bluuebunny/crossref_metadata_2025 huggingface dataset:
Coping and Adjustment in Alaryngeal Speakers
Authors: Blood Gordon W. , Luther Amy R. , Stemple Joseph C.
Published: July 2014

In this investigation the coping, adjustment, self-esteem, general well-being, perceived communication abilities, and preferred communication modes of 41 patients with laryngectomies were evaluated. Specifically, we wanted to determine how well patients with laryngectomies adjust to and cope with their cancer, whether differences in coping and adjustment vary as a function either of the type of alaryngeal voice used or the amount of time since the laryngectomy, and whether relationships exist between the speech of patients with laryngectomies and their adjustment. Standardized interview protocols and tests were employed during face-to-face interviews. Results revealed that 73% of the sample showed good adjustment and used predominantly problem-focused and seeking-social-support strategies to cope with their cancer. The 27% who were classified as poor copers also performed poorly on self-esteem and general well-being measures and used more self-blame and avoidance strategies. There were no significant differences among different types of preferred communication modes. Significant differences existed between patients with recent and distant laryngectomies; the latter showed better overall adjustment. The subjects who were well adjusted also tended to view their voice rehabilitation as more beneficial and rated themselves as more easily understood by listeners than did those subjects demonstrating psychological distress and poor adjustment. Implications for advanced voice therapy, the need for counseling and referrals, and the relationship among voice, self-esteem, and therapy are discussed.
Early Childhood Stuttering
Authors: Yairi Ehud , Carrico Denise M.
Published: July 2014

A nationwide survey of pediatricians was conducted to assess their practices with and attitudes and beliefs about young children who stutter and their stuttering. Data obtained from 439 respondents were analyzed. The findings indicated mixed trends. Although the opinions of the majority of the pediatricians agreed with current information about stuttering, on several important matters a significant percentage held outdated or erroneous beliefs about the etiology of the disorder or characteristics of young children who stutter. Beliefs about etiology appeared to influence opinion of treatment choice with a strong tendency for delaying intervention and a preference for parent-oriented intervention. Respondents were inconsistent in their interpretation of early diagnostic signs of stuttering. Interest among pediatricians in obtaining updated information about stuttering was strong. Practical implications for speech-language pathologists are discussed.
Communicating With Young Children
Authors: MacDonald James D. , Carroll Jennifer Y.
Published: July 2014

An ecological model is presented for the communication development of young children. The model translates research on parent-child interaction into a series of clinical guides for parents and professionals to assist children in building language learning relationships. Contrasting examples and rationale are presented for five adult interaction styles for facilitating communication.
The Early Identification of Beginning Stuttering II
Authors: Gordon Pearl A. , Luper Harold L.
Published: July 2014

This article follows an earlier
American Journal of Speech-Language Pathology
publication (Gordon & Luper, 1992) in which six protocols used in the differential diagnosis of beginning stuttering were reviewed. This paper presents both advantages and limitations in the use of the previously reviewed protocols. One of the apparent problems in the selection and use of protocols is the clinician’s difficulty in categorical diagnostic decision-making and consequent concern about possible misdiagnosis. In addition, insufficient quantification of the various criteria used in the protocols and inadequate demonstration of their reliability and validity are further problems to be weighed by clinicians. Recommendations about the clinical use of differential diagnostic protocols are made and areas of future research are discussed. Potential advantages include the simplification of a complex task, the provision of initial guidance in the selection of an appropriate treatment strategy, and early intervention for those selected.
Social Support in Laryngeal Cancer Survivors
Authors: Blood Gordon W. , Simpson Kathleen C. , Raimondi Susan C. , Dineen Mary , Kauffman Susan M. , Stagaard Kimberly A.
Published: July 2014

Patients who had laryngectomies were grouped according to adjustment scales into "good copers" and "poorer copers." More than 70% of the laryngeal cancer survivors were well adjusted and classified as "good copers." Three social support scales were administered and revealed that "good copers" perceived themselves as having better quality networks and more functional support. A subjective self-evaluation of the subjects’ voices revealed a relationship between perceived voice quality, adjustment, and perceived social support. Rehabilitation for some patients with laryngectomies may need to include more direct nurturing; speech-language pathologists may want to suggest self-help groups or professional support counseling.
Developmental Phonological Disorders
Authors: Shriberg Lawrence D.
Published: July 2014

