bluuebunny/crossref_metadata_2025 huggingface dataset:
Semantic Deficits in Children With Language Impairments
Authors: Brackenbury Tim , Pye Clifton
Published: April 2006

Children with language impairments demonstrate a broad range of semantic difficulties, including problems with new word acquisition, storage and organization of known words, and lexical access/retrieval. Unfortunately, assessments of children’s semantic skills are often limited to measures of receptive and expressive vocabulary size. As a result, the semantic deficits of these children may not receive the attention they need. This article explores the word-learning, lexical storage, and lexical access skills of children with language impairments and the theories that account for their performance. Our review culminates with specific recommendations for speech-language pathologists to improve the breadth of their semantic assessments.
Diagnostic Accuracy of the Structured Photographic Expressive Language Test: Third Edition (SPELT-3)
Authors: Perona Kristen , Plante Elena , Vance Rebecca
Published: April 2006

Purpose:
This study examined the empirical evidence for using the Structured Photographic Expressive Language Test: Third Edition (SPELT-3; Dawson, Stout, & Eyer, 2003) to diagnose language impairment in preschool children. The SPELT-3 is a revision of the SPELT-II (Werner & Kresheck, 1983), which has been proven in the past to have high levels of discriminant accuracy in identifying preschoolers with language impairment.

Method:
Forty-two 4- and 5-year-old children with a specific language impairment (SLI) and 43 children with typically developing (TD) language abilities were studied to determine the classification accuracy and other aspects of validity for the SPELT-3.

Results:
Results from both an exploratory and a confirmatory sample indicated 90% sensitivity and 100% specificity when a cutoff standard score of 95 was applied to the data. In addition, use of the SPELT-3 was supported by additional data on convergent and divergent aspects of validity.

Implications:
The data provide empirical support for the use of the SPELT-3 for the purpose of differentiating between children with normal language and those with impaired language.
Grammatical Morphology in Children Learning English as a Second Language
Authors: Paradis Johanne
Published: April 2006

Purpose:
This study was conducted to examine whether the expressive language characteristics of typically developing (TD) children learning English as a second language (ESL) have similarities to the characteristics of the English that is spoken by monolingual children with specific language impairment (SLI), and whether this could result in the erroneous assessment of TD English-language learners (ELLs) as language impaired.

Method:
Twenty-four TD language-minority children who had been learning ESL for an average of 9.5 months participated in the study. The children’s accuracy and error types in production of the following grammatical morphemes were examined in spontaneous and elicited speech: third person singular [-s], past tense [-ed], irregular past tense, BE as a copula and auxiliary verb, DO as an auxiliary verb, progressive [-ing], prepositions
in
and
on
, plural [-s], and determiners
a
and
the
. The elicitation probes were part of a recently developed standardized test for identifying language impairment, the Test of Early Grammatical Impairment (TEGI; M. Rice & K. Wexler, 2001).

Results:
The ELLs’ accuracy rates and error patterns with the grammatical morphemes were similar to those that have been reported for same-age monolingual children with SLI, in both spontaneous and elicited speech. In addition, the ELL’s elicitation probe scores were compared to the criterion scores and group means from the sample of monolingual children used to develop the TEGI and their performance on the TEGI was in the range of the clinical population even though there is no reason to suspect that any of these children is language impaired. Both analyses point to the possibility that TD ELLs could be mistaken as language impaired.

Clinical Implications:
The results provide information that can be used to set appropriate expectations of error patterns and rate of grammatical development in the early stages of ESL learning. The results also emphasize how the use of English standardized tests with nonnative English-speakers is not a good practice, and suggestions are given for points to consider when assessing ELLs.
Phonological Awareness Intervention and the Acquisition of Literacy Skills in Children From Deprived Social Backgrounds
Authors: Nancollis Alex , Lawrie Barbara-Anne , Dodd Barbara
Published: April 2006

Purpose:This study examined the effect of phonological awareness intervention that focused on syllable and rhyme awareness on the acquisition of literacy and the development of phonological awareness skills 2 years post intervention. The longitudinal study compared two groups of children from deprived socioeconomic backgrounds in the United Kingdom. One group received a program of phonological awareness intervention and one did not.

Method:Ninety-nine children received a 9-week program of phonological awareness intervention in the summer term of their final preschool year. These children were then assessed on measures of phonological awareness and language in the first term of their first year at school (Mage=4;7 [years;months]) and again 2 years later (Mage=6;8) on measures of phonological awareness and literacy. One year earlier, a control group of 114 children from the same schools were also assessed at these two points in their schooling on the same measures. This group did not receive any phonological awareness intervention.

Results:At the second assessment, the group of children who received phonological awareness intervention performed better than those children who received no intervention (control group) on rhyme awareness and nonword spelling. Surprisingly, however, the control group performed better than the children who had received intervention on the phoneme segmentation task.

