improving morphosyntax and text comprehension skills. Implications of this investigation showed that Shape Coding may be a viable therapeutic intervention tool to assist students with improving their morphosyntax and comprehension skills and therefore, may improve their academic performance.
Key Words: grammar, reading comprehension, therapeutic intervention, Shape CodingTM
The Effect of Communication Modeling on Social Communication in Pediatric AAC Users
Published Year: 2021 Program: Doctor of Speech Language Pathology
Woodson, Kacy Jakobs
Objective: The purpose of this investigation was to determine if the use of a sibling model during structured play therapy would increase participants’ social participation using an AAC device, as evidenced by commenting, compared to using an adult model. Method: This investigation used an Adapted Alternating Treatment Design (AATD) with an n of 1. The primary dependent variable (DV) was the number of communication attempts made, defined as a comment directed toward the parent or sibling with the intent of participating or making a statement using the AAC device. The secondary dependent variable was the number of communication attempts made, defined as a question directed toward the parent or the sibling with the intent of gaining information using the AAC device. The independent variables were sibling-modeling and parent-modeling on an AAC device. The investigation included three phases: baseline, four communication partner training session, and intervention. Results: Data displayed an accelerating trend during both interventions. Percentage of non-overlapping data (PND) for the sibling modeling condition was 100%, while the PND for the parent modeling condition was 83%. Sibling modeling reached the criterionof five occurrences for three consecutive sessions first, in session. Parent modeling, though measurable change was achieved, did not meet the criterion. Social communication, defined as comments, improved for both treatment conditions; however, sibling modeling was more effective than parent modeling. Conclusion: The data supported the initial claim that preschool children with limited verbal skills, whose primary mode of communication is an augmentative and alternative communication (AAC) device, make more communication attempts when receiving AAC therapy with a sibling model, as evidenced by the increase in number of communication attempts (comments) compared to the use of an adult model. The results have future implications for speech-language pathologists (SLPs) providing services to AAC users and training families of AAC users to improve social communication.
The Effect of Skillstreaming in Preschool Children with Pragmatic Language Delays
Published Year: 2021 Program: Doctor of Speech Language Pathology
Zombotti, Carol
Objective: Young children with pragmatic language delays often have difficulty interacting with peers, initiating and responding to conversations, and asking others to play. The purpose of this investigation was to examine the effect of the Skillstreaming social skills program on preschool children with pragmatic language delays. Method: Three male children, ages 3.0-3.3 years with pragmatic language delays, were recruited for this investigation. An A/B design was used to measure participants’ responses to peers across two weeks of Skillstreaming intervention. Participants were provided small group instruction while bing taught Skillstreaming’s “Asking to Play” thereafter given opportunities to generalize the skills with a matched peer from a neurotypical dyad group in a preschool classroom setting. Results: Upon the initiation of the Skillstreaming intervention, no changes in level were evident. However, after two to three intervention sessions, all three participants gradually showed increases in the defined behavior of responses to peers. This investigation found Skillstreaming to be a successful intervention as the total number of responses increased from baseline to treatment phases. Further, subjective checklists completed by parents of participants pre- and post-intervention showed increases in the mean number of social skills displayed in the home environment. Conclusion: With strategic and varying generalization, social skills training, using Skillstreaming continues to be a valuable resource for teaching social skills to preschool-aged children. Varying activities, increasing the number of peers, expanding locations for generalization, along with adult modeling and prompts would increase consistency of responses to peers and should be considered.
2022
The Effects of Vocabulary Instruction Using Spaced Retrieval Training on Expressive Emotional State Vocabulary in Bilingual Spanish/English-Speaking Children Exposed to Trauma
Published Year: 2022 Program: Doctor of Speech Language Pathology
Andrade, Alicia Helena Bolanos
Purpose: This investigation aimed to improve the vocabulary for expressing emotional states (feeling words) using vocabulary instruction with Spaced-Retrieval intervention in bilingual Spanish/English-speaking children exposed to trauma. Method: Three participants, ages 9:2 (P1), 8:4 (P2), and 7:10 (P3), were included in the ABA single-subject withdrawal design. P1 and P2 had environmental trauma, and P3 had a diagnosis of medical trauma. Baseline data using a stability envelope were obtained before implementing the intervention (three data points), followed by repeated measures. The investigator collected data on emotional-state-feeling words presented randomly at the beginning of each session. The intervention phase included five sessions and the withdrawal phase (three data points). Results: The results of the current study revealed that the application of Vocabulary Instruction using Spaced Retrieval Intervention was a successful intervention technique to increase the emotional state vocabulary of three students with trauma. Two participants demonstrated a statistically significant difference from baseline to intervention. The third participant experienced a statistically significant difference between experimental conditions indicating more rapid improvement in increasing the vocabulary with SR intervention. Conclusion: This investigation substatiates prior research with different populations, suggesting that Vocabulary Instruction using Spaced Retrieval intervention effectively improved expressive vocabulary. This research should be further explored across other ethnicities, language, ages, communicative disorders, and related trauma utilizing a larger sample.
The Effect of Motivational Interviewing on Caregiver Facilitation of Home Practice
Published Year: 2022 Program: Doctor of Speech Language Pathology
Benton-Vitz, Brittany
Objective: The purpose of the investigation was to determine the effects of motivational interviewing (MI) on caregiver facilitation of articulation from practice. Method: A multiple baseline across participants design was used for this investigation. The percent of completed caregiver-facilitated homework was collected daily throughout the investigation (at baseline, intervention, and during follow-up). MI was sequentionally introduced to three caregivers who all initially identified feelings of ambivalence surrounding home practice completion. Each caregiver participated in three MI sessions (2 times per week across 2 weeks). Results: There were three demonstrations of an increase in the percentage of home practice facilitation, which supports a conclusion of a functional relationship between MI and home practice facilitation. Overall, the data concluded that MI may improve caregiver facilitation of home practice. Conclusion: The results of this investigation demonstrated that all participants improved their ability to facilitate articulation home practice with their children after participating in MI sessions, compared to baseline. Additionally, results indicated that this guiding style of communication may be useful for resolving ambivalence surrounding articulation home practice facilitation.
The Effects of Virtual Resilience-Based Clinical Supervision on Burnout in Medical Speech-Language Pathologists
Published Year: 2022 Program: Doctor of Speech Language Pathology
Caron, Hannah
Resilience-based clinical supervision (RBCS) is a program that reduces occupational stress and burnout symptoms in healthcare professionals. Research has not yet evaluated the program with medical speech-language pathologists (SLPs) or with an online delivery model. This investigation used virtual RBCS to address burnout in medical SLPs during the COVID-19 pandemic. Six medical SLPs participated in this ABA single-subject experimental design. RBCS was held on Zoom during the intervention phase twice a week for eight total sessions. Exercises included brief mindfulness meditations, emotional labeling, and guided reflective discussions on underlying source of stress. An adapted four-question version of the Oldenburg Burnout Inventory (OLBI) collected repeated measures of burnout twice a week across all study phases. Preintervention and postintervention data were collected with full OLBI assessments to further evaluate intervention effects. All participants showed a decrease in burnout at the end of the study, and five experienced statistically significant reductions in burnout due to the intervention. This investigation contributes to the growing body of evidence supporting RBCS for reducing healthcare burnout, offering a means to increase convenience and accessibility through virtual delivery.
The Effect of Dosage on the Production of Nouns in Persons With Chronic Aphasia, Through Use of a Speech Generating Device
Published Year: 2022 Program: Doctor of Speech Language Pathology
Carter, Shawnise L.
Objective: This investigation aimed to determine the effect that repeated trials using a speech-generating device (SGD) have on the production of nouns in persons with chronic expressive aphasia. Many persons with aphasia (PWAs) have trouble naming items. Pictures are used to convey messages that they are unable to verbalize. Methods: Three males, ages 67-76 years old, 2-8 years post diagnosis with conduction, Broca’s, and anomic aphasia types, respectively, participated in an ABAB study to examine their ability to verbally produce five repeated trials of 20 nouns of everyday use when presented on an (SGD) using personally photographed icons, two times a week, for four weeks via remote video meetings. Results: Participant 1 exhibited an average increase in performance of 31.7% from Phase A1 to Phase B1 and a 20% increase from Phase A2 to Intervention Phase B2. Participant exhibited an average increase in performance of 28.2% in Phase A1 to Phase B1 and a 24.5% increase from Phase A2 to Phase B2. Participant 3 had a 33.7% increase from Phase A1 to Phase B1 and a 33% increase from Phase A2 to Phase B2. Conclusions: The results of this study support other findings that visual images help to stimulate language and word meanings. Further, intensive dosing with repetition may improve skills in regaining language and increasing vocabulary for PWAs.
The Effect of the Expanding Expression Tool on School-Age Students’ Descriptions of Everyday Items
Published Year: 2022 Program: Doctor of Speech Language Pathology
Cohen, Kathleen
Objective: The purpose of this study was to investigate the effectiveness of the Expanding Expression Tool (EET) to improve expressive semantics of school-aged students with language impairment (LI), as evidenced by an increased number of attributes used in verbal descriptions of common nouns. Method: This was a single-subject multiple baseline across participants design. The participants were three boys with diagnosed language impairment and identified weakness in vocabulary as evidenced by current educational records. The independent variable, EET, is a scaffolded vocabulary intervention that uses extended instruction to explicitly teach semantic attributes by providing increased frequency of exposure. The EET strategy accesses multiple modalities using a mnemonic chant and a colorful beaded rope manipulative. The dependent variable was an expressive semantic task to describe everyday items with semantic attributes. Results: All participants significantly increased in the number and type of attributes produced verbally to describe everyday items. Conclusion: The EET is an effective language intervention to improve depth of vocaulary for school-age students with LI.
The Effects of 22-Day Alkaline Hydration on Laryngopharyngeal Reflux
Published Year: 2022 Program: Doctor of Speech Language Pathology
Conniff, Cynndra J.
The purpose of this investigation was to determine if drinking alkaline water without making other dietary, lifestyle, or medication changes would positively impact symptoms of laryngopharyngeal reflux (LPR). Symptom indicators were measured and analyzed, including Reflux Symptom Index (RSI) scores and total scores, including general-health and LPR-related quality of life measurements. In this nonconcurrent single-subject multiple probe AB design across subjects, four participants completed a 22-day intervention phase during which they drank 64 ounces of alkaline water. Web-based surveys were sent to participants during the control phase and experimental phases to collect data on LPR-related symptoms and quality of life. LPR symptoms analyzed were voice, cough, throat clearing, swallow, and reflux. The four participants demonstrated varying levels of improvement in throat-related LPR symptoms, RSI scores, and total scores. Mixed results were seen with the specific symptom of reflux; three experienced reduced reflux symptoms while one had increased symptoms. This investigation supported previous research that indicated alkaline water could effectively treat LPR symptoms but did not support to use fo alkaline water to treat typical gastroesophageal reflux symptoms such as heartburn, chest pain, and indigestion.
Using Classical Music to Increase Food Consumption in Individuals with Dementia in the Long-Term Care Setting
Published Year: 2022 Program: Doctor of Speech Language Pathology
Demetria, Alina S.
Objective: Individuals with dementia in the long-term care setting are at an increased risk of malnutrition and dehydration. The investigation sought to determine if classical music affects food consumption in individuals with dementia. Method: This investigation used an A-B-A-B single-subject experimental design (SSED) where the participant served as her own control through objective serial data collection of her food consumption with and without classical music. This investigation lasted 11 weeks in a long-term care facility during the COVID-19 pandemic. Results: One participant was appropriate for the investigation and indicated a trending decline in food consumption before introducing the intervention. During the initial intervention phase, the participant had a significant upward trend in increasing food consumption. Once intervention was withdrawn, there was a significant drop, and the average level of food consumption significantly decreased. When the intervention was reintroduced, the average level of food consumption increased, but not at the same trend as when classical music was first introduced. Conclusion: The investigation introduced an objective method to measure food consumption and provided promising support for providing music during meals. It adds to the research that music has varying results for increasing food consumption in individuals with dementia, including having a positive attitude toward meals. Future research should further investigate the effects of various music genres or participant-specific music preferences on increasing food consumption and the quality of life of individuals with dementia.
The Effects of Self-Affirmation on Imposter Phenomenon in Second Year SLP Graduate Students
Published Year: 2022 Program: Doctor of Speech Language Pathology
Gaff, Danielle
Purpose: The purpose of this study was to examine the effects of self-affirmation practices on feelings of imposter phenomenon (IP) in second year SLP graduate students. Methods: Six second-year SLP graduate students participated in tihs A-B-A-B withdrawal design investigation to examine the impact of 5-minute, 3 times a week guided self-compassion sessions on confidence and levels of IP. The guided sessions, included broad affirmations, such as “I am capable.” A 5-question Likert scale was administered to quantify the particpants’ confidence levels in their own abilities as a student and clinician. The Clance Impostor Phenomenon Scale was administered as a pre- and post-test measure, to assess an increase or decrease in feelings of IP. Results: While five of six participants showed an increase in their self-confidence scores across the research study, there were also decreases during intervention phases of all but one participants. Five of the six participants had a decrease in their CIPS score, indicating an improvement in their feelings of IP. Conclusion: While no true trend allowed conclusions to be drawn about the impact the self-affirmations had on self-confidence scores, self-affirmations were shown to be a useful tool in addressing feelings of IP as well as to better understand IP in this population.
The Relationship Between Elbow Flexion Posture and Overhead Reaching in Birth Brachial Plexus Injuries
Published Year: 2022 Program: Doctor of Speech Language Pathology
Goins, Tiffany R.
Objective: Individuals with a birth brachial plexus injury present with impairments in overhead reaching, as well as elbow flexion contractures with altered muscle lengths of the biceps. This study aimed to determined the relationship between elbow flexion postures and overhead reaching in individuals with birth brachial plexus injuries by investigating how changes in elbow posture and muscle fiber length impact force-generating capacity of the biceps on the elbow and shoulder simultaneously. Methods: An experimental and sensitivitiy analysis. Ten subjects participated in the experimental study, in a repeated measures design. The sensitivity analysis utilized an upper extremity musculoskeletal model via OpenSim software. Results: Overhead reaching improved in the birth brachial plexus population when the elbow was immobilized in less flexed postures. Sensitivity analysis revealed peak shoulder elevation moments in less flexed postures in the altered long head of the biceps muscle length of 30% compared to the typical length. As such, both studies indicate and increased passive force in the altered muscle length of the biceps contributes to higher shoulder elevation in the BBPI population. Muscle activity of the biceps and triceps demonstrated a direct relationship with increased overhead reaching. However, triceps muscle activity demonstrated an inverse relationship with peak shoulder flexion. Conclusion: Elbow postures in elongated postures, via immobilization, may result in higher shoulder elevation due to increased passive forces when there is an altered muscle state of the biceps in the birth brachial plexus population, providing clinicians guidelines for interventions to assist this population with improved function.
Effectiveness of Vestibular Stimulation in Promoting Intentional Communication Acts in Preschool Children with Autism Spectrum Disorder
Published Year: 2022 Program: Doctor of Speech Language Pathology
Hampton, Lanita F.
Objective: The research aimed to determine the effectiveness of vestibular stimulation in promoting communicative intents in preschool children with autism. Method: Three participants participated in this single-subject A-B-A design for this investigation. The independent variable for this investigation was vestibular stimulation, and the dependent variable was the frequency of communicative intentions. The baseline phase included three sessions without intervention. During the sessions, the participants chose various communicative activities and were only given the prompt, “what would you like to play with?”. The intervention phase included nine sessions of vestibular stimulation at the beginning of each session. The intervention was implemented for five minutes, and the vestibular activity was prescribed by a licensed occupational therapist (OT). The withdrawal phase included three sessions without vestibular stimulation, and the participants chose various communicative activities. Results: Data analysis revealed that upon receiving the intervention, two participants showed an immediacy in a change of behavior when the intervention was introduced. Conclusions: Implementing vestibular stimulation resulted in increased communicative intent for two participants. Limitations of this study included small sample size, each participant choosing the same play materials offered in each phase, and each participant receiving a different type of vestibular input. Follow-up research is necessary to determine if one vestibular activity is more beneficial than another.