I have argued that notwithstanding considerable research activity in developmental phonological disorders, the basic questions remain unanswered. I have proposed that a central problem with the research culture in child phonology is that it includes too little cross-laboratory collaboration of the type seen when significant breakthroughs are reported in other biological and social sciences. Finally, I have suggested the need for a shared classification system for developmental phonological disorders—to promote cross-laboratory research, as well as to strengthen the efforts of individual clinical research groups. As stressed by one of my teachers, Ralph Shelton, collaboration is a cornerstone of scholarship. I am optimistic that our discipline will evolve toward a productive 21st century marked by vital, collaborative scholarship.
Examining Readiness for Learning Two-Word Utterances by Children With Specific Expressive Language Impairment
Authors: Bain Barbara A. , Olswang Lesley B.
Published: July 2014

Dynamic assessment examines how children respond to cues presented hierarchically from least to most supportive. The hypothesis is that children's responsiveness reflects readiness to learn a new behavior; that is, responsiveness to the least supportive cuing indicates a readiness for immediate learning (Vygotsky, 1978). A dynamic assessment procedure was employed with 15 preschool children with specific expressive language impairment to determine their readiness for producing two-word utterances. Three types of validation were examined for the dynamic assessment procedure: construct, predictive, and concurrent. The results supported construct validity in that the subjects were able to produce more two-word utterances correctly with the more supportive cuing than they produced with the least supportive cuing. The results also supported predictive validity in that subjects who demonstrated responsiveness to the cuing hierarchy generally demonstrated greater language change during the 9-week study period than those subjects not responsive to the cuing hierarchy. The concurrent validity results revealed rather unexpected findings. In general, the subjects produced a greater variety of two-word categories and more lexical combinations during the language sample than during the dynamic assessment procedure. Clinical and theoretical implications of the results are discussed.
The Use of Visual Feedback to Elicit Correct /r/
Authors: Shuster Linda I. , Ruscello Dennis M. , Toth Amy R.
Published: July 2014

Biofeedback in the form of the visual display from the monitor of a real-time spectrograph was presented to a 10-year-old boy and a 14-year-old girl who had been unable to attain correct production of /r/ despite years of treatment. Both perceptual ratings and acoustic measures were made of the clients' productions of /r/ before and after treatment with the spectrograph. The results indicated that children and adolescents can use this type feedback to attain correct production of /r/ when other methods have failed. Potential reasons for the success of this approach are discussed.
Confrontation Naming and the Provision of Superordinate, Coordinate, and Other Semantic Information By Individuals With Aphasia
Authors: Beeson Pelagie M. , Holland Audrey L. , Murray Laura L.
Published: July 2014

Thirty-three individuals with aphasia (11 Broca's, 11 conduction, and 11 anomic) and 11 healthy control subjects were studied using a confrontation naming task. Each naming trial was followed by requests for the superordinate, other semantic information, and an in-class coordinate. All groups were as successful at giving semantic and coordinate information about items as they were at giving the basic level names for the items. Giving the superordinate category was the most difficult task for individuals with aphasia, regardless of type. These results suggest that in the face of anomia for basic level name, the provision of semantic information or an in-class coordinate is likely to be a better compensatory strategy than trying to provide the superordinate category.
Evaluation of a Training Manual for the Early Detection of Intraoral Pathologies Secondary to Smokeless Tobacco Use
Authors: VanLue Michael J. , Frank Elaine M. , Lemon James
Published: July 2014

This study evaluated the effectiveness of a training manual developed for speech-language pathologists for providing education and early detection of oral health problems secondary to smokeless tobacco use. The training manual content, based on the curriculum objectives and oral pathology detection by speech-language pathologists, was evaluated in two phases. Phase I assessed the curriculum objectives, using a pretest/post-test evaluation, and assessed the clinical implementation by means of an oral screening of high school baseball team members. Phase I demonstrated mastery of the training manual content but a need for further training of speech-language pathologists in clinical detection of oral lesions. The prevalence of smokeless tobacco use among the baseball team members was 46%, and oral pathologies were present in 27% of the players. Phase II evaluated the training manual used with improved clinical identification training of oral lesions secondary to smokeless tobacco use. Phase II also showed mastery of the curriculum objectives of the training manual, and showed improved clinical detection of oral lesions.
Applying Basic Neuroscience to Aphasia Therapy
Authors: Keefe Kristen A.
Published: July 2014

Advances in basic neuroscience have increased our knowledge about the neural processes underlying learning and memory and the cortical reorganization that occurs in response to environmental demands and cortical injury. This article provides a selective review of published studies conducted in animals that examine functional and structural substrates of neural plasticity in the adult mammalian brain, and discusses the implications of this knowledge for aphasia therapy. The processes and constraints identified in the studies reviewed can be used to refine and justify current aphasia therapies, as well as to design additional behavioral interventions.
Application of Semantic Feature Analysis as a Treatment for Aphasic Dysnomia
Authors: Boyle Mary , Coelho Carl A.
Published: July 2014

