Theses and Dissertations - Department of Communicative Disorders

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Browsing Theses and Dissertations - Department of Communicative Disorders by Author "Cheimariou, Spyridoula"

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    All purees are not created equal: thickness, adhesiveness, and cohesiveness of commercially available first foods
    (University of Alabama Libraries, 2019) Summerford, Mickalyn Sue; Gosa, Memorie M.; University of Alabama Tuscaloosa
    The purpose of this study was to investigate the thickness, cohesiveness, and adhesiveness of foods typically consumed as feeding skills develop in the first year of life. The subjective feeding difficulty levels 1-4, presented by Gerber and Beech-Nut, were examined with the International Dysphagia Diet Standardization Initiative (IDDSI) drip test, spoon tilt test, and fork pressure test to determine the thickness, cohesiveness, and adhesiveness of the foods offered at each of the four levels. The drip test, which measures overall thickness, was conducted by recording the amount of liquid that drips out of a 10-mL syringe after 10 seconds. The spoon tilt test, which evaluates cohesiveness and adhesiveness, was performed by tilting a sample of purée in a spoon and assessing the state of the sample as it slides off. Lastly, the fork pressure test utilized a standard metal fork to apply pressure to food samples to determine if particles are safe to swallow. The results of this study concluded that thickness, cohesiveness, and adhesiveness are not impacted by brand, marketed stage (levels 1-4), or packaging. However, this study did establish that food packaged in pouches are slightly less adhesive than food packaged in jars. This finding indicates that food in pouches require less oral motor skill to swallow. The results signify that the proposed levels of baby food are not based on a hierarchy of difficulty but are instead for marketing purposes. The results also concluded that the texture of food was not impacted by the use of “natural ingredients.” The difficulty level of each food was determined and mapped to the IDDSI framework to provide guidance on the developmental appropriateness of each “starter food” for use by clinicians treating pediatric patients with dysphagia.
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    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.
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    Discrepancy between defining and intervening with premature feeding and swallowing in the NICU: a survey
    (University of Alabama Libraries, 2019) Barnes, Jennifer Elizabeth; Gosa, Memorie M.; University of Alabama Tuscaloosa
    Feeding during infancy is a complex, multidimensional task that involves dynamic coordination between sucking, swallowing, and breathing (Wolf & Glass, 1992). Infants born prematurely, however, often display delayed swallow and/or immature/uncoordinated suck, swallow and respiration (Amaizu et. al, 2008). Neonatal Intensive Care Unit (NICU) guidelines for discharge typically include the following four physiological competencies: thermoregulation, control of breathing, respiratory stability, feeding skills and weight gain (Jefferies, A.L, 2003). A recent evidenced based systematic review that investigated the variables used to define successful feeding in the literature showed significant variability in the outcome measures used by medical and allied health professionals. This project sought to document the variables used by practicing speech language pathologists and nurses that care for premature infants in the NICU setting to define “successful feeding”, the potential influencers of those definitions, and to determine if a quantifiable difference exists in the variables used to label feeding as successful or unsuccessful between the two disciplines. The results showed that the variability documented in the literature, for identifying successful feeding, is also seen in current clinical practice. Further research to develop a standardized clinical guideline and to determine the efficacy of feeding/swallow interventions is warranted to guide clinicians through this intricate process of decision-making.
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    Impact of common morbidity on attainment of oral feeding skills in a modern cohort of infants born prematurely: a retrospective analysis
    (University of Alabama Libraries, 2018) Schweers, Madeline G.; Gosa, Memorie M.; University of Alabama Tuscaloosa
    Feeding during infancy is a complicated, multidimensional task involving dynamic coordination between sucking, swallowing, and breathing (Wolf & Glass, 1992). The synactive theory of infant development discusses the influence of the autonomic, motor, and state systems on the resulting stability and homeostasis of newborns (Als, 1982). The synactive theory proposes that the core of stability for all developing infants is the autonomic nervous system, especially the respiratory, circulatory, and digestive systems. The motor system supports the development of the state system – levels of arousal that range from deep sleep to a vigorous cry. The ability to attend and to actively process incoming stimuli is supported by the ability to maintain stability in the autonomic and motor systems and remain alert (Ross, 2012). By the synactive theory, feeding can be conceptualized as a developmental skill that emerges when the coordination for sucking/swallowing/breathing is present at approximately 35 weeks post gestational age along with maturation of the state system (Ross, 2012). Previous research has established that many common newborn morbidities, such as those that impact the cardiac and respiratory systems, can delay the post gestational age at which infants born prematurely achieve full oral feeding competency. The purpose of this project is to establish the impact of common newborn morbidities, as measured by the Morbidity Assessment Index for Newborns, on the resulting transition time and post conceptual age at which a modern cohort of preterm infants attain the skills and coordination necessary to support nutritional intake by exclusive oral means.
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    Vowel production variation in college students based on social integration
    (University of Alabama Libraries, 2020) Chapman, Sarah Kristin; Reed, Paul E.; University of Alabama Tuscaloosa
    Exemplar theory represents the encoding of individual experiences as a collection of episodic memories known as exemplars, which form “exemplar clouds” (Drager & Kirtley, 2016). Originally used to model phonetic classification in perception, the exemplar theory has been extended to speech production with evidence that the perception-production loop can cause shifts over time. While exemplars are considered robust and stable categories, Clopper (2014) suggested that shifts can occur when individuals move to an environment in which they are exposed to a high quantity of exemplars from different regional or social distributions. The present study investigated the following research question: Does involvement in highly structured social groups, such as Greek life, influence the variation of vowel productions in young adults? The overarching purpose of the study was to explore how immersion in new social groups leads to exemplar shifts in college students. The data from this study was collected from 30 in-state female students at The University of Alabama (15 Greek, 15 non-Greek) from a semi-structured interview, reading passages, and word list tasks. Results indicated a statistically significant difference in degree of monophthongization of /a͡ɪ/ based on Greek status. Specifically, participants in Greek organizations were significantly more diphthongal in reading passages and word list tasks, and the difference was trending towards significance for conversational tasks and all tasks combined. Thus, these results indicate that involvement in highly integrated groups such as Greek life may impact exemplar shifts in college students. Key words: sociophonetics, exemplars, production shift, social integration, monophthongization