Can gesture input support toddlers' fast mapping?

Forty-eight toddlers participated in a word-learning task to assess gesture input on mapping nonce words to unfamiliar objects. Receptive fast mapping and expressive naming for target object-word pairs were tested in three conditions - with a point, with a shape gesture, and in a no-gesture, word-only condition. No statistically significant effect of gesture for receptive fast-mapping was found but age was a factor. Two year olds outperformed one year olds for both measures. Only one girl in the one-year-old group correctly named any items. There was a significant interaction between gesture and gender for expressive naming. Two-year-old girls were six times more likely than two-year-old boys to correctly name items given point and shape gestures; whereas, boys named more items taught with the word only than with a point or shape gesture. The role of gesture input remains unclear, particularly for children under two years and for toddler boys.

Comparison of Patient-Reported and Caregiver-Reported Swallowing-Related Quality of Life in Parkinson's Disease.

This pilot study explored agreement on swallowing-related quality-of-life scores reported by individuals with Parkinson's disease (PD) and their caregivers. Thirty-six patient-caregiver pairs completed the Swallowing Quality of Life Questionnaire (SWAL-QOL) using an online survey format. Additional background and clinical information was ascertained. A Wilcoxon signed-rank test was completed to compare the means of scores between individuals with PD and caregivers. Factors potentially influencing SWAL-QOL scores (age, employment status, sex, ethnicity, race, previous history of swallowing evaluation or treatment, caregiver concern about patient cognition, caregiver burden, and time since onset of disease) were explored using Spearman Coefficient Correlation tests. The Holm-Bonferroni method was used to adjust for multiple comparisons. Results did not reveal significant differences in SWAL-QOL scores between individuals with PD and caregiver pairs. There was a moderate degree of reliability and agreement between paired patient and caregiver scores, with the average ICC measures being 0.598 (95% CI [358, 0.748]) (F(71, 72) = 2.451, p < 0.0001). After adjusting for multiple comparisons, caregiver burden was found to be the only significant factor associated with caregivers' reported scores. No significant influential factor on reported scores by individuals with PD was found. These pilot results suggest individuals with PD and their caregivers may report similar swallowing-related quality-of-life scores. Further, caregiver burden appears to be an influential factor for caregiver-reported scores. Future studies should investigate the clinical benefits of including caregiver SWAL-QOL ratings in assessments, either as a supplement to patient scores to identify discrepancies across the dyad or in place of patient scores if needed. Further, caregiver burden and its influence on dysphagia identification and management should be explored, with targeted interventions to manage caregiver burden.

Interprofessional Collaborative Practice Trends Between Speech-Language Pathologists and Audiologists.

PURPOSE: This study investigated interprofessional practice (IPP) trends and attitudes between speech-language pathologists (SLP) and audiologists (AUD). METHODS: Clinical SLPs and AUDs completed an online survey, consisting of demographics, caseload trends, collaborative practice trends, and barriers to collaborative practice. RESULTS: A total of 237 participants (131 SLPs, 106 AUDs) completed an online survey. Survey results indicated that IPP is important or very important to both professions. A smaller proportion of SLPs reported collaborating with AUDs than AUDs reported collaborating with SLPs. The most frequently identified barrier to collaboration experienced by the two professions was "access." Based on their beliefs, however, the top barriers differed between the professions. Specifically, SLPs believed that "access" was the top barrier to collaboration with AUDs whereas AUDs believed that "attitudes and perceptions" was the top barrier to collaboration with SLPs. Findings from the revised Attitudes Towards Health Care Teams Scale indicated that SLPs had a significantly more positive attitude toward IPP than AUDs. CONCLUSIONS: This study indicated that although IPP is valued by SLPs and AUDs, barriers continue to limit the percentage of practitioners engaging in IPP. Although both professions experienced common barriers, their beliefs about barriers to collaboration differed.

Fostering Cognitive Presence, Social Presence and Teaching Presence with Integrated Online-Team-Based Learning.

This paper describes the development of the Integrated Online-Team-Based Learning (IO-TBL) model and details students' perceptions of IO-TBL using the Community of Inquiry framework. IO-TBL is an online team-based learning course design that combines the flexibility of asynchronous engagement with the connectedness offered through synchronous meetings. Student comments from small group instructional feedback sessions and end-of-course teaching evaluations were grouped into clusters of similar statements about what was going well and suggestions for improvement, which were then assigned to one of the three presences of the Community of Inquiry framework. While students most commonly identified increased learning, synchronous meetings, teamwork, and the instructor as going well in the course, students found IO-TBL to impose a heavy workload and require a significant amount of time. Clusters were most often related to teaching presence, followed by social presence, and then cognitive presence.