Despite agreement that dysnomia affects virtually every aphasic patient, there is no consensus about the purpose and effectiveness of techniques to treat it. Semantic feature analysis (SFA), a treatment technique designed to improve retrieval of conceptual information by accessing semantic networks, was used to treat aphasic dysnomia in a 57-year-old male who exhibited Broca's aphasia secondary to a left frontoparietal ischemic infarction. SFA was effective for improving confrontation naming and for generalized improvement to untreated pictures. However, no generalization to connected speech was seen on the measures of mean words per minute, mean correct information units per minute, or the percentage of all words that were correct information units.
The Contribution of Discourse Markers to Communicative Competence in Aphasia
Authors: Simmons-Mackie Nina N. , Damico Jack S.
Published: July 2014

Discourse markers, expressions used to organize conversational interaction, are widely used by speakers in social conversation. An ethnographic investigation of compensatory strategies employed in natural communication by two aphasic subjects revealed a variety of behaviors fulfilling the requirements of discourse markers. The role of discourse markers as compensatory strategies to promote conversation in aphasia is discussed, with descriptive examples drawn from the ethnographic study.
Narrative Discourse in Children With Closed Head Injury, Children With Language Impairment, and Typically Developing Children
Authors: Chapman Sandra Bond , Watkins Ruth , Gustafson Carol , Moore Stefanie , Levin Harvey S. , Kufera Joseph A.
Published: July 2014

In this paper, narrative discourse abilities are compared across three groups—children with a moderate to severe closed head injury (CHI), children with language impairment (LI), and a group of typically developing peers— using narrative retells and generation of story morals. Narrative expression is also examined in a subset of the CHI group who manifested language problems on structured measures. Narrative retells are analyzed at multiple levels of representation, including language and information measures, using the methods described in the companion paper to this article (Chapman, this issue). The most important finding was the significant impairment on information measures in children with moderate to severe CHI, despite relatively good recovery on language measures. The children with LI performed significantly lower than the typical group on measures of both language (amount and complexity of language) and information structure (amount, preserved semantic meaning, episodic structure), as well as generating abstract story morals. The CHI group showed the greatest variability in performance, with discourse abilities overlapping both the LI and control groups. Additional analyses suggested that a subgroup of children with CHI, those with an associated language impairment, were particularly at risk for deficits on information measures. The utility of discourse tasks for differential diagnosis and treatment is discussed.
Linguistic Deficits in Children With Reading Disabilities
Authors: Lombardino Linda J. , Riccio Cynthia A. , Hynd George W. , Pinheiro Shireen B.
Published: July 2014

Although recent research into the nature of linguistic abilities and disabilities in children with developmental reading disorders points to phonological processing difficulties as the core deficit in this population, broader-based linguistic deficits have been described in several studies. In this study, children with a primary diagnosis of specific reading disability (RD) were compared on measures of oral language, phonological coding, reading, and spelling with a clinical contrast group of children diagnosed with attention deficit hyperactivity disorder (ADHD) and with a control group of children developing normally. The results of this study revealed that the RD group showed relatively depressed scores on measures of oral language and phonemic processing when compared with children in the ADHD group. The pattern of language deficits observed in this study clearly contributes to the converging evidence that deficient linguistic processes as measured by both phonological coding tasks and formal tests of oral language characterize the language of children with severe reading disability.
Instrumentation in Voice Assessment and Treatment
Authors: Behrman Alison , Orlikoff Robert F.
Published: July 2014

Sophisticated, computer-based instrumentation has become increasingly available to the voice clinician. Yet substantial questions remain regarding its clinical necessity and usefulness. A theoretical model based on the scientific method is developed as a framework that can be used to guide the clinician in the selection and application of instrumental measures. Using the process of hypothesis testing, instrumentation is presented as an integral component of clinical practice. The uses of instrumental measures, and their relevance to long- and short-term treatment goals, are addressed. Clinical examples are presented to illustrate the incorporation of instrumentation and the scientific method into assessment and treatment.
Clinical Value of Online Measures for Adults With Right Hemisphere Brain Damage
Authors: Tompkins Connie A. , Baumgaertner Annette
Published: July 2014

In this paper, we argue that online measures hold considerable promise for helping us to understand, assess, and treat communication difficulties that follow right hemisphere brain damage (RHD) in adults. Online techniques contrast with offline assessments, which form the core of clinical practice. Offline measures capture the end products of the variety of cognitive operations that occur on the way to a final interpretation or response, but online techniques are capable of revealing areas of strength and weakness during language processing. This paper reviews both rationales and data that support the relevance of online techniques for adults with RHD. In addition, clinical implications are discussed that follow from the arguments and evidence we present.
Phonological Assessment and Treatment of Bilingual Speakers
Authors: Yavas Mehmet , Goldstein Brian
Published: July 2014

