bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of Two Language Tests to Identify Pragmatic Language Problems in Children With Autism Spectrum Disorders
Authors: Young Edna Carter , Diehl Joshua J. , Morris Danielle , Hyman Susan L. , Bennetto Loisa
Published: April 2006

Purpose:Pragmatic language disorders (PLDs) are difficult to diagnose in a cost-effective manner, and there are few assessment tools that yield quantitative data. This investigation was designed to determine whether two formal assessment tools would differentiate PLDs in children with autism spectrum disorders (ASDs) from controls matched on verbal IQ and language fundamentals.

Method:Thirty-four matched participants were given the Test of Pragmatic Language (TOPL; D. Phelps-Terasaki & T. Phelps-Gunn, 1992) and the Strong Narrative Assessment Procedure (SNAP; C. J. Strong, 1998).

Results:Participants with ASDs had significantly poorer scores than controls on the TOPL. On the SNAP, the children with ASDs performed similarly to controls on syntax, cohesion, story grammar, and completeness of episodes. The controls performed significantly better only on the ability to answer inferential questions.

Clinical Implications:The TOPL was effective in differentiating PLDs in children with ASDs when performance was compared to matched controls. The SNAP did not clearly differentiate language problems in these two groups. Research is needed to develop formal assessment tools that target the unique language disabilities of high-functioning individuals with ASDs.
Preschool Teachers’ Perceptions and Reactions to Challenging Classroom Behavior
Authors: Nungesser Nicole R. , Watkins Ruth V.
Published: April 2006

Awareness of issues of social competence and challenging behavior related to childhood language and communication disorders has been increasing. The purpose of this clinical exchange is to provide speech-language pathologists with basic information on communication disorders and challenging behaviors, as well as with insights into ways to support both students and classroom teachers. To provide effective services to children with language impairments and optimally support classroom staff, speech-language pathologists need to recognize (a) the interdependence of language, communication, social competence, and challenging behaviors; (b) the significance that challenging behaviors can have on evaluations of academic competency; and (c) how teachers in early childhood classrooms perceive and react to challenging behaviors. This clinical exchange provides an overview of the relationship between language, communication, and social competence, and presents preliminary survey research data investigating teachers’ perceptions and reactions to challenging behaviors. Clinical implications are discussed, including considerations for intervention with children who may exhibit challenging behaviors in combination with language disabilities, and the speech-language pathologist’s instrumental role in educating and supporting classroom staff to use communication strategies when managing challenging classroom behaviors.
An Examination of Phonological Awareness Treatment Outcomes for Seventh-Grade Poor Readers From a Bilingual Community
Authors: Swanson Teri J. , Hodson Barbara W. , Schommer-Aikins Marlene
Published: April 2006

Purpose:The goal of this study was to examine posttreatment outcomes following direct, systematic phonological awareness instruction for seventh-grade poor readers, most of whom had English as their second language.

Method:The treatment group (n=35) participated in small-group instruction sessions that emphasized phonological awareness at the phoneme level and incorporated explicit linkages to literacy. The treatment, which was administered in the participants’ school setting over a 12-week period, involved approximately 45 hr of contact with a trained instructor. Postintervention performance of the treatment group was compared to performance of students from the same school and grade level who were waiting to receive phonological awareness treatment (nontreatment group,n=33).

Results:ANCOVA results for total reading scores and MANCOVA results for Phonological Awareness, Word Attack, Word Identification, Word Comprehension, and Passage Comprehension subtests indicated that group differences were significant. The posttreatment scores of the treatment group were higher for all measures.

Clinical Implications:Seventh-grade poor readers, including bilingual students who have English as their second language, can benefit from direct, systematic instruction that emphasizes phonological awareness and is linked to literacy.
Communication in Context: A Qualitative Study of the Experiences of Individuals With Multiple Sclerosis
Authors: Yorkston Kathryn M. , Klasner Estelle R. , Swanson Kristen M.
Published: April 2006

The purpose of this study was to examine an insider’s perspective on communication in multiple sclerosis (MS), a disease of the central nervous system in which scattered lesions or plaques produce varying combinations of motor, sensory, and/or cognitive impairments. Qualitative research methods were used because they are designed to provide a systematic way of exploring complex issues, such as communication, that cannot be separated from the context in which they occur. Seven participants, all of whom had mild communication impairments, described their everyday experiences of communication and the impact of MS on these experiences. Themes derived via inductive analysis of verbatim transcripts included:
watching the communication changes
,
it’s about participating in my life
, and
communicating is unpredictable
. Using the World Health Organization model of disablement, the participants’ communication impairments were mild. However, participants reported major lifestyle changes characterized by important limitations in communicative participation. Whereas some of the limitations were attributed to changes in speech and language, others were thought to be the result of changes in cognition, vision, mobility, and susceptibility to fatigue. Clinical implications include the need to develop assessment protocols and outcome measures that capture issues related to communicative participation in natural contexts and participation in society.
Language Change Following Computer-Assisted Language Instruction With Fast ForWord or Laureate Learning Systems Software
Authors: Gillam Ronald B. , Crofford Julee A. , Gale Meghan A. , Hoffman LaVae M.
Published: April 2006

