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Objective. To determine what effect, if any, the presence or absence of a nasogastric (NG) tube in the same person had on the incidence of anterograde aspiration. Design. Case series with planned data collection. Setting. Large, urban, tertiary care teaching hospital. Subjects and Methods. Referred sample of 62 consecutively enrolled adult inpatients for fiber-optic endoscopic evaluation of swallowing (FEES). Group 1 (n = 21) had either small-bore (n = 13) or large-bore (n = 8) NG tubes already in place and had a FEES first with the NG tube in place and a second FEES after NG tube removal. Group 2 (n = 41) did not have an NG tube and had a FEES first without an NG tube and a second FEES after placement of a small-bore NG tube. Time between FEES was approximately 5 minutes. Patients were tested with thin liquid and puree food consistencies. Occurrence of aspiration for each consistency dependent on the presence or absence of an NG tube was recorded. Results. There were no significant differences (P > .05) in aspiration status for both liquid and puree consistencies in the same person dependent on presence or absence of either a small-bore or large-bore NG tube. Conclusions. Since objective swallowing evaluation (eg, FEES) can be performed with an NG tube in place, it is not necessary to remove an NG tube to evaluate for aspiration. Similarly, there is no contraindication to leaving an NG tube in place to supplement oral alimentation until nutritional requirements are achieved.

Purpose: This qualitative study explored the practices of hospital-based speech-language pathologists (SLPs) conducting modified barium swallow studies (MBS) for infants at risk for dysphagia. Specifically, this research aimed to determine whether or not SLPs use side-lying position during MBS, to examine possible differences in the use of positioning, and to better understand SLPs' perceptions and experiences in this practice. Using a constructivist view, research questions guiding this inquiry were as follows: What is the current practice of hospital-based pediatric SLPs in regard to the use of side-lying position during infant MBS? What is the experience of the hospital-based SLP in their use of side-lying position during MBS? How do SLPs report perceived barriers or benefits to using side-lying position during MBS? Method: Employing a purposive-convenience sampling technique, data were collected using semistructured interviews of SLPs serving at-risk infants with dysphagia. All participants were practicing in Level-III or -IV neonatal intensive care units. Interviews were recorded, transcribed, loaded into NVivo, and coded using initial and consensus coding. Themes achieved saturation following six interviews. Results: Three themes emerged from the analysis: (a) variations in practice patterns, (b) factors influencing clinical practice, and (c) items that SLPs identified as needs to facilitate change in their clinical practice. Conclusions: Although SLPs acknowledged the importance of MBS replicating an infant's typical feeding, some SLPs who consistently use side-lying position during feeding do not assess feeding in side-lying position during MBS. This inconsistency in practice results from SLPs' perceived barriers, including lack of experience, concern over interdisciplinary conflict, need for MBS protocols, and lack of research on the potential impacts of side-lying positioning on swallowing. Participants reported the need for research to determine whether side-lying position alters, possibly improves, swallow functions and safety (e.g., airway protection) for at-risk infants.

Purpose: To compare the amplitude, latency, morphology, and threshold of the auditory P300 using standard oddball and omitted paradigms. Research Design: P300 waveforms were measured from the Cz electrode site. Frequent stimuli for both paradigms were 1000 Hz tone bursts. Target stimuli for the standard oddball paradigm were 2000 Hz tone bursts and an omitted stimulus, or silent gap, for the omitted paradigm. Study Sample: Fifteen bilaterally normal-hearing young adults. Results: There were significantly lower amplitudes, poorer morphology, and higher thresholds for the P300 using an omitted paradigm compared to the standard oddball paradigm. Conclusion: These results suggest that the auditory P300 could have a larger exogenous component than traditionally thought.