The Effectiveness of Two Cueing Hierarchy Treatments at the Inpatient Rehabilitation Level
Published Year: 2022 Program: Doctor of Speech Language Pathology
Higgins, Kacee J.
Objective: The purpose of this investigation was to compare two well-established cueing treatments for word retrieval deficits in aphasia to guide clinicians who treat patients at the inpatient rehabilitation level of recovery. Phonological cueing treatment (PCT) and semantic cueing treatment (SCT) were used to examine the recovery of word retrieval for verbs in persons with aphasia at this level of care. Method: A combined multiple baseline design (MBD) across participants and alternating treatment design (ATD) were used to examine the effects of treatments applied concurrently. Two females diagnosed with Broca’s aphasia and receiving services on an inpatient rehabilitation unit participated. Word retrieval skills were assessed to develop treatment stimuli tailored to each participant. Treatment effects on verb retrieval were systematically measured in probes across all study phases. Results: Participant 1 demonstrated gains in verb retrieval for both SCT and PCT but reached treatment criterion with SCT. Participant 2 demonstrated limited gains in verb retrieval for both SCT and PCT. Conclusion: These findings suggest that SCT and PCT may have utility in facilitating verb retrieval for some speakers with aphasia at an inpatient rehabilitation level of recovery, but the effects of these treatments may vary across speakers. Further research is needed with a variety of patients to determine if one cueing treatment is more effective for individuals with aphasia at an inpatient level of care.
The Effects of Individualized Narrative Intervention on Story Retelling Skills in 5 to 7-Year-Old Children with Specific Language Impairments
Published Year: 2022 Program: Doctor of Speech Language Pathology
Johnson-Walker, Janette
Objective: Children encounter narratives at home, in school, and across social interactions. They produce narratives to express thoughts and feelings about experiences and events that are real or imagined. Narrative skills are believed to form the bridge between oral language and literacy. The narrative performance of children with specific language impairment (SLI) reveales a general capacity delay producing narratives. The purpose of this investigation was to examine the effect of an individualized narrative-based intervention, Story Champs on narrative retell skills in students ages 5 to 7 with SLI. Method: Three participants ages six to seven years old participated in an A-B-A single subject design to determine the effects of the individualized narrative intervention on narrative retell skills. A total of 18 sessions were completed with all participants. Results: The results from this investigation indicated a positive relationship between the interventions and narrative retell skills. All three participants demonstrated an increase in story grammar elements in narrative retells. Conclusion: In conclusion, these findings demonstrate that individualized narrative intervention can increase narrative retell skills in children with SLI.
The Effect of Discrete Video Modeling on Facial Expression Recognition in Preschool Children with Severe Developmental Delays and Complex Communication Needs
Published Year: 2022 Program: Doctor of Speech Language Pathology
McLaughlin, Bharathi Dara
Objective: Facial expression recognition is considered the cornerstone of social-emotional learning (SEL). Increasing literature has shown that improving social communication positively affects students socially and academically. Video modeling is known for its efficiency in improving many types of skills. This investigation reports the results of adding a discrete video modeling supplement to in-vivo instructions to teach facial expressions to students with severe developmental delays and complex communication needs (SDD-CNN). Method: A multiple baselines across behaviors single case research design was used to study the effect of passive instruction through discrete video modeling (DVM) on facial expression recognition skills. As a group, participants watched a 3-minute video clip on loop 15 minutes daily for three weeks on the classroom SMART board during snack time. The video clip was produced through the Gemiini DVM system. Individually, participants also completed a short game daily on the Boom Learning platform to collect data on facial expression recognition. Results: The results demonstrated the passive learning through DVM may be an efficient method for teaching facial expression recognition to preschool children with SDD-CCN. Data analysis revealed that 4 of the 5 participants showed a gradual accelerated trend through the intervention and follow-up phases indicating clinical significance.
The Effects of Multimodal Intervention on Vocabulary Comprehension of School Age English Learners with Specific Language Impairment
Published Year: 2022 Program: Doctor of Speech Language Pathology
Miller, Mesa
Objecive: The use of multimodal intervention on vocabulary comprehension has been proven to be beneficial in language therapy. Several research investigations in the literature focused on vocabulary development of English Learners (EL) who were older or diagnosed with learning disabilities. A limited number of studies focus soley on EL students with Specific Language Impairment (SLI). Additionally, studies connected with EL students with SLI focused on the use of Spanish and English during the intervention phase. In 2019, ASHA conducted a demongraphic profile to identify bilingual service providers. Of the 201,961 individuals ASHA represented, which excluded NSSLHA members, 13,211 (6.5%) indicated they met the ASHA definition of bilingual service provider. Investigating the effects of multimodal intervention on vocabulary comprehension can faciliatethe improvement of evidence-based practices used by monolingual SLPs. This investigation set out to determine the effectiveness of vocabulary in school-age English learners (K-2) with SLI. This study’s secondary purpose aimed to establish an ecologically valid and reliable design that could be replicated on a larger scale in future research. Method: The investigation utilized a single subject case changing criterion research design in order to determine the effectiveness of multimodal vocabulary intervention on vocabulary comprehension. The multimodal intervention was used to present a set number of targeted vocabulary words to the participants. Participants completed a pretest and posttest to further support the effectiveness of the intervention. Vocabulary was presented verbally and visually. Participants attended three 30-minute therapy sessions per week, for a total of 15 sessions. Results: The results from this investigation indicated a positive relationship between the intervention and vocabulary comprehension. While the data analysis did not indicate a significant difference, the posttest scores and upward trend in the intervention phases of this investigation showed that multimodal intervention may be a viable therapeutic intervention tool to assist EL students with improving their vocabulary acquisition and comprehension skills. Therefore, the intervention may improve the populations academic performance. Further invesitgation is warranted to determine a significant difference.
The Effect of Phonemic Awareness Intervention with Multisensory Letter-Sound Training on Reading Decoding in Children with Speech or Language Impairment
Published Year: 2022 Program: Doctor of Speech Language Pathology
Munoz, Yuliya
Objective: The current investigation aimed to explore the effect of phonemic awareness intervention focused on segmenting and blending with multisensory letter-sound training on graphophonic decoding in children with speech or language impairment accompanied by a phonological awareness deficit. Method: Two children, ages 6;1 and 6;6, participated in the study. Participant 1 presented with moderate language impairment; Participant 2 presented with mild speech sound disorder (SSD). The experimental intervention was delivered four times a week, one-to-one, at a private practice. A non-concurrent multiple baseline across participants design was used to assess a functional relationship between the experimental intervention and participants’ decoding skills. Pseudoword probes were used to measure participants’ graphophonic decoding. Participants received no speech, language, or literacy-related interventions during the baseline phase. After four baseline sessions, Participant 1 received 13 intervention sessions. Whereas Participant 2 completed six baseline sessions followed by seven intervention sessions. Results: Visual and statistical analyses revealed rapid statistically significant gains in pseudoword decoding accuracy in both participants after the experimental intervention. Conclusion: The findings suggest that phonemic awareness intervention with multisensory letter-sound training may be a practical intervention for developing decoding skills in children with speech or language impairment.
Effects of Vestibular Sensory Stimulation on Expressive Language and Attention in Young Children with Autism
Published Year: 2022 Program: Doctor of Speech Language Pathology
Muscato, Miranda
Objective: The objective of this investigation was to determine the efficacy of using vestibular sensory stimulation in increase expressive language and attention in young children with autism. Linear swinging on a platform swing was utilized for vestibular sensory input before playing with a structured task. Three participants, all male and between the ages of 3 and 6 years and 11 months were recruited. All participants had a diagnosis of autism and demonstrated vestibular sensory dysfunction. Method: The investigation followed multiple baselines across participant (MBAP) investigation with three participants. The baseline phase was followed by an intervention phase which utilized five minutes of linear swinging for vestibular sensory input. Following vestibular input, a structured play task was chosen by the participant where spontaneous requests and attention to task (in minutes) were recorded for five minutes. Results: Analysis of the data revealed that all three participants demonstrated significant improvement in both spontaneous requests and attention to a task as demonstrated by visual analysis of data. Conclusion: In conclusion, utilizing vestibular sensory stimulation in the form of linear swinging resulted in increased expressive language and attention for all three participants. Limitations of this study include a small sample size, only one gender represented, the same play task utilized for each trial, and the time-of-day trials take place. These, as well as other limitations, should be considered in the replication of the current investigation.
The Effect of Training Jaw Stability on Jaw Lateralization and Speech Production
Published Year: 2022 Program: Doctor of Speech Language Pathology
Nagai, Tiffany T.
Objectives: The jaw is foundational in speech, yet there is a paucity of literature regarding its role in speech sound disorders (SSDs). This investigation explores a jaw therapy program compared to standard speech therapy to determine effectiveness in improving jaw stability and speech in one participant with SSD. Method: One participant demonstrating 64% intelligibility at the single word level, and jaw lateralization during speech participated in this investigation. Receptive language and cognitive skills were within normal limits. Standard speech therapy was compared with Talk Tools� Bite Blocks and Jaw Grading Treatment protocol (Rosenfeld-Johnson, 2005), each with 4 sessions provided sequentially. Jaw lateralization and speech production were assessed at baseline and post interventions to determine jaw stability and its relationship to speech accuracy. Results: The participant demonstrated decreased jaw lateralization and inconsistent results for speech production. These included minimal changes in speech sounds accuracies, with decreased intelligibility in single words, but increased intelligibility in sentences and connected speech. Conclusions: Jaw lateralization generally decreased after four sessions of a simplified version of a jaw grading treatment program; however, changes were minimal and highly variable. This challenges whether the changes were meaningful or sustainable. Speech production accuracy also changed minimally after each intervention. Limitations included insufficient intervention sessions, practice, homework, and number of participants.
The Effectiveness of Neuromuscular Electrical Stimulation Combined with Traditional Dysphagia Therapy in Improving Tongue Strength
Published Year: 2022 Program: Doctor of Speech Language Pathology
Peart-Turner, Michiel
Objective: This investigation examined the impact of neuromuscular electrical stimulation (NMES) combined with traditional dysphagia therapy (TDT) on improving tongue strength, as measured by the Iowa Oral Performance Instrument (IOPI) in two sub-acute stroke patients with mild-moderate oropharyngeal dysphagia. Method: This ABA single case investigation assessed tongue strength utilizing the IOPI at baseline, intervention and the withdrawal period. During the 12 intervention sessions NMES combined with TDT: namely, chin-tuck against resistance (CTAR) anf effortful swallows were utilized. Secondarily, pre and post measures of swallow strength were taken. The participant’s swallowing amplitude average was measured to objectively assess the strength and improvement in the participants’ swallow. The Eat-10 was given to obtain a subjective rating of the participants’ perception of swallow function. Results: While one participant experienced an improvement in tongue strength, and the other showed a decline, both exhibited better bolus control, bolus propulsion, oral clearance, and overall swallow function. Conclusion: The combined NMES/TDT treatment had an impact on improving tongue strength while facilitating a functional swallow. There was also a significant improvement observed in the secondary objective of effortful swallow. Future research should explore NMES/TDT across other neurological impairments utilizing a larger sample.
The Effectiveness of Increased Frequency of SLP Services on Discrete Morphological Usage
Published Year: 2022 Program: Doctor of Speech Language Pathology
Perrigo, Viola Irene
Objective: This investigation explored the currently limited research for an increased frequency with shortened treatment time delivery model (three times a week for 10 minutes per session) and to provide evidence that this distributed delivery model could be effective in increasing discrete language skills. This first step in a series of investigations may inform practicing clinicians about possible alternatives to the common practice of one to two sessions per week (30 minutes each) of direct skilled speech therapy services. Methods: Three children, aged 5,5;6 and 11 years old, with morphology deficits of regular past tense (-ed) and 3rd person singular (-s) of less than 30% usage participated in an adapted alternating treatment design. The study compared distribution and massed distributions of treatment over 5 weeks to discover which distribution was more effective. Results: Participant 1 final data collection indicated a 100% increase in morphological usage for the distributed condition and a 40% increase for the massed condition. Participant 2 final data collection indicated a 100% increase in morphological usage for the distributed condition and a decrease in morphological usage for the massed condition. Participant 3 was disqualified from the study. Participant 4 final data collection indicated a 100% increase for both distributions. Conclusions: The findings of this investigation support the current evidence reported by Meyers-Denman and Plante. While they found that focused enhanced conversational recasts were efficacious for grammatical morpheme acquisition in both distributed and massed conditions, this was not the case for all participants in this research endeavor.
Effect of Video Modeling and Social Stories on Emotion Identification and the Associated Nonverbal Cues
Published Year: 2022 Program: Doctor of Speech Language Pathology
Post, Stephanie N.
Objective: This investigation aimed to determine the effectiveness of using social scripts and video models for identifying emotions and nonverbal cues in adolescents and young adults with autism spectrum disorder (ASD) on a telehealth platform. Previous research with adolescents has focused on pro-social behaviors, social interactions, and turn-taking. Methods: Three young adults ages 17 to 21 years with a diagnosis of ASD and social communication weaknesses participated in this A-B-A investigation. The dependent variables measured participants’ ability to identify emotions and nonverbal cues. During baseline (Phase A1) and withdrawal (Phase A2), participants were presented with a social script alone. During intervention (Phase B), the PI introduced video modeling with the social script. Results: Participants 2 and 4 displayed a gradual increase in the identification of emotions within Phase B, with an immediate decrease between Phase B and A2. Participant 4 demonstrated increased identification of nonverbal cues within Phase B, with rising trends across all phases. Conclusion: The mixed results indicate that video models, social scripts, and a combination of both may improve social skills. However, there is no clear indication that one treatment is more effective than another. Additional research is needed for more evidence-based interventions designed for adolescents and young adults with ASD.
Effects of Seasonings on Oral Intake with Altered Consistencies for Geriatric Dysphagia Patients
Published Year: 2022 Program: Doctor of Speech Language Pathology
Prewitt, Alisa Yvette
Objective: This study was designed to investigate if increasing the taste of food by adding seasonings in addition to salt and pepper would improve the oral intake of meals. Participants for the current study were aged 75-95 years old with a diagnosis of dysphagia, who tolerated their texture-modified diet with ease and had no signs or symptoms of aspiration. Methods: Four participants were enrolled in a single-study A-B-A research design. The independent variable was the use of garlic powder, onion powder, and fresh herbs (rosemary and oregano) as additional flavorings. The dependent variable was the measurement of the amount of food that was consumed. The baseline and withdrawal phases consisted of four meals prepared with salt and pepper only. During the intervention phase, three meals were served with additional seasonings of garlic powder, onion powder, and fresh rosemary. Participants’ plates were weighed before and after consumption. Participants also answered a qualitative questionnaire about emotions and feelings associated with meals. Results: Visual data analysis revealed that when seasoning was added to meals, immediate oral intake increased with an accelerating trend. When the seasonings were withdrawn, the participants’ oral intake decreased. Further, participants reported that the taste of food is a factor of happiness with meal selections. Conclusion: The findings of this study demonstrated that taste is a factor in meal consumption behavior. This research should be further explored using a larger sample of different age groups, genders, and ethnicities.
A Comparison of Sound Production Treatment and Metrical Pacing Therapy for Apraxia of Speech
Published Year: 2022 Program: Doctor of Speech Language Pathology
Purcell, Charlotte
Objective: The purpose of this investigation was to compare the effects of two different specific treatment protocols for acquired apraxia of speech (AOS): Sound Production Treatment (SPT) and Metrical Pacing Therapy (MPT) in four individuals ages 54-80 years old with moderately severe chronic AOS and aphasia following left ischemic stroke. Method: Treatment protocols were compared using a noncurrent multiple baseline across participants and behaviors design. Treatment outcomes were compared with respect to whole word correctness (WWC) in acquisition and generalization of multisyllabic word targets and participant-reported communicative participation. Results: Three of the four participants experienced statistically significant improvements in WWC with SPT, and three of the four participants experienced statistically significant improvements with MPT. Based on a priori analysis measures, three participants demonstrated relatively greater benefit from MPT. Using the measure of communicative participation, three of the four participants reported improvements across the treatment conditions. Only one participant in this investigation indicated a statistically significant change between his communicative participation at baseline and during washout, and this was following the MPT treatment. Conclusion: This investigation demonstrated that individuals in the chronic stages of AOS can benefit from participation in both SPT and MPT, corroborating prior research related to articulatory kinematic and rate and rhythm treatment approaches. Additional investigation is necessary to further identify characteristics of individuals for whom the treatments are most likely beneficial to assist in clinical decision making.