Conclusion:The phonological awareness intervention that was implemented, which focused on enhancing syllable and rhyme awareness, had little effect on later literacy development and may have interfered with the acquisition of phoneme awareness. Implications for intervention with children from deprived socioeconomic backgrounds are discussed in the context of current research.
Paradoxical Vocal Fold Motion: A Tutorial on a Complex Disorder and the Speech-Language Pathologist’s Role
Authors: Mathers-Schmidt Barbara A.
Published: April 2006

Paradoxical vocal fold motion (PVFM) is presented as a complex, poorly understood disorder that merits our clinical and research attention. This tutorial examines PVFM characteristics, etiologies, differential diagnosis, and medical/psychological intervention. The role of the speech-language pathologist in diagnostic evaluation and intervention is delineated. An assessment protocol and specific treatment suggestions are provided. The need for future research is discussed.
Reducing Test Bias Through Dynamic Assessment of Children's Word Learning Ability
Authors: Peña Elizabeth , Iglesias Aquiles , Lidz Carol S.
Published: April 2006

This study examined the performance of preschool children from culturally and linguistically diverse backgrounds, both typically developing and with low language ability, on a word-learning task. A pretest-teach-posttest method was used to compare a mediation group to a no-mediation group. Children in the mediation group were taught naming strategies using mediated learning experience (MLE). Results indicated that typically developing and low language ability children were differentiated on the basis of pretest-posttest change and that dynamic measures (e.g., posttest scores of single-word labeling and modifiability ratings from the mediation sessions) predicted the ability groups better than static measures (e.g., pretest scores of single-word labeling, description, and academic concepts). These results suggest that dynamic assessment approaches may effectively differentiate language difference from language disorder.
Children With a History of Expressive Vocabulary Delay
Authors: Girolametto Luigi , Wiigs Megan , Smyth Ron , Weitzman Elaine , Pearce Patsy Steig
Published: April 2006

Outcomes of 21 children who were previously identified as late talkers were investigated at 5 years of age. The model of service delivery used for these children included a parent program for preventive intervention when the children were 2 years old, followed by focused direct intervention for children whose gains in speech and/or language skills continued to be slow. Their outcomes at 5 years of age were investigated using general language measures as well as higher level language tasks designed to stress the language system. Late talkers’ results were compared to those of a comparison group of children with histories of typical language development. Scores on standardized tests of language development indicated that the majority of late-talking children (i.e., 86%) had ‘caught up’ to their age-matched peers in expressive grammar and vocabulary. However, weaknesses remained in a number of higher level language areas, including a standardized test designed to measure facility with teacher-child discourse, a novel task that examined the child's use of pragmatic cues for anaphora resolution of ambiguous sentences, and narrative tasks. The clinical implications of these findings include close monitoring of these children as they reach school age and intervention in key areas of weakness for children who continue to demonstrate language difficulties as they mature.
Black and White Adults' Expressive Language Performance on Three Tests of Aphasia
Authors: Molrine Charlotte J. , Pierce Robert S.
Published: April 2006

Few or no Black adults have been included in normative samples for tests of aphasia, nor have test and item bias with Black adults been evaluated for such popular tests as the Boston Diagnostic Aphasia Examination (BDAE; Goodglass & Kaplan, 1983), the Minnesota est for Differential Diagnosis of Aphasia (MTDDA; Schuell, 1965), and the Western Aphasia Battery (WAB; Kertesz, 1982). To address this, group differences were investigated in expressive language test performance on the BDAE, MTDDA, and WAB by 48 nonbrain-damaged Black (
n
=24) and White (
n
= 24) adults. Each test was administered by a White female examiner and audiotaped. The responses of subjects and subject foils with aphasia were scored by graduate speech-language pathology students who were blind to the purpose of the study. A comparison of the test scores on the expressive language subtests revealed that, with the exception of three subtests, there were no statistically significant differences in obtained scores for upper and middle SES subjects. Those differences that were found were not a function of age, gender, or social network status. Moreover, differences in subtest performance were not obviously due to grammatical or phonological features of African American English (AAE), but rather to task-related AAE style differences.
Early Communication, Symbolic Behavior, and Social Profiles of Young Males With Fragile X Syndrome
Authors: Roberts Joanne E. , Mirrett Penny , Anderson Kathleen , Burchinal Margaret , Neebe Eloise
Published: April 2006

This study examined the communication and symbolic behavior profiles of 22 males with fragile X syndrome (FXS) developmentally younger than 28 months and the relationship of these profiles to the children's communication skills one year later. The boys, ranging in age from 21 to 77 months, were tested using the Communication and Symbolic Behavior Scales and the Reynell Developmental Language Scales. The children showed significant delays and substantial individual variability in their profiles. Overall, they showed relative strengths in verbal and vocal communication and relative weaknesses in gestures, reciprocity, and symbolic play skills. Children who scored higher in communicative functions, vocalizations, verbalizations, and reciprocity scored higher in verbal comprehension one year later. Children with higher scores in verbal communication also scored higher in expressive language development when tested one year later.
Miscue Analysis in School-Age Children
Authors: Laing Sandra P.
Published: April 2006

