CSD Graduate Student Conference Papers

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    Contralateral masking in air-conduction Auditory Brainstem Response recordings: A literature review
    (Wichita State University, 2023-04-14) Keithly, Alice; Sun, Xiao-Ming
    INTRODUCTION: Auditory Brainstem Response (ABR) is a clinical test for evaluating the functional status of the auditory system. Electric potentials of the auditory nerve and brainstem are measured with stimulus sounds. An ABR waveform includes five waves; wave V is the largest in most cases. Contralateral masking with noise is used to prevent the cross-hearing phenomenon in hearing tests. This occurs in patients with unilateral or asymmetric hearing loss when the test tone in the test ear is so loud that it crosses over to the non-test ear, which causes the hearing in the test ear to appear better than it is. Thus, even in the early years of application of ABR recording, researchers suggested employing contralateral masking in patients with a significant difference in hearing between ears. Some studies investigated whether contralateral masking is necessary and effective to eliminate false ABR waves due to crossover, while others investigated if the masking sound in the non-test ear affects true ABR waves recorded in the test ear. The outcomes of these studies have been controversial. Literature reviews are needed to summarize and evaluate previous work and inspire further clinical research on this topic. PURPOSE: To determine (1) the necessity of contralateral masking in ABR tests of individuals with unilateral hearing loss; (2) the effectuality of this procedure in eliminating crossover; and (3) the validity of the masking procedure in ABR recordings. METHODS: The search engines Google Scholar and WSU Library SmartSearch were used. The keywords used to select articles were: "auditory brain-stem response," "contralateral masking," "auditory brainstem response," and "brain stem auditory evoked response." Selection criteria were set up concerning type of study, hearing status, and objective of study. RESULTS: Thirteen studies were collected. Three studies included participants with normal hearing only, five with hearing loss only, and five with both conditions. Of a total of 68 patients with unilateral hearing loss in ten studies, 73.5% had a wave V recorded in the deaf ears, for 88% of which, wave V disappeared with white noise introduced to the normal-hearing ear. Results suggested that crossover occurred in most patients and contralateral masking eliminated the false wave V. Seven of the eight studies of normal-hearing individuals found that wave V was not significantly altered by contralateral noise. Results indicated that certain factors, such as central masking and the acoustic stapedial reflex, could be ruled out. CONCLUSION: (1) Contralateral masking is needed to prevent crossover in patients when unilateral or asymmetric hearing loss is suspected. (2) Contralateral masking is an effective and valid procedure to prevent crossover in ABR recordings. (3) Limitations of previous studies on unilateral hearing loss are: (A) Almost all studies reported only a few cases; (B) Almost all studies were conducted over two to four decades ago, which used headphones instead of commonly applied insert earphones today. Further well-designed research is warranted.
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    Effects of Aphasia-Friendly Readings: Responsive reading for couples
    (Wichita State University, 2021-04-02) Zwanziger, Madison; Nicks, Lindsey; Bailey, Brittney; Powell, Addison; Keese, Daphne; Recker, Breanna; O'Bryan, Erin
    INTRODUCTION: This is a presentation that shows the progress of a person with aphasia after having eight weeks of Aphasia-Friendly Readings Therapy, a family-centered therapy approach developed by the spouse of a person with aphasia (Regier, 2019). PURPOSE: The purpose of this study is to determine if Aphasia-Friendly Readings is a successful therapy process for improving speech among those with expressive aphasia, while also being an enjoyable activity for both the person with aphasia and their partner. METHODS: A 70-year-old female with expressive aphasia and her husband participated in the current study to test the effects of Aphasia-Friendly Readings. Before therapy began, the participant was administered the Western Aphasia Battery-Revised (WAB-R), the Reading Comprehension Battery for Aphasia (RCBA), and the Assessment for Living with Aphasia (ALA). After the pre-testing, the clinician worked with the couple to compose a script in the Aphasia-Friendly Readings format. The couple met with the clinician once a week for an average of 60 minutes per session to practice reading the script together aloud. During the session, the clinician provided cues for the participant, while also training the husband, so that he could use the cues while they practiced at home. The pre-treatment tests were readministered as post-treatment tests in order to measure progress. RESULTS: Prior to the treatment, the participant was given a variety of pre-tests. The results of the pre and post-test of the WAB-R show that she improved her aphasia quotient score by 4.5%. Her WAB-R post-test aphasia quotient of 52.2 out of 100 is indicative of expressive aphasia and is classified as severe Broca's aphasia. Her pre-test and post-test results from the RCBA show that her reading comprehension ability moved up from the 55th percentile to the 56th percentile. The results of the pre-test and post-test of the ALA show that she reported improved quality of life by 0.16 points on a 5-point scale. During the first treatment session, the participant independently read 4.6% of the words correctly from the script. During the seventh week of the treatment, she was able to independently read 73.5% of the words correctly. A follow-up reading showed that four weeks after treatment ended, she was able to independently read 69.9% of the words correctly. CONCLUSION: In conclusion, the person with aphasia showed an increase in the number of words she could read independently from the script. The couple expressed that they were very pleased with what they accomplished. In an interview, the husband shared, "Her communication, in the time that we have done this research and working on the story, at home she, instead of just using words or I mean, even a couple words, she's trying to put things together in a sentence structure to communicate with me which, that's one of the reasons why I'm so excited [about it]."