Effects of Mental Imagery on Listening Comprehension in Children with Language Disorders
Published Year: 2022 Program: Doctor of Speech Language Pathology
Randone, Doreen Annice
Objective: The purpose of this investigation was to determine the effects of mental imagery on listening comprehension in children with mild-moderate receptive language disorders and average working memory. Method: A single case A-B research design was used for this investigation. Three participants between the aged of 8.4 and 11.0 were included in the study. Participants received 30-minute virtual intervention sessions 3 times per week for 4 weeks. Participants learned how to visualize sizes, shapes, and colors using everyday objects. Participants responded to comprehension questions about verbally presesnted sentences while using mental imagery. Results: All participants made progress in accurately responding to comprehension questions when using mental imagery. All participants met the mastery criterion. Conclusion: Results confirm that all participants improved their ability to respond to comprehension questions when using mental imagery compared to their baseline. The results of this investigation indicate that mental imagery may be a useful receptive language intervention for children with mild-moderate receptive language disorders and average working memory.
The Effect of Morphological Awareness and the Use of Graphic Organizers on the Retention of Tier 2 Words in Middle School Students with Mild to Moderate Language Impairments
Published Year: 2022 Program: Doctor of Speech Language Pathology
Roberts, Jennifer
Purpose: The purpose of this investigation was to determine if graphic organizers are an effective tool in teaching morphological awareness to increase the retention of newly learned Tier 2 words in middle school students with mild to moderate language impairments. Method: Three 7th grade males participated in this ABA study. All three participants had a primary eligibility of Specific Language Disability (SLD) and secondary eligibility of Speech Language Impairment (SLI). This 8-week intervention included direct vocabulary instruction focused on morphological awareness with the use of a graphic organizer. Intervention occurred 2 times a week for 30-minutes a session. Data were collected on an expressive labeling task that required the students to identify the correct word following presentation of definitions. The Vocabulary Knowledge Scale, a self-assessment, was used as a pre-test and post-test measure. Results: The number of correct words increased during the intervention, with an accelerated trend throughout. Participant 1 used 7 of 10 words in a sentence accurately, participants 2 and 3 both used 5 of 10 words in sentences accurately. Participants 1 and 2 labeled greater than 80% of the words at follow-up. Conclusions: The study showed that targeting morphological awareness and utilizing graphic organizers may lead to increased vocabulary knowledge and use in middle school students with mild to moderate SLI. Future research should explore the effects of this treatment approach as a multi-component intervention to improve learning and retention.
The Effect of a Multisensory and Unisensory Intervention on Vocabulary Acquisition
Published Year: 2022 Program: Doctor of Speech Language Pathology
Rock, Adrienne
Purpose: The purpose of the investigation was to examine and compare the effect of a multisensory and unisensory intervention conditions on novel vocabulary acquisition in typically developing three-year-old children. Method: An adapted alternating treatment research design was used for this investigation in order to evaluate the effectiveness of a receptive word learning task with (multisensory) and without (unisensory) access to speech reading cues. Three participants, ages 3;5 (P1), 3;6 (P2), and 3;0 (P3) were included in the investigation. P1 received nine sessions that were scheduled twice per week for 30 minutes. P2 received two 30-minute sessions per week for four weeks, and P3 received two 30-minute sessions per week for three weeks. Results: Results of the investigation indicate that participants demonstrated evidence for learning novel words in both condition (MSI, UI), however demonstrated increased evidence for learning and acquiring target words when access to speech reading cues were limited (UI condition). Conclusion: These findings reveal that both interventions were found to be effective treatment programs for acquiring vocabulary words in typically developing three-year-old children. However, when access to speech reading cues were removed, participants demonstrated acqusition more efficiently. Future research will replicate the investigation to focus on expanding the participants to include a broader age range and individuals with language delays/disorders.
The Effect of Recast Therapy with a Visual Cue Versus Recast Therapy without a Visual Cue in Remediating Target Syntax Skills for Preschoolers with Expressive Language Delays
Published Year: 2022 Program: Doctor of Speech Language Pathology
Rosmarin, Chaya
Objective: This study compared the effectiveness of recast intervention with an added visual cue and without an added visual cue ont he usage of target grammar skills in three preschoolers with expressive language delays. Method: This study used a single case-adapted alternating treatment design. Participants were seen one-on-one twice a week for 30-minute sessions for eight weeks and received two grammar interventions within each session, recast with and without and added visual cue. Each session had a dosage of 12 interventions for each modality, for a total of 24 productions for each session. In addition, there were five probes before each condition, which measured goals learned from previous sessions. Probes were the outcomes measured. There were two variables measured for each participant. Non-standardized measures were used to measure outcomes. Results: Each participant participated in two different interventions, which measured a total of six conditions. The investigation demonstrated evidence for recasts as a form of grammar intervention for preschoolers with expressive language delays. However, there was no statistical improvement when a visual cue was added. Conclusion: Results continue to support the efficacy of recast intervention to improve grammar skills. Future research should evaluate whether a lower dosage within each session will allow for additional processing time for the preschooler and whether a visual cue supports grammar learning for preschoolers with expressive language delays.
Effectiveness of Recasting in Spanish Tense Marking Treatment in Spanish-Speaking Children with Specific Language Impairment
Published Year: 2022 Program: Doctor of Speech Language Pathology
Santos, Delma
Purpose: Children with specific language impairment (SLI) commonly demonstrate many morphological errors in their verbal productions across languages, especially with tense morphemes. This study aims to investigate if the use of recasts in Spanish grammar language treatment decreases the incidence of tense marking errors in Spanish-speaking children with SLI. Method: A 12-year-old Spanish-speaking child with SLI participated in a single case research design (SCRD) study. The subject attended nine intervention sessions to receive a recasting treatment to decrease the number of errors of a target tense morpheme, Results: A visual analysis reveals a significant decrease in the subject’s tense percent errors. Implications: Although the results support recasting as an effective grammar treatment strategy to remediate tense marking errors, in Spanish-speaking children with SLI, further research is needed.
The Efficacy of Individual Phonemic Awareness Intervention on Pre-Kindergarten Children with Developmental Language Disorders
Published Year: 2022 Program: Doctor of Speech Language Pathology
Schneider, Jess L.
Purpose: This investigation examined the efficacy of an individual phonemic awareness intervention for pre-kindergarten children with developmental language disorders (DLD). Method: A single-subject A-B-A research design was selected for this investigation. Three participants, ages 4;10 (P1), and 5;6 (P3), were included. P1 and P3 met the criterion for DLD, and P2 had typically developing language (TL). Baseline data using a stability envelope were obtained before implementing treatment (three data points). The investigators collected probe data on a combination of phoneme blending tasks (words, syllables, and sounds) presented randomly at the beginning of each session. The intervention phase included 12 sessions, and the withdrawal phase included three data points. Results: The investigation indicated a positive effect on two of the three dependent variables of phoneme blending for P1 and P3 with DLD. P1 and P3 could blend words and syllables, two critical phonological awareness stages foundational to blending sounds. With additional time and treatment sessions, it is reasonable to conclude that the participants would progress towards blending sounds. In contrast, P2, with TL, maintained preestablished skills from pre to post-test for blending words and syllables. However, as the intervention continued, results for blending sounds suggested a therapeutic effect. Conclusion: The data supported the initial hypothesis that early literacy skill of phoneme blending increased in pre-kindergarten children with a developmental language disorder when given a supplemental phonemic awareness literacy intervention, rejecting the null hypothesis.
Anxiety Reduction in Mechanically Ventilated Patients
Published Year: 2022 Program: Doctor of Speech Language Pathology
Seitan, Carmen
Objective: The objective of this investigation was to determine the effect of diaphragmatic breathing on self-reported levels of anxiety, respiratory rate, and heart rate in mechanically ventilated adult tracheostomized participants. Method: One participant was recruited and participated in the investigation, which took place at a long-term acute care hospital in San Antonio, Texas. Using an ABAB Withdrawal design, the independent variable of diaphragmatic breathing was used to determine its effect on anxiety as quantified by the dependent variables of self-reported anxiety score on the Visual Analogue Score for Anxiety (VAS-A), respiratory rate, and heart rate. Results: All three dependent variables improved with the introduction of the intervention, with therapeutic slopes greater during the intervention phases. When the percentage of non-overlapping data was analyzed, intervention phases had between 75-100% PND compared to non-intervention phases, showing a strong effect of the intervention. Conclusion: The literature supports diaphragmatic breathing to reduce anxiety; this study adds additional support to its application to mechanically ventilated individuals. Further research is indicated to validate these findings in a larger study, with possible exploration across additional diagnoses.
Effect of Thermal-Tactile Stimulation and Sour Bolus on Swallowing Functions in Patients with Dysphagia Secondary to Acute Stroke Using Masa Scoring
Published Year: 2022 Program: Doctor of Speech Language Pathology
Selvaraj, Rajesh
Objective: The objective of this investigation was to determine the efficacy of combining thermal tactile stimulation (TTS) and sour bolus, in comparison to thermal tactile stimulation (TTS) alone on the improvement of swallowing function in acute stroke patients. Method: Three acute stroke patients participated in this investigation, which took place at a sub-acute skilled nursing facility (SNF). Using an alternating treatment design (ATD), the intervention of TTS alone and combining TTS and sour bolus were used to examine their respective effect on swallowing function, as well as a withdrawal of the two study interventions (diet assessment alone). The results were quantified by the Mann Assessment of Swallowing Abilities (MASA). Results: All three participants experienced improved swallowing function with both the TTS alone as well as with the combination of TTS and the sour bolus. However, the study did not establish which one of the interventions was more effective. The literature supports both the TTS and sour bolus independent of one another. Conclusion: As hypothesized, both interventions achieved an efficient improvement of swallowing skills, however the results did not establish that the combined intervention was better than TTS alone. This research should be further explored across other neurological impairments and related dysphagia.
The Effect of Graphic Organizers on Higher-Level Language Skills
Published Year: 2022 Program: Doctor of Speech Language Pathology
Solomon, Kayla Marie
Objective: This investigation aimed to determine the effectiveness of intervention using graphic organizers on higher-level language (HHL) skills in adolescent participants identified as having language-learning disabilities (LLD). Since HHL encompasses an array of skills, the investigation focused on comprehension and expression of main idea and key supporting details from expository texts. Method: A multiple probe across participants design was implemented. The primary investigator administered self-generated probes. All sessions took place on a teletherapy platform. Four participants aged 11;0 to 13;11 enrolled in the investigation, with three remaining through its completion. Higher-level language probes intermittently and at the same frequency during baseline and maintenance probe conditions. One visual display graphic organizer was used in all intervention sessions. Results: All participants demonstrated improvement from baseline to intervention, with two maintaining criterion accuracy into the maintenance condition. Conclusion: The results support the claim that adolescents with LLD demonstrate improvement in higher-level language skills using graphic organizers.
Effect of CAT on Nursing Staff Morale with a Pediatric Long-Term Care Facility
Published Year: 2022 Program: Doctor of Speech Language Pathology
Soos, Stacey M.
Objective: One role of the Speech-Language Pathologist (SLP) is to collaborate and train nursing staff as part of the scope of practice and in the resident’s and multi-disciplinary team best interest, especially with children with medical complexities (CMC). Motivation directly impacts the fidelity with training and cognitive processing of new information that the SLP provides to the nurse. So, as the SLP collaborates and trains the nurses in feeding, swallowing, augmentative and alternaitve communication (AAC) and other areas within our scope of practice, finding ways to connect with and motivate staff is essential, valued, and needed. This study aims to discover if using canine -assisted therapy (CAT) will improve morale to further the literature on motivating training within our scope. Method: This investigation was an A-B-A withdrawal design with multiple concurrent participants, as it is difficult to blind staff to the canine’s presence. The PI gathered baseline data using the ProQOL-5th andthe VAS twice per shift for three shifts before intervention initiation. The VAS was gathered twice per shift post CAT and then during follow-up phase. ProQOL-5th was also administered post intervention. Results: The three participants did not demonstrate statistically significant improvements with positive morale compared to baseline. Two participants demonstrated more consistent level of morale during the intervention. Conclusion: The data does not support a positive impact on staff morale with incorporation of CAT.
Effect of the Cycles Approach on Speech Intelligibility in Preschool Children Using Teletherapy
Published Year: 2022 Program: Doctor of Speech Language Pathology
Stavish, Mindy
Summary: Objective: The purpose of this investigation was to determine if the cycles approach was an effective intervention to remediate the phonological processes velar fronting and cluster reduction delivered through teletherapy in preschool children with severe to profound phonological disorders. Method: This study used a modified cycles approach, targeting two phonological processes. Five participants with severe to profound phonological disorders participated in two cycles of teletherapy in an A-B research design. Treatment sessions included auditory stimulation, production practice with the targeted sound, experiential play, and phonological awareness activities. Results: Three out of five participants exhibited clinically significant improvements in speech intelligibility, as indicated by a 15% improvement or more on the percentage of consonants correct during a conversational speech sample. Conclusion: Results of the investigation supported the hypothesis that the cycles approach delivered through teletherapy appears to be an effective phonological treatment program for children with severe to profound phonological disorders.
Virtual Training for Siblings of AAC Users
Published Year: 2022 Program: Doctor of Speech Language Pathology
Stevens, Christine A
Purpose: The purpose of the investigation was to examine the effect of a virtual training on typically developing children’s ability to provide aided language input using their sibling’s AAC system. Method: An A-B-A single-subject researcj design was used for this investigation. Four participants, ages 6 years, 10 months to 11 years, 6 months, participated in a three-session virtual training program that addressed skills of modeling, core and fringe vocabulary, and shared storybook reading. Data related to the number of models provided were collected at baseline, during the intervention phase, and following completion of the training sequence. Results: The results of this investigation indicated a positive relationship between the completion of virtual training and the ability to provide aided language input. All four participants demonstrated an increase in the number of models provided. Conclusion: These findings demonstrated that participation in virtual training can increase a typically developing child’s ability to provide aided language input using their sibling’s AAC system.
The Impact of Telehealth on Exercise Adherence in the Head and Neck Cancer Population
Published Year: 2022 Program: Doctor of Speech Language Pathology
Thompson-Henry, Sheri
Objective: The purpose of this investigation was to compare the effectiveness of telehealth vs. the traditional care model of phone calls at changing the target behavior of adherence to a swallowing exercise program delivered to those undergoing RT/CRT for treatment of HNC. Method: A single-subject comparison of competing interventions design was used. After baseline data was collected, telehealth sessions were administered during weeks two and three of RT/CRT followed by phone sessions given during weeks four and five. Results: Both telehealth and phone calls demonstrated a positive effect on adherence when compared to baseline data. Telehealth was introduced in phase B, showing an accelerating trend from baseline (phase A) with a mean adherence rate of 85.71%. Telehealth to phase C (telephone calls) demonstrated a decelerating trend, however exercise completion rates remained above those completed during phase A (baseline) at 46.42% vs. 2.85% respectively for a single participant. Conclusion: The data show that telehealth may have a positive impact on exercise adherence during RT/CRT, however, many confounding factors limit interpretation, such as enrollment of a single participant, expected onset of negative treatment sequalae related to RT/CRT at the mid-point of the study, and the inability to alternate the introduction of phases B and C with an additional. The importance of any intervention type during treatment for HNC can be drawn for this participant, however future larger scale studies are recommended to validate telehealth as a superior method.