It has been suggested that children who have trouble learning to read may use less effective decoding strategies than children who learn to read typically. The present investigation examined reading miscues (errors) made by typically developing children and children who demonstrated below-average language and reading abilities to answer the following questions: (a) Do typically developing children and children with below-average language and reading skills evidence similar types of miscues while reading aloud? (b) Do typically developing children make more grapho-phonemically similar errors (in which the error resembles the text word in two or more phonemes) and more nonsense-word errors than children with below-average language and reading ability and, (c) What is the relationship between the nature of reading miscues and comprehension performance? Results suggested that typically developing children made more miscues that preserved the meaning of the text than children with below-average language and reading abilities. Groups were equally likely to make errors that were grapho-phonemically similar and/or nonsense words. Comprehension performance for both groups was best predicted by omission of content words and phonologically similar real-word errors that maintained the meaning of the text. Analysis of oral-reading errors may be useful in prescribing specific intervention to improve automaticity and efficiency in reading for children with language-learning disorders.
Children's Story Retelling Under Different Modality and Task Conditions
Authors: Gazella Jamie , Stockman Ida J.
Published: April 2006

This study was motivated by the possibility of standardizing a story-retelling task well enough to function as a brief screener of children's global syntactic features. Specifically, the study determined whether the story presentation modality (i.e., audio-only or combined auditory and visual presentation) differentially influenced the quantity of talk, its lexical diversity and sentence complexity, as expressed in children's retold story narratives and responses to direct questions about the story. Twenty-nine Caucasian male preschoolers, who ranged in age from 4;2 to 5;6 (years;months), were randomly assigned to a modality presentation condition. The audio-only group did not differ significantly from the audiovisual group in the amount of talk, lexical diversity, or syntactic complexity of sentences used in the narratives or responses to direct questions. Nevertheless, the story-retelling task yielded the longest and most grammatically complete utterances. Responses to direct questions yielded the largest number of utterances and different words. The clinical implications of these results for standardizing language sampling are discussed.
Speech Evaluation and Treatment for Patients With Cleft Palate
Authors: Kuehn David P. , Henne Lisa J.
Published: April 2006

This compendium has been written in conjunction with a cleft lip and palate surgical mission that took place in Villahermosa, Mexico, February 4–9, 2001. Fifty children, 10 per day, received lip or palate surgery. This report, available in both English and Spanish, is intended as a practical and concise guide to basic aspects of evaluation and treatment of speech disorders associated with cleft palate. More detailed and comprehensive sources dealing with this topic are available and have been reviewed by D. P. Kuehn and K. T. Moller (2000).
Contributions of Qualitative Research to the Knowledge Base of Normal Communication
Authors: Simmons-Mackie Nina N. , Damico Jack S.
Published: April 2006

As clinical speech-language pathology moves toward a progressive use of qualitative research methodologies and applications for clinical purposes, it is helpful to know how the qualitative paradigm has influenced our field. This article reviews a number of studies from the social sciences and their impact on our knowledge of the properties of communication and the investigation of cognitive and language acquisition. This review indicates that qualitative research currently has a significant impact on our knowledge bases in clinical speech-language pathology.
Quantitative and Qualitative Documentation of Early Literacy Instruction
Authors: Culatta Barbara , Kovarsky Dana , Theadore Geraldine , Franklin Amber , Timler Geralyn
Published: April 2006

Quantitative and qualitative procedures were used in this pilot study to develop and evaluate the effectiveness of a language and literacy instruction model for meeting the needs of children with impairments, delays, and differences in regular Head Start classrooms. Although the project addresses a variety of literacy domains, this article focuses on rhyming and letter naming. In the instruction model, children were exposed to motivating examples of rhyme and letter targets in different activity structures embedded across the curriculum. A crossover design compared two classrooms of children trained on letter and rhyme targets in a different order. Results of an analysis of variance revealed a significant Condition (rhyme first vs. letter first) x Task (rhyme generation vs. letter generation) x Time (Posttest 1 vs. Posttest 2) interaction. At the first posttest, children in the rhyme-first condition performed better than those in the letter-first condition on rhyme generation, whereas children in the letter first condition performed better on letter generation. At the second posttest, after the groups had experienced instruction in both areas, the children performed comparably on both tasks. In addition to the quantitative analyses, qualitative analyses were also conducted. A qualitative examination of children's participation revealed their affective involvement and engagement in instructional activities. Changes in the children's awareness of their capacity to rhyme and changes in their displayed abilities to participate in rhyming activities were also documented.
Language Functioning of Residents in Family Homeless Shelters
Authors: O'Neil-Pirozzi Therese M.
Published: April 2006

