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This study evaluated the effectiveness of an embedded naturalistic intervention for teaching augmentative and alternative communication (AAC) application responses to three preschool-aged males with autism spectrum disorder (ASD). Parents were taught to embed opportunities for their child to communicate with a grid-based AAC application during every-day routines such as play or mealtime. Communication targets included requesting objects using two-step taxonomic navigational responses, and requesting assistance, rejecting items, or making social comments/responses using a two-step message-strip response. During intervention, parents used strategies such as time delay, prompting, reinforcement, and device proximity (faded over time) to encourage target responses. Display formats and intervention targets were selected in consideration of prior dynamic assessment results. Effects of intervention were evaluated using a multiple probe across participants design. For functional navigational AAC item requesting, all three participants showed an immediate increase in responding that maintained at high levels. Functional AAC responding for other communicative purposes also increased, but at a more gradual pace. All three participants showed generalized responding when new items were added to displays, and when display pages with a larger array of folders and vocabulary items were introduced. Generalization to labeling tasks was mixed. © 2021 International Society for Augmentative and Alternative Communication.

In this study, researchers implemented a brief training plus coaching program in naturalistic developmental behavioral intervention with three participant triads. Each triad consisted of an early intervention provider, an English-speaking Latinx parent, and that parent’s young child with autism spectrum disorder (ASD) or early signs of ASD who had limited vocal speech. The effects a single training session, plus two researcher coaching sessions were evaluated using a nonconcurrent multiple probes across participants design. Primary dependent variables included (a) the number of completed targeted communication turns between the parent and child and (b) the number of child independent target communication responses (gestures and manual signs) during family-selected routines. Additional measures examined whether parents used strategies taught to them during training, and whether early intervention providers addressed strategies taught via coaching. A social validity measure was used to determine parent and provider views of the training. Due to COVID-19 restrictions, training and post-training sessions were delivered via telehealth for two triads. While data trends and variability differed across triads, following training, all three families increased the number of completed target communication turns and all three children showed higher rates of independent communication responses. Parents and providers implemented strategies taught and reported positive effects of the program. Implications regarding the use of naturalistic intervention methods for Latinx families, the utility of brief training models to meet the needs of under-resourced early intervention programs, and potential uses of telehealth are discussed. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

This study was designed to evaluate maximum length sequences-auditory brainstem responses (MLS-ABR) in children with auditory processing disorders and to compare these results with a normal control group matched for age, intelligence, and gender. Although each waveform was analyzed for the presence of waves I, III, and V, the primary focus was wave V. Although absolute latency measures for wave V were obtained from all subjects, waves I and III were not always identified. Although the results showed latency increases for all waveforms in both groups, the only significant difference noted was an increase in wave V latency for both the left and right ears in the clinical group. These results suggest that the MLS-ABR may be useful in the assessment of auditory processing disorders. Implications for the potential use of the MLS-ABR in management programs are discussed.

Objective: The goal of the study was to evaluate the effectiveness of tympanometry and wideband reflectance (WBR) in detecting conductive hearing loss (CHL) in young infants., Methods: Type of hearing loss was determined using auditory brainstem response using air- and bone-conducted tone bursts in 84 ears from 70 infants (median age = 10 weeks). Of these 84 ears, 60 are included in the current analysis: 43 with normal hearing (NH) and 17 with CHL. Tympanometry was measured using probe tone frequencies of 226, 678, and 1000 Hz. Tympanograms were evaluated in two ways: (1) Acoustic middle ear admittance (Ya, in millimhos); and (2) two-category classification (normal/abnormal), as described by Baldwin (2006). Measures of Ya were evaluated in two ways: by admittance-magnitude tympanograms and calculated admittance magnitude from subcomponents (conductance and susceptance). WBR was measured in response to a chirp stimulus after probe calibration. WBR was analyzed into thirteen 1/3 octave bands. Tests for statistical differences for two-category classification were analyzed using Chi-squared and Ya, and WBR were analyzed using repeated-measures analyses of variances. Cohen's d and likelihood ratios were computed for comparison with statistically significant differences., Results: Ya measured with 678- and 1000 Hz probe tones was significantly different between ears with CHL and NH. Two-category classification of tympanograms using a 1000 Hz probe tone was significantly different between ears with CHL and NH. Neither two-category classification nor Ya was significantly different between ears identified with CHL and NH using a 226 Hz probe tone. WBR was significantly higher in the frequency bands 800 to 2500 Hz and in the frequency band centered at 6300 Hz in infants with CHL. Effect sizes (Cohen's d) were greater than 2 for several WBR frequency bands and Ya measured with 1000 Hz probe tones. The results were similar for calculations of Ya from admittance-magnitude and subcomponent tympanograms. Positive likelihood ratios for WBR ranged between 8.1 and 38, and those for Ya using 1000 Hz ranged between 12.5 and 32., Conclusions: CHL in young infants can be detected well with WBR or tympanometry using probe frequencies of 678 and 1000 Hz., (C) 2013 by Lippincott Williams & Wilkins

Research on receptive language development in typical children, especially as explicated in a classic paper by Robin Chapman, is reviewed. These findings raise three challenges for clinicians assessing comprehension in children with language disorders: (1) contrary to popular wisdom, comprehension does not always precede production in a simple step-by-step way; (2) comprehension is a private event; indicators of comprehension must be used to assess it, and these indicators can be misleading; and (3) children with subtle comprehension deficits may do well on standardized tests that are not sensitive to their difficulties with real-time discourse. Some strategies for addressing these challenges, as well as a framework for assessing comprehension, are offered.

Due to the errors occurred in the originally published version, this article is being reprinted in its entirety as Correction. All errors have been corrected. It is the correct version. © 2021, Springer Science+Business Media, LLC, part of Springer Nature.

This article reports on a collaborative research project involving faculty in writing studies, communication disorders, and applied linguistics that sought to empirically describe the reading skills of students (N = 910) in freshman composition classes at one college and two universities in the northeast United States. The research team developed and administered a questionnaire that evaluated students’ reading abilities according to six categories: inferential ability, background knowledge, general comprehension, vocabulary, figurative language/jargon, and morphosyntactic structures (grammar/syntax). Our statistically significant results showed that students scored best in the categories of background knowledge and general comprehension, which are well researched in a college population. However, students struggled in categories such as figurative language/jargon and morpho-syntactic structures, which are not well researched in a college population. Further, comprehension seemed generally discrete (understanding specific points of an essay) rather than holistic (indicated by an ability synthesize those points into a general statement about the author’s thesis). These findings suggest that further empirical research in this area will help describe the reading skills of college students and consequently will inform the development of pedagogical approaches that more effectively address students’ current needs. © 2021 College Reading and Learning Association.

Objectives: To determine whether a modifiable risk factor, endotracheal tube size, is associated with the diagnosis of postextubation aspiration in survivors of acute respiratory failure. Design: Prospective cohort study. Setting: ICUs at four academic tertiary care medical centers. Patients: Two hundred ten patients who were at least 18 years old, admitted to an ICU, and mechanically ventilated with an endotracheal tube for longer than 48 hours were enrolled. Interventions: Within 72 hours of extubation, all patients received a flexible endoscopic evaluation of swallowing examination that entailed administration of ice, thin liquid, thick liquid, puree, and cracker boluses. Patient demographics, treatment variables, and hospital outcomes were abstracted from the patient's medical records. Endotracheal tube size was independently selected by the patient's treating physicians. Measurements and Main Results: For each flexible endoscopic evaluation of swallowing examination, laryngeal pathology was evaluated, and for each bolus, a Penetration Aspiration Scale score was assigned. Aspiration (Penetration Aspiration Scale score ≥ 6) was further categorized into nonsilent aspiration (Penetration Aspiration Scale score = 6 or 7) and silent aspiration (Penetration Aspiration Scale score = 8). One third of patients (n = 68) aspirated (Penetration Aspiration Scale score ≥ 6) on at least one bolus, 13.6% (n = 29) exhibited silent aspiration, and 23.8% (n = 50) exhibited nonsilent aspiration. In a multivariable analysis, endotracheal tube size (≤ 7.5 vs ≥ 8.0) was significantly associated with patients exhibiting any aspiration (Penetration Aspiration Scale score ≥ 6) (p = 0.016; odds ratio = 2.17; 95% CI 1.14-4.13) and with risk of developing laryngeal granulation tissue (p = 0.02). Conclusions: Larger endotracheal tube size was associated with increased risk of aspiration and laryngeal granulation tissue. Using smaller endotracheal tubes may reduce the risk of postextubation aspiration. © 2020 International Anesthesia Research Society.

