Theses and Dissertations - Department of Communicative Disorders

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Attitudes of stuttering within the social networks of people who stutter
(University of Alabama Libraries, 2019) Hawkins, Haley; Buhr, Anthony P.; University of Alabama Tuscaloosa
This study examined attitudes about stuttering in the social networks of people who stutter. This study included seven people who stutter (PWS) as well as 21 other participants across the social networks of the PWS. The PWS were asked to identify up to five individuals they consider to be close to, constituting the inner “circle” of their social network. These individuals were asked to identify two acquaintances and two strangers of the PWS to also participate in the study, constituting the outer circles of the social network. However, low participation rate made it possible to examine only the inner circle. A series of surveys were administered to the PWS and all recruited participants to assess how attitudes toward stuttering change as a function of the “distance” from the PWS, and to evaluate the prevalence of negative attitudes (i.e., stigma) about stuttering in the network. Results showed that perceived stigma was similar between PWS and those in their social networks. In addition, PWS rated their overall experiences of stuttering and the level of debilitation as less negative than their social networks. The perceived closeness of the individuals did not appear to have a major impact on the attitudes about stuttering. One limitation of the study is that stigma of stuttering proved to be an obstacle to studying the stigma itself. This suggests a need for more communication about stuttering within the networks of PWS.
Bama perks: the use of simulated context as treatment for adults with aphasia
(University of Alabama Libraries, 2017) Tucker, Marie Louise; Barber, Angela B.; University of Alabama Tuscaloosa
There is a growing interest in examining the efficacy of aphasia treatment programs that examine meaningful real-life outcomes rather than therapeutic outcomes within structured intervention settings (Chapey et al., 2008). This study measured language abilities, social networks, and quality of life for nine patients with aphasia over a ten-week span during a simulated coffee shop social communication intervention called Bama Perks. Using an evaluative approach, strengths and weaknesses were examined and results supported the feasibility of Bama Perks as a supplement to traditional therapy. Clinician and caregiver measures indicated client improvement in language skills and social communication skills, a growth in social networks, and a reduction in burden of diagnosis. Daily rating scales taken during each Bama Perks session revealed variability with marginal growth across measures of communication function, flexibility, and overall communication production. These findings contribute to growing evidence supporting socially simulated environments as therapeutic contexts for individuals with aphasia.
Common practices of speech-language pathologists in bilingual assessment and intervention
(University of Alabama Libraries, 2013) Aguilar, Carla Janette; Saffo, Rachel W.; University of Alabama Tuscaloosa
Research in the literature shows that the percentage of individuals who are multicultural and multilingual is steadily increasing in the United States (Shin & Kominski, 2010). This rise has led to the increase of children who are bilingual on the caseloads of speech-language pathologists (SLPs) in the United States (Caesar & Kohler, 2007; Kritikos, 2003). Research is beginning to delineate evidence-based practice (EBP) in assessment and intervention for bilingual children. However, recent survey studies have shown that most SLPs in the United States are not providing this type of evidence-based service to children who are bilingual (Caesar & Kohler, 2007; Kritikos, 2003). The current survey study sought to identify variables that influence SLPs' use of evidence-based practice and their confidence in culture and assessment, as well as the influence of treatment methods on reported therapy gains. The researcher created an online survey and distributed it to SLPs across the United States (n=435). Regression analysis revealed that years of experience inversely predicted use of some methods of EBP, and language skill and number of bilingual SLPs in the facility positively predicted the use of other methods. Experiential demographics influenced confidence in culture and assessment more than didactic factors, and confidence in treatment and assessment positively predicted therapy gains.
Differences in dietary intake, sensory processing, anthropometric measures, mealtime behaviors, and parental stress of children with ASD and other neurodevelopmental impairments
(University of Alabama Libraries, 2017) Henderson, Elizabeth Dianne; Gosa, Memorie M.; University of Alabama Tuscaloosa
Feeding difficulty is a frequently reported feature of neurodevelopmental delays and disorders that affect children, including Autism Spectrum Disorder (ASD). According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the diagnosis of ASD can include deficits in social interaction, restrictive and repetitive behaviors, rigid routines, fixated interests, and hypo- or hyperreactivity to sensory input. All of these factors can affect mealtime behaviors. Parents of children with a diagnosis of ASD frequently report problem behaviors at mealtime and decreased dietary variety. However, the extent to which specific characteristics of feeding difficulty are unique to children with ASD has not been determined. This study examined whether reported problem mealtime behaviors and decreased dietary variety are symptoms exclusive to children diagnosed with ASD or whether similar behaviors and patterns of dietary intake are present in other neurodevelopmentally delayed or impaired populations. The data for this project was collected through a variety of assessment measures that examined dietary patterns, problem mealtime behaviors, sensory processing, growth, and parental stress in children referred for evaluation by the University of Alabama’s ASD Clinic. The purpose of this study was to compare dietary intake, patterns of sensory processing, measures of growth, mealtime behaviors, and levels of parental stress among children with ASD to children with other neurodevelopmental diagnoses (speech-language delay, attention deficit disorder, or not otherwise specified). In this study, we found that children diagnosed with ASD did not exhibit significant differences in terms of dietary intake, patterns of sensory processing, measures of growth, mealtime behaviors, and levels of parental stress when compared to age-matched peers with other neurodevelopmental delays or disorders.