The number of individuals who are homeless is rising, particularly among families (typically mothers) with preschool children. This study examined the speech-language abilities of 25 mothers and their preschool children residing in urban homeless shelters. Results of standardized testing revealed that the majority of the mothers and their preschool children presented with overall language deficits or delays which were present in at least 1 of 4 language modalities: auditory comprehension, verbal expression, reading, and writing. Clinical and research implications of these results for both the mothers and their children are discussed.
Training Day Care Staff to Facilitate Children’s Language
Authors: Girolametto Luigi , Weitzman Elaine , Greenberg Janice
Published: April 2006

This exploratory study investigated the outcome of in-service training on language facilitation strategies of child care providers in day care centers. Sixteen caregivers were randomly assigned to experimental and control groups. Caregivers were taught to be responsive to children’s initiations, engage children in interactions, model simplified language, and encourage peer interactions. At posttest, the experimental group waited for children to initiate, engaged them in turn-taking, used face to face interaction, and included uninvolved children more frequently than the control group. In turn, children in the experimental group talked more, produced more combinations, and talked to peers more often than the control group. The results support the viability of this training model in early childhood education settings and suggest directions for future research.
Automated Developmental Sentence Scoring Using Computerized Profiling Software
Authors: Channell Ron W.
Published: April 2006

This study examined the accuracy of fully automated Developmental Sentence Scoring (DSS; L. L. Lee, 1974) analysis performed by the Computerized Profiling (CP) software (S. H. Long, M. E. Fey, & R. W. Channell, 2000). Samples from 48 school-age children (28 with language impairment) yielded 9,084 utterances that were DSS coded both manually and by CP. The point-by-point agreement of CP with manual coding was 78%, with per-category levels of agreement ranging from 0% to 98%. Agreement levels were about 2% lower on samples from children with language impairment. Though significantly higher, the scores computed by CP were highly correlated (
r
= .97) with the manually computed scores. Further work on improving the accuracy of automated DSS analysis is warranted.
Effects of Intensive Voice Treatment (the Lee Silverman Voice Treatment [LSVT]) on Ataxic Dysarthria
Authors: Sapir Shimon , Spielman Jennifer , Ramig Lorraine O. , Hinds Stephanie L. , Countryman Stefanie , Fox Cynthia , Story Brad
Published: April 2006

This study examined the effects of intensive voice treatment (the Lee Silverman Voice Treatment [LSVT®]) on ataxic dysarthria in a woman with cerebellar dysfunction secondary to thiamine deficiency. Perceptual and acoustic measures were made on speech samples recorded just before the LSVT program was administered, immediately after it was administered, and at 9 months follow-up. Results indicate short- and long-term improvement in phonatory and articulatory functions, speech intelligibility, and overall communication and job-related activity following LSVT. This study’s findings provide initial support for the application of LSVT to the treatment of speech disorders accompanying ataxic dysarthria. Potential neural mechanisms that may underlie the effects of loud phonation and LSVT are addressed.
Neuromuscular Treatments for Speech and Swallowing
Authors: Clark Heather M.
Published: April 2006

Despite the proliferation of oral motor therapies, much controversy exists regarding the application and benefit of neuromuscular treatments (NMTs) such as strength training for alleviating dysarthria and/or dysphagia. Not only is limited empirical support available to validate the use of NMTs, but clinicians may also lack the foundational information needed to judge the theoretical soundness of unstudied treatment strategies. This tutorial reviews the theoretical foundations for several NMTs, including active exercises, passive exercises, and physical modalities. It highlights how these techniques have been used to address neuromuscular impairments in the limb musculature and explores potential applications to the speech and swallowing musculature. Key issues discussed in relation to active exercise are the selection of treatment targets (e.g., strength, endurance, power, range of motion), specificity of training, progression, and recovery. Factors influencing the potential effectiveness of passive exercises and physical modalities are presented, along with discussion of additional issues contributing to the controversy surrounding oral motor therapies.
Telehealth
Authors: Mashima Pauline A. , Birkmire-Peters Deborah P. , Syms Mark J. , Holtel Michael R. , Burgess Lawrence P. A. , Peters Leslie J.
Published: April 2006