Given the demographic changes currently taking place in the United States, speech-language pathologists increasingly are being asked to provide speech and language services to bilingual speakers. The acquisition of more than one language presents unique challenges to speech-language pathologists in the assessment of and intervention for phonological disorders. This paper provides speech-language pathologists information about common and uncommon phonological patterns across a variety of languages, the influence of the sound patterns of one language on another, and guidelines for assessment and intervention.
Speech Breathing in Able-Bodied Children and Children With Cerebral Palsy
Authors: Solomon Nancy Pearl , Charron Sandy
Published: July 2014

Management of the communication problems of children with cerebral palsy presents many challenges to speech-language pathologists. In this paper, we focus on one aspect of that challenge, speech breathing. To understand the nature of speech breathing problems in children with dysarthria, it is necessary tohave a thorough knowledge of speech breathing in able-bodied children. In the first part of this paper, we review this literature according to four parameters: air pressure, lung volume, air flow, and chest wall shape. Incorporated into this section are data and clinical reports of speech breathing in children with cerebral palsy. In the second part of this paper, we have provided management suggestions for the speech-language pathologist working with children with cerebral palsy. These include the general topics of muscle weakness and incoordination, body positioning, and neurodevelopmental treatment. Throughout this review, it becomes clear that little information regarding either the nature or the treatment of speech breathing in children with cerebral palsy is available and that there is a definite need for basic research as well as treatment efficacy studies.
Voice Treatment Techniques
Authors: Pannbacker Mary
Published: July 2014

Clinicians are confronted with several treatment options for which there are limited data about efficacy. Some voice treatment practices have broad acceptance, whereas others, such as breathing exercises and optimum pitch, are controversial. This paper reviews what is currently known about the efficacy of voice treatment and makes recommendations for future studies of voice treatment outcomes and efficacy.
Facilitating Peer Interaction
Authors: Hadley Pamela A. , Schuele C. Melanie
Published: July 2014

Research over the past decade has provided the rationale to target the peer-related social-communicative competence of children with specific language impairment (SLI). Yet our clinical experiences suggest that verbal interaction skills with peers rarely are emphasized in speech/language intervention with these children. We argue that it is particularly important for speech-language pathologists to target socially relevant language objectives with children with SLI because these children eventually must live up to standard societal expectations in social, educational, and vocational settings. In this paper, we identify several barriers that may prevent speech-language pathologists from addressing socially relevant language intervention objectives. Several case examples are provided to illustrate ways in which practitioners can address these types of objectives.
Training Analogical Reasoning Skills in Children With Language Disorders
Authors: Masterson Julie J. , Perrey Christine D.
Published: July 2014

The benefit or effects of direct training of analogical reasoning was examined in school-aged children with language disorders. Analogy training was divided into two phases. The first phase consisted of direct instruction in the componential processes of analogical reasoning, and the second phase included bridging activities incorporated into school curriculum and life-skill situations. The performance of the trained children was compared to the performance of a control group of peers with language disorders, matched for mental age. There was a significant positive effect for training on students’ performance on verbal analogy problems.
Widening Access to Electropalatography for Children With Persistent Sound System Disorders
Authors: Gibbon Fiona , Stewart Fiona , Hardcastle William J. , Crampin Lisa
Published: July 2014

Previous studies have demonstrated the value of using electropalatography (EPG) to assess, diagnose, and treat persistent sound system disorders in children. However, the application of EPG research has been limited in clinical contexts because most speech-language pathologists do not have access to the technique. This article provides an overview of recent EPG research on persistent sound system disorders and describes a network that has been established to widen access to EPG. The use of EPG via the network is illustrated in the case description of an 8-year-old boy, Robbie, who presented with a persisting speech disorder. The network was used because the clinician treating Robbie did not have an EPG. The main perceptual feature of Robbie’s speech before EPG treatment was the deviant phonological process of backing /t/ and /d/ targets to velar place of articulation. EPG was used to assess articulatory patterns before treatment, to provide visual feedback as part of a treatment program, and to record changes in tongue-palate contact patterns as treatment progressed. Robbie achieved normal /t/ and /d/ articulatory patterns after treatment and was subsequently discharged. Factors that could have contributed to the successful outcome in this case are discussed, and areas requiring further research are identified.
Readability of Educational Materials for Clients With Cleft Lip/Palate and Their Families
Authors: Kahn Alice , Pannbacker Mary
Published: July 2014