The effects of focused stimulation, vertical structuring, and expansions on verbal language in young minimally-verbal children with Autism Spectrum Disorder
(University of Alabama Libraries, 2015) Chiarelli, Chelsea Renee; Barber, Angela B.; University of Alabama Tuscaloosa
Speech pathologists are often the first line of referral for young children at risk for an ASD. Often, SLPs, especially those who work in state-funded Early Intervention Programs (Part C-Early Intervention, IDEA, 2004), do not have access to training on autism-specific early intervention models (Stahmer, Collings, & Palinkas, 2005). In addition, children who are receiving Early Intervention in community settings often do not have available options for autism-specific interventions, which are offered in many university settings. As a result, the facilitation strategies of focused stimulation, vertical structuring, and expansions are often being implemented in therapy with these children. To our knowledge, no study has measured the effects of these commonly used language strategies on the verbal language in minimally verbal children with ASD. The purpose of this study was to measure the effects of focused stimulation, vertical structuring, and expansions on the acquisition of verbal language in minimally verbal children with ASD. Three toddlers diagnosed with autism were recruited for this study. Intervention took place twice a week for 20-minute sessions, followed by two-generalization probes 4 weeks post intervention. Two out of our three participants demonstrated gains in their verbal language inside of the intervention environment. Results of this study conclude that these intervention strategies are capable of being implemented in community-based intervention settings with successful outcomes.
Efficacy of Auditory-Verbal Therapy (AVT) over Total Communication (TC) for language outcomes in children with cochlear implants: a systematic review
(University of Alabama Libraries, 2017) Shoffner, Amber; Hay-McCutcheon, Marcia; University of Alabama Tuscaloosa
Children with cochlear implants require intervention for both receptive and expressive language. Auditory-Verbal Therapy (AVT), which primarily focuses on the development of language through the auditory channel, and Total Communication (TC), which allows for the combination of sign, lipreading, and auditory stimuli for language development, are two intervention methods often used for children with CIs. This systematic review presents language outcomes in children using AVT and TC intervention approaches. We hypothesized that the use of AVT would result in better expressive language outcomes compared to the use of TC. We also hypothesized that both intervention approaches would result in equivalent receptive language outcomes. We found that children who received AVT had a higher percentage of favorable outcomes for both receptive and expressive language outcomes compared to children who used TC. Other additional factors were found to be significant for language outcomes such as age at implantation, communication mode, parent/family involvement, age at diagnosis, device differences, additional disabilities, socioeconomic status, and gender. Overall, we found a lack of research literature directly comparing AVT and TC. A large-scale systematic study of the interventions is still needed in order for professionals and families to make firm conclusions on the efficacy of these treatments for children with cochlear implants.
Exploration of gender influences in restricted and repetitive behaviors in children with autism spectrum disorder
(University of Alabama Libraries, 2018) Evans, Madeleine G.; Barber, Angela B.; University of Alabama Tuscaloosa
More boys than girls have ASD at a ratio of 4:1 (Baio et al., 2018). In general, boys tend to demonstrate more ritualistic and repetitive behaviors (RRBs) than girls (Szatmari et al., 2012) though a gender bias may lead to under diagnosis of girls. Therefore, a female phenotype should be differentiated to improve diagnostic accuracy. This study seeks to describe and compare RRB profiles and frequencies in two age cohorts of girls and boys with ASD as measured by the Repetitive Behavior Scale-Revised (RBS-R) and the Childhood Routines Inventory (CRI). 214 children with ASD (42 girls; 172 boys) between 16 months and 10 years old (mean = 46.1 months) were included from an ASD clinical research database Two age cohorts were used (1-3 years; 4-10 years) to compare RRBs using parent reports. Girls younger than 3 had more repetitive (t = -1.66; p = .03), ritualistic (t = -.12; p = .004), and sameness behaviors (t = -1.9; p = .002). Older girls had more stereotyped behaviors than boys (t = -2.2; p = .001) and more ritualistic behaviors in general. Younger girls (n = 23) had more stereotyped (62.7%), restricted interests (58%), sameness (41%), compulsive (46%), ritualistic (36%), and self-injurious behavior (27%). Boys displayed RRBs and stereotypical behaviors. Girls demonstrate more repetitive behaviors than boys. RRB patterns and profiles will be discussed comparatively. These findings contribute the understanding of the female ASD phenotype.
An investigation into stuttering development: a longitudinal approach
(University of Alabama Libraries, 2017) Treleaven, Shanley Belle; Buhr, Anthony P.; University of Alabama Tuscaloosa
The purpose of this study is to examine the relation between daily emotions and stuttering. A longitudinal design was used to evaluate changes in the relation between emotions and stuttering over the fall and spring semesters of the 2015-2016 school year. The study participant consisted of child who was three years old when enrolled in the study. The child’s caregiver provided daily information regarding the four greatest emotional events and associated emotional arousal and speech disfluency. Conversational samples of speech were collected on weekly visits to the clinic, which were transcribed and coded for speech disfluencies. It was hypothesized that emotional arousal would be related to the child’s stuttering. It was also hypothesized that routine would impact longitudinal change in emotional arousal and associated stuttering. Results showed that intensity of emotional arousal was predictive of parent-observed stuttering when emotion was negative. However, stuttering did not significantly change over the duration of the study, and change in routine was not related to longitudinal change in emotion and stuttering.
Is dosage important?: parent and child outcomes with project impact therapy
(University of Alabama Libraries, 2015) Noble, Hylan; Barber, Angela B.; University of Alabama Tuscaloosa
The primary purpose of this study was to compare both pre- and post- language and social communication outcomes between two different groups, receiving various dosages of ImPACT (Improving Parents as Communicative Partners) therapy. A secondary objective was to investigate the feasibility of parent adherence to the ImPACT strategies and levels of self-perceived parent competency in implementing the treatment. Parent-mediated therapy has been shown to be a successful form of facilitating social skills and language in children with ASD (Ingersoll, 2012). Specifically, Project ImPACT implemented as an “off the shelf” model has resulted in increased social-engagement and communication as well as decreased parental stress (Ingersoll and Wainer, 2015). Results demonstrated clinically significant gains in social-communication across both groups, particularly in children receiving a higher dose of treatment. Parents also demonstrated increased parental satisfaction. Overall, the study highlights (1) the feasibility of implementing an “off the shelf” approach of the manualized Project ImPACT intervention in a clinic setting, without prior formal training, (2) emphasizes the importance of implementing parent-mediated interventions for the purposes of increasing overall functional communication in children with an ASD.
Peer mediated intervention to improve social communication in young children with ASD
(University of Alabama Libraries, 2013) Craft, Lydia Dyer; Barber, Angela B.; University of Alabama Tuscaloosa
To date, no study has measured the effects of peer-mediated intervention (PMI) on autism symptoms in children under than four years of age. The current study examines the efficacy of the Stay, Play, Talk PMI (English, K., Shafer, K., Goldstein, H., & Kaczmerek, L., 1997) on the social communication skills of young children diagnosed with autism. The investigator paired three typically developing children (ages 3-5 years) each with a young child with autism (ages 3-4 years). These dyads played together during two to three, 20-minute weekly sessions for 6-8 weeks. A multiple baseline design across participants was implemented to measure the effectiveness of PMI on young children with autism's social initiations and responses characterized by non-coordinated gestures, gestures, and words. The investigator coded the frequency of each child's social initiations and responses to topics/conversations for each 20-minute play sessions. All three children with autism demonstrated increased social responses, though initiations remained variable. Typical peer buddies demonstrated increases in social initiations and responses. Results of this study support the usefulness of this intervention to improve social communication of young children with autism and contribute to limited knowledge of effective early social communication interventions for young children with autism.
The perception of emotion through static and dynamic facial expression in children with Autism Spectrum Disorder
(University of Alabama Libraries, 2017) Queen, Melanie Wilkie; Barber, Angela B.; University of Alabama Tuscaloosa
The current project examined the ability of children with Autism Spectrum Disorder (ASD) to perceive and judge emotional information conveyed in facial expression when compared to typically developing peers. The purpose of this study was to (a) compare how children with ASD and children with typical development (TD) differ in their ability to perceive and judge the emotional information conveyed by happy, sad, angry, and scared static facial expression; (b) compare how static decoding abilities relate to decoding abilities of integrated dynamic facial expressions, prosody, and verbal content; (c) measure the ability of children with ASD and children with TD to perceive and judge emotional information based on the perceptual features of the speaker (cartoon vs. human); and (d) examine the role of timing in the perception and judgment of emotional information in children with ASD and children with TD.