Telehealth offers the potential to meet the needs of underserved populations in remote regions. The purpose of this study was a proof-of-concept to determine whether voice therapy can be delivered effectively remotely. Treatment outcomes were evaluated for a vocal rehabilitation protocol delivered under 2 conditions: with the patient and clinician interacting within the same room (conventional group) and with the patient and clinician in separate rooms, interacting in real time via a hard-wired video camera and monitor (video teleconference group). Seventy-two patients with voice disorders served as participants. Based on evaluation by otolaryngologists, 31 participants were diagnosed with vocal nodules, 29 were diagnosed with edema, 9 were diagnosed with unilateral vocal fold paralysis, and 3 presented with vocal hyperfunction with no laryngeal pathology. Fifty-one participants (71%) completed the vocal rehabilitation protocol. Outcome measures included perceptual judgments of voice quality, acoustic analyses of voice, patient satisfaction ratings, and fiber-optic laryngoscopy. There were no differences in outcome measures between the conventional group and the remote video teleconference group. Participants in both groups showed positive changes on all outcome measures after completing the vocal rehabilitation protocol. Reasons for participants discontinuing therapy prematurely provided support for the telehealth model of service delivery.
The Voice Use Reduction Program
Authors: Merwe Anita van der
Published: April 2006

The purpose of this article is to describe a structured behavior modification approach tothe reduction of voice use by clients with voice disorders. The Voice Use Reduction (VUR) Program is conceptualized as part of a comprehensive approach to the treatment of voice. The VUR Program provides guidelines for the classification of voice use situations, the assignment of voice use units to different situations, and the calculation of the maximum number of units per day and per week in a severe, moderate, and low voice use reduction program. Two case examples are described to illustrate the application of the VUR Program. The results of an evaluation of the VUR Program by 10 female students who presented with vocal nodules and applied the program also are included.
Gesture-Speech Combinations as a Transition to Multiword Utterances
Authors: McEachern Diane , Haynes William O.
Published: April 2006

This study was designed to determine if certain types of gesture-speech combinations act as transitional phenomena preceding production of 2-word utterances. Ten normally developing children with a mean age of 15 months at the beginning of the study participated in this research. The children were sampled longitudinally at monthly intervals as they approached the onset of early multiword utterances. Temporally synchronized gesture-speech combinations were analyzed over a 6-month period to describe whether they encoded 1 semantic element (pointing to a car and saying "car") or 2 semantic elements (pointing to a car and saying "big"). These gesture-speech combinations were examined in terms of their onset in relation to early multiword combinations. It was found that there was a significant increase in gesture-speech combinations encoding 2 semantic elements during the 6-month period and that the onset of these combinations preceded or co-occurred with the 1st productions of multiword utterances. This finding, coupled with prior studies on smaller numbers of participants, suggests that gesture-speech combinations encoding 2 elements may be a transitional element between single-word communication and the onset of multiword combinations.
Oral Language Expectations for African American Children in Grades 1 Through 5
Authors: Craig Holly K. , Washington Julie A. , Thompson Connie A.
Published: April 2006

Reference profiles for characterizing the language abilities of elementary-grade African American students are important for assessment and instructional planning. H. K. Craig and J. A. Washington (2002) reported performance for 100 typically developing preschoolers and kindergartners on 5 traditional language measures: mean length of communication units, amount of complex syntax production, number of different spoken words, responses to
wh
-questions, and understanding of active/passive sentence construction. The present study reports performances on the same measures for 295 typically developing African American children in the 1st through 5th grades. Findings revealed increasing performance scores with increasing grades on 4 of the tasks. A ceiling effect was evident on the task that assessed comprehension of active and passive voice. Gender, socioeconomic status, and community influenced the values in systematic ways, and responses to requests for information varied relative to vocabulary skill. These measures are recommended for inclusion in culturally fair assessment protocols designed to characterize the language abilities of elementary-grade African American students.
Discourse Formulation in Children With Closed Head Injury
Authors: Hay Emma , Moran Catherine
Published: April 2006

In this study, narrative and expository discourse-retelling abilities were compared in 9 children with closed head injury (CHI) age 9;5–15;3 (years;months) and 9 typically developing age-matched peers. Narrative and expository retellings were analyzed according to language variables (i.e., number of words, number of T-units, and sentential complexity) and information variables (i.e., number of propositions, number of episodic structure elements, and number of global structure elements). A measure of participants’ ability to generate a story moral or aim was also taken. The children with CHI differed significantly from their age-matched peers across language and information domains and in their ability to formulate a moral or aim in both the expository and narrative retellings. In addition, differences across genre were found with performance on narrative tasks superior to performance on expository tasks. The exception was that it was easier for participants to generate an aim for the expository passage than a story moral for the narrative passage. The results are discussed relative to a working memory theory of impairment following CHI. Future directions for research are proposed.
Getting Started in Evidence-Based Practice for Childhood Speech-Language Disorders
Authors: Johnson Carla J.
Published: April 2006

Purpose

Evidence-based practice (EBP) entails a critical mindset and rigorous methods that foster the judicious integration of scientific evidence into clinical decision making. The purpose of this tutorial is to present strategies, resources, and examples to help speech-language pathologists get started in EBP for childhood speech and language disorders.