Educational materials for clients with cleft lip/palate and their families and materials for the general public produced by the American Speech-Language-Hearing Association were analyzed for readability. The SMOG Grading Formula, a simple, fast procedure for predicting grade-level difficulty of written material, and the Fry index of readability, a more lengthy measure of readability, were used to analyze 30 publications. Reading levels were computed, and results ranged from elementary to college level. The majority of materials were written at or above the high school readability level. Results suggest a need for revision of current materials to lower reading levels. Writers should consider the appropriateness of reading level for readers when preparing educational materials.
Topic Scenes in Conversations With Adults With Right-Hemisphere Brain Damage
Authors: Kennedy Mary R. T.
Published: July 2014

Eight adults with right hemisphere damage (RHD) and seven non-brain-damaged (NBD) matched controls participated in first-encounter conversations. The incidence and nature of topic scenes, as well as their location in the conversation, were investigated based on the notion that topic scenes are organized into “memory organization packets” (MOPs). A conversation MOP is a mental superstructure that provides organization for topics that are discussed in order to achieve the goal of the conversation. No significant group differences in the overall proportion of topic scenes contributed were found, and all participants produced more topic scenes in the maintenance phase than in the initiation or termination phase. Participants with RHD produced larger proportions of topic scenes during the termination phase than NBD participants. The majority of topic scenes discussed by participants with RHD and all the topic scenes discussed by NBD participants and partners belonged to the first-encounter conversation MOP. However, some participants with RHD generated topic scenes that differed in nature and location from the first-encounter conversation MOP, whereas NBD adults did not generate topic scenes that differed. These results are discussed in relation to differences in the relationships between the RHD participant/partner dyad and the NBD participant/partner dyad, research findings that some adults with RHD produce statements that are out-of-context, and research findings that suggest that adults with RHD may have difficulty suppressing secondary information during discourse comprehension tasks.
African American Mothers’ Views of Their Infants’ Language Development and Language-Learning Environment
Authors: Hammer Carol Scheffner , Weiss Amy L.
Published: July 2014

The purpose of this investigation was to develop an understanding of how African American mothers living in an urban setting in the South (a) viewed their children’s language development and (b) structured their children’s language-learning environment in general. Semi-structured interviews were conducted with six African American mothers of low socioeco-nomic status (SES) and six African American mothers of middle SES as part of a larger study. Three themes emerged from the analysis of the data: (a) how children learn to talk, (b) perceptions of children’s language development, and (c) structuring children’s experiences. Results revealed some similarities between the views of mothers of low and middle SES, with individual variations occurring within each of the groups.
Effect of Color on Developmental Picture-Vocabulary Naming of 4-, 6-, and 8-Year-Old Children
Authors: Barrow Irene M. , Holbert Donald , Rastatter Michael P.
Published: July 2014

This study examined the effect of color on the naming process in children for pictures of increasing vocabulary difficulty levels. Picture-naming reaction times and accuracy rates were measured for both black and white line drawings and color drawings in 30 normally developing children, ages 4, 6, and 8 years, via a tachistoscopic viewing paradigm. Statistical analysis of reaction time data revealed that color affected speed of naming only when the vocabulary level of the picture was within the developmental range of the child. That is, for vocabulary within an emerging period for the child, colored drawings were named significantly faster than black and white line drawings. However, color did not significantly influence speed of naming for pictures either for vocabulary well established in the child’s lexicon or for vocabulary above the child’s developmental age. Statistical analysis of accuracy data revealed significant color by vocabulary interactions. Specifically, when the vocabulary level of the pictures exceeded chronological age level, children named color drawings with significantly higher accuracy rates than black and white line drawings.
Speech and Language Screening for Audiologists
Authors: Pannbacker Mary , Batchelor Barbara , Binderim Lori
Published: July 2014

Speech and language screening by audiologists is not new, although few audiologists screen speech and language, which should be an integral component of the audiological evaluation. This article considers ASHA’s views about speech and language screening by audiologists, screening tests available to audiologists, and the training of audiologists to screen speech and language.
Parents’ Reactions and Recommendations After Diagnosis and Hearing Aid Fitting
Authors: Sjoblad Stephanie , Harrison Melody , Roush Jackson , McWilliam R. A.
Published: July 2014

This study was designed to explore parent reactions to the early stages of audiologic assessment and intervention. A total of 213 parents whose children were under the age of 6 years returned a mail survey. Respondents from 45 states participated. Parents were asked to (1) report the approximate age of diagnosis and hearing aid fitting; (2) comment on reasons for any delays encountered from diagnosis to fitting; and (3) respond to questions concerning their reactions to the initial fitting of amplification. The median age of identification was earlier than some previous investigations; however, substantial delays occurred between diagnosis and hearing aid fitting. Reasons for delay included the need for further audiologic evaluation, problems obtaining return appointments, illness of the child, and difficulties obtaining adequate earmolds. Parent reactions to hearing aids, once fitted, included concerns about appearance and questions about maintenance and use, but attitudes regarding hearing aids and their perceived benefits improved over time.
The Human Auditory Brain-stem Response to High Click Rates
Authors: Burkard Robert F. , Sims Donald
Published: July 2014

In the December 2001 issue (Vol. 10, No. 2), "The Human Auditory Brain-stem Response to High Click Rates: Aging Effects" by Robert F. Burkard and Donald Sims was incorrectly classified as a
viewpoint
. It should have been classified as an
article
. In addition, the table of contents indicated an incorrect page number for "Neurophysiologic Basis for Cochlear and Auditory Brainstem Implants" by Aage R. Miller. The correct page number is 68. We regret these errors.
Multifrequency Tympanometry
Authors: Hunter Lisa L. , Margolis Robert H.
Published: July 2014

Multifrequency tympanometry has emerged as a clinically feasible test with the advent of computer-controlled systems that can store and analyze complex immittance components at multiple probe tone frequencies. The theoretical basis for understanding multifrequency tympanometry has existed for years, but the diagnostic utility of data obtained at frequencies higher than 660 Hz needs further clarification. In this short course, the Vanhuyse model for the analysis of multifrequency tympanograms is discussed and clinical examples illustrating the usefulness of the model are presented. Normative data are provided for adults and children, and various methods for data acquisition and measurement of resonant frequency are presented.
Cost Justifications for Multifrequency Tympanometry
Authors: Hanks Wendy D. , Robinette Martin
Published: July 2014

MFT has the potential to become the standard of care when dealing with possible middle ear pathologies. By applying those applications appropriate to the individual practice, and with a reasonable marketing effort, the cost of MFT-capable equipment should be readily recoverable.

Finally, and most importantly, MFT is being shown in the current literature to be a better diagnostic tool than traditional tympanometry and to improve the level of care being provided to many clients by the audiologist and the physician. In my mind, this alone justifies the expenditure.
A Multimedia Approach for Estimating Speech Recognition of Multilingual Clients
Authors: McCullough June Antablin , Wilson Richard H. , Birck Jonathan D. , Anderson Linda G.
Published: July 2014

Spanish picture-identification materials have been created specifically for presentation in a computer-driven multimedia format. Normative performance data in conventional oral, open-set conditions and in computer-controlled pointing, closed-set conditions are being established for the Spanish Picture-Identification Task and will be forthcoming. The use of auditory/visual materials in the computer-controlled format represents an innovative use of multimedia technology that appears to be uniquely applicable for assessing the growing numbers of multilingual clients. It is reasonable to expect that word lists and corresponding illustrations will be developed soon for many common languages, perhaps stored on CD-ROM and accessed by audiologists through the touch of a button.
Congenital Cytomegalovirus and Deafness
Authors: Schildroth Arthur N.
Published: July 2014

Although the incidence of medical and neurological problems resulting from congenital cytomegalovirus (CMV) infection is relatively low, the widespread and indiscriminate nature of this infection and the severity of these conditions when they do occur are such that it warrants the close attention of medical specialists, audiologists, and educators. The identification of congenital CMV is especially difficult because of its largely nonsymptomatic character, and because conditions associated with it, including hearing impairment, can be either progressive in nature or occur only later in life. Data reviewed in this study resemble those reported for children with impaired hearing from the 1964–65 maternal rubella epidemic: hearing loss in the severe to profound range, often accompanied by serious additional disabilities, especially mental retardation and cerebral palsy. Depressed achievement test results of children with CMV-induced hearing loss are further indications of the serious nature of this disease.

The presence of any symptoms of CMV infection in infants or of risk factors associated with it—e.g., purplish skin rash, severe asphyxia, jaundice, low birth weight, swollen lymph glands, and other mononucleosis-like symptoms—signals the need for immediate testing, including audiological evaluation, and, if results are positive, the initiation of early medical and educational intervention.
Programmable Telecoil Responses
Authors: Davidson Stephanie A. , Noe Colleen M.
Published: July 2014

Ten experienced hearing aid users were tested to evaluate an assistive listening device inductively coupled to three different hearing aids—their own BTE hearing aid and associated telecoil, a programmable hearing aid with the telecoil programmed using the manufacturer's algorithm, and the same programmable hearing aid with the telecoil programmed so that the real-ear gain obtained with the hearing aid-assistive listening device combination matched a prescriptive target. Results indicated that modifying the telecoil response to match a prescriptive target can result in enhanced speech understanding and higher preference rankings.
The Application of an Adaptive Speech Perception Procedure to Older Listeners
Authors: Sapp Julie Vesper , DeChicchis Albert R.
Published: July 2014

This investigation was conducted to examine whether adaptive, up-down, speech perception procedures predicted the level yielding 50% correct response as well for older listeners as for younger listeners. The 50% criterion level for NU6 stimuli was estimated via an adaptive procedure in quiet and in two noise conditions for ten older (ages 67–84) and ten younger (ages 20–27) subjects, all with hearing threshold levels < 25 dB HL for the octave frequencies 250–4,000 Hz. Word recognition scores were obtained at the levels estimated by the adaptive procedure. The older group means were closer to 50% in two of the three conditions. No significant group difference was found in the third condition.
Older Women and Hearing
Authors: Garstecki Dean C. , Erler Susan F.
Published: July 2014

Health-related research and clinical management efforts only recently have begun to recognize gender differences. Women live longer than men, but are more likely to experience debilitating health conditions. Compounding their risk for poorer health and subsequent reduced quality of life are a variety of socio-cultural factors. In addition, hearing loss is commonly experienced by all older adults. Even moderate hearing loss may greatly reduce a person's ability to communicate effectively and to maintain a sense of competence. In spite of its handicapping potential, little is known about the impact of hearing loss among the increasing, older adult segment of the population. This paper reviews health and hearing-related factors, focusing particularly on older women, and identifies issues for hearing professionals to address in future research and clinical management.
Modality Specificity as a Criterion for Diagnosing Central Auditory Processing Disorders
Authors: McFarland Dennis J. , Cacace Anthony T.
Published: July 2014

A central "auditory" processing disorder (CAPD) is an auditory perceptual dysfunction that cannot be explained on the basis of peripheral hearing loss. As a concept, CAPD has not been completely validated, and many issues continue to be controversial. A primary issue of concern is whether currently used tests to evaluate CAPD are sensitive to factors that are not of an auditory perceptual nature. In this paper, we consider the case for modality specificity as a criterion for improving the specificity of diagnosing CAPD. Demonstrating the modality-specific nature of sensory processing deficits is one way to rule out nonperceptual factors as explanations for observed dysfunction.
Analysis of View Angle Used in Speechreading Training of Sentences
Authors: Bauman Sara L. , Hambrecht Georgia
Published: July 2014

This study examines the effects of sentence perception across three speaker viewing angles: front view (0°), quarter view (45°), and side view (90°). The performance of a female adult with postlingual hearing loss was measured for accuracy at each angle. The present study used a single-subject, alternating treatment design where three treatment angles were randomly presented in every session. The percentage accuracy levels for each session were compared to determine the most effective treatment viewing angle of the speaker. The results indicated that the side-view angle was most effective, as the percentage gain of improvement was greatest in combination with the consistent upward trend of the data points across treatment sessions. The performance at front-view and quarter-view angles was also successful. The results of this preliminary effort indicate the value of treatment for visual sentence perception at all three angles, including the nontraditionally targeted side view.
Screening Receptive Communication of Older Adults in Residential Care
Authors: Erber Norman P. , Heine Chyrisse
Published: July 2014

Receptive communication of 341 older adults was evaluated in 9 nursing homes. The following assessments were conducted: case history, otoscopic examination, visual perception of facial movements, hearing aid function, sentence identification, and ratings of conversational fluency. The majority of clients reported hearing loss and low vision that interfered with their communication. Otoscopic examination revealed that nearly a third of the ears contained excessive cerumen. Visual perception results indicated that nearly all clients could see the clinician's head movements, but that some clients could not see mouth or eye movements. Fewer than half of the clients owned hearing aids, but not all owners used them. Common problems related to non-use of hearing aids included blocked earmolds and dead batteries. Sentence identification and conversational fluency were improved by the use of amplification, but positive results often depended on application of communication strategies by the partner. Recommendations are provided for training staff and caregivers to increase their awareness of client needs and to modify their own behavior for more effective communication with older people.
Repeatability of a Real-Ear-to-Coupler Difference Measurement as a Function of Age
Authors: Sinclair Sheila T. , Beauchaine Kathryn L. , Moodie K. Shane , Feigin Judith A. , Seewald Richard C. , Stelmachowicz Patricia G.
Published: July 2014

For a given individual, the applicability of an average real-ear-to-coupler transfer function in the fitting of hearing aids is of limited utility, because the acoustical properties of individual ears may differ substantially from average transformation values (Feigin, Kopun, Stelmachowicz, & Gorga, 1989; Fikret-Pasa & Revit, 1992). It has been suggested, therefore, that individual real-ear-to-coupler difference (RECD) measures should be obtained whenever possible and applied within the fitting process (Hawkins, 1992; Nelson Barlow, Auslander, Rines, & Stelmachowicz, 1988). The purpose of this study was to investigate the repeatability of a specific RECD measurement procedure that has been developed for clinical application with young children (Moodie, Seewald, & Sinclair, 1994). The test-retest reliability of this procedure is reported for 10 adults and 90 children in the birth-to-7-year age range.
Toward a Model Clinical-Trials Protocol for Substantiating Hearing Aid User-Benefit Claims
Authors: Walden Brian E.
Published: July 2014

It has been argued that there is a need to adopt a uniform core set of dependent measures and test conditions for use in manufacturer-sponsored clinical trials to substantiate hearing device user-benefit claims in FDA applications. A framework for developing a model protocol was presented, and a core set of dependent measures and test conditions was suggested that may serve as a springboard for discussion.