Purpose This longitudinal study investigated the emergence of English tense marking in young (Spanish–English) dual language learners (DLLs) over 4 consecutive academic semesters, addressing the need for longitudinal data on typical acquisition trajectories of English in DLL preschoolers. Method Language sample analysis was conducted on 139 English narrative retells elicited from 39 preschool-age (Spanish–English) DLLs (range = 39–65 months). Growth curve models captured within- and between-individual change in tense-marking accuracy over time. Tense-marking accuracy was indexed by the finite verb morphology composite and by 2 specifically developed adaptations. Individual tense markers were systematically described in terms of overall accuracy and specific error patterns. Results Tense-marking accuracy exhibited significant growth over time for each composite. Initially, irregular past-tense accuracy was higher than regular past-tense accuracy; over time, however, regular past-tense marking outpaced accuracy on irregular verbs. Conclusions These findings suggest that young DLLs can achieve high tense-marking accuracy assuming 2 years of immersive exposure to English. Monitoring the growth in tense-marking accuracy over time and considering productive tense-marking errors as partially correct more precisely captured the emergence of English tense marking in this population with highly variable expressive language skills. Supplemental Materials https://doi.org/10.23641/asha.5176942

Purpose: Generalization has been defined and instantiated in a variety of ways over the last half-century, and this lack of consistency has created challenges for speech-language pathologists to plan for, implement, and measure generalization in aphasia treatment protocols. This tutorial provides an overview of generalization with a focus on how it relates to aphasia intervention, including a synthesis of existing principles of generalization and examples of how these can be embedded in approaches to aphasia treatment in clinical and research settings. Method: Three articles collectively listing 20 principles of generalization formed the foundation for this tutorial. The seminal work of Stokes and Baer (1977) focused attention on generalization in behavioral change following treatment. Two aphasia-specific resources identified principles of generalization in relation to aphasia treatment (Coppens & Patterson, 2018; Thompson, 1989). A selective literature review was conducted to identify evidence-based examples of each of these 20 principles from the extant literature. Results: Five principles of generalization were synthesized from the original list of 20. Each principle was supported by studies drawn from the aphasia treatment literature to exemplify its application. Conclusions: Generalization is an essential aspect of meaningful aphasia intervention. Successful generalization requires the same dedication to strategic planning and outcome measurement as the direct training aspect of intervention. Although not all people with aphasia are likely to benefit equally from each of the principles reviewed herein, our synthesis provides information to consider for maximizing generalization of aphasia treatment outcomes. Supplemental Material: https://doi.org/10.23641/asha.24714399

Assessments of oral reading are widely used for screening, progress monitoring, and comprehensive evaluations. Despite the utility and technical adequacy of these tools, there are subgroups of students for whom measures of oral reading may be inappropriate. The first section of this article focuses on how tests of oral reading may underestimate word reading ability and reading fluency among four subgroups of students with speech, language, or learning difficulties. These include school-age students who demonstrate word-finding difficulties (which are common among students with a learning disability or developmental language disorder), developmental stuttering, childhood apraxia of speech, and pediatric dysarthria. The second section offers practical recommendations for more accurate assessment procedures, correct placement decisions, relevant professional learning activities, and strategic interdisciplinary teaming. © Hammill Institute on Disabilities 2023.

Greater informational masking is observed when the target and masker speech are more perceptually similar. Fundamental frequency (f0) contour, or the dynamic movement of f0, is thought to provide cues for segregating target speech presented in a speech masker. Most of the data demonstrating this effect have been collected using digitally modified stimuli. Less work has been done exploring the role of f0 contour for speech-in-speech recognition when all of the stimuli have been produced naturally. The goal of this project was to explore the importance of target and masker f0 contour similarity by manipulating the speaking style of talkers producing the target and masker speech streams. Sentence recognition thresholds were evaluated for target and masker speech that was produced with either flat, normal, or exaggerated speaking styles; performance was also measured in speech spectrum shaped noise and for conditions in which the stimuli were processed through an ideal-binary mask. Results confirmed that similarities in f0 contour depth elevated speech-in-speech recognition thresholds; however, when the target and masker had similar contour depths, targets with normal f0 contours were more resistant to masking than targets with flat or exaggerated contours. Differences in energetic masking across stimuli cannot account for these results.