Method

The tutorial begins with an overview of key principles of EBP, including potential benefits and challenges, and other initial considerations. Five recommended steps for implementing EBP are then presented: posing a question, locating the evidence, appraising the evidence, making and implementing clinical decisions, and evaluating those decisions. Included is a compilation of synthesized evidence resources, such as systematic reviews/meta-analyses and EBP guidelines. Finally, illustrative examples are provided to assist practitioners with integrating research evidence into clinical decision making in childhood speech-language disorders.

Conclusion

Speech-language pathologists who work with children are encouraged to adopt EBP for clinical decision making.
The Effect of Sample Size on the Assessment of Stuttering Severity
Authors: Sawyer Jean , Yairi Ehud
Published: April 2006

The relationships between the length of the speech sample and the resulting disfluency data in 20 stuttering children who exhibited a wide range of disfluency levels were investigated. Specifically, the study examined whether the relative number of stuttering-like disfluencies (SLD) per 100 syllables, as well as the length of disfluencies (number of iterations per disfluent event), varied systematically across 4 consecutive, 300-syllable sections in the same speech sample. The difference in the number of SLD per 100 syllables between the early and later sections of the speech sample was statistically significant. In addition, the length of the speech sample had a critical influence on the identification of stuttering in children exhibiting relatively low levels of disfluency. Also, when a 20% difference in the number of SLD per 100 syllables was taken as a criterion, 50% of the children exhibited upward shifts in continuous speech samples that were longer than 300 syllables (i.e., 600, 900, and 1,200 syllables). Results indicated that, in general, group means for SLD grew larger as the sample size increased. The length of disfluent events did not significantly differ as the sample size increased; however, there were large differences for some children. Implications for clinicians and investigators are discussed.
The Occlusion Effect and Ear Canal Sound Pressure Level
Authors: Fagelson Marc A. , Martin Frederick N.
Published: April 2006

Comparisons were made between changes in the audibility of bone-conduction stimuli to differences in the sound pressure present in the external auditory canal when ears were occluded. Fifteen listeners with normal middle ear function were tested using pure tones of 250, 500, and 1000 Hz, delivered via a bone-conduction oscillator placed on the mastoid process and the frontal bone. At all three frequencies, and both sites of stimulation, ear canal sound pressures were greater in the occluded than in the unoccluded conditions. Concurrently, the test signals were detected at lower intensities, although the changes in audibility and external canal sound pressure levels were not unity. The occlusion effect was attenuated slightly when the skull was vibrated from the frontal bone.
State of the States
Authors: Arehart Kathryn Hoberg , Yoshinaga-Itano Christine , Thomson Vickie , Gabbard Sandra Abbott , Brown Arlene Stredler
Published: April 2006

This study reports the results of a comprehensive survey of 16 states regarding the coordination and characteristics of universal newborn hearing screening, audiologic assessment, and intervention programs. The survey establishes a baseline assessment that was conducted by states as part of their first year of participation in a Maternal and Child Health Bureau grant on state systems for universal newborn hearing screening, assessment, and intervention. States are making progress toward achieving universal newborn hearing screening. However, several issues continue to impede the establishment of statewide systems for linking screening programs to diagnosis and intervention.
Ambient Noise Levels in Nursing Homes
Authors: Lankford James E. , Hopkins Catherine M.
Published: April 2006

Conducting hearing tests and hearing screenings in the nursing home environment can be a challenge. One issue which may affect the validity of the test results is the level of ambient noise in those facilities when a sound-treated booth is not available. This study sampled the ambient noise levels in ten different nursing homes and compared those results to the ANSI S3.1-1999 criteria for maximum permissible ambient noise levels. Based on the results of this investigation, the use of insert earphones for air conduction assessments is recommended when a sound-treated booth is unavailable and noise levels exceed the ANSI criteria. Other suggestions regarding air-conduction and bone-conduction assessments are discussed.
Verifying Loudness Perception After Hearing Aid Fitting
Authors: Cox Robyn M. , Gray Ginger A.
Published: April 2006

During the verification phase of a hearing aid fitting, clinicians often want to assess the extent to which loudness perceptions for amplified sounds are similar to those typical of normal hearers. This type of verification calls for a criterion for "normal" loudness perception of sounds presented in a sound field. This research sought to answer several questions about the parameters of a valid "normal" criterion for a verification procedure using the Contour test of loudness perception. Loudness data were obtained from 30 listeners with normal hearing. Results indicated that a loudness growth function obtained with earphone listening is not an appropriate normative reference for hearing aid fitting verification. Instead, the normative data should be based on sound field listening. Results also indicated that the same normative function could be used to assess both unilateral and bilateral fittings. Further, it is likely that the same normative function can be used for most frequency responses that are likely to be used in feasible fittings. Finally, it was found that a previously published normative function obtained using an automated test procedure was not faithfully replicated using a carefully executed fully manual test procedure. We concluded that, until a replicable normative function is established, practitioners will need to generate their own local norms to perform postfitting verification of loudness normalization.
Dehiscence of Bone Overlying the Superior Semicircular Canal as a Cause of an Air-Bone Gap on Audiometry
Authors: Cox Kenneth M. , Lee Daniel J. , Carey John P. , Minor Lloyd B.
Published: April 2006