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    Computerized sentence building as a treatment for Aphasia
    (Wichita State University, 2021-04-02) Keese, Daphne; Powell, Addison; O'Bryan, Erin
    INTRODUCTION: Acute cerebrovascular disease (stroke) is one of the leading causes of death in the United States, and those who survive are often left with significant long-term disabilities. Aphasia, which frequently occurs secondary to stroke, results in loss of the ability to speak freely. One cause of difficulty producing conversational speech is an impairment in the ability to build sentences. Existing treatments have shown improvement in spoken language (e.g., Thompson et al., 1997; Doyle et al., 1987), but treatments may not reach full recovery potential. People with aphasia express eagerness to find new therapy approaches to improve communication abilities and to have home therapy programs in addition to in-person therapy. There continues to be a need for effective sentence production treatments that can be easily translated into a home program. PURPOSE: The purpose of this study is to conduct a pre-efficacy study to try the computerized sentence building task as a treatment for several people with aphasia, to measure whether dependent variables improve, and to ask people with aphasia what they think of the task. METHODS: Seven participants with aphasia were trained to do the computerized sentence building task called the word maze. This computerized task provides practice with word-by-word sentence building. Participants had sessions once or twice per week in forty-minute-long periods for a total of 6-7 sessions. Pre-treatment and post-treatment measures included the Assessment for Living with Aphasia (ALA) and the Western Aphasia Battery-Revised (WAB-R) Part 1. The ALA is a quality of life assessment that uses a pictographic approach and a visual 0 to 4-point scale which allows for participation across a full range of severity. A few example questions from the ALA include, "How would you rate your talking?" and "Are you making decisions about things that are important to you?" The WAB-R Part 1 assesses language skills most frequently affected by aphasia to provide differential diagnosis information as well as a baseline level of performance to measure change over time. A few example tasks from the WAB-R Part 1 include answering yes/no questions and following sequential commands. At the end of each treatment session, participants completed a subjective questionnaire about their experience. RESULTS: All participants showed improved task accuracy, faster reaction times and increased scores on the Assessment for Living with Aphasia. Two of the seven participants showed an 7- point increase in the WAB-R Part 1 aphasia quotient. This indicates a decrease in the severity of their aphasia, according to this specific standardized assessment. The subjective experience questionnaire results indicated that all seven participants like the treatment. CONCLUSION: This pre-efficacy study suggests that the computerized sentence building task may have therapeutic value for people with aphasia. All participants improved at the task and showed a concomitant increase in their scores on the ALA which suggests improved quality of life. The subjective experience questionnaire results showed that people with aphasia found the task fun, helpful, not difficult, and not stressful.
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    Post-secondary education experiences and needs of students with autism spectrum disorder
    (Wichita State University, 2021-04-02) Her, Aleshea N.; Tang, Yazmin; Self, Trisha L.