Word Learning in Adolescents with Developmental Language Disorder : A Comparison of the Frayer Model and Semantic Mapping
Published Year: 2022 Program: Doctor of Speech Language Pathology
Waldron, Natasha
Objective: This investigation aimed to compare the effectiveness of utilizing semantic mapping and the Frayer model on word definition ability in adolescents with developmental language disorder (DLD). Method: An adapted alternating treatment design (AATD), including two experimental conditions and a control condition, was utilized for this investigation. Treatment outcomes were analyzed across experimental conditions and participants to determine the effectiveness of the semantic mapping condition compared to the Frayer model condition. Results: The semantic mapping condition resulted in a higher absolute level of change and a greater slope in a therapeutic direction for all three participants when compared with the Frayer model condition. Results: The semantic mapping condition resulted in a higher absolute level of change and a greater slope in a therapeutic direction for all three participants when compared with the Frayer model condition. Conclusion: This investigation substantiates prior research suggesting that a phonological-semantic approach utilizing graphic organizers is an effective intervention to improve the word definition ability of children with DLD. Implementing semantic mapping caused a greater positive change in all three participants’ ability to define newly taught vocabulary words when compared with the Frayer model. Follow-up research is necessary to examine further the effectiveness of various vocabulary interventions in adolescents with DLD.
Examining an Explicit Phonological Awareness Intervention : The Impact on First Sound Fluency in Young Children
Published Year: 2022 Program: Doctor of Speech Language Pathology
Walsh, Mary
Objective: This study evaluated the impact of an explicit phonological awareness modeling intervention, conducted with four-year-old typically developing children, on their ability to say the first sounds in words. Method: Three preschool children participated in the study, which employed a single subject A-B-A design. The independent variable was shared book reading with embedded explicit phonological awareness modeling of first sound fluency in words. The dependent variable was the participant’s ability to say the first sound in words in response to probes presented at the end of each session. Initially, a baseline phase included four to five sessions without any intervention, after which probes were used to elicit first sound fluency. An intervention phase followed with twelve sessions of explicit modeling with probes provided to elecit correct responses with hierarchal cueing. A follow-up phase included three sessions without intervention but with similar probes. Results: Visual analysis of data revealed improvement in first sound fluency skills as all three participants demonstrated an immediate behavior change in an accelerating trend direction for first sound fluency performance. Conclusion: These findings demonstrate that typically developing four-year-old children exposed to explicit first sound fluency modeling during shared book reading will acquire this skill. Preschool staff can use this strategy to help preschool children acquire the phonological awareness skills needed upon kindergarten entry.
Effects of Visual Cue Intervention on the Ability to Follow Verbal Directions in Preschool-Age Children
Published Year: 2022 Program: Doctor of Speech Language Pathology
Webb, Maureen V.
Objective: Preschool children with receptive language delay often have difficulty following directions. Speech-language pathologists need evidence-based strategies to support the development of following directions. The purpose of this study was to examine the effect of the use of visual cues to improve following directions in preschool-aged children. Method: This research was a single-subject experimental study utilizing a noncorrent multiple baseline design. Three preschoolers between the ages of 4- and 5-years with a diagnosis of receptive language delay participated. All participants showed difficulty with following directions. Picture cards and objects listed on the directional cards were presented to each participant. The participants were asked to place objects in the position depicted on the picture card. Participants were asked to follow either one-step, two-step, simple, or complex directions. These directions were randomized on index cards. Each participant had difficulty attending to the picture cards and objects. Results: Each participant achieved baseline after four sessions but stayed in the intervention stage for longer than eight sessions due to decreased scores. All three participants in the study displayed decreased skills versus improved skills. Conclusion: The use of visual cues did not improve the child’s ability ability to follow directions. In this study, children were given at least four objects and 10 sets of directions; future research should focus on using fewer objects and simpler directions.
The Effects of Homegoals Parent Coaching Program on Parent Stress by Increasing Knowledge of Disorder and Use of Language Intervention
Published Year: 2022 Program: Doctor of Speech Language Pathology
Williams, Cherina
Objective: The purpose of this study was to examine the effects of the HomeGoals Parent Coaching Program (HG-PCP), a tailored coaching program for parents of toddlers with expressive language delay. The HG-PCP, is designed to support families with their current needs by providing diagnosis education, implementing intervention in natural environments, and prepare them to provide ongoing support of their child’s early language needs and thereby decrease parent perceived stress. Method: This investigation utilized a multiple baseline across participants design to examine the effects of the HG-PCP, to increase knowledge and skills in implementing treatments and to thereby decrease parent stress. Two parent-child dyads participated in the investigation 3 times a week over the course of five weeks. Results: Results indicate that the HG-PCP had a positive effect on parent knowledge and skills. Further, as knowledge and skills increased perceived parent stress decreased. Conclusion: These findings reveal that HomeGoals may be considered an effective program which increases parent knowledge and skills while decreasing perceived parent stress and mitigating expressive language gaps in the 16-24 month population. These findings support the need for professionals working in early intervention to empower parents with information in a systematic format in order to offset parent’s perceived stress. Future research will replicate the investigation with parent-child dyads, train additional SLPs to implement HG-PCP to compare validity and reliability and investigate dosage protocols to suggest best practice standards to reduce expressive language gaps.
Effects of Phonation Resistance Training Exercises and Inspiratory Muscle Strength Training with an Older Adult with Presbyphonia
Published Year: 2022 Program: Doctor of Speech Language Pathology
Yao, Theresa Jingyun
Purpose: RseultThis study aimed to examine the effects of using Phonation Resistance Training Exercises (PhoRTE) and Inspirator Muscle Strength Training (IMST) sequentially on voice outcomes of presbyphonia in older adults. Method: This was a single-subject experimental study on a 73-year-old female with a diagnosis of presbyphonia who received three baseline sessions and eight weekly sessions using PhoRTE and IMST. Primary outcome measures were acoustic voice quality index (AVQI), acoustic breathiness index (ABI), perceived vocal effort, and maximal vocal intensity (MVI). Secondary outcome measures were Aging Voice Index (AVI) and the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). Results: When comparing baseline to PhoRTE treatment phase, significant changes were observed in AVQI and ABI. When baseline was compared to the IMST treatment phase, as well as the whole intervention phase, significant changes were observed in all outcome measures. The percentage of nonoverlapping data (PND) for baseline vs. PhoRTE, and baseline vs. IMST was over 75% for all outcome measures. PND between two interventions (PhoRTE vs. IMST) was 100% for MVI, but non-significant for other measures. AVI score and CAPE-V ratings all reduced after the 8-week intervention. Conclusion: The preliminary results demonstrated the potential for using PhoRTE and IMST sequentially to improve voice quality and reduce vocal effort in patients with presbyphonia. Future research is needed to investigate effects of combining IMST with PhoRTE simultaneously is larger cohorts of older adults with presbyphonia and reversing the order of interventions.
The Effect of Self-Assessment on Speech Sound Accuracy in Conversational Speech
Published Year: 2022 Program: Doctor of Speech Language Pathology
Yoder, Lisa M.
Objective: Children with residual speech errors often stay in school-based speech therapy for months or years at the structured continuous speech level without progessing to spontaneous conversation. The purpose of this investigation was to determine if the use of self-assessment (SA) during therapy practice at the word, sentence, ad echo reading levels had a positive impact on the targeted speech sound at the conversational level compared to treatment as usual (TAU). Method: Two participants received three baseline measurements and seven sessions each of TAU and SA in an A-B-C single case research design. TAU consisted of practice at the word, sentence, and echo reading levels with knowledge of performance and knowledge of results feedback. Phase C added the element of SA to the practice stimuli. Conversational samples were collected at each session to identify carryover of speech sound accuracy from practice levels to spontaneous speech. This investigation occurred in a typical school-based 1:1 speech therapy setting. Results: Neither participant significantly increased correct production of target sounds in conversational speech in with treatment condition. Participant 1 (P1) showed an absolute level of change from Phase A to Phase B of 0, from Phase B to Phase C of 10, with a relative level of change 0 across all conditions. Participant 2 (P2) showed an absolute level of change of 0 for all phases, both within and between conditions. Conclusion: The lack of change in production at the conversational level in this investigation support previous findings. Future research should examine the effects of introducing SA earlier in the therapy sequence. Further, this treatment protocol did not explicitly target production or SA at the conversational level, but rather examined generalization to conversation as a function of traditional intervention. Future research should examine the use of SA along with treatment that explicitly targets sounds at the conversational level.
Generalization of Core Words Through Matrix Training in Children with Autism Spectrum Disorder
Published Year: 2022 Program: Doctor of Speech Language Pathology
Younes, Christine J.
Objective: The objective of this investigation was to determine the efficacy of using matrix training to teach generalization of the core word ‘open’, across verbal operants and activities. A 3×3 matrix was used across storybooks, playtime, and discrete trial teaching for mands, tacts, and verbal operants. Three participants, two males and one female, were recruited between the ages of 6-8 and were all functionally non-verbal. All three participants live in the Middle East and were from bilingual homes. Method: The investigation followed a multiple baseline across participants (MBAP) investigation with three participants. The baseline phase was followed by an intervention phase which utilized most to least errorless teaching for the matrix diagonal. The intervention phase was then followed by a generalization probe to see the effects of generalization across the matrix. Results: In analysis of the data, the statistical relevance is not significant. However, a slight increase in independent generalization across the verbal operants occurred across two of the three participants. Conclusion: In conclusion, generalization of core words, across verbal operants using matrix training resulted in minimal generalization across two of three participants. However, one of the participants was not introduced to the intervention due to session attendance. This is a primary limitation in the MBAP investigation. Other limitations identified include, extended duration of the investigation, changes in the baseline stability definition, and effects of challenging behavior. These, as well as other, limitations should be considered in replications of the present investigation.
The Use of Melodic Based Communication Therapy as a Tool to Impact Expressive Vocabulary Skills in Children Ages 2-4
Published Year: 2022 Program: Doctor of Speech Language Pathology
Breaux, Mia
Objective: Including music in learning environments to assist with developing expressive language skills is becoming common. However, there is limited research on the use of melodic-based communication therapy, specifically, to assist in developing expressive vocabulary skills in preschool aged kids. Melodic-based communication therapy is an intervention designed to pair music and language in speech therapy, targeting non-verbal and limited verbal children with autism. This investigation set out to determine the effectiveness of Melodic Based Communication Therapy as an intervention for children without autism between the ages of 2-4, with limited expressive vocabulary skills. Method: This investigation utilized a single subject A-B single case research design in order to determine if melodic-based communication therapy increased axpressive vocabulary skills. The melodic-based communication application was used to present target melodies and vocabulary words to the participants. Target pictures and objects, provided in the MBCT kit, were also utilized. Participants attended tweo to three, 25-minute sessions per week, for a total of 8 sessions. Results: The results of this investigation demonstrated that incorporating MBCT into speech therapy sessions may be beneficial in improving expressive vocabulary skills. While the data analysis did not indicate a significant difference, the upward trend in the intervention phase indicated a clinical difference. Further investigation is warranted to determine if a signficnat difference exists.
2023
The Impact of Visual Cues on the Recall of Functional Information in People with Dementia
Published Year: 2023 Program: Doctor of Speech Language Pathology
Beach, Gina L.
Objective: The population of people with dementia (PWD) is steadily growing. These individuals display increased difficulty with cognitive functioning, impacting routine daily activities and communication with family and caregivers. This investigation aimed to provide evidence of the benefit of visual cues as a compensatory strategy for PWD to increase the recall of functional information related to personal identificationand their environment. Method: Using an A-B-A-B single-subject research design, participants included one male and four female participants, ages 68-90, residing in a skilled nursing facility diagnosed with dementia of various etiologies. The dependent variable (DV) was the recall of functional information by people with dementia. The DV was measured by the number of correct responses to simple “Wh-” questions concerning functional information. The independent variable (IV) included the presentation of visual cues consisting of reminder pages. Results: Results of this investigation demonstrated that the initial intervention pahse (B1) was effective for all participants. Further, all participants demonstrated decreased performance once the intervention was withdrawn (A2). Four out of five (80%) participants in this study showed significant positive change with the replication of intervention (B2). Conclusion: The results support existing literature which imply that external reminders such as visual cues benefit PWD by increasing functional communication skills. Functional cues may benefit PWD with recalling functional information and increasing participation in routine activities.
Effect of a Modified Dialogic Storybook Reading Intervention on the Emergent Comprehension Skills of Young Children with Developmental Delays and Language Impairments
Published Year: 2023 Program: Doctor of Speech Language Pathology
Bienstock, Janine
Objective: The purpose of this study was to identify the differences between using literal and inferential prompts during a modified Dialogic Storybook Reading (DSR) intervention on the emergent comprehension skills of young children diagnosed with either Developmental Delay (DD) or Language Impaired (LI). Method: An alternating treatment design compared literal-only prompting during DSR and heavy inferential prompting on the comprehension of story element questions. Four (n=4) participants identified with either DD and/or LI in an early intervention preschool classroom received 7-9 weeks of DSR sessions in a large group. Results: All 4 participants in this study showed an immediate positive behavior change with the introduction of both treatment conditions. The magnitude of change varied with each participant. However, for each participant, treatment condition B2, mostly inferential, was either equal to or higher in slope trajectory. Conclusion: This investigation provided evidence that a mostly inferential modification to DSR contributed more to the overall improvement of young children’s emergent comprehension skills. While the overall effectiveness of traditional DSR was further supported, the comparison of treatment conditions revealed that a combination of treatments contributed more to increases in the emergent comprehension skill versus literal prompting alone.
Effects of the Social Emotional Engagement Knowledge and Skills for Early Childhood Professional Development on Kindergarten Teachers’ Use of Student Engagement Strategies
Published Year: 2023 Program: Doctor of Speech Language Pathology
Cabrera, Rocio
Objective: This investigation explored the effects of the Social Emotional Engagement-Knowledge and Skills for Early Childhood (SEE-KS-EC) professional development program on kindergarten teachers’ use of student engagement (SE) strategies. It also explored the impact of participating in SEE-KS-EC on the teachers’ level of burnout, their sense of self-efficacy, and the relationship between the teacher and a neurodiverse student. Method: Utilizing a multiple baseline design across participants design, three public school kindergarten teachers participated. The primary dependent variable was the teacher’s use of SE strategies as measured by data collection from classroom video/audio recordings. The independent variable was the SEE-KS-EC professional development program conducted once weekly. The duration of the investigation was 7-8 weeks (3-4 weeks in the baseline phase, 4 weeks in the intervention phase). Results: Upon reaching baseline stability, the intervention was introduced. All three participants showed an accelerating trend in their data, and a statistically significant change from baseline to intervention, as evidenced by Participants 1 and 2 having 100% non-overlapping data (PND) and participant 3 having 92% PND. Further, all participants showed improved self-efficacy and student-teacher relationships. No association was noted in their self-report of burnout. Conclusion: Results from this investigation demonstrate that the SEE-KS-EC professional development program is an effective tool for increasing teacher use of student engagement strategies. Future research should focus on replicating with a larger sample size and exploring the scope and depth of impact of the SEE-KS-EC program.
The Effect of Aided Language Stimulation on Joint Attention Commenting in Nonverbal Autistic Adolescent
Published Year: 2023 Program: Doctor of Speech Language Pathology
Caccavale, Marissa Jynn
Objective: The purpose of the investigation was to determine effect of aided language stimulation (ALS) on commenting skills in nonspeaking autistic adolescents who use augmentative and alternative communication (AAC) as their primary method of communication. The investigation focused on the number of comments created by nonspeaking autistic adolescent AAC users when ALS was provided during naturalistic and participant let speech and language therapy sessions. Method: The primary investigator (PI) implemented a multiple probe across participants design. All sessions took place in the speech room at a nonpublic school. Three participants aged 13;0 to 16;10 were enrolled in the investigation, with two completeing all investigation phases. Probes were used to measure the number of comments created during sessions. Intervention sessions included ongoing ALS provided by the PI on a separate device that mirrored the participants’ devices. Results: Implementation of ALS resulted in an immediate increase in the number of comments created by all participants from baseline to intervention. Removal of ALS resulted in a return to baseline levels of commenting. Conclusion: The results support the claim that ALS will increase the number of comments created by nonspeaking autistic adolescent AAC users.