Factors Influencing Oral Bolus Hold Type: Tipper or Dipper.

Purpose: This retrospective study investigated the impact of age, sex, and swallow task on bolus hold location during cued liquid swallows in healthy, community-dwelling adults. Furthermore, we investigated the association between bolus hold location and Modified Barium Swallow Impairment Profile (MBSImP) Components 2 (bolus hold) and 4 (lingual transport) scores. Method: Cued swallows of standardized barium liquids (thin, nectar-thickened, honey-thickened) observed during videofluoroscopy in 195 participants were judged as either tipper or dipper bolus hold type. Logistic regression was used to determine relationships between bolus hold location and age, sex, and swallow task. Fisher's exact test was used to determine associations between MBSImP scores and bolus hold type. Results: The majority of swallow tasks (95%) were of tipper bolus hold type. A significant relationship was observed between age and bolus hold type for swallows of 5-ml thin liquid and 5-ml honey-thickened liquid, with older individuals more likely to demonstrate a tipper bolus hold type. Sex was observed to be a significant factor for two swallow tasks (cup sip of thin liquid and 5 ml of nectar-thickened liquid), with males being more likely to be dippers. No significant relationships were observed between bolus hold type and MBSImP Component 2 or 4 scores. Conclusions: A tipper bolus hold type was the most common type observed in healthy adults, although the dipper bolus hold type was also observed (albeit at a lower frequency). These study findings further contribute to defining typical swallowing behaviors.

Using Team-Based Learning to Teach Human Subjects Research Ethics.

BACKGROUND: For health sciences students, understanding human subjects research ethics is essential for providing equitable healthcare. Active learning approaches were needed to engage students with the content and support transfer of knowledge to clinical practice. ACTIVITY: A team-based learning (TBL) module was developed and implemented in an evidence-based practice undergraduate nursing course across 3 semesters with 169 students to promote understanding and application of research ethics principles. RESULTS AND DISCUSSION: Thematic analysis of student reflections showed five themes: change in attitude, learning/understanding, application of ethical principles, specific terminology, and specific examples. Faculty facilitators reported increased engagement, understanding, and application.

Safe Medication Administration in Patients with Communication Disorders: A Simulation-Enhanced Interprofessional Education Approach.

Medications and their associated side effects impact systems treated by speech-language pathologists and audiologists, such as speech, language, voice, swallowing, hearing, tinnitus, and balance. However, students in these disciplines receive limited training in pharmacology, while nursing students receive training in pharmacology but limited training in communication disorders. In this interprofessional simulation experience to increase understanding of the impact of medications on communication, swallowing, and balance, audiology, nursing, and speech-language pathology students worked together to interview standardized patients (SPs) about their medications and symptoms in a simulated clinical setting. Goals were for students to understand professional roles, identify high-risk medications with potential communication implications, provide patient education, and evaluate interdisciplinary collaboration. The SPs demonstrated symptoms patients may have as they take high-risk medications. Students (n = 101) completed a knowledge pretest, online training, simulation, debriefing facilitated by faculty experts, and posttest and impressions survey. Results indicated high satisfaction with teamwork and interprofessional interactions. Student knowledge of high-risk medications was improved as a result of this exercise, with nursing and speech-language pathology students demonstrating statistically significant improvements in posttest results. While knowledge deficits of some high-risk medications were evident across student groups, the overall effects demonstrated benefits of the simulation-enhanced interprofessional education experience.

Training Students to Evaluate Preterm Infant Feeding Safety Using a Video-Recorded Patient Simulation Approach.

Purpose: The purpose of this study was to determine if brief video-recorded patient simulation training increased students' ability to assess feeding skills in preterm infants. Method: Baccalaureate-level nursing students (N = 52) and graduate-level speech-language pathology students (N = 42) were randomized to 1 of 2 groups: didactic training (N = 51) or didactic training plus video simulation (N = 43). Outcome measures included knowledge test scores, calculated clinical judgment scores, and clinical marker documentation accuracy. Results: Students' knowledge increased as the result of training, without differences in test scores between the 2 types of training. Students who received video simulation training interpreted simulated feeding behaviors of preterm infants more accurately than students who received didactic training. Infant distress signs were also documented with higher accuracy for students who received video simulation training. After training and regardless of method, participants correctly attributed distress behaviors during bottle-feeding to increased risk for feeding difficulty. Conclusions: In the current educational environment, training opportunities with high-risk preterm infants are constrained by access to health care settings specializing in care for this population and availability of clinical supervisors with expertise in this area of practice. Patient simulators are expensive; however, video simulation offers inexpensive opportunities for students to effectively gain knowledge and skills for assessing feeding in preterm infants. With video simulation, students effectively apply principles of preterm infant feeding to cases and practice critical thinking skills before entering related clinical practicum placements.