This exploratory study was designed to evaluate functional language changes during and after treatment with language intervention software. Two children with language impairments received Fast ForWord (FFW; Scientific Learning Corporation, 1997), and two other children received a bundle of intervention programs published by Laureate Learning Systems (LLS). The children received intervention for 1 hour and 40 minutes per day for 20 days (4 weeks). Treatment was delivered according to a multiple-probe design in which one child was enrolled in Fast FFW immediately after a baseline phase. Another child remained in an extended baseline phase before beginning FFW. The design was replicated for the bundle of LLS programs. The children with extended baselines were identical twins. Progress was measured by gains on the Oral and Written Language scales (OWLS) and by visual and mathematical examination of trends for language sample measures.

All four children made clinically significant gains (posttest scores outside the 95% confidence interval of the pretest scores) on the OWLS. Two children who received the LLS software and one child who received FFW software made clinically significant gains on mean length of utterance in morphemes (MLU), but only one child, who received treatment with the LLS software, had fewer grammatical errors after treatment. The three children with improved MLU also produced a higher proportion of utterances with mazes. Measures of language content (percent of response errors) and language use (percentage of assertive utterances) were not informative due to high variability and floor effects. The similarity of the treatment effects (especially in the case of the identical twins) was surprising since FFW and the bundle of LLS programs targeted different levels of language, used different types of auditory stimuli, and were designed to promote different kinds of learning.
Phonologically Disordered German-Speaking Children
Authors: Fox Annette V. , Dodd Barbara
Published: April 2006

Speech sound disorders affect more children than any other developmental communication disorder and are associated with long-term social and academic difficulties. The diversity of presenting symptoms has resulted in the need for classifying subgroups of speech disorders. Research on English-speaking children suggests that there are four types of surface speech error patterns (B. Dodd, 1995): articulation disorder (e.g., lisp); delay (i.e., normal developmental patterns that are inappropriate for chronological age); consistent use of atypical error patterns (e.g., deletion of all initial consonants); and inconsistent pronunciation of the same lexical items. Classification typologies should be language independent. This study investigated whether the same four subgroups, in similar proportions, would be found in German-speaking children who had disordered speech. A total of 110 monolingual German-speaking children, aged 2 years 7 months to 7 years 7 months, participated in the study. They had been referred for assessment of a suspected speech disorder. The results supported the subgroup classification, providing evidence for the universal character of speech disorders. One significant difference was the relatively high proportion of children classified as having an articulation disorder. This was explained by the uncertainty regarding a lisp as a disorder in German, since it is also found in up to 40% of normally developing children of the same age. The theoretical and clinical implications of the findings are discussed.
Understanding the Language Difficulties of Children With Specific Language Impairments
Authors: Montgomery James W.
Published: April 2006

Many children with specific language impairment (SLI) demonstrate deficits in both verbal working memory (VWM) and language. Among child language researchers, the debate continues whether these two deficits are related. In this article, I take the position that there is indeed a connection between SLI and VWM. I review evidence suggesting that the lexical/morphological learning and sentence comprehension problems of many of these children are associated with deficient VWM abilities. Evidence is also reviewed for the possibility that deficient VWM provides a clinical marker of SLI. I end by offering various assessment and intervention techniques that may prove useful in SLI.
Disabilities as Viewed by Four Generations of One Hispanic Family
Authors: Salas-Provance Marlene B. , Erickson Joan Good , Reed Jean
Published: April 2006

Forty members of one Hispanic family ranging in age from 21 to 96 years were interviewed by a bilingual professional who was also a family member. The interviews were conducted in the homes of the participants in the language of their choice. The results indicate that culture plays an important role in folk and medical belief systems regarding health and illness. Stereotypical attitudes of this cultural group toward the causes and treatment of disabilities, including communication disorders, were both supported and rejected. Analysis of the responses to the closed-ended questions indicated that a large number and variety of folk beliefs were held by participants and varied according to factors such as age, income, education, and gender. In contrast, strong beliefs in medically based causes and cures of disabilities were apparent across the generations and showed little variation by age, income, education, or gender. Responses to open-ended questions indicated that medical beliefs were more frequently reported than folk beliefs. Clinical implications of the results of this research reinforce the need for professionals to increase their cultural awareness, knowledge and skills in order to provide culturally sensitive clincial services.
A Comparison of Mothers' Individual and Simultaneous Book Sharing With Preschool Siblings
Authors: Kleeck Anne van , Beckley-McCall Amy
Published: April 2006