Background: The bedside swallowing evaluation (BSE) is an assessment of swallowing function and airway safety during swallowing. After extubation, the BSE often is used to identify the risk of aspiration in acute respiratory failure (ARF) survivors. Research Question: We conducted a multicenter prospective study of ARF survivors to determine the accuracy of the BSE and to develop a decision tree algorithm to identify aspiration risk. Study Design and Methods: Patients extubated after ≥ 48 hours of mechanical ventilation were eligible. Study procedures included the BSE followed by a gold standard evaluation, the flexible endoscopic evaluation of swallowing (FEES). Results: Overall, 213 patients were included in the final analysis. Median time from extubation to BSE was 25 hours (interquartile range, 21-45 hours). The FEES was completed 1 hour after the BSE (interquartile range, 0.5-2 hours). A total of 33% (70/213; 95% CI, 26.6%-39.2%) of patients aspirated on at least one FEES bolus consistency test. Thin liquids were the most commonly aspirated consistency: 27% (54/197; 95% CI, 21%-34%). The BSE detected any aspiration with an accuracy of 52% (95% CI, 45%-58%), a sensitivity of 83% (95% CI, 74%-92%), and negative predictive value (NPV) of 81% (95% CI, 72%-91%). Using recursive partitioning analyses, a five-variable BSE-based decision tree algorithm was developed that improved the detection of aspiration with an accuracy of 81% (95% CI, 75%-87%), sensitivity of 95% (95% CI, 90%-98%), and NPV of 97% (95% CI, 95%-99%). Interpretation: The BSE demonstrates variable accuracy to identify patients at high risk for aspiration. Our decision tree algorithm may enhance the BSE and may be used to identify patients at high risk for aspiration, yet requires further validation. Trial Registry: ClinicalTrials.gov; No.: NCT02363686; URL: www.clinicaltrials.gov; © 2020 American College of Chest Physicians

Speech-language pathology and special education graduate student teams participated in an intensive summer practicum for social communication skills with children with autism spectrum disorders, utilizing a transdisciplinary approach that aligned to the frameworks utilized for implementation science. Questionnaires measuring transdisciplinary approach knowledge and comfort level were administered pre/post-practicum. Results of the questionnaires, written daily team reflections, course evaluations, and a focus group interview indicated an increase in all measures, including an increased knowledge of TA, increased understanding and comfort level with the other discipline, and a higher level of confidence and openness in working collaboratively utilizing a transdisciplinary approach. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.

The mechanisms responsible for aspiration are relatively unknown in patients recovering from acute respiratory failure (ARF) who required mechanical ventilation. Though many conditions may contribute to swallowing dysfunction, alterations in laryngeal structure and swallowing function likely play a role in the development of aspiration. At four university-based tertiary medical centers, we conducted a prospective cohort study of ARF patients who required intensive care and mechanical ventilation for at least 48 h. Within 72 h after extubation, a Fiberoptic Flexible Endoscopic Evaluation of Swallowing (FEES) examination was performed. Univariate and multivariable analyses examined the relationship between laryngeal structure and swallowing function abnormalities. Aspiration was the primary outcome, defined as a Penetration- Aspiration Scale (PAS) score of 6 or greater. Two other salient signs of dysphagia—spillage and residue—were secondary outcomes. A total of 213 patients were included in the final analysis. Aspiration was detected in 70 patients (33%) on at least one bolus. The most commonly aspirated consistency was thin liquids (27%). In univariate analyses, several abnormalities in laryngeal anatomy and structural movement were significantly associated with aspiration, spillage, and residue. In a multivariable analysis, the only variables that remained significant with aspiration were pharyngeal weakness (Odds ratio = 2.57, 95%CI = 1.16–5.84, p = 0.019) and upper airway edema (Odds ratio = 3.24, 95%CI = 1.44–7.66, p = 0.004). These results demonstrated that dysphagia in ARF survivors is multifactorial and characterized by both anatomic and physiologic abnormalities. These findings may have important implications for the development of novel interventions to treat dysphagia in ARF survivors. Clinical Trials Registration ClinicalTrials.gov Identifier: NCT02363686, Aspiration in Acute Respiratory FailureSurvivors. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.

The localization ability of 10 normally hearing adults was determined under varying microphone separations and varying sound source azimuths. The stimuli (white noise bursts) were prerecorded, after being transduced through 'body' hearing aids and then played to the subjects over headphones. Results indicated that there was an improvement in localization ability for all azimuth conditions when the microphones were spaced wider than 12.7 cm apart (15.2-30.5 cm). The smaller the separations (5.5-12.7 cm), the poorer the localization. Localization was always poorer at 30° azimuth (the smallest used) than at any of the other azimuths (0° 30° 60° 90° right and left), regardless of microphone spacing. Implications are made about the relation of these findings to the use of binaural body aids on infants and young children. © 1977 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

This study tested and confirmed the clinical impressions that (a) the novice psychotherapist may focus so much upon the exact words and nonverbal behavior patterns of his client (the process of making “concrete” statements) that he may lose sight of the larger picture that his client may be revealing at any given moment during the interview; (b) the experienced psychotherapist, on the other hand, seems to be responding to the words of the patient at a level of abstraction that attempts to integrate and understand the messages that the patient is trying to convey about himself; and (c) this latter process is reflected in the making of relatively more “abstract” comments than is true of the novice. S s were 24 first-year psychiatric residents and 19 staff psychologists and psychiatrists at a veterans hospital and a medical school. The learning theory implications of these findings is discussed. © 1976 Taylor & Francis Group, LLC.

A 58-item Likert attitude scale was developed and administered to thirty Speech-Language Pathology graduate students in order to obtain their perceptions of a self-evaluation procedure used in a clinical training facility. Significant correlations were obtained between the clinicians’ perception of the overall usefulness of this self-evaluation procedure, and a majority (61%) of the items on the scale. Significant correlations were obtained for several pairs of demographic items. The implications of these results for the clinical supervision process are discussed, as well as the need for further research on this topic. © 1988 by The Haworth Press, Inc. All rights reserved.

A knowledge of normal articulation is needed before the prosthodontist can assess the compensatory articulation used by glossectomy patients. The amount and portion of tongue resected is directly correlated with speech intelligibility. The loss of the tip of the tongue is more critical to intelligibility than a hemiglossectomy. Partial glossectomy speakers can often use the residual tongue stump to perform adaptive movements that approximate normal movements and should be treated as an articulation problem. The compensatory articulation used by the total glossectomy patient was reviewed. The prosthodontic management of patients with partial tongue resection often includes lowering the palatal vault, while the management of the total glossectomy patient usually requires a mandibular tongue prosthesis. These prostheses can be refined with the use of multiview videofluoroscopy, videotaping, and spectrographic analysis. © 1985.

In order to avoid obtaining variable measurement data it is critical to control pressure applied to the tongue by positioning clamps used in lingual vibrotactile research. A pressure sensing plate, associated electronics, and procedures are described which, when employed with positioning clamps in current use, will permit monitoring lingual pressure during vibrotactile investigations.

Normative data for children who are speakers of Black American English (BAE) were obtained on the Test of Language Development (Newcomer & Hammill, 1977). In two urban sites 198 children (age 4–8 yrs.) were tested. Positive identification as a speaker of BAE was based on a two part screening test which contained 10 distinct features of BAE. Results of the investigation revealed that children who are predominantly speakers of BAE differed significantly in their performance from children on whom the test was standardized. The study demonstrated the inappropriateness of using a test of Standard American English (SAE) as a test of language development for children whose primary language exposure is other than SAE.