The Effects of Social Communication Interventions Delivered via Telepractice Among Adolescents and Young Adults with Autism
Published Year: 2023 Program: Doctor of Speech Language Pathology
Campos, Angela Luther
Objective: This systematic review aims to determine the effectiveness of social communication interventions for adolescents and young adults with autism when delivered via telepractice. Method: Three research databases were searched, yielding four studies that met the inclusion and exclusion criteria. Inclusion criteria were published journal articles with adolescent or young adult participants with an autism spectrum disorder. The interventions used targeted social communication with an interventionist and needed to be conducted via telehealth for 50% of the intervention. Studies were excluded if participants had significant mental health diagnoses. Studies were also excluded if the intervention used a computer-based intervention or artificials intelligence. Results: PEERS was determined to be an effective intervention when delivered to adolescents via telepractice, as evidenced by two randomized controlled trials. Two other interventions were documented in the literature with positive results, though they did not show consistent generalization of learned social skills across non-treatment contexts, such as increased social outings. Conclusion: Telepractice is a viable method of delivery when teaching social communication. Participants were satisfied with the results of all interventions. Interventions should include a component meant to address generalization deficits.
The Effect of Spanish Narrative Intervention on the Story Retells of Sequential Bilingual Preschool Children
Published Year: 2023 Program: Doctor of Speech Language Pathology
Campos, Yesenia
Objective: Many researchers have documented the benefits of narrative intervention for bilingual children, using English intervention materials and measures. However, there is a lack of work examining the use of the first language. This investigation examined the effect of Spanish narrative intervention on the Spanish story retells of sequential bilingual Spanish-English preschool children. Method: This single case A-B study included three children, ages 4;3 and 4;6 with less than a year of exposure to English. Retells were measured using the Spanish CUBED listening retell subtest during baseline and intervention. Following five baseline sessions, participants received ten 30-minute Spanish language narrative intervention session, five times a week for a total of 4 weeks. Results: Visual analyses revealed significant gains in Spanish story retells for all participants after receiving Spanish narrative intervention. All participants had 100% percent non-overlapping data. Conclusion: The findings suggest that providing Spanish narrative intervention to Spanish-English bilingual preschoolers can help improve the story retells produced in Spanish. Future research should examine the effect of English and Spanish narrative intervention on bilingual preschool children with speech-language disorders.
The Effect of Role-Play and Coaching on EI Providers and their Use of Parent Coaching Strategies
Published Year: 2023 Program: Doctor of Speech Language Pathology
Castle, Danielle
The purpose of this investigation was to explore how the implementation of coaching, adult learning principles, and the use of role-play impacts Early Intervention (EI) providers who are using coaching strategies. Method: This study utilized an AB design to investigate the direct effect of role-play and coaching with adult learning principles onparticipants’ use of coaching strategies. Participants in this study included four English speaking EI providers with three years or less of experience working with families specifically in the field of EI. The dependent variable (DV) of independent use of coaching strategies was measured at the start of every intervention session through a brief role play scenario. The intervention phase of an introduction/orientation, six intervention sessions, and a final seventh data collection session spanned six weeks. Results: All participants had at least four successive data points outside the upper band of the two-stranded deviation band analysis. These results demonstrate a statistically significant increase in independent utilization of the coaching strategies upon introduction of the intervention. Conclusion: This study’s findings emphasize the impact of adult learning principles, role-play, and the use of coaching strategies to increase the use of coaching strategies with EI providers. Future research should examine the effect of practicing coaching strategies within role play to the independent use of coaching strategies when working directly with families.
The Effect of Enhanced Milieu Teaching Strategies Learned Through an Asynchronous Model on Parents’ Use of Strategies with Children with Autism Spectrum Disorder
Published Year: 2023 Program: Doctor of Speech Language Pathology
Colonna, Christina
Objective: This investigation was to determine if parents with limited knowledge and skills of engagement with children with autism spectrum disorder would increase the frequency of their use of strategies as a result of receiving parent coaching through telepractice in an asynchronous format. Method: An A-B-A maintenance design was selected for this investigation and four participants were recruited. Following baseline data, participants received coaching in using three enhanced milieu teaching (EMT) strategies including matched turns, time delays, and target talk through a telepractice model. Criterion was established as 80% accuracy of use of the targeted strategy across two consecutive sessions. Results: Visual analysis revealed positive therapeutic changes for all participants. The percent of non-overlapping data between adjacent phases was 100% with all data points falling outside of the range of the baseline phase. Data also revealed continued use of the strategy after the intervention phase. Conclusion: The findings demonstrate that parents with children with autism spectrum disorder can be coached via an asynchronous, telepractice model to utilize EMT strategies in the home.
Effect of Family-Centered Therapy on Caregiver’s Use of Language Expansion on Children Under 3 Years Old
Published Year: 2023 Program: Doctor of Speech Language Pathology
Courtwright-Waldron, Kristin
Purpose: The purpose of this investigation was to determine the effect of family-centered therapy on caregiver’s use of language expansion during parent-child interactions in naturalistic environments with children of early intervention age, specifically under three years old. Family-centered therapy, or parent coaching, included the practices of observation, demonstration, guided practice, feedback, and reflection. Method: Two parent child dyads participated in this A-B-B single subject design. Both children were under 3-years old for the duration of the investigation and participated with a biological parent. Participants received three to five intervention sessions that provided parent coaching specific to the use of language expansion. Parent coaching was comprised of observation, demonstration, guided practice, feedback, and reflection. Data was calculated to determine the number of times the caregivers used language expansion in response to 20 spontaneous utterances made by their child during sessions. Results: Both participants increased their use of language expansion during the intervention phase which was evident by 100%. Percentage of nonoverlapping data (PND) from baseline to intervention. Participants maintained their use fo language expansion at a frequency greater than was found at baseline. Conclusion: Family-centered therapy positively impacted caregivers use of language expansion during their spontaneous interactions with their children of the early intervention age. This study adds to the growing body of research that supports parent-coaching in natural environments for children under three.
The Effects of a Scaffolded Clinical Experience on Evidence-Based Practice Behavior and Confidence in Novice Student Clinicians
Published Year: 2023 Program: Doctor of Speech Language Pathology
Cowburn, Kacey
Purpose: This study examined the effects of a scaffolded clinical experience using a learning module and scripted storybook practice on novice speech-language pathology (SLP) student clinicians’ use of the number of opportunities to respond (OTR) during vocabulary instruction and their self-efficacy in applying evidence to clinical practice. Method: Four student clinicians participated in this multiple baseline design across participants study. Before the intervention phase, clinicians viewed a learning module describing a streamlined evidence-based practice (EBP) process related to vocabulary instruction. Generalization probes measured clinicians’ use of OTR without scripts. A secondary measure examined if the intervention affected the number of times participants engaged children in other story-related conversations (SRC). Student EBP self-efficacy was measured with pre- and post-test surveys. Results: During baseline and following the learning module, few OTR to targeted vocabulary were provded. Upon introduction of the scripted practice, clinicians’ use of OTR immediately increased while no change was noted in other SRC. During unscripted generalization readings, OTR decreased compared to scripted readings, but did not return to baseline levels. Additionally, clinicians improved their self-efficacy in applying EBP to clinical practice. Conclusion: Scripted storybook practice improved novice student clinicians’ use of OTR during vocabulary instruction. This teaching model provides a feasible way for clinical educators to incorporate EBP into early clinical experiences.
The Effect of an IDDSI Training Program on Registered Nurses’ Ability to Test Level 5 Textures
Published Year: 2023 Program: Doctor of Speech Language Pathology
Culpitt, Aeriana
Objective: This investigation examined the effect of an International Dysphagia Diet Standardization Initiative (IDDSI) training program on registered nurses’ (RN) ability to test and identify Level 5 Minced and Moist textures. The investigation took place in a rural critical access hospital. Participants of this investigation were three RNs working full-time with an active nursing license in Wisconsin. Methods: This multiple baseline across participants design utilized staggered initiation of the independent variable, an IDDSI training program. The primary investigator utilized observation and simulation training methods in this program to teach participants through globally accessible IDDSI.org print and video materials. The dependent variable of this investigation was the ability to test and identify Level 5 Minced and Moist textures as measured in percentage correct when presented with a tray of various food items. Results: Visual analysis of the data revealed that the IDDSI training program had an immediate and significant impact on the participant’s ability to test and identify Level 5 Minced and Moist textures. An accelerating trend from baseline to intervention was noted across all participants, each meeting the goal criterion within three to four sessions. Conclusion: Findings of this investigation demonstrated that an IDDSI training program significantly improved the ability of RNs to test and identify Level 5 Minced and Moist textures. Further research in different settings, such as skilled nursing facilities, is recommended, as well as with different medical professionals.
The Effects of a Listening Program on Attention Skills in People with Mild Traumatic Brain Injury
Published Year: 2023 Program: Doctor of Speech Language Pathology
DeFluiter, Jennifer
Objective: Auditory integration training (AIT), a method implementing music into therapeutic intervention, using special headphones, has been used to increase attention for many years for individuals with developmental delays. ASHA does not recognize AIT as evidence-based practice but states further investigation is warranted. This investigation sought to examine the effects of AIT on attention for individuals with mild traumatic brain injury. Method: The investigation utilized an alternating treatment design to compare cognitive remediation with AIT to cognitive remediation without AIT. The dependent variable was complex and selective attention as measured by the Paced Auditory Serial Addition Test. Three participants with a diagnosis of mTBI completed 40 sessions with and without AIT. Results: All three participants experienced an increase in attention with both presented conditions. However, the increase with the use of AIT appeared more substantial. This investigation focused on one AIT system. Several AIT systems exist, it is unclear if all systems would produce the same results. Conclusion: Combining AIT with cognitive remediation demonstrated a more substantial increase in attention among participants than cognitive remediation alone. A longitudinal investigation to ascertain the continued resolution of attention decifits would be beneficial.
The Effect of Using Social Thinking and the Self-Concept Framework Methodologies on Accurate Sense of Self in Neurodiverse Adolescents
Published Year: 2023 Program: Doctor of Speech Language Pathology
Dern, Darrell
Objective: This investigation examined the effectiveness of Social Thinking and The Self-Concept Framework Methodologies on an accurate sense of self in neurodiverse adolescents. Participants were adolescents between the ages of 13;0-19;0 with social learning differences. Method: This investigation employed a single-subject, A-B experimental design. Three participants completed this virtual, synchronous investigation. Participants completed lessons created by the PI that used treatment frameworks, social metacognitive strategies, activities, and tools to enhance observation of the social world and understanding and valuing dimensions of self. Participants engaged in two sessions of 60 minutes per week for 5-7 sessions. The dependent variable- accurate sense was measured after each session using a 7-point clinicians scoring rubric assessing the participants’ response to two probe questions elicited by a 7- point Likert scale completed by the participant. Results: All three participants demonstrated increased ability to describe accurate sense of self from intervention phase to baseline scores. The behavior change indicates a functional relationship between the DV and IV and a compelling demonstration of effect. Conclusion: An intervention combining the Social Thinking methodology with The Self-Concept Framework methodologies increased neurodiverse adolescents accurate sense of self. These findings show this intervention may be an effective tool to provide neurodiverse individuals with strategies to navigate the social world.
The Effect of Telerehabilitation on Voice Feminization in Transgender Women
Published Year: 2023 Program: Doctor of Speech Language Pathology
Dutta, Nabonita
Objective: Voice feminization is gender-affirming care frequently sought out by transgender women. Due to mulitple barriers to receiving in-person services, telerehabilitation is an increasingly favored mode of getting voice feminization therapy. Improved intervention outcomes, therapy attendance, and compliance with home exercise programs with telerehabilitation in transgender women led to the conception of this research topic. The purpose of this investigation was to determine the effect of telerehabilitation on average speaking fundamental frequency and self-perception of vocal feminity in transgender women. Method: In this A-B-A design, four transgender women aged 18 to 55 received voice feminization therapy two times a week for four weeks via the Zoom video platform. All four participants indentified increasing their speaking pitch as their primary goal. The voice feminization protocol adapted traditional voice therapy techniques and integrated them with voice production, vocal hygiene education, and speech tasks. Results: The results of this investigation demonstrated increased average speaking fundamental frequency and statistically significant improvement in the Trans Woman Voice Questionnaire scores across four participants. Conclusion: The findings contribute to the small body of research on tele-speech therapy, voice feminization, and the use of telerehabilitation in gender-affirming voice care.
Author has declined to share this capstone.
A Core Vocabulary Word of the Week Coaching Program : Effect on Aided AAC Modeling in Preschool Educators
Published Year: 2023 Program: Doctor of Speech Language Pathology
Eskridge, Sabrina A.
Objective: The purpose of the investigation was to determine the effect of a core word of the week coaching program on preschool educators’ frequency of aided augmentative and alternative communication (AAC) modeling during routine classroom activities. Method: Using a single-subject, A-B follow-up research design, three participants received a 30-minute training on core vocabulary and aided AAC modeling techniques. Following the training, participants received a maximum of two 20-minute individual coaching sessions per week until the criterion was met. Data collection of participants’ modeling count occurred during 10-minute routine classroom activities across baseline, intervention, and follow-up phases. Results: The results of the investigation revealed a positive relationship between participation in a coaching program centered around a core word of the week and the frequency of aided AAC modeling in natural classroom activities. Marked improvement from baseline to intervention and accelerating trends from intervention to follow-up occurred across participants. All participants increased their number of models to meet the criterion within four to six coaching sessions. With no declines in the follow-up phase, the participants maintained higher levels of modeling once the intervention ended. Conclusion: Implementation of a core word of the week coaching program can increase the aided AAC modeling of preschool educators. Future research is needed to validate these findings with a larger, more homogeneous sample size and to explore the long-term effects of the packaged intervention approach.
The Effect of Culturally Representative Intervention Materials on African American Preschool-Aged Child Engagement
Published Year: 2023 Program: Doctor of Speech Language Pathology
Francis, Veedra E.
Objective: The purpose of this investigation was to explore the effect of the use of culturally representative intervention materials versus non-culturally representative intervention materials on verbal engagement (specifically child verbal initiations and responses to request for communication) during speech and language intervention structured play tasks in african american preschool-aged children. Method: This study utilized an alternating treatment design (ATD) to directly compare the effect of using culturally representative and non-culturally representative intervention materials on engagement, a reversible behavior, in speech treatment sessions. This design allowed the investigator to determine which of the two interventions had a greater impact on engagement as measured by verbal initiations and responses to requests for communciation. The participants were three female and two male African American preschoolers ages 4;5 to 5;3 with a speech language impairment (SLI) eligible individualized education plan (IEP). Results: Results of the investigation indicated that all five participants demonstrated increased participation and verbal engagement when using cutlurally representative intervention materials during speech and language structured play tasks. Conclusion: These findings suggest that using culturally representative intervention materials during speech and language structured play tasks increases participation and verbal engagement in African American preschool-aged children compared to using non-culturally representative intervention materials.
The Effects of a Brief Mindfulness-Based Meditation Program on Perceived Stress and Trait Mindfulness in Speech-Language Pathologists
Published Year: 2023 Program: Doctor of Speech Language Pathology
Franks, Angelyn
Objective: This investigation aimed to evaluate the effectiveness of a brief mindfulness-based intervention (MBI) on perceived stress and trait mindfulness. Participants were licensed speech-language pathologists (SLPs) who worked full-time in healthcare and reported experiencing moderate levels of stress. Method: This investigation utilized a single-subject, A-B-A experimental design. Three participants completed this virtual, asynchronous investigation. Participants used a commercially available mobile application (app) to complete one short, guided meditation each day for 15 days. Each session was between 6-17 minutes long. The primary dependent variable, perceived stress, was measured after every third mindfulness session, using the 10-item Perceived Stress Scale (PSS-10). The secondary dependent variable, trait mindfulness, was measured before and after the investigation phase using the Mindful Attention and Awareness Scale (MAAS). Results: All three participants demonstrated statistically significant reductions in perceived stress compared to their baseline scores. When comparing pre- and post-test mindfulness scores, two participants demonstrated a positive change in trait mindfulness. Conclusion: A 15-day mindfulness-based intervention was effective in reducing perceived levels of stress in SLPs working in healthcare. These findings illustrate that brief MBIs might be a potential solution to the growing problem of chronic stress experienced by healthcare workers.
The Effect of Mindfulness on Subjective and Objective Measures of Attention for Adults with Persistent Post-Concussion Symptoms
Published Year: 2023 Program: Doctor of Speech Language Pathology
Fritschi, Dana C.
Objective: This investigation examined the effect of mindfulness on subjective and objective measures of attention for adults with persistent post-concussion symptoms (PPCS). Evidence indicates various mindfulness practices can improve cognitive skills among different populations. However, research utilizing mindfulness as an adjunct to speech-language pathologist (SLP) facilitated cognitive therapy for individuals with PPCS has yet to be studied. Method: This A-B-A withdrawal, single-subject research design included three adults with a concussion diagnosis, self-report of PPCS, and prior participation in outpatient cognitive therapy. Participants attended two weekly mindfulness sessions for six weeks via telehealth where they engaged in a guided 10-minute mindfulness practice focusing on one’s breath. Attention was measured subjectively via bi-weekly completion of The Mindful Attention Awareness Scale (MAAS; Brown & Ryan, 2003). Results: All three participants demonstrated increased MAAS scores during the treatment phase compared to baseline scores. The magnitude of change varied among participants. One participant presented statistically significant increases in MAAS scores compared to their baseline scores, and one showed improvement when comparing pre-and postintervention objective attention scores. Conclusion: The findings of this investigation support the potential of using mindfulness as an adjunct to cognitive therapy for adults with PPCS and confirm the need for additional research exploring the impact of mindfulness in speech-language pathology.
Effect of Core Vocabulary Instruction Using AAC on Protesting and Aggression in Children with Autism
Published Year: 2023 Program: Doctor of Speech Language Pathology
Gary, Delayna
Objective: This investigation aimed to examine the effect of core vocabulary instruction using a high-tech speech-generating device (SGD) on appropriate protesting ad aggressive behaviors in minimally speaking preschool children with autism spectrum disorder (ASD). Method: Two participants with autism completed this single-subject nonconcurrent multiple baseline across participants (MBAP) design. Data were collected on the primary dependent variable of protesting via SGD and the secondary dependent variable of aggressive behaviors. Treatment consisted of fifteen 30-minute intervention sessions for both participants. The independent variable of core vocabulary instruction targeted four protesting words, which included “no, stop, finished, all done.” Results: Participant 1’s percent non-overlapping data (PND) was 26.67% and Participant 2’s PND was 0%. These results indicate that the intervention was not effective in improving appropriate protesting. While both participants’ aggressive behaviors decreased upon implementation of the intervention, it is unclear whether the intervention was the primary factor in that change. Conclusion: The findings from this investigation did not support the use of core vocabulary instruction to increase protesting via high-tech SGD. Future research is recommended to further examine the relationship between effective, functional communication and aggression.
Effect of Integral Stimulation on Articulatory Accuracy in Phonological Disorders
Published Year: 2023 Program: Doctor of Speech Language Pathology
Haymon, Jessica L.
Purpose: This investigation aimed to determine the effects of integral stimulation on articulatory accuracy in children with a severe phonological disorder. While there are many treatment approaches for phonological disorders, research on motor-based treatment approaches for this linguistically based speech sound disorder is limited. This study aimed to add to the available evidence to support the claim that phonological disorders may have motoric underpinnings, and that a motor-based approach may be another option for treatment. Method: Three participants ages 4;0 to 5;6 years of age were recruited for this multiple baseline across participants investigation. All participants were diagnosed with severe phonological disorders. The participants received five to nine treatment sessions targeting three treatment words with one target phoneme per word. The researcher used a modified practice block schedule and fading cueing hierarchy. The dependent variable was the percentage of consonants correct in targeted phonemes of words (PCCtp). Results: Using the two standard deviation band method, all three participants made improvements from baseline. All three participants made improvements on the secondary dependent variables as well. Conclusion: This investigation adds to the literature in demonstrating phonological disorders may have a motoric underpinning. Further, this investigation provided additional evidence that a motor-based treatment approach may be an option for treating phonological disorders.
The Effects of Dialogic Reading on the Vocabulary Acquisition of Young Children with Language Delays or Disorders
Published Year: 2023 Program: Doctor of Speech Language Pathology
Heinle, Kristina
Objective: The aim of this investigation was to measure the effectiveness of dialogic reading with young children with language delays or disorders. Dialogic reading (DR) utilizes the CROWD questions (comprehension, recall, open ended, wh-, and distancing) with PEER prompting (prompt, evaluate, expand, and recall). Method: Four children ages 4;3 to 5;11 took part in this multiple baseline across participants single-case research design study. Sessions took place for 15-25 minutes per sessions, two to three times per week in a speech resources room in a rural public school. Baseline condition consisted of verbatim book readings with no additional questions or comments. The independent variable was the use of DR for a total of 25 receptive and expressive vocabulary words selected from five books for each participant. Five words were selected from each book and targeted two times each reading for a total of 10 prompts per reading. Results: All four participants demonstrated a positive change in their targeted expressive vocabulary acquisition following the DR intervention. Participants 2,3, and 4 demonstrated the most growth in receptive vocabulary during the baseline phase and maintained or slightly increased in intervention. Participants 1 demonstrated a slight increase in the slope of receptive vocabulary after the introduction of DR. Conclusion: Dialogic reading may be an effective treatment to improve the expressive vocabulary skills of children with language delays or disorders. Receptive vocabulary outcomes demonstrated a positive trend in baseline with verbatim readings.
The Effect on Stuttering of Adults Who Stutter Following a Virtual Non-Programmed Prolonged Speech Intensive Therapy Program
Published Year: 2023 Program: Doctor of Speech Language Pathology
Hernandez, Daisy J.
Objective: This investigation examined the effects of a virtual non-programmed prolonged speech intensive therapy program on stuttering of adults who stutter (AWS). The objective of this study was to determine if the treatment would decrease the participants’ (a) percent syllable stuttered (%SS), (b) perception of their stuttering severity via the Self-Assessment Severity Rating Scale (SASRS), and if so, (c) were participants able to maintain their fluency levels during a 2-week maintenance program. Methods: Four adult participants with a perception of moderate to moderate-severe stuttering disorder were included in this A-B-A nonconcurrent multiple baseline across participants investigation. The dependent variables (DV) were the participants’ frequency of %SS and the participants’ perception of stuttering severity. The independent variable (IV) was the implementation of a virtual four week intensive nonprogrammed prolonged speech program. Results: Results revealed positive outcomes for both measures. All four participants demonstrated a level change between phases A and B. Upon entering the maintenance phase (Phase A2), all participants revealed a continued decrease in severity perception and a maintained %SS. Conclusion: The findings demonstrated a positive treatment effect on the perception of stuttering severity and frequency of %SS, and levels were maintained throughout the maintenance phase. Further investigation examining the participants’ speech naturalness or pre- and post-intervention data is warranted.
Investigation of a Modified Cycles Approach for Phonological Process Disorders
Published Year: 2023 Program: Doctor of Speech Language Pathology
Holmes, Kathleen M.
Objective: This investigation examined the effect of a modified cycles approach with a home program in single word productions of 3 children ages 7 years 4 months to 7 years six months of age who currently receive school-based intervention for speech-sound production. Method: An A-B-C-B-C-multiple treatment single case research design was used for this investigation. The dependent variable was the decrease of phonological patterns in single words measured by word probes. The independent variables were a modified cycles approach followed by the addition of a home practice program. Three participants completed the investigation; a fourth participant withdrew after the baseline phase. All participants exhibited gliding of liquids and vowelization. Targets for all participants consisted of /r/ and /l/ with Phase B including consonant blends in the initial position of words and Phase C including consonant blends in the final position of words. Results: Results for this intervention were inconclusive as P1 and P2 made greater gains with intervention alone. Conversely, P3 demonstrated a zero-celerating to accelerating trend with intervention alone and a decelerating to zero-celerating trend when the home program was incorporated. Conclusion: The inconclusive results reveal that further investigation is needed to determine the benefits of a home program for speech sound production. Some limitations of the current investigation include the research design, limited data points per phase, and the possible treatment interference from Phase to Phase.
The Effect of Online Palliative Care Training on Knowledge and Comfort of Medical Speech-Language Pathologists
Published Year: 2023 Program: Doctor of Speech Language Pathology
Horvath, Brittany Christine McKee
Purpose: Current research supports favorable outcomes resulting from online continuing medical education, as well as a perceived lack of training in palliative care by practicing speech-language pathologists (SLPs). Therefore, this investigation aimed to determine the effectiveness of online palliative care training on medical SLPs’ levels of knowledge and comfort. Method: In this multiple baseline across participants (MBAP) method, ten participants completed online training modules provided by the Center to Advance Palliative Care (CAPC). An electronic visual analog scale (eVAS) was used to collect their ratings of knowledge and comfort. Seven intervention modules were completed asynchronously, with knowledge and comfort measured across each session. A follow-up phase was utilized to determine if gains would be maintained three weeks after intervention. Results: Nine of ten participants experienced statistically significant improvements in knowledge, which were maintained through the follow-up phase. Eight of ten participants demonstrated statistically significant improvements in comfort, which were maintained through the follow-up phase. Conclusion: To date, no other published investigations have examined the effect of online palliative care training on medical SLPs. This investigation provides evidence that online, asynchronous continuing education for medical SLPs can improve self-perceived knowledge and comfort in palliative care.
The Effects of Parent-Implemented Interventions: Using Enhanced Milieu Teaching Across Daily Routines
Published Year: 2023 Program: Doctor of Speech Language Pathology
Horvath, Kathryn
Objective: This investigation evaluated the effect of the Teach-Model-Coach-Review (TMCR) instructional method, within the natural environment, on Parent Implemented Intervention-Enhanced Milieu Teaching (PII-EMT) with caregivers of late language emergence toddlers. The dependent variable was the participant’s use of three EMT support strategies matched turns, time delays, and expansions with their child during daily routines of mealtime, dressing tasks, and playtime. Method: Three female participants, aged 32 to 48 years, received treatment in a multiple baseline across participants (MBAP) design. Participants received two 60-minute training sessions per week for 8 to 10 weeks. Sessions occurred in the natural environment. Resuts: All participants demonstrated a stable baseline. While all participants made immediate intervention gains, Participant 1’s gains stabilized through the intervention phase, whereas Participants 2 and 3 made gradual gains. The follow-up phase was zero-celerating revealing maintenance of the learned strategies. The immediate intervention effect across all participants suggested that the TMCR instruction was the cause of improvement in the intervention phase. Conclusion: The results indicated that the Teach-Model-Coach-Review instructional method resulted in increased use of Enhanced Milieu Teaching language support strategies across multiple family routines. Results cannot be correlated with changes in child language skills nor indicate the necessity or frequency of maintenance to caregivers.
Enhancing Parent-Child Communication Through Parent Coaching with Picture Exchange
Published Year: 2023 Program: Doctor of Speech Language Pathology
Howard-Owens, Kristina
Objective: This study examined the effect of parent coaching and training paired with picture exchange on parent communication with their late-talking preschool aged children. Method: Three parent/child dyads participated in an AB Single case design investigation. The dependent variable was the parent’s recognition and acknowledgement of their child’s communication attempts. The independent variable utilized the Teach Model Coach Review (TMCR) method on the identification of communication attempts via verbal responses or picture exchanges. The participants attended six 30-minute virtual coaching sessions, then recorded 10 to12-minute videos of themselves applying session strategies. All participants completed a pre- and post-survey to measure parent disposition toward use of strategies. Results: Participant 1 began the intervention with a stable baseline and intervention data showed an accelerating trend with 100% PND. While participants 2 and 3 also displayed a positive trend in intervention, the baseline data were not stable. All participants reported that the intervention enhanced their ability to communicate with their children. Conclusion: This study supported the use of parent coaching and picture cards as an effective means to increase parents’ communication with their children. Further, it supports the use of coaching and modeling to improve parent disposition toward language modeling and communication.
The Effect of Communication Partner Training on the Frequency of Modeling Social Communicative Functions Using AAC
Published Year: 2023 Program: Doctor of Speech Language Pathology
Jenkins, Ashley
Objective: This investigation aimed to determine the effectiveness of a communication partner training program in teaching educators to provide aided language modeling focused on social-communicative functions during student-led activities. Method: A multiple baseline across participants single-subject research design was utilized for this investigation. Three participants completed this investigation. Following baseline data collection, each participants received 20-minute training sessions, utilizing the components of description, demonstration, roleplay, and coaching to provide aided language modeling focused on social-communicative functions during student-led activities. Data were collected within 24 hours of each intervention session. The criterion was established as eight modeling occurrences within a 10-minute observation. Maintenance sessions occurred one and two weeks after the intervention. Results: Results of the investigation indicated that each participant demonstrated an increased frequency of aided language modeling during the intervention phase. All participants met the criterion within three to five intervention sessions. Results during the maintenance condition were mixed, with P1 demonstrating a slight decrease in modeling occurrences, P2 demonstrating a sharp decrease in modeling occurrences, and P3 reverting to baseline. Conclusion: The findings of the this investigation support that a communication partner training program that utilizes the components of description, demonstration, roleplay, and coaching effiectively increases the frequency of educators providing aided language modeling focused on social communicative functions. Additionally, the outcome suggests the need for continuous training for educators instead of short-term training sessions. Further research is needed utilizing this intervention with different communication partner populations and setting.
The Impact of Adding Therapeutic Tastes to an Oral Stimulation Program on Premature Infant Feeding
Published Year: 2023 Program: Doctor of Speech Language Pathology
Kirsch, Jennifer
Objective: Prolonged feeding and swallowing difficulties are often observed in premature infants beyond hospital discharge. Understanding the role of positive early feeding experiences and preventing long-term complications is important. The purpose of this study was to compare oral stimulation alone and with the addition of therapeutic tastes on overall oral intake upon feeding initiation. Method: Two of seven referred premature infants participated in this alternating treatment design study conducted at the infant’s bedside, during usual three-hour care times. The dependent variables (DVs) were proficiency of oral intake and Neonatal Eating Outcome Assessment scores. The independent variables (IVs) were oral stimulation using the Premature Infant Oral Motor Intervention (PIOMI) alone (Treatment A) and with therapeutic tastes (Treatment B). Results: Participant 1 born at 31 4/7 weeks gestation, and in room air at 34 weeks PMA completed eleven data points and six full feedings over four days. Participant 2 born at 32 weeks gestation, and in room air at 33 6/7 weeks PMA completed nine data points and seven full feeding over four days. Both participants’ showed decelerating trends across sessions for both DVs for both IVs, though Treatment A had a steeper decelerating trend. Conclusion: Significant conclusions cannot be drawn due to limited data points due to physiological instability. Both participants demonstrated signs of stress during Treatment A and after consecutive interventions. Further research is needed to determine effective and safe premature infant feeding intervention.
Effects of Music-based Activities on Children with Expressive Language Delay
Published Year: 2023 Program: Doctor of Speech Language Pathology
Kooh, Serena
Summary: Objective: This investigation aimed to determine the impact music with joint action routines have on the expressive vocabulary production of single words in preschool-aged children. Specifically, compared to the use of joint action routines alone. Method: This ABAB Single Case Design investigation included three preschool-aged participants. The dependent variable was the production of single words. The independent variable was the presentation of music combined with joint action routines. The sessions were 30-minute individual sessions. Participants attended three baseline and six withdrawal sessions of therapy without music. They attended six sessions of therapy with music for both B phases. Results: All participants achieved a stable baseline and upon initiation of the intervention, showed accelerating trends. The percent of non-overlapping data (PND) of more than 80% for all participants indicates an effective intervention. Upon withdrawal of the intervention, Participants 2 and 3 showed an immediate decelerating trend, while Participant 1 showed a delayed decelerating trend. All participants produced an immediate increase in vocabulary use, with the data accelerating when intervention was re-introduced. Conclusion: Results support the use of a combination of music and joint action routines to increase single-word production in children with expressive vocabulary delay. Future research might examine the effects of extending the amount of time music is included in intervention.
The Effects of Dialogic Reading Strategies on Vocabulary in Spanish-Speaking Dual-Language Learners with Development Language Disorder
Published Year: 2023 Program: Doctor of Speech Language Pathology
Kuyuk, Maria Laura
Purpose: The purpose of this investigation was to compare the efficiency of dialogic reading strategies (DRS) provided bilingually (Spanish and English) and solely in English on the acquisition of vocabulary of young school-aged dual-language learners (DLLs) with developmental language delayrs (DLD). Method: Five participants between the ages of 5 and 8, identified with or suspected of having a DLD, participated in this adapted alternating treatment design investigation. The primary dependent variable (DV) was English vocabulary naming, and the secondary DV was Spanish vocabulary naming. Participants received 5 weeks of shared book reading with DRS intervention alternatively in English only and bilingually, either individually or in a small-group format. Results: Each participant exhibited a noticeable increase in English vocabulary naming after introducing both treatment conditions. However, the bilingual rendition of DRS was more efficient because all five participants learned not only English words (L2) but also Spanish (L1) vocabulary during the intervention. Conclusion: This investigation provided evidence that a bilingual approach to DRS is a practical and efficient way to increase vocabulary in both L1 and L2 when used to treat young school-aged DLLs with DLD. Further research is needed to examine the effects of this intervention in Spanish-speaking DLLs who present a broaders range of linguistic and academic needs, as is the case of students in special education self-contained classes.
Parent-Implemented Interventions with Guyanese Caregivers
Published Year: 2023 Program: Doctor of Speech Language Pathology
Livan, Sharlen
Objective: This study examined the effect of online parent coaching of the teach-model-coach-review (TCMR) instructional approach on Guyanese parents’ use of langauge expansion during routine-based activities for children with expressive language impairment. Method: A multiple baseline design across participants (MBAP) design was used for this study. Three parent-child dyads participated. The dependent variable for this investigation was the caregiver’s use of language expansion strategies in free-play activities with their children. The independent variable utilized the TMCR instructional approach to language expansion during routine-based activities at home. Participants attended intervention sessions and then recorded themselves applying strategies. Results: Participant 1 began the intervention with a stable baseline; Participants 2 and 3 began the intervention phase after each prior participant met criteria. All three participants’ data indicated a significant treatment effect with 100% of data non-overlapping. Additionally, all participants continued using strategies at maintenance. Conclusion: Parents demonstrated a positive intervention effect by substantially increasing their use of language expansion during routine activities with their child. Following the intervention’s conclusion, parents could maintain their use of the strategy once coaching had been discontinued. This study supports the use of parent coaching and teaching in supporting parents of children with language delay.
The Effect of Oromyofunctional Therapy on Speech Production in School-Aged Children with Interdental Lisps
Published Year: 2023 Program: Doctor of Speech Language Pathology
Makki-Karnib, Nada
Objective: Considering the documented increase in oral dysfunction in children with speech sound disorders, there is a lack of evidence on the effects of oromyofunctional therapy (OMT) for remediation. This study aimed to assess the effect of OMT on the accuracy of the /s/ phoneme in children aged between 8 and 12 with persistent interdental lisps. Method: Following dental referral for interdental lisps and tongue thrust patterns, four participants, ages 8;6 to 12;8 were recruited for this multiple baseline across participants investigation. The independent variable was the accuracy of /s/ in word-initial position, at the word level. The independent variable included the modified Australian Orofacial Myology Collaboration treatment protocol. Intervention was conducted for two 30-minute sessions and home practice was required. Additional information was collected pertaining to the participants’ compensatory behaviors and oral dysfunction. Results: Results fo the investigation demonstrated effectiveness of the intervention for all four participants. The improvements in /s/ accuracy appeared to coincide with improvements in oral functions, such as swallowing patterns and mouth breathing, and reduced compensatory behaviors, such as jaw sliding. Conclusion: This investigation provided evidence in support of the effectiveness of oromyofunctional therapy in the remediation of /s/ in children with persistent interdental lisps. Concurrent improvements in oral functions such as breathing, swallowing and correct resting tongue posture were observed.
The Effects of Multimodal Intervention on Receptive Vocabulary in High School Students with Language Impairments
Published Year: 2023 Program: Doctor of Speech Language Pathology
Mims, Austyn
Objective: The purpose of this investigation was to determine the effectiveness of multimodal intervention using InferCabulary, a web-based program, on receptive vocabulary in high school students with language impairments. Method: The investigation utilized a multiple baselines across participants, single-subject research design. Three participants completed one pretest to determine unknown Tier 2 words. Following the baseline data collection, participants participated in 20-to-30 minute multimodal intervention sessions (verbal and visual stimuli derived from InferCabulary) 4x a week for a maximum of 12 sessions. Data were collected after each session to determine the percentage of Tier 2 words identified. Results: Results indicated a significant therapeutic effect in receptive vocabulary skills once the intervention was introduced. All participants’ data demonstrated 100% of non-overlapping data and 100% of intervention data points fell outside of the two-standard deviation band. These results provide additional evidence that the intervention was effective, and results were not due to chance. Conclusion: The findings suggested that multimodal intervention effectively increases receptive vocabulary skills in high school students with language impairments. Further research, including the replication or expansion of the current study is needed to generalize results and determine long term effects.
The Effect of Individual, Short, Frequent, Intense, Speech Treatment Sessions on the Percent Accuracy of Target Sounds in Kindergarten Through Third-Grade Students with Mild to Moderate Speech Language Disorders
Published Year: 2023 Program: Doctor of Speech Language Pathology
Payton, Marva
Objective: This investigation examined the effects of individual, short, frequent, intense speech treatment sessions on the percent accuracy of target sounds in kindergarten through third-grade students with mild to moderate speech sound disorders in the public school setting. Method: Three kindergarten through third-grade students with an active individualized education plan received individual speech treatment sessions three times per week, 10 minutes per session with 70 target sound productions for four weeks. Improvement was measured by the percent accuracy of target sounds in single words. The participant’s IEP was used to determine target phonemes. Results: All participants exhibited an improvement in target sound productions by the final speech treatment session. Of the three participants, two participated reached the investigation goal of 80% accuracy over two consecutive therapy sessions before the completion of the investigation. One participants did not reach the investigation goal of 80% accuracy of target sounds but received 70% accuracy in the final two sessions of the study. Conclusion: The results of this investigation support the use of individual, short, frequent, intense speech treatment sessions as an effective service delivery model.
The Effect of Emotional Recognition Intervention on the Ability to Identify Emotions via Telepractice
Published Year: 2023 Program: Doctor of Speech Language Pathology
Prati, Christa E.
Objective: This investigation examined the effect of emotional recognition intervention via telepractice on the ability to identify emotions in children aged 7;0-10;11 years with a confirmed diagnosis of autism spectrum disorder. Method: A multiple baseline across participants (MBAP) design was utilized for this investigation. The primary dependent variable (DV) was identification of a randomly selected set of emotions. Two participants completed this study, ages 8;10 (P2) and 8;1 (P3). The intervention phase included 2 treatment sessions for P2 and 16 treatment sessions for P3. A maintenance period of two weeks ensued once the criterion of 9/10 (90%) emotions was met. At the two-week mark, another data collection session was completed to check carryover. The investigation was completed in 8 weeks. Results: This study began with three participants, however the first reached criterion in baseline. The additional 2 participants demonstrated positive effect in the ability to correctly identify emotions. The data were supportive of the initial claim that participants’ emotional recognition improves when taught a specific and systematic way to identify emotions. Conclusion: Findings suggest that emotional recognition treatment via telepractice is an effective intervention for autistic children aged 7;0-10;11 years. Additional research is necessary to compare level 1 to level 2 autistic participants, as well as to expand the criterion for mastery or maintenance phase to determine long-term retention of skill.
The Effect of Minimal Pairs Intervention on Speech Sound Accuracy in Elementary-Aged Children
Published Year: 2023 Program: Doctor of Speech Language Pathology
Pryer, Sharlene Ruffin
This investigation examined the effect of minimal pairs intervention on school aged children with a phonological disorder. Method: The research design implemented a multiple baseline design across participants. The independent variable was the minimal pairs intervention. During multiple baselines across participants’ design, the independent variable was introduced sequentially across all participants. Results: Upon completion of this intervention, all three participants exhibited a positive effect on their ability to produce the targeted speech pattern. Participants’ 1 and 2 presented with immediate change in behavior when the intervention was introduced. Conclusion: All three participants demonstrated positive gains with sound speech sound production. The data supports the claim that the implementation of the minimal pairs intervention is an effective intervention to improve speech sound accuracy for school age children presenting with a phonological disorder. Based on the results of this investigation, minimal pairs intervention is a valid intervention in children with a speech sound disorder. Further research is needed to address generalization of skills.
Impact of Asynchronous Training on School-Based SLPs’ Knowledge and Application of Assessment Procedures When Assessing Culturally and Linguistically Diverse Students
Published Year: 2023 Program: Doctor of Speech Language Pathology
Purkayastha, Jayeeta
Objective: The purpose of this investigation was to explore the impact of asynchronous training on school-based SLPs’ knowledge of cultural competence anc culturally responsive assessment procedures when assessing culturally and linguistically diverse (CLD) elementary students. Method: Four school-based SLPs who expressed a need for training in CLD assessment procedures participated in this A-B follow-up investigation. The dependent variable (DV) was recall and application of essential components of assessment with CLD students measured by responses to questionnaires. The independent variable (IV) included reviewing pre-recorded online modules for five days. One follow-up data point was taken seven days after the last intervention session. Results: Participants 1, 2, and 4 showed an immediate increase in correct responses upon introduction of the IV, while Participant 3 (P3) showed an immediate decline. However, Percent non-overlapping data was 80% for P1, 40% for P2, 0% for P3, and 40% for P4. The absolute level of change (ALOC) from Intervention to the follow-up was 13.4 for Participant 1, 23.4 for Participant 2, 10 for Participant 3, and 0 for Participant 4. Conclusion: The variable results render these results inconclusive. Several limitations likely impacted the results, including the length and asynchronous format. Further research is needed to determine the best method for supporting best practices for assessing CLD students.
The Effect of Modeling During Routine-Based Activities on the Initiation of Verbal Communication Attempts and Expressive Vocabulary in Children Diagnosed with “Late Language Emergence”
Published Year: 2023 Program: Doctor of Speech Language Pathology
Reed, Ashley Michele
Objective: The purpose of this study is to investigate the use of modeling during routine-based activities with an increased intensity of sessions on verbal communication attempts and expressive vocabulary. Method: Three participants 24-37 months of age were recruited for this A-B-A-B single-subject design. Treatment sessions took place 5 times a week for 30 minutes per sessions in the home during routine-based activities (two sessions were held at the local park). The dependent variable was the number of new vocabulary words produced during a 30-minute session. The criterion level for acquisition was set at 10 different and new vocabulary words. The independent variable was the use of modeling (recasting, self-talk, parallel talk, and focused stimulation) during routine-based activities. Results: All three participants increased their expressive vocabulary. P1 increased his vocabulary by learning 147 new words, P2 by learning 115 new words, and P3 by learning 157 new words. This positive growth in vocabulary for all participants revealed a possible functional relationship between the intervention and the dependent variable. Conclusion: The use of modeling during routine-based activities at a high frequency over a short period of time yielded positive results for all three participants. There was a positive, accelerating trend during the intervention phases. While the withdrawal phase revealed continued learning for each participant, the level of growth between participants was not as varied or to the same degree as seen during the intervention phase.
The Effect of EET on the Number of Semantic Features Used to Describe Tier 1 Vocabulary Words
Published Year: 2023 Program: Doctor of Speech Language Pathology
Rice, Karen
Objective: The purpose of this investigation was to examine the effectiveness of the Expanding Expression Tool (EET) to improve overall vocabulary skills of school-age children diagnosed with expressive language impairment (LI) by targeting semantic features through this multi-modal approach. Method: Three second and third graders diagnosed with expressive LI and on an active Individualized Education Plan (IEP) participated in this AB single case design investigation. The primary dependent variable (PDV) was the number of semantic features produced to describe the Tier 1 vocabulary words. The secondary dependent variable (SDV) assessed was the number of semantic features each participant provided to describe grade-level high frequency vocabulary words. The independent variable (IV) was the EET, a multi-modal intervention tool that targets semantic language through explicit instruction of semantic features. Results: All five participants’ data showed an increase in the number of semantic features produced when measuring their performance for the PDV. Additionally, all participants exhibited increases when measuring their progress for the SDV. Conclusion: The results of this investigation support the use of The EET intervention program as an effective means to facilitate the depth and breadth of the vocabulary skills of school-age students diagnosed with LI. Future research is needed to provide further evidence that the skills acquired during intervention are retained over time.
Evaluating the Effect of Targeted Intervention on Syntax Production in American Sign Language
Published Year: 2023 Program: Doctor of Speech Language Pathology
Sanzo, Kimberly Anne
Objective: The purpose of this study was to investigate the efficacy of a targeted syntax intervention on the ability of Deaf children with an incomplete first language to produce subject-verb-object (SVO) sentence structure in American Sign Language (ASL). Method: This was a single-subject AB design with follow-up. Participants were two Deaf children ages 8 and 9 with language difficulties in both ASL and English. The independent variable was a targeted intervention that utilized visuals to help teach word order. The dependent variable was the participants’ ability to produce SVO structure in ASL. Results: Both participants made significant gains in their ability to produce SVO structure in ASL. One participant reached the criterion of 9/10 in 6 sessions and the other participant in 10 sessions. Intervention demonstrated a therapeutic effect that was maintained in follow-up sessions. Conclusion: This intervention is a quick and effective way to help young Deaf children with language deprivation learn to produce basic word order in ASL. Future research should investigate the use of this intervention on Deaf children within a wider age range and who have additional disabilities. It would be useful to examine the efficacy of this intervention when trialed with a more representative population of Deaf students.
Feeding Aversion in Children with History of Pre-Term Birth : The Effects of an Oral Brushing Program on Oral Intake
Published Year: 2023 Program: Doctor of Speech Language Pathology
Sebro-Calderon, Tasanyia K.
Objective: The purpose of this investigation was to assess the potential for young children to increase their oral intake of food and liquids, as measured in ounces, when an oral brushing routine was paired with traditional feeding intervention. Method: This multiple baselines across participants investigation included three children, two boys 4 years of age and one boy 7 years of age. All participants had a history significant for prematurity and a diagnosis of oral feeding aversion. Previously conducted swallow instrumentation reports were used to determine cadidacy for participation and to establish safe consistencies for the feeding tasks. Outcomes were investigated under two conditions: 1) Baseline phase – traditional feeding intervention with oral feeding tasks, and 2) Intervention phase – an oral brushing task performed immediately prior to traditional feeding intervention with oral feeding tasks. The United States Department of Agriculture’s MyPlate food guide was used to determine criterion levels. Results: All three participants weaned from tube-feeding and either maintained or gained weight during the investigation. Of note, all participants had poor oral care at baseline, which improved daily oral care during and immediately post-intervention. While all children increased the volume and variety of orally accepted food, changes in volume were not statistically significant. Conclusion: Ongoing investigation is needed to explore interventions that can assist in increasing oral intake in children who have feeding aversion and a history of prematurity.
The Effectiveness of Using a Music-Based Approach to Treat Children with Speech-Sound Disorders
Published Year: 2023 Program: Doctor of Speech Language Pathology
Torres, Jessica
Objective: The purpose of this investigation was to determine if a music-based treatment approach is effective in treating children with speech-sound disorders. This investigation utilized a music-based approach to increase motivation and enjoyment of the therapeutic process while decreasing gthe explicit teaching that typically occurs in speech sound disorder intervention. Method: A multiple baseline across participants design was replicated across three participants ranging in age from 6;7 to 7;6 that demonstrated a level of phonological impairment within the moderate or severe range. The participants received seven to 11 treatment sessions targeting a phonological error pattern. The investigation used a three-phase music-based approach for the independent variable. The dependent variable was the percentage of consonants correct (PCC).
The Role of Sensorimotor Integration on Children with Food Aversions
Published Year: 2023 Program: Doctor of Speech Language Pathology
Toscano, Teresa
Objective: This study aimed to assess the effects of applying sensorimotor stimulation and oral motor exercises on increasing the intake of novel foods in children between the ages of 6 to 14 with moderate to severe food selectivity. Method: This investigation used a single-subject case AB design with follow-up. Participants were three children recruited from a nearby elementary school who presented with moderate food aversions. Data were collected on the dependent variable of bites taken during trials of a novel food. The independent variable was sensorimotor exercises, designed from the Sensory Motor Approach to Feeding. During the intervention phase, participants performed and individualized oral motor exercise program until the criterion was met. In the follow-up phase, participants were assessed if intake of the non-preferred food was maintained. Results: Two participants demonstrated positive effects on consuming the novel foods. This was evidenced by the maintentance of intake between the termination of the intervention phase and the follow-up session, as well as a check-in with the parents eight weeks post-intervention, who verified the continuation of intake of the novel foods. One participant demonstrated inconsistent performance until discontinuing the study. Conclusion: Sensorimotor intervention effiectively improves the intake of novel foods for children with moderate food aversions. Consistent and individualized intervention appeared to result in quick and lasting changes.