Many studies have demonstrated that adults fine tune book-sharing discussions to the developmental levels of preschoolers, but little is known regarding how reading simultaneously to different-aged preschoolers is negotiated. We observed five mothers of different-aged preschoolers sharing books with each child individually and with both children together. Analyses focused on the linguistic complexity of the book, the amount of time spent sharing a book, and on several aspects of the mothers' book-sharing mediation. Results revealed developmental differences on several measures of how mothers mediated with younger as compared to older children individually. Book complexity, the time spent sharing books, and the percent of utterances at higher levels of abstraction were higher when reading to the older children; the number of mediation strategies per minute and the percent of mothers' behaviors that were used to get and maintain attention were higher when reading to the younger children. When reading to both children simultaneously, which aspects of the mediation fell at these different levels varied among the different mothers. This suggests that different mothers reach different solutions to the task of simultaneously reading to preschoolers of different ages. One mother approached the simultaneous book sharing much as she did sharing a book with her older child, one mother approached it as she did with her younger child, one mother simply read and did little mediation, and two mothers appeared to use a mixed strategy in the simultaneous reading condition.
Clinical Problem Solving
Authors: Miccio Adele W.
Published: April 2006

In the lead article of this forum, Ken Bleile explains his approach to the initial assessment of Bobby, a 4;3 (years; months) old child with suspected problems with articulation and phonology. Bleile argues that to meet the challenge of balancing thoroughness and efficiency under less than ideal conditions and time limitations, one must resist the temptation of following the lead of the referral source and instead, focus on determining the general nature of the problem. In contrast, this article will argue for the efficiency of focusing on the suspected problem. Although doing so involves some of the same tasks described by Bleile, philosophical differences lead to different conclusions and subsequently, a different approach to clinical treatment, particularly treatment target selection.
An Analysis of the Test of Language Development—Primary for Item Bias
Authors: Hammer Carol Scheffner , Pennock-Roman Maria , Rzasa Sarah , Tomblin J. Bruce
Published: April 2006

The purpose of this research was to examine the Test of Language Development-P:2 (TOLD-P:2; Newcomer & Hammill, 1991) for item bias. The TOLD-P:2 was administered to 235 African American and 1,481 White kindergarten children living in the Midwest. Test items were examined for evidence of differential item functioning (DIF) using inferential and descriptive methods. Sixteen percent of all items of the TOLD-P:2 were found to have DIF. Of these items, 75% were found to be harder for the African American group. The percentages of items on the five core subtests identified as having DIF were as follows: Picture Vocabulary, 17%; Oral Vocabulary, 17%; Grammatic Understanding, 12%; Sentence Imitation, 20%; and Grammatic Completion, 13%. The implications of these findings are discussed in relation to the TOLD-P:3.
Speech and Language Skills of Individuals With Prader-Willi Syndrome
Authors: Lewis Barbara A. , Freebairn Lisa , Heeger Shauna , Cassidy Suzanne B.
Published: April 2006

The speech and language of 55 individuals (27 males and 28 females) with Prader-Willi syndrome (PWS), aged from 6 months to 42 years, were examined through standardized testing and spontaneous speech sample analysis. While great variability was noted in speech and language abilities, most subjects presented with speech sound errors characterized by imprecise articulation (85%), and oral motor difficulties (91%). Hypernasality was noted in 62% and hyponasality in 14%. Other speech characteristics included a slow speaking rate, flat intonation patterns, abnormal pitch of the voice, and harsh/hoarse voice quality. Narrative retelling abilities were poor, with specific deficits in sequencing of story events. Individuals with PWS as a result of deletions of chromosome 15 did not differ significantly in speech and language from individuals with PWS as a result of uniparental disomy.
Treating Phonological Disorders in a Multilingual Child
Authors: Ray Jayanti
Published: April 2006

This study was undertaken to examine the efficacy of cognitive-linguistic approach in treating a phonological disorder in a five-year-old trilingual child. The child's native languages were Hindi and Gujarati, with English acquired during preschool. The child's speech was mildly unintelligible, characterized by normal as well as deviant phonological processes and inconsistent errors in all three languages. A cognitive-linguistic approach that incorporated process elimination and minimal contrast therapies was used to treat the phonological disorders in English only. Posttherapeutic assessment after five months of treatment indicated significant improvements in the child's overall speech intelligibility in all three languages, indicating generalization. It may be hypothesized that a multilingual child is likely to use a common phonological system that may be shared by two or more languages during early learning stages. Clinical implications regarding assessment and intervention for bilingual/multilingual children with disordered phonology are discussed.
Ten Principles of Grammar Facilitation for Children With Specific Language Impairments
Authors: Fey Marc E. , Long Steven H. , Finestack Lizbeth H.
Published: April 2006

Although they often have significant difficulties in other areas, most children with specific language impairment (SLI) have special difficulties with the understanding and use of grammar. Therefore, most of these children will require an intervention program that targets comprehension or production of grammatical form. Language interventionists are faced with the difficult task of developing comprehensive intervention programs that address the children's grammatical deficits while remaining sensitive to their other existing and predictable social, behavioral, and academic problems. The purpose of this article is to present and justify 10 principles that we regard as essential for planning adequate interventions for children with language-learning problems. These principles are relevant for all children with problems in the use of grammar, but they are especially appropriate for 3- to 8-year-old children with SLI. Although all of our examples are from English, the principles we have chosen are sufficiently broad to cut across many linguistic and cultural boundaries.
Comparison of Two Reading Feedback Strategies in Improving the Oral and Written Language Performance of Children With Language-Learning Disabilities
Authors: Crowe Linda K.
Published: April 2006

Twelve school-age children with language-learning disabilities (LLD) participated in a study comparing the effects of two reading feedback strategies for improving their oral and written language performance. Children were matched for age, disability, gender, and general reading performance. Participants were assigned to one of three study groups, Treatment 1 (T1), Treatment 2 (T2), or Control (C). Children were pre- and posttested on standardized tests of reading and oral vocabulary. T1 and T2 participated in 6 weeks of reading intervention. T1 used traditional decoding-based feedback strategies, and T2 used meaning-based feedback strategies, termed Communicative Reading Strategies (CRS). Significant differences across groups were found for reading comprehension, oral reading, and expressive vocabulary measures. Pairwise comparisons indicated that T2 performed significantly better than T1 and C on reading comprehension at posttest. Though not reaching levels of significance, T2 made greater gains than T1 and C on oral reading and expressive vocabulary measures. Results are discussed with implications for using CRS (T2) with school-age poor readers.
The Influence of Information and Role-Playing Experiences on Children's Attitudes Toward Peers Who Use AAC
Authors: Beck Ann R. , Fritz-Verticchio Heidi
Published: April 2006

A school-based intervention designed to increase the positive nature of children's attitudes toward peers who use AAC is described. Small groups of children were given only information about AAC or they were given information about AAC and the opportunity to role-play being nonspeaking. Results indicated a greater positive effect of the information plus role-play experience compared to the effects of being given information alone for older children and boys. Clinical implications and suggestions for future research are discussed.
Age, Working Memory, Figurative Language Type, and Reading Ability
Authors: Qualls Constance Dean , Harris Joyce L.
Published: April 2006

This study investigated the cognitive and linguistic factors presumed to be associated with adult comprehension of figurative language, including age, working memory (WM), figurative language type, and reading comprehension (RC). Forty younger (M=22 years) and 40 older (M=63 years) healthy African American adults completed WM and reading tasks, and the 60-item forced-choice multiple-category (20 idioms, 20 metaphors, and 20 metonyms) Figurative Language Comprehension Test. After controlling for WM and RC, the older adults outperformed the younger adults on idioms and metonyms. Metaphor comprehension was comparable between the groups. Findings demonstrate that WM and RC underlie adults' comprehension of figurative language and should be considered when interpreting performance on tests assessing figurative language competence in this population.
A Thematic Analysis of Late Recovery From Stuttering
Authors: Anderson Tracy K. , Felsenfeld Susan
Published: April 2006

This study used thematic analysis to gain a better understanding of the experiences of individuals who reported late recovery from stuttering. Using a semistructured interview, 6 adults who reported recovering from stuttering after the age of 10 were asked to relate their recovery stories, with particular emphasis on their perceptions of factors responsible for the recovery process. The interviews were parsed into information-rich quotations that were ultimately placed into thematic categories. Three thematic categories appeared to capture the majority of the recovery attributions: (a) increased confidence; (b) increased motivation, expressed as a desire to make positive changes in speech; and (c) direct speech changes. Narrative case studies were subsequently developed to illustrate the 3 different "pathways to recovery" that were described by our participants.
The Relationship Between Standardized Measures of Language and Measures of Spontaneous Speech in Children With Autism
Authors: Condouris Karen , Meyer Echo , Tager-Flusberg Helen
Published: April 2006

This study investigated the relationship between scores on standardized tests (Clinical Evaluation of Language Fundamentals [CELF], Peabody Picture Vocabulary Test-Third Edition [PPVT-III], and Expressive Vocabulary Test) and measures of spontaneous speech (mean length of utterance [MLU], Index of Productive Syntax, and number of different word roots [NDWR]) derived from natural language samples obtained from 44 children with autism between the ages of 4 and 14 years old. The children with autism were impaired across both groups of measures. The two groups of measures were significantly correlated, and specific relationships were found between lexical-semantic measures (NDWR, vocabulary tests, and the CELF lexical-semantic subtests) and grammatical measures (MLU, and CELF grammar subtests), suggesting that both standardized and spontaneous speech measures tap the same underlying linguistic abilities in children with autism. These findings have important implications for clinicians and researchers who depend on these types of language measures for diagnostic purposes, assessment, and investigations of language impairments in autism.
The Development of Symbolic Play and Language in Toddlers With Cleft Palate
Authors: Snyder Lynn E. , Scherer Nancy
Published: April 2006

This study compared the longitudinal performance of two groups of toddlers with palatal clefts and an age-matched group of children without palatal clefts on measures of elicited symbolic play at 18, 24, and 30 months. The results indicated that the group with isolated cleft palate differed significantly from both the cleft lip and palate group and the noncleft group on all but 1 play measure. Correlational analyses for each group indicated significant positive correlations between a number of the play variables at 18 months and productive vocabulary and MLU at 24 and 30 months of age. The findings suggest that assessment of early play gestures may assist clinicians in identifying children with clefts who are at risk for later language impairment.
A Language Screening Protocol for Use With Young African American Children in Urban Settings
Authors: Washington Julie A. , Craig Holly K.
Published: April 2006

Language screenings represent an important tool for early identification of language impairments in young children between 3 and 5 years of age. This investigation examined the utility of a well-established set of assessment measures for screening young African American children. One hundred and ninety-six children participated in the screening. Based upon the outcomes of the screening, 25 children who failed and a random sample of 56 children who passed were administered a larger language and cognitive assessment battery. Sensitivity and specificity of the screening were determined to be high. The number of different words, the Kaufman Nonverbal Scale, and nonword repetition accounted for a significant amount of the variance in performance. The screening is brief, valid, and culturally fair for use with preschool- and kindergarten-aged African American children living in urban settings.
Does Barium Influence Tongue Behaviors During Swallowing?
Authors: Steele Catriona M. , Lieshout Pascal H. H. M. van
Published: April 2006

The validity of videofluoroscopic swallowing assessments rests on the understanding that thin, nectar-, honey-, and spoon-thick radiopaque liquids resemble nonopaque liquids, both in their consistency and in the variations in swallowing that they elicit. Tongue movements during sequential swallows of opaque and nonopaque liquids were studied in 8 healthy participants in 2 age groups (<30 years, >50 years) using electromagnetic midsagittal articulography. Differences included smaller sip size, longer oropharyngeal transit times, and greater variability in tongue movement patterns with opaque liquids compared to nonopaque liquids, but effect sizes for these differences were small. Transit times were significantly longer for older participants than younger participants. We recommend matching radiopaque bolus size in videofluoroscopy to the patient’s habitually preferred sip mass for comparator nonopaque liquids.
Utility of the MacArthur—Bates Communicative Development Inventory in Identifying Language Abilities of Late-Talking and Typically Developing Toddlers
Authors: Heilmann John , Weismer Susan Ellis , Evans Julia , Hollar Christine
Published: April 2006

The present study investigated the validity of the MacArthur—Bates Communicative Development Inventory (CDI) for a group of toddlers 30 months of age. Study 1 examined the concurrent validity of the CDI for a group of 38 late talkers. Significant correlations were found between the CDI and direct measures of language abilities. Study 2 used likelihood ratio analysis to determine how well the CDI sorted 100 toddlers (38 late talkers and 62 children with a history of normal language development) according to language status based on direct assessment measures. The analyses showed that the CDI was effective in identifying children with low language skills up to the 11th percentile and in identifying children with normal language skills above the 49th percentile.
Story Presentation Effects on Children’s Retell Content
Authors: Schneider Phyllis , Dubé Rita Vis
Published: April 2006

This study investigated the possibility that the amount of content children include in their stories is affected by how stories are presented. Simple stories were presented to kindergarten and Grade 2 children in 3 conditions: orally (oral only), pictorially (pictures only), and combined oral and pictures. The kindergarteners recalled more content in the combined condition than in pictures only. The 2nd graders recalled more content in the oral only and combined conditions than in pictures only. The grades differed in both conditions involving oral presentation, but not in the pictures only condition. Thus, children in both grades provided more story information when they retold a story presented orally than when they told the story from pictures alone.
Concurrent Validity of the Language Development Survey: Associations With the MacArthur—Bates Communicative Development Inventories
Authors: Rescorla Leslie , Ratner Nan Bernstein , Jusczyk Peter , Jusczyk Anne Marie
Published: April 2006

This study examined the concurrent validity of the Language Development Survey (LDS), a 310-word parent report screening tool for language delay in toddlers, by testing its associations with the MacArthur—Bates Communicative Development Inventories: Words and Sentences (CDI:WS), a 680-word parent report instrument. Participants were 239 toddlers 23–25 months of age. The correlation between total vocabulary score on the 2 instruments was .95, and correlations across comparable semantic categories ranged from .84 to .94. The correlation between the LDS and the CDI:WS for mean length of phrases calculated on 3 examples of the child’s longest and best phrases was .90. Both instruments demonstrated that parents reported higher vocabulary and mean phrase length scores for girls. The study indicates that information obtained from the LDS about rank ordering of toddlers in terms of their reported vocabulary and mean length of phrases is equivalent to that obtained from the longer CDI:WS.
Science and Pseudoscience in Communication Disorders
Authors: Finn Patrick , Bothe Anne K. , Bramlett Robin E.
Published: April 2006

Purpose:
The purpose of this tutorial is to describe 10 criteria that may help clinicians distinguish between scientific and pseudoscientific treatment claims. The criteria are illustrated, first for considering whether to use a newly developed treatment and second for attempting to understand arguments about controversial treatments.

Method:
Pseudoscience refers to claims that appear to be based on the scientific method but are not. Ten criteria for distinguishing between scientific and pseudoscientific treatment claims are described. These criteria are illustrated by using them to assess a current treatment for stuttering, the SpeechEasy device. The authors read the available literature about the device and developed a consensus set of decisions about the 10 criteria. To minimize any bias, a second set of independent judges evaluated a sample of the same literature. The criteria are also illustrated by using them to assess controversies surrounding 2 treatment approaches: Fast ForWord and facilitated communication.

Conclusions:
Clinicians are increasingly being held responsible for the evidence base that supports their practice. The power of these 10 criteria lies in their ability to help clinicians focus their attention on the credibility of that base and to guide their decisions for recommending or using a treatment.
Speech and Language Findings Associated With Paraneoplastic Cerebellar Degeneration
Authors: Paslawski Teresa , Duffy Joseph R. , Vernino Steven
Published: April 2006

Paraneoplastic cerebellar degeneration (PCD) is an autoimmune disease that can be associated with cancer of the breast, lung, and ovary. The clinical presentation of PCD commonly includes ataxia, visual disturbances, and dysarthria. The speech disturbances associated with PCD have not been well characterized, despite general acceptance that dysarthria is often part of the initial presentation. A retrospective study was conducted of the speech, language, and swallowing concerns of patients with PCD evaluated at the Mayo Clinic in Rochester, MN, between 1990 and 2001. Prospective speech and language assessments were then conducted with 5 patients who had PCD. While ataxic dysarthria was the most common speech diagnosis, a spastic component was recognized frequently enough to suggest that the subacute (days to weeks) emergence and progression of an ataxic or mixed ataxic-spastic dysarthria in the setting of a more diffuse cerebellar ataxia should raise suspicions about PCD and justify further investigation of a possible immune-related etiology.
An Internet-Based Telerehabilitation System for the Assessment of Motor Speech Disorders: A Pilot Study
Authors: Hill Anne J. , Theodoros Deborah G. , Russell Trevor G. , Cahill Louise M. , Ward Elizabeth C. , Clark Kathy M.
Published: April 2006

Purpose

This pilot study explored the feasibility and effectiveness of an Internet-based telerehabilitation application for the assessment of motor speech disorders in adults with acquired neurological impairment.

Method

Using a counterbalanced, repeated measures research design, 2 speech-language pathologists assessed 19 speakers with dysarthria on a battery of perceptual assessments. The assessments included a 19-item version of the Frenchay Dysarthria Assessment (FDA; P. Enderby, 1983), the Assessment of Intelligibility of Dysarthric Speech (K. M. Yorkston & D. R. Beukelman, 1981), perceptual analysis of a speech sample, and an overall rating of severity of the dysarthria. One assessment was conducted in the traditional face-to-face manner, whereas the other assessment was conducted using an online, custom-built telerehabilitation application. This application enabled real-time videoconferencing at 128 kb/s and the transfer of store-and-forward audio and video data between the speaker and speech-language pathologist sites. The assessment methods were compared using the J. M. Bland and D. G. Altman (1986, 1999) limits-of-agreement method and percentage level of agreement between the 2 methods.

Results

Measurements of severity of dysarthria, percentage intelligibility in sentences, and most perceptual ratings made in the telerehabilitation environment were found to fall within the clinically acceptable criteria. However, several ratings on the FDA were not comparable between the environments, and explanations for these results were explored.

Conclusions

The online assessment of motor speech disorders using an Internet-based telerehabilitation system is feasible. This study suggests that with additional refinement of the technology and assessment protocols, reliable assessment of motor speech disorders over the Internet is possible. Future research methods are outlined.
Examining Communication Repairs of 2 Young Children With Autism Spectrum Disorder: The Influence of the Environment
Authors: Meadan Hedda , Halle James W. , Watkins Ruth V. , Chadsey Janis G.
Published: April 2006

Purpose

The purpose of this study was to examine the repair strategies of 2 young children with autism spectrum disorder from an environmental rather than a developmental perspective.

Method

A scripted protocol that included opportunities for requests and repair was followed. The environmental variables investigated were activity type (e.g., puzzle, shapes, book) and breakdown type (i.e., request for clarification, wrong response, and ignore). The sessions were videotaped, and each child’s behavior was coded.

Results

The results revealed that (a) both participants repaired the majority (70%) of their unsuccessful initial requests and (b) the repair strategies varied across children, activities, and breakdowns.