Given the state of the art, designing a protocol to evaluate hearing aid benefit requires that certain assumptions and compromises be made in defining this benefit and selecting test materials. The limitations of our knowledge and testing methods make it inevitable that the results of our efforts will not be perfect. The problems created by limited knowledge and methodology certainly are not unique to our discipline or to this endeavor. Although perfect prediction of everyday performance should be our goal, currently it cannot be our expectation. However, this should not deter us from our best attempt to reach our goal.

The clinical-trials protocol described in this paper has been used in two manufacturer-sponsored clinical trials conducted at Walter Reed Army Medical Center. Although there has been general satisfaction with this protocol on the part of both the manufacturer and the researchers who have conducted these trials, the potential to improve this protocol certainly exists. The laboratory measures included in the Walter Reed protocol depend on traditional "objective" measures of speech recognition. There are other potentially useful methodologies (e.g., subjective ratings of intelligibility, paired-comparison techniques), and other dimensions of user performance (e.g., sound quality, loudness growth) that are ignored.

Although the involvement of hearing researchers in manufacturer-sponsored clinical trials to substantiate user-benefit claims is relatively new, valuable experience has been gained in several clinical research laboratories. A collective effort on the part of manufacturers, researchers involved in this research activity, and government regulators, could lead to a model protocol that would benefit both hearing-impaired consumers and hearing instrument manufacturers.
ANSI Update
Authors: Frank Tom
Published: July 2014

ANSI S3.6-1996
Specification for Audiometers
represents our most current and best resource for information regarding audiometers. It also contains reference threshold levels for all commonly used transducers in one standard. ANSI S3.6-1996 incorporates existing ANSI, ISO, and IEC standards in an effort to obtain worldwide uniformity. ANSI S3.6-1996 will be reviewed in 5 years and, if necessary, will be revised to include new information. All audiologists are strongly encouraged to read ANSI S3.6-1996 because there are many more aspects of the standard than those discussed in this article. Information for ordering a copy of ANSI S3.6-1996 can be obtained from the Standards Secretariat, Acoustical Society of America, 120 Wall Street, 32nd Floor, New York, NY 10005-3993 (Tel: 212-248-0373; Fax: 212-248-0146).
Performance of Monolingual and Bilingual Speakers of English and Spanish on the Synthetic Sentence Identification Test
Authors: Lopez Susan M. , Martin Frederick N. , Thibodeau Linda M.
Published: July 2014

Differences in the performance of adults with normal hearing were evaluated on the English and Spanish versions of the Synthetic Sentence Identification (SSI) test in the ipsilateral competing message (ICM) format. Previous work has shown that bilingual subjects perform significantly better on the Spanish version of the SSI at a –30 dB message-to-competition ratio (MCR). The previous investigators attributed this difference in performance to the existence of a greater number of pauses in the competing message of the Spanish version compared to the English version.

In the present study, seven bilingual speakers and ten monolingual speakers each of English and Spanish completed two conditions—the standard competing message (SC) and the competing message mixed with speech noise (SC+N)—in order to reduce or eliminate the effect of pauses on performance. Bilingual subjects’ scores in each language were not significantly different from monolingual subjects’ scores. Scores from bilinguals were significantly better in Spanish compared to English—even when speech noise was used to fill in the natural pauses present in the competing message at a –10 dB MCR. It is suggested that this performance difference may be a result of the unequal average number of syllables per stimulus sentence in the English and Spanish versions. However, further research will be needed to explore the impact that different language structures have on SSI performance.
Texas Hospitals’ Quality Control Approach to Universal Infant Hearing Detection
Authors: Albright Kathryn , Finitzo Terese
Published: July 2014

To paraphrase Stein (1995), designing, implementing, and maintaining a cost-effective process for UIHD may be the most challenging responsibility we face as audiologists because those activities affect 4 million babies and their families each year. We are confident that we will be successful as audiology implements quality measures, when information management programs are designed to meet our needs, when partnerships are embraced, and when our leadership and management skills are refined. Each baby that passes through our programs will be screened; infants with hearing impairment will be detected and connected to service. The motto of the
Sounds of Texas Project
is “Detect and connect—one baby at a time.”