Effect of Speech-Language Pathologist Training on Handfeeding Techniques Implementation on Persons with Dementia
Published Year: 2023 Program: Doctor of Speech Language Pathology
Trejos-Ibata, Kelly
Objective: This investigation aimed to explore the effectiveness of virtual handfeeding technique training on a novice speech-language pathologist (SLP). This investigation assessed a novice SLP’s independent use of different handfeeding techniques with a person with dementia (PWD) while also assessing resistive/agitated behaviors and percentage estimate of PO intake of the PWD. Method: This investigation utilized an alternating treatment design with one participant. All treatment sessions were conducted virtually. Following five baseline sessions, the participant participated in 12 20-30-minute virtual training sessions implementing either hand-under-hand (UH) or hand-over-hand (OH) feeding technique one-four times per week for four weeks. Treatments were randomized using a computerized system (random.org) with no more than two sessions of a single intervention. Analyses of the baseline phase to intervention phases showed a positive therapeutic direction for the independent use of handfeeding techniques of the participant. Implementation of trained handfeeding feeding techniques led to increased agitated/ resistive behaviors and also increased consumption of food/liquids in the PWD. Conclusions: Results from this investigation demonstrate that virtual handfeeding training of novice SLPs led to improvement in the use of handfeeding techniques during their treatment sessions. Future investigations should consider a larger sample size, access to training materials, and incorporate coaching about the appropriate use of techniques.
Comparison of the Traditional Service Delivery Method with a Collaborative Intervention Model Targeting Multiple Meaning Words with Third-Grade Students
Published Year: 2023 Program: Doctor of Speech Language Pathology
Vestal, Kimberly
Purpose: The purpose of this study was to compare the efficacy of a traditional pull-out therapy and a collaborative push-in therapy delivery models. Secondarily, to determine teachers’ perceptions of barriers and benefits of a collaborative intervention model with an SLP. Method: Using a single-subject alternating treatment design, seven of ten 3rd-grade participants completed the investigation. Probe data on participants’ prior knowledge of multiple-meaning words were collected. The intervention phase included 10 alternating intervention sessions over five weeks. Three 3rd-grade teacher participants were surveyed regarding their perception of barriers and benefits to engaging in the collaborative service delivery model before and after the investigation. Results: Both conditions resulted in a positive effect, with all participants showing achievement of the criterion by the final intervention assessment. Four of the seven participants who completed the investigation, showed higher gains in the collaborative condition. The teacher survey results indicated that five of the six perceived barriers before the intervention were seen as benefits or eliminated after the study. In total, six benefits were added by the teacher participants post-intervention. Conclusion: The data supported the initial hypothesis that a collaborative, push-in intervention model would be as effective as the traditional small group, pull-out service delivery model. Teachers found value in all students’ benefitting from the intervention, observing that students integrated the new vocabulary learned in multiple contexts. Teachers also noted gains from what they learned from the SLP’s expertise.
The Effects of Individualized Think Aloud Intervention on the Reading Comprehension Skills of 7-9-Year-Old Children Diagnosed with Speech and Language Impairments
Published Year: 2023 Program: Doctor of Speech Language Pathology
Walker, Stephanie Elizabeth
Objective: The purpose of this investigation was to determine the effectiveness of the think aloud method in increasing the reading comprehension skills of children 7-9 years of age diagnosed with specific language impairment. Method: Four children ages 7-9 years were selected to participate in an ABA single-subject design. The think aloud method was the independent variable. This method was chosen to help the children become active participants in their learning processes as opposed to passive learners. The dependent variable was measured by the number of accurate responses to reading comprehension questions. Results: Upon conclusion of the withdrawal period, visual analysis of the results revealed an increase in comprehension responses for three of the four participants. Three participants showed a positive response to the intervention with accelerating trends and 100% nonoverlapping data. Participant 3 showed some improvement in their ability to respond to questions; however, the percentage of overlapping data points was 50%. The think aloud method may be a resourceful tool for increasing the reading comprehension skills of students diagnosed with specific language impairment.
The Effect of Multimodal Vocabulary Intervention on Receptive Vocabulary in School-Aged Children with a Mild to Moderate Language Disorder
Published Year: 2023 Program: Doctor of Speech Language Pathology
Wallis, Vanessa
Purpose: This investigation aimed to determine the effect of a multimodal intervention targeting the acquisition of novel vocabulary words in students with a mild to moderate language disorder (LD). In this context, multimodal is defined as a broad-spectrum approach utilizing various therapy delivery models to optimize treatment outcomes. Method: Three 7th grade students with primary eligibility of mild to moderate LD participated in this AB study with posttreatment follow-up. Following baseline data collections, a four-week intervention targeted ten predetermined vocabulary words which were taught using a multimodal intervention structure. Strategies included drawing, discussing and using the words, and playing a game based on the targeted words. Participants received six 30-45 minute vocabulary intervention sessions 1-2 times a week over four weeks and completed one follow-up test two weeks after the last session. Data were collected after each session to determine the percentage of words learned. Results: Upon completion of the intervention, all participants met criterion. Data revealed a statistically significant increase in the knowledge of the targeted words for all participants. At posttreatment follow-up, participants continued to demonstrate a clear understanding of the targeted words with retention scores remaining at or above criterion. Conclusion: Results signify a positive relationship between the intervention and successful lexical expansion, indicating that a multimodal approach is a viable tool in teaching new vocabulary words. Further research is needed to explore the effects of this treatment approach to improve and expand a student’s lexical base.
Effect of Imitation on Object-Directed Tasks in Young Children with Autism Spectrum Disorder
Published Year: 2023 Program: Doctor of Speech Language Pathology
Williams, Sharon
Objective: The purpose of this investigation was to examine the effectiveness of object-directed tasks on motor and verbal/vocal imitation behaviors in three young children with mild-to-moderate autism. Method: This investigation utilized a single-subject multiple baseline across participants (MBAP) design. Participants engaged in Structure-Elicited Imitation of adult-directed tasks. Participants were randomly assigned to a three-, six-, or nine-point-data baseline phase. Treatment sessions consisted of 10 sessions (10 imitation trials with four associated target acts) delivered once a day for 10 consecutive sessions. Imitation behaviors (motor and vocal/verbal) were assessed. Results: Results indicated that all three participants imitated more using object-directed acts during the treatment phase. Participant A showed the greatest change, with an absolute level of change of 35 on motor imitation and 40 on verbal/vocal imitation. Participant B’s level of change showed 33 on motor imitation and 31 on verbal/vocal imitation. Participant C’s level of change showed 30 on motor imitation and 30 on verbal/vocal imitation. Conclusion: Speech and language professionals can improve the motor and vocal skills of young children with ASD by developing intensive intervention procedures which utilize self-directed tasks. This treatment option is effective, simple and can be incorporated in treatment plans.
Effectiveness of Maximal Oppositions Approach on Children Aged Three to Six with Moderate-Severe Phonological Disorders
Published Year: 2023 Program: Doctor of Speech Language Pathology
Wiltshire-Scala, Nichole
Objective: This study was designed to investigate using maximal oppositions to treat phonological disorders in children aged 3;0-6;0 with moderate to severe phonological disorders. Methods: Three participants were enrolled in a single-subject ABAB study design. The primary dependent variable was increased accuracy of targeted and untargeted speech sound errors. The secondary variable was the acquisition of untreated speech sounds. Dependent variables were measured by increased the accuracy of target speech sounds and the presence of new speech sounds. The independent variable was the maximial opposition approach. Baseline and withdrawal sessions include sham treatments, including no direct speech sound intervention. Results: Visual analysis revealed increased speech sound accuracy for all three participants. Two participants (P1 and P2) reached the 90% criterion in the first intervention phase B1: therefore, new targets were chosen for the second intervention phase B2. P3-maintained target sound accuracy during the withdrawal phase achieved during the first intervention phase B1. P3 continued to improve accuracy throughout B2. Conclusion: These findings demonstrate that the maximal opposition approach may effectively treat children with severe speech sound disorders. For two participants, the investigation became an AB design due to the change in targets. Future research could include a comparative study with several different phonological approaches.
Effects of Family-Centered ASL Instruction on Hearing Parents’ Child-Directed Signing
Published Year: 2023 Program: Doctor of Speech Language Pathology
Zarchy, Razi
Objective: The purpose of this investigation was to explore the effect of direct, routine-based American Sign Language (ASL) instruction on hearing parents’ child-directed ASL. Method: The investigation followed a single-case design. Participants included five parents of deaf and hard-of-hearing children ages six months to two years and 11 months. The participants attended a once-weekly class for eight weeks, following the ASL at Home curriculum. They video-recorded themselves during playtime with their child twice per week. The dependent variables, the quantity and variety of the participants’ ASL output during an untreated routine, playtime, were measured to gain information about how they generalized incorporating ASL into their communication with their children. Results: Both dependent variables increased across participants upon the introduction of the intervention and remained consistent or increased over time. Conclusion: These findings brought attention to the importance of formal ASL instruction designed for hearing parents to apply during daily routines with their young deaf children. Most participants’ signed output varied widely across sessions, so there were likely additional factors influencing their ASL output. Future research is recommended to determine what those factors were and how early intervention providers can support parents’ learning and use of ASL to provide accessible, language-rich environments for their deaf children.
2024
The Effects of Visual Biofeedback Speech-to-Text on the Articulation of Phonemes in CVC Words
Published Year: 2024 Program: Doctor of Speech Language Pathology
Casey, Traci
Objective: The purpose of this investigation was to examine the effects the visual biofeedback tool, speech-to-text technology, has on the articulation of phonemes in consonany-vowel-consonant (CVC) words in school-aged students. It was hypothesized that using speech-to-text as an intervention tool with school-aged students will positively affect phoneme articulation in CVC words. Method: Four students aged 6 to 10 years of who were currently receive speech therapy participated in this AB single-case design investigation. All four participants were actively working with an SLP/SLPA on articulation skills. This investigation examined the effect of the independent variable, speech-to-text, on the dependent variable, percent consonant corrects (PCC), on a target phoneme in CVC words. A maximum of eight intervention sessions were conducted. Results: All four participants demonstrated an increase in their PCC. Two of the four participants met the criteria set for mastery in this study. While two participants did not meet the criteria set for this study, the results exhibited a clinically significant effect on the dependent variable. Data analysis using the percentage of non-overlapping data, mean, and the two-standard deviation band method demonstrated significant change from baseline to intervention for all participants. Conclusion: The results of this investigation support the use of speech-to-text as an effective intervention tool when working on the articulation of target phonemes in CVC Words.
The Efficacy of Oromyofunctional Treatment on Lateral Bracing During Speech Production
Published Year: 2024 Program: Doctor of Speech Language Pathology
Fowler, Rebbecca
Purpose: Lateral bracing occurs when the tongue makes contact against the teeth and palate during articulation of speech sounds. Lateral bracing is critical in providing the lingual stability necessary for accurate articulation. Research suggests that lateral bracing is a consistent and effortful process in the typical production of most speech sounds. However, few interventions propose to improve lateral bracing in clients with speech sound disorders. This study aimed to assess the impact of oromyofunctional therapy on lateral bracing in school-aged children with persistent speech sound errors involving the pre-vocalic /r/ sound. Method: The effect of oromyofunctional therapy on isolated pre-vocalic/r/ production and perceptual accuracy by listeners were examined using a non-concurrent multiple baseline design with three participants between 9 and 15 years of age. The participants received oromyofunctional therapy sessions two times a week for 4 weeks, each session lasting 45 minutes. Electropalatography evaluation were used to measure palatal contact during speech and a perceptual analysis of /r/ productions was conducted before and after treatment. Results: The investigation yielded promising results, as two of the three participants significantly improved lateral bracing during isolated pre-vocalic/r/ productions. Futhermore, perceptual analysis of /r/ production for all three participants improved after the treatment sessions. Discussion: While this investigation does not provide definitive evidence supporting its efficacy in improving lateral bracing, it may provide information that may help guide clinical practice and future research.
The Effect of Frequent, Short, and Intensive Treatment Sessions on Speech Sound Disorders in Kindergarten Through Third-Grade
Published Year: 2024 Program: Doctor of Speech Language Pathology
Gibson, Dana M.
Objective: This investigation examined the effects of frequent, short, intense speech treatment sessions in the small group format on the percent accuracy of target sounds in imitative sentence tasks in kindergarten through third-grade students with mild to moderate speech sound disorders (SSDs) in the public school setting. Method: Four students with an active Individualized Education Plan (IEP) participated in this nonconcurrent multiple baseline design investigation. The dependent variable was accuracy of target sound production in sentence imitation tasks. The independent variable was speech therapy offered four times a week, 15-minutes per session across 4 weeks. Improvement was measured by the percent accuracy of target sounds in imitative sentences. Of note, Participants 2, 3, and 4 were seen for small group therapy as intended, while Participant 1 (P1) was seen in a one-on-one format due to a lack of matched grade-level participants. Results: Data show that all participants, who received the small group intervention increased correct productions of target sounds. The Percent Non-Overlapping Data (PND) showed that the intervention was effective for two of the four participants. However, TAU-U analysis of the data showed significant change for P2, P3, and P4 at the p<.05. Conclusion: The results of this investigation support the growing body of evidence that the use of frequent, short, intense treatment sessions in a small group format may be an effective service delivery model. Future research should also investigate this service delivery model’s effectiveness by considering severity level and group size.
The Effects of Virtual Modules on SLPs’ Knowledge of Pediatric Feeding Disorders in Infants
Published Year: 2024 Program: Doctor of Speech Language Pathology
Graves, Amanda
Objective: This investigation aimed to determine if pre-recorded virtual education modules could increase speech-language pathologists’ knowledge and confidence regarding Pediatric Feeding Disorder (PFD) in infants. It was hypothesized that the participants would increase their knowledge and confidence regarding PFD in infants. Method: Three SLPs participated in this changing criterion design investigation. The dependent variable was knowledge regarding PFD in infants as measured by a 100 pt quiz. The independent variable included seven pre-recorded asynchronously presented training modules regarding PFD in infants. Participants completed 17 to 20 self-paced sessions in total. Pre- and post-intervention self-rated confidence measures were also completed. Results: All three participants had baseline scores below 35 before intervention and improved by at least 52 points by study completion. While all three participants failed to meet the criteria set for mastery by the study’s conclusion, clear improvement in knowledge was demonstrated. Two of the three participants also self-reported an increase in confidence from pre- to post-intervention. Conclusion: Overall, participants increased their knowledge regarding PFD in infants and retained it throughout the investigation and some increased confidence as well. Although this study had multiple limitations, there are promising findings that lay the groundwork for future investigations regarding education of SLP’s that have limited access to knowledge acquisition.
Language Intervention Specifically Targeting Language Negation in 3- and 4-Year-Old Children
Published Year: 2024 Program: Doctor of Speech Language Pathology
Thompson, Whitney Jai
Objective: Parents and teachers have been trained to use affirmative language to increase positive behaviors and improve learning. While this approach benefits these goals, researchers have not addressed the possibility that minimizing negative language may impact children’s understanding and use of language negation. According to Knolle and Montag exposure to language negation and complex sentence structures improves a child’s ability to comprehend and use them. This investigation sought to determine if increasing a young child’s exposure to langauge negation in a positive play-oriented setting would increase their functional comprehension of negation. Method: Three participants aged 3 years, 11 months to 4 years, 3 months received nine 30-minute intervention sessions in an individual virtual setting in this non-concurrent multiple baseline investigation. The total investigation was 8 weeks. Figurines and accessories were the primary sources of materials used to demonstrate negation during each session. The participants demonstrated their understanding of negations in each session using pictures they could draw on. Participants were assessed at the start of each session to determine what they retained from the previous session. Results: Results indicated that the use of positive exposure to “no” and “not” was an effective intervention to improve children’s comprehension of negation. This study gives insight into the benefits of using play-oriented therapy to target negation with 3 – and 4-year-old chidlren and highlights the potential for further research in this area.