The relationship between representational, beat, and cohesive gestures and speech disfluency in the 2012 presidential debate
(University of Alabama Libraries, 2017) Puzinauskas, Katerina Joanna; Buhr, Anthony P.; University of Alabama Tuscaloosa
Hand gestures are yoked to speech in a highly-correlated system, often referred to as co-speech (Hostetter, 2011). Both disfluency and gesture have been show to influence audience reaction during political debates (e.g., Pennebaker, Mehl, & Niederhoffer, 2003). This study examined the relation between speech disfluency and hand gesture in the First 2012 Presidential Debate between President Barack Obama and Governor Mitt Romney. Specifically, the frequency and type of speech disfluencies and gesticulations generated by candidates were identified, annotated, and compared. Speech and gesture variables were examined across multiple speech domains, including utterance and speaking turn. Results showed a correlation between the level of speech disfluency and the type of gesture within a set speaking turn for both speakers. Overall, findings suggest 1) associations between speech disfluencies and the five taxonomies of gestures (iconic, metaphoric, deictic, cohesive, and beat, and 2) relationships between variables and audience-reported outcomes for debate success.
Relationship of articulation and feeding skills in children: a pilot study
(University of Alabama Libraries, 2018) Dent, Lacey; Gosa, Memorie M.; University of Alabama Tuscaloosa
Feeding development begins during the embryologic and fetal periods with maturation of the head, face, and neck, the emergence of early oral motor reflexes, and continues well into early childhood. Children learn to eat in a predictable sequence. They transition from nutritional intake of a single consistency (liquid) to complex, multi-textured foods in just two short years. Children continue to refine their feeding skills through elementary age. Simultaneous to feeding development during childhood is speech and language development. One component of speech and language development is articulation. Articulation refers to the establishment of clear and distinct sounds in speech. Speech sounds are developing from birth and should be fully developed by age eight all the while, gaining clarity with repetition and feedback. Articulation and feeding both require intact orofacial structure and adequate oral motor function. Although the relationship between these two developmental processes is implied because of their shared developmental periods and anatomical structures, it has not been fully explored in the literature. This study investigated the relationship between feeding and articulation in children with known articulation deficits. A total of ten participants were recruited from the University of Alabama Speech and Hearing Center (UA SHC), but only three were included after exclusion. Participants demonstrated overlapping sound errors that corresponded to overlapping feeding skill error. For clinical purposes, the implication of an articulation and/or feeding screener would be beneficial in the evaluation process of either disorder to aid in the success of the child’s therapy.
The relationship of developmental functioning to symptom presentation in young children with ASD
(University of Alabama Libraries, 2010) Pouncey, Melissa VanKirk; Barber, Angela B.; University of Alabama Tuscaloosa
The present study examined the differences between young children with Autism Spectrum Disorders (ASD) and typical development (TD) on developmental skills and core symptoms of ASD. Further, the relationship between core symptoms of ASD and developmental functioning level were assessed. Specific symptoms, joint attention, symbolic play, gestures, and RSB, as well as general symptom categories were assessed in children with ASD (n=10) and children with typical developmental (n=10) who were matched on mental age and gender. Method: Measures of social communication, speech, symbolic play, gestures, and joint attention were obtained through the Communication and Symbolic Behavior Scales (CSBS: Wetherby and Prizant, 2002). Developmental level was measured using the Mullen Scales of Early Learning (MSEL: Mullen, 1992). Results: Children with ASD demonstrated decreased abilities in symbolic play and understanding, social communication, joint attention, and gestures compared to children with TD. Children with ASD also demonstrated more RSB with body and objects. Strong correlations among social, symbolic, speech, and gestural were observed. Speech and symbolic skills, as well as social and gestural skills were the only relationships to remain highly correlated even when developmental level was controlled. Conclusions: These findings highlight the diagnostic significance of developmental level to core symptoms of ASD. Research aims and the impact of these findings on the development of specific therapy goals are also discussed.
Social influences on autonomic arousal in autism spectrum disorders
(University of Alabama Libraries, 2014) Turner, Carolyn Kate; Buhr, Anthony P.; University of Alabama Tuscaloosa
The purpose of this study was to gain new understanding of autonomic nervous system (ANS) dysfunction in familiar and unfamiliar social situations in children with autism spectrum disorder (ASD). Both Children with ASD and typically developing peers viewed three sets of stimuli on a computer screen: 1) a screensaver (initial and final baseline), 2) objects moving to music (attention), and 3) narratives produced by both a caregiver and a stranger (familiar and unfamiliar social situations). Physiological measures of heart rate and skin conductance were acquired to assess ANS functioning. It was expected that 1) ANS activity would differ between children with ASD and typically developing peers at baseline, 2) differences in ANS activity between the two groups would be greater in the attention vs. the baseline task, and 3) differences in ANS activity between the two groups would be greater in the unfamiliar vs. the familiar tasks. Results showed that sympathetic, but not parasympathetic, arousal was greater for children with ASD as compared to typically developing children, but these measures did not differ across tasks. Results are interpreted to suggest that children with ASD perceived the experimental conditions as more challenging as compared to children who are typically developing.

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Browsing Theses and Dissertations - Department of Communicative Disorders by Author "Barber, Angela B."

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