Conclusions

The findings of this study suggest that the 2 young children with autism and limited expressive language discriminated among environmental variables (i.e., type of activity and type of breakdown). The participants modified their repair topographies to correspond to changes in the environment. The findings from this study offer ways to enhance assessment and intervention of early communication. Implications for future research and practice are discussed.
Tympanometric Screening Norms for Adults
Authors: Roup Christina M. , Wiley Terry L. , Safady Staci H. , Stoppenbach Daniel T.
Published: April 2006

The purpose of this study was to reexamine the Margolis and Heller (1987) normative tympanometric data (also American Speech-Language-Hearing [ASHA], 1990 interim norms) using a strict control over subject age and gender. Normative values for peak, compensated static acoustic admittance (Peak Y
tm
), acoustic equivalent volume (V
ea
), and tympanometric width (TW) were determined for 102 young adults with normal hearing. Relative to the Margolis and Heller normative values, significant differences were found for V
ea
and TW. Although statistically significant, these differences were small and of little clinical importance. However, significant and clinically important gender differences in young adults were observed for each of the tympanometric measures. Compared to males, females had lower Peak Y
tm
values, smaller V
ea
values, and higher TW values.
SP/AP Area Ratio in the Diagnosis of Ménière's Disease
Authors: Ferraro John A. , Tibbils Richard P.
Published: April 2006

Conventional analysis of the click-evoked electrocochleogram includes measurement of the amplitudes of the cochlear summating potential (SP) and auditory nerve action potential (AP) to derive the SP/AP amplitude ratio. It is now well documented that an amplitude ratio where SP is elevated relative to AP may be a positive finding for endolymphatic hydrops in patients suspected of having Meniere's disease (MD). However, the incidence of an elevated SP/AP amplitude ratio in the general MD population is only ≈60%. This relatively low value necessitates efforts to improve the diagnostic sensitivity of electrocochleography (ECochG) for MD. A review of early and more recent literature in this area indicates that consideration of both the amplitude
and
duration of ECochG components may help to achieve this goal. The present study combined these features to measure the "area" of the SPAP complex in normal and MD populations. A software routine was used to measure the amplitude x duration area of the SP-AP complex in (a) normally hearing adults with normal SP/AP amplitude ratios (Group 1), (b) confirmed MD patients with elevated SP/AP amplitude ratios (Group 2), and (c) probable MD patients with normal SP/AP amplitude ratios (Group 3). Ninety percent of the confirmed MD patients in Group 2 displayed elevated SP/AP area ratios relative to the normative value established from Group 1. In addition, almost half of the probable MD patients from Group 3 displayed elevated area ratios. These findings indicate that measurement of the SP/AP area ratio holds promise for improving the sensitivity of ECochG in the diagnosis of MD.
Penetrating Injury to the Brainstem After a Nailgun Accident
Authors: Bauch Christopher D. , Olsen Wayne O. , Lynn Susan G. , Reading Carl C. , Dale Allan J. D.
Published: April 2006

Nonfatal penetrating injuries to the brainstem offer a unique opportunity to assess subcortical auditory pathway function. A case study of a patient suffering a severe nailgun accident is presented. Hearing sensitivity and acoustic reflexes were normal bilaterally, but word recognition was reduced for one ear. Auditory brainstem response results indicated waves I–IV were present bilaterally, but wave V was absent bilaterally. Results of vestibular findings indicated central pathology also. Results of audiologic, vestibular, radiologic, neurologic, and physical medicine examinations are discussed.
Identifying Hearing Loss
Authors: Luterman David , Kurtzer-White Ellen
Published: April 2006

Universal neonatal hearing screening programs are being established across the country at a rapidly accelerating rate, prompted by professional endorsement, legislated mandates, and available technology. The subsequent early identification of hearing impairment in infants will have significant impact on families as well as the audiologists who serve them. However, there have been no studies that surveyed parents of children who are deaf and or have hearing loss as to their opinions about early detection of hearing loss and the process that ensues after its detection. Here, we present the results of a retrospective survey of 75 parents whose children have known hearing loss. Their responses to a five-item questionnaire reflect parents' perspectives and identify key elements of a comprehensive management program: parent contact, unbiased information, sufficient time to process complex information, and counseling from a skilled, empathic audiologist. Implications for counseling issues and professional training are also discussed.
Effect of Speech Processor Program Modifications on Cochlear Implant Recipients’ Threshold and Maximum Acceptable Loudness Levels
Authors: Sun John C. , Skinner Margarate W. , Liu S. Y. , Huang T. S.
Published: April 2006

This study’s purpose was to determine whether or not modifications in speech processor electrical stimulation levels were associated with changes in five Nucleus 22 cochlear implant recipients’ thresholds or maximum acceptable loudness levels (MALs). These modifications in minimum and maximum stimulation levels were made to optimize hearing in everyday life. One threshold and one MAL were obtained on each active electrode during six, weekly test sessions, three before and three after program modification. Only one participant had a significant change in threshold after program modification; this participant and four others had significant changes in MAL. Participants’ threshold variability was the same, but MAL variability was higher than that observed in other studies. Because these participants had no experience making MAL judgments prior to this study, this result suggests that implant recipients should be given sufficient practice in making MAL judgments to provide a stable clinical estimate of the upper boundary of the electrical dynamic range.
Screening for Hearing Loss and Middle-Ear Disorders in Children Using TEOAEs
Authors: Taylor Carmen L. , Brooks Rebecca P.
Published: April 2006

The purpose of this research was to obtain the sensitivity and specificity of transient evoked otoacoustic emission (TEOAE) screening procedures compared with conventional audiometric pure-tone screening and tympanometry.