    INTRODUCTION: The number of individuals with autism spectrum disorder (ASD) pursuing a post-secondary degree is increasing nationwide. Shattuck and colleagues (2012) reported that approximately 55% of students with ASD received some type of postsecondary education in the United States; accounting for approximately 1-2% of students enrolled in universities. Unfortunately, a significant number of those students did not graduate. This poor outcome has been attributed in part to the loss of services students experienced when they left high school and entered unfamiliar situations with unfamiliar instructors (Zeedyk et al., 2016). In response, universities have been working to put supports in place for students on the autism spectrum. PURPOSE: The purpose of this study was to conduct an on-line survey to determine and better understand the academic and non-academic experiences, supports, and needs of students with ASD at Wichita State University (WSU). METHOD: Students enrolled at WSU, who had self-identified as individuals with ASD through the Office of Disability Services (ODS), were recruited to participate in this study. ODS administrators agreed to assist with recruitment. A total of 15 students with ASD, of the 37 who had registered with ODS, agreed to participate. Students were sent an instructional email from the graduate student researcher on how to access the on-line survey via a specified Survey Monkey link. No identifying information was included in the survey and responses were submitted anonymously. Completed survey data was exported and summarized as group data. RESULTS: Respondents included 11 males, 3 females, and 1 student who identified as other. Students ranged in age from 18 - 25+ years. Participants identified the following perceived strengths in the postsecondary setting: attention to detail (n=15), intense interest in their area of study (n=14), and the ability to solve problems (n=13) and use technology (n=13). Several reported staying on task (n=10) and time management (n=10) as areas of difficulty. Non- academic areas perceived as moderate to high areas of concern included feeling lonely, isolated, and quality of sleep. Overall, the most significant postsecondary concerns were academics, sensory activities, mental health challenges, social requirements, and activities of daily living. Students were asked to rate services and supports provided through ODS. Flexibility with exams (e.g., due dates, alternate room, computer use) and consultation with a disability officer were rated as helpful but were reportedly used by less than half the respondents. The most common reason for not using a support was that it was not needed, or they did not know how to ask for it. CONCLUSION: Obtaining a first-person perspective of students' academic and non-academic experiences, supports, and needs may provide postsecondary personnel with the information needed to develop and promote accommodations and supports for students with ASD. This may also help to improve retention and graduate rates for students on the autism spectrum.
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    The effects of varying melodic intervals in Melodic Intonation Therapy for persons with Aphasia
    (Wichita State University, 2021-04-02) Darland, Kylie; O'Bryan, Erin; Bernstorf, Elaine; Richburg, Cynthia M.
    INTRODUCTION: Broca's Aphasia is an acquired language disorder that most commonly occurs after a stroke. It is characterized by deficits in expressive language, both spoken and written. Melodic Intonation Therapy (MIT) is an evidence-based approach to the treatment of Broca's Aphasia, which emphasizes the musical elements of speech (i.e., pitch and rhythm) to facilitate language recovery. Clients are taught to sing phrases intoned on a single melodic interval while tapping their left hand in rhythm. Many studies have illustrated the importance of the rhythmic component of MIT; however, little research has directly evaluated the effects of using different melodies (i.e., melodic intervals) in therapy. PURPOSE: The purpose of this study was to evaluate the effects of using two different melodic intervals in MIT: a common, perceptually pleasant interval known as the minor third, and an uncommon, perceptually unpleasant interval known as the tritone. METHODS: Two participants received MIT twice a week for six weeks via teletherapy. Each was exposed to twenty-four pairs of phrases equal in number of syllables and intonation pattern. One phrase of each pair was intoned on the minor third and the other on the tritone. Following a Latin- square design, the interval assigned to each phrase within the pair was opposite for the two clients. An assessment of trained phrases measuring syllable intelligibility was administered pre- and post- treatment to monitor progress. RESULTS: An effect size was calculated using a formula designed specifically for single-subject, multiple baseline aphasia studies. It was determined that the effect size for the tritone was greater than the effect size of the minor third for both participants. The researchers believe the difference is meaningful; however, no equation has yet been developed to determine the statistical significance of the difference in effect sizes using the preceding formula. Regardless of pitch both participants showed significant improvement in trained phrases, providing evidence that MIT is efficacious in the teletherapy format. CONCLUSION: The results contradict the researchers' hypothesis that using a common and perceptually pleasant interval would yield greater success in MIT. The findings may have implications for MIT protocol, which recommends intoning phrases on a common interval such as the minor third. Limitations to this study include a small sample size and human error associated with pitch. Future research should continue to evaluate the complex interaction of rhythm and pitch within MIT to ensure treatment is as effective as possible.
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