Dehiscence of bone overlying the superior semicircular canal can result in a syndrome of vertigo and oscillopsia induced by loud noises or by maneuvers that change middle ear or intracranial pressure. Patients with this disorder can also experience a heightened sensitivity to bone-conducted sounds in the presence of normal middle ear function. High-resolution CT scans of the temporal bones demonstrate the dehiscence. The authors describe a patient with bilateral superior canal dehiscence who had bilateral low-frequency conductive hearing loss, normal middle ear function, intact acoustic reflexes, and intact vestibular-evoked myogenic potentials. These findings would not be expected on the basis of a middle ear cause of the conductive hearing loss. A high-resolution CT scan of the temporal bones in this patient revealed bilateral superior canal dehiscence. Normal acoustic immittance findings in the presence of conductive hearing loss should alert clinicians to the possibility of inner ear cause of an air-bone gap due to superior canal dehiscence
Using Talking Lights Illumination-Based Communication Networks to Enhance Word Comprehension by People Who Are Deaf or Hard of Hearing
Authors: Hinman Roderick T. , Lupton E. C. , Leeb Steven B. , Avestruz Al-Thaddeus , Gilmore Robert , Paul Donald , Peterson Nancy
Published: April 2006

This article details a new method that has been developed to transmit auditory and visual information to people who are deaf or hard of hearing. In this method, ordinary fluorescent lighting is modulated to carry an assistive data signal throughout a room while causing no flicker or other distracting visual problems. In limited trials with participants who are deaf or hard of hearing, this assistive system, combined with commercial voice recognition software, showed statistically significant improvement in sentence recognition compared to recognition of audio-only or audio-plus-speech-reading stimuli.
Factor Analysis of the Tinnitus Handicap Inventory
Authors: Baguley D. M. , Andersson G.
Published: April 2006

The Tinnitus Handicap Inventory (THI; C. W. Newman, G. P. Jacobson, & J. B. Spitzer, 1996) is widely used in a clinical context to assess tinnitus-related self-reported handicap and to report treatment outcomes. Test-retest reliability has been reported to be high, and high convergent validity with other measures of tinnitus distress has been reported. Factor analysis of the subscales of the THI has previously been reported for a Danish translation, but not for the English version. In the present study, the THI was factor analyzed using data collected from a group of 80 clinical tinnitus patients and 116 patients with unilateral vestibular schwannoma. The factor analysis yielded strong support for a unifactorial structure of the scale, with a majority of items loading on the first factor, and high internal consistency of the total score. The authors recommend use of the total score in research and in clinical practice.
Visual Reinforcement Audiometry Using Digital Video Disc and Conventional Reinforcers
Authors: Schmida Milton J. , Peterson Harry J. , Tharpe Anne Marie
Published: April 2006

Visual reinforcement audiometry (VRA) is a test procedure routinely used to evaluate hearing in infants and young children (6 months to 2 years). Most research and current clinical practice uses flashing lights and/or animated toys to provide reinforcement to a child during VRA. New technology capable of generating a moving video image is now available for providing visual reinforcement to infants during VRA testing. It is reasonable to expect that video images, with presumed greater novelty and complexity, would be more interesting and rewarding to children than conventional, animated mechanical toy reinforcers. On the other hand, in today’s society, children are frequently exposed to video images in the home and elsewhere. Therefore, three-dimensional animated toys may present with greater novelty than video images. The purpose of this study was to compare auditory localization behavior, as defined by the number of head turn responses until habituation, during VRA with 2-year-old children using two types of reinforcers: (a) moving images generated by a digital video disc player/monitor and (b) a conventional, animated mechanical toy. Twenty children were selected randomly from a total group of 40 and tested using conventional reinforcement. The remaining 20 children were tested using video reinforcement. The average number of head turn responses prior to habituation was approximately 15 for the video-reinforced group and approximately 11 for the conventional toy-reinforced group, suggesting that during VRA a video image may be more reinforcing than a conventional animated toy.
Speech Perception by Students With Cochlear Implants Using Sound-Field Systems in Classrooms
Authors: Iglehart Frank
Published: April 2006

Cochlear implants support deaf students' language development through the improved use of audition in the classroom. Unfortunately, the acoustics of typical classrooms greatly reduce auditory speech perception by these students. Sound-field systems can increase speech-to-noise ratios in classrooms and thus improve use of audition. These systems are used by 80% of students with cochlear implants who use an FM system in the classroom. The present study compares speech perception by 14 school-age cochlear implant recipients via 2 classroom sound-field systems, 1 wall-mounted and the other a personal, or desktop, system. Testing was conducted in 2 classroom environments, 1 noisy and reverberant (typical of many classrooms) and the other ideally quiet with reverberation of short duration. In the quiet room with low reverberation, both sound-field systems produced improved phoneme recognition, but there was no difference between the 2. In the noisy room with high reverberation, the sound-field benefits were greater, and the desktop systems provided more benefit than the wall-mounted systems.
Exploring Possible Sociocultural Bias on the SCAN-C
Authors: Woods Alicia G. , Peña Elizabeth D. , Martin Frederick N.
Published: April 2006

Sociocultural bias on the SCAN-C (R. W. Keith, 2000) was investigated with 20 Anglo American and 20 Latino American 8-year-old children from low- and mid-high-socioeconomic status (SES) backgrounds. Univariate and repeated measures analyses of variance (ANOVAs) failed to reveal any significant differences between the groups when clustered by ethnicity and SES. The Latino American participants' scores were analyzed for dialectal variations, and the ANOVA analyses were repeated using the corrected scores. No significant interactions were observed. Classification analyses revealed that 10% more Latino American children than Anglo American children fell into the borderline-to-disordered category based on SCAN-C composite scores; these classification differences were most apparent on the Filtered Words subtest (with a difference of 25%). When scores with dialectal rescoring were considered, the classification distribution for the Latino American children more closely matched that of the Anglo American children. Given the increased likelihood of Latino American children scoring in the borderline-to-disordered category, caution should be used in interpreting SCAN-C results for Latino American children. Dialect scoring should be applied when Latino American children fall in the borderline-to-disordered category.
An Investigation of Telephone Use Among Cochlear Implant Recipients
Authors: Cray Jonathan W. , Allen Rose L. , Stuart Andrew , Hudson Suzanne , Layman Elizabeth , Givens Gregg D.
Published: April 2006

The purpose of this study was to examine telephone use among cochlear implant recipients. A questionnaire was constructed and mailed to 803 adults who received a Clarion cochlear implant system manufactured by Advanced Bionics Corporation. Question-naire recipients were implanted at least 12 months prior to receiving the questionnaire (i.e., they were implanted in 1998 or 1999). Approximately 60% (
n
= 478) responded, of whom 70% (
n
= 336) were considered "telephone users" (i.e., they answered the telephone and/or initiated calls). Telephone users were significantly younger and had significantly more daily hours of cochlear implant use than nonusers. Not surprisingly, there were differences between groups with respect to method of communication (i.e., more users employed oral communication, while more nonusers employed both oral and manual communication) and ability to understand words without lipreading (i.e., more users were able to understand). Thirty-seven percent of the telephone users were male, and 63% were female. The average age was 51.8 years (
SD
= 15.5). Ninety-five percent of users initiated calls to family and friends, 65% made appointments by phone, and approximately 50% asked for information about a product or service and conducted business over the phone. Over 95% of users could identify a dial tone, a busy signal, and voices. The average telephone use per week was 5.4 hr. Approximately 85% indicated that they were able to interact with strangers on the telephone within 5 months of receiving the sound processor. Approximately 30% communicated via a cellular phone for personal use. The findings of this survey suggest an increase in cochlear implant users' telephone use relative to a decade earlier. Advances in cochlear implant and telephone technologies are 2 of several factors that may contribute to the changes observed.
Clinical Guide for Audiologic Tinnitus Management II
Authors: Henry James A. , Zaugg Tara L. , Schechter Martin A.
Published: April 2006

Purpose:
This article is the second of 2 that address the need for basic procedures that can be used commonly by audiologists to manage patients with clinically significant tinnitus, as well as hyperacusis. The method described is termed audiologic tinnitus management (ATM).

Method:
ATM was developed specifically for use by audiologists. Although certain procedural components were adapted from the methods of tinnitus masking and tinnitus retraining therapy, ATM is uniquely and specifically defined. A detailed description of the ATM assessment procedures is provided in the companion article (J. A. Henry, T. L. Zaugg, & M. A. Schechter, 2005). The present article describes a specific clinical protocol for providing treatment with ATM.

Results:
The treatment method described for ATM includes structured informational counseling and an individualized program of sound enhancement that can include the use of hearing aids, ear-level noise generators, combination instruments (noise generator and hearing aid combined), personal listening devices (wearable CD, tape, and MP3 players), and augmentative sound devices (e.g., tabletop sound generators). Ongoing treatment appointments involve primarily the structured counseling, evaluation, and adjustment of the use of sound devices, and assessment of treatment outcomes. The informational counseling protocol and an interview form for determining treatment outcomes are each described in step-by-step detail for direct clinical application.

Conclusion:
This article can serve as a practical clinical guide for audiologists to provide treatment for tinnitus in a uniform manner.