Pass/refer values were obtained from a group of 297 ears of 152 preschool and school-aged children, 3 to 8 years of age. The sensitivity and specificity of the TEOAE screenings compared with the pure-tone screenings were 81% and 95%, respectively. The sensitivity and specificity of TEOAE screenings compared with tympanometric screenings were 60% and 91%, respectively.
Insert Earphone Depth and the Occlusion Effect
Authors: Dean Margaret S. , Martin Frederick N.
Published: April 2006

Twenty individuals were tested to determine the occlusion effect caused by supraaural earphones and by insert earphones with shallow and deep insertion of its foam eartip. The bone-conduction oscillator was placed both on the forehead and the mastoid. It was concluded that using deeply inserted earphones is the most practical way in which to carry out clinical bone-conduction measurements.
Central Auditory Processes and Test Measures
Authors: Schow Ronald L. , Seikel J. Anthony , Chermak Gail D. , Berent Matthew
Published: April 2006

The theoretical issues surrounding central auditory processing disorders (CAPD) are reviewed here, especially with reference to the central auditory behavioral processes and the auditory test measures as prescribed in the ASHA (1996,
American Journal of Audiology, 5
(2), 41–54) statement on CAPD. A simplified nomenclature is recommended that directly relates process and test measure to facilitate the diagnostic process in CAPD. This new terminology closely follows the ASHA (1996,
American Journal of Audiology, 5
(2), 41–54) document, but provides some refinement based on recent research in CAPD. To support this recommendation, a confirmatory factor analysis (CFA) was applied to the findings of Domitz and Schow (2000,
American Journal of Audiology
who proposed use of a battery of CAPD tests, the Multiple Auditory Processing Assessment (MAPA) for testing school children. The CFA was found to reinforce the four-factor model, which clearly emerged in the exploratory factor analysis of Domitz and Schow. The model was found to be reasonably consistent even when subtests from the SCAN were included in the analysis. Refinement and revision of ASHA (1996,
American Journal of Audiology, 5
(2), 41–54) is recommended to facilitate diagnosis, subclassification, and intervention for CAPD.
Celebrating a Decade of Evaluation and Treatment
Authors: Gold Susan L. , Formby Craig , Gray William C.
Published: April 2006

The University of Maryland Tinnitus & Hyperacusis Center in Baltimore was the first center in the United States dedicated to the evaluation and treatment of tinnitus and hyperacusis patients implementing an habituation-based protocol that has become known internationally as Tinnitus Retraining Therapy (TRT). A crucial feature of the model is the postulate that a number of systems in the brain are involved in the emergence of tinnitus. The cochlea and auditory periphery play only a secondary role. To facilitate the goal of habituation of the tinnitus signal, TRT implements both directive counseling to neutralize the negative emotional associations toward the tinnitus, and sound therapy to interfere with the signal. As an outgrowth of the work with tinnitus, the evaluation and treatment of hyperacusis has emerged as an increasingly important part of our program. This report describes the unique facility, staff, and services of the Center as we celebrate a decade of research and clinical management dedicated to the scientific understanding of tinnitus and hyperacusis.
Personal and Social Conditions Potentially Influencing Women’s Hearing Loss Management
Authors: Garstecki Dean C. , Erler Susan F.
Published: April 2006

Little gender-specific data related to hearing loss and hearing loss management are available. The purpose of this investigation was to examine personal and social conditions affecting women at selected stages of the adult life course that may influence hearing loss management. In all, 191 women in three age groups, ranging from 35 to 85 years old, participated. None reported hearing problems. Participants completed a demographic data form and were given a standard audiometric evaluation to confirm age-normal hearing. Each completed assessments of speech understanding in quiet and noise, auditory signal duration discrimination, and binaural processing. Measures of hearing knowledge, behaviors, and attitudes; health-related locus of control; ego strength; and, social support were administered. Results revealed that although some variables deteriorate among subsequent age groups (i.e., hearing thresholds, central auditory processing, and ego strength), the reverse is true for others (i.e., social interaction and satisfaction with income). Age-specific sociodemographic burdens that may interfere with hearing loss management were noted. New psychosocial data are revealed against which women and men with impaired hearing may be compared.