The Effect of Signal-to-Noise Ratio on Linguistic Processing in a Semantic Judgment Task: An Aging Study.

BACKGROUND: Aging effects on speech understanding in noise have primarily been assessed through speech recognition tasks. Recognition tasks, which focus on bottom-up, perceptual aspects of speech understanding, intentionally limit linguistic and cognitive factors by asking participants to only repeat what they have heard. On the other hand, linguistic processing tasks require bottom-up and top-down (linguistic, cognitive) processing skills and are, therefore, more reflective of speech understanding abilities used in everyday communication. The effect of signal-to-noise ratio (SNR) on linguistic processing ability is relatively unknown for either young (YAs) or older adults (OAs). PURPOSE: To determine if reduced SNRs would be more deleterious to the linguistic processing of OAs than YAs, as measured by accuracy and reaction time in a semantic judgment task in competing speech. RESEARCH DESIGN: In the semantic judgment task, participants indicated via button press whether word pairs were a semantic Match or No Match. This task was performed in quiet, as well as, +3, 0, -3, and -6 dB SNR with two-talker speech competition. STUDY SAMPLE: Seventeen YAs (20-30 yr) with normal hearing sensitivity and 17 OAs (60-68 yr) with normal hearing sensitivity or mild-to-moderate sensorineural hearing loss within age-appropriate norms. DATA COLLECTION AND ANALYSIS: Accuracy, reaction time, and false alarm rate were measured and analyzed using a mixed design analysis of variance. RESULTS: A decrease in SNR level significantly reduced accuracy and increased reaction time in both YAs and OAs. However, poor SNRs affected accuracy and reaction time of Match and No Match word pairs differently. Accuracy for Match pairs declined at a steeper rate than No Match pairs in both groups as SNR decreased. In addition, reaction time for No Match pairs increased at a greater rate than Match pairs in more difficult SNRs, particularly at -3 and -6 dB SNR. False-alarm rates indicated that participants had a response bias to No Match pairs as the SNR decreased. Age-related differences were limited to No Match pair accuracies at -6 dB SNR. CONCLUSIONS: The ability to correctly identify semantically matched word pairs was more susceptible to disruption by a poor SNR than semantically unrelated words in both YAs and OAs. The effect of SNR on this semantic judgment task implies that speech competition differentially affected the facilitation of semantically related words and the inhibition of semantically incompatible words, although processing speed, as measured by reaction time, remained faster for semantically matched pairs. Overall, the semantic judgment task in competing speech elucidated the effect of a poor listening environment on the higher order processing of words.

Short-Term Memory Performance in 7- and 8-Year-Old Children: The Relationship Between Phonological and Pitch Processing.

Purpose: The relationship between short-term memory for phonology and pitch was explored by examining accuracy scores for typically developing children for 5 experimental tasks: immediate nonword repetition (NWR), nonword repetition with an 8-s silent interference (NWRS), pitch discrimination (PD), pitch discrimination with an 8-s silent interference (PDS), and pitch matching (PM). Method: Thirty-six 7- and 8-year-old children (21 girls, 15 boys) with normal hearing, language, and cognition were asked to listen to and repeat nonsense words (NWR, NWRS), make a same versus different decision between 2 tones (PD, PDS), and listen to and then vocally reproduce a tone (PM). Results: Results showed no significant correlations between tasks of phonological memory and tests of pitch memory, that participants scored significantly better on nonword repetition tasks than PD and PM tasks, and that participants performed significantly better on tasks with no silent interference. Discussion: These findings suggest that, for typically developing children, pitch may be stored and rehearsed in a separate location than phonological information. Because of fundamental task differences, further research is needed to corroborate these data and determine the presence of developmental effects and neuroanatomical locations where a potential language/music overlap is occurring in children.

Children with SLI exhibit delays resolving ambiguous reference.

Fast mapping weaknesses in children with specific language impairment (SLI) may be explained by differences in disambiguation, mapping an unknown word to an unnamed object. The impact of language ability and linguistic stimulus on disambiguation was investigated. Sixteen children with SLI (8 preschool, 8 school-age) and sixteen typically developing age-matched children selected referents given familiar and unfamiliar object pairs in three ambiguous conditions: phonologically distinct word (PD), phonologically similar word (PS), no word (NW). Preschoolers with SLI did not disambiguate, unlike typically developing age-matched participants, who consistently selected unfamiliar objects given PD. School-age children with SLI disambiguated given PD. Delays in disambiguation for young children with SLI suggest limitations in processes that facilitate word learning for typically developing children. School-age children with SLI consistently selected familiar objects for PS, unlike typically developing children, suggesting differences in phonological activation for word learning.

Digit speech recognition threshold (SRT) in children with normal hearing ages 5-8 years.

PURPOSE: The purpose of this study was to compare digit stimuli to popular spondees when measuring speech recognition threshold (SRT) in children with normal hearing and to determine the influence of increment size using a descending method (ASHA, 1988). METHOD: SRT was measured with paired digit stimuli (D-SRT) and pediatric word stimuli (W-SRT) using 2 step sizes (5 dB, 2 dB) in 30 typically developing children with normal hearing ages 5;0 (years;months) to 8;11. Pure-tone and SRT tests were administered in both ears. The D-SRT and W-SRT were compared to pure-tone average (PTA) thresholds per ear. RESULTS: Analysis of variance revealed a significant interaction of test and step size: PTA was significantly lower when measured with 2-dB than with 5-dB increment; however, step size yielded no differences in D-SRT and W-SRT. Right ear thresholds across tests were significantly lower than left ear. Pearson correlations were significant for all tests except two; D-SRT was highly correlated to W-SRT (r = .49-.72) in both ears. Regression analyses for both ears and step sizes revealed that prediction of the hearing threshold for speech from PTA was equally accurate for SRT measured with digit pairs or popular pediatric spondee stimuli. CONCLUSION: Digit pairs are an appropriate alternative stimulus for SRT measurement in children with normal hearing. Future diagnostic audiology implications, including application for other pediatric populations, are discussed.

The impact of listening condition on background noise acceptance for young adults with normal hearing.

PURPOSE: To evaluate the effect of different speech conditions on background noise acceptance. A total of 23 stimulus pairings, differing in primary talker gender (female, male, conventional), number of background talkers (1, 4, 12), and gender composition of the background noise (female, male, mixed) were used to evaluate background noise acceptance. METHOD: A repeated measures research design was used. Participants were 15 female and 15 male young adults with normal hearing. Background noise acceptance was evaluated with the acceptable noise level (ANL). RESULTS: The results revealed main effects of primary talker gender, number of background talkers, and listener gender. ANL was lower for conditions of a female primary talker and for conditions with multitalker backgrounds. Male listeners had significantly lower ANLs than female listeners. An interaction occurred between primary talker and background noise composition. For female primary talker conditions, the male talker backgrounds produced the lowest ANLs. For male primary talker conditions, the lowest ANLs were obtained with the female and male background talker conditions. CONCLUSIONS: Background noise acceptance depends on the listener and the stimulus condition. Stimulus selection can influence the measurement of ANL. The results support the use of the commercially available ANL materials.

Speech intelligibility differences across sound classes with in-the-ear and free-field microphones in quiet.

Speech intelligibility performance with an in-the-ear microphone embedded in a custom-molded deep-insertion earplug was compared with results obtained using a free-field microphone. Intelligibility differences between microphones were further analyzed to assess whether reduced intelligibility was specific to certain sound classes. 36 participants completed the Modified Rhyme Test using recordings made with each microphone. While speech intelligibility for both microphones was highly accurate, intelligibility with the free-field microphone was significantly better than with the in-the-ear microphone. There were significant effects of place and manner of sound production. Significant differences in recognition among specific phonemes were also revealed. Implications included modifying the in-the-ear microphone to transmit more high frequency energy. Use of the in-the-ear microphone was limited by significant loss of high-frequency energy of the speech signal which resulted in reduced intelligibility for some sounds; however, the in-the-ear microphone is a promising technology for effective communication in military environments.

Pitch-matching accuracy in trained singers and untrained individuals: the impact of musical interference and noise.

The effects of musical interference and noise on pitch-matching accuracy were examined. Vocal training was explored as a factor influencing pitch-matching accuracy, and the relationship between pitch matching and pitch discrimination was examined. Twenty trained singers (TS) and 20 untrained individuals (UT) vocally matched tones in six conditions (immediate, four types of chords, noise). Fundamental frequencies were calculated, compared with the frequency of the target tone, and converted to semitone difference scores. A pitch discrimination task was also completed. TS showed significantly better pitch matching than UT across all conditions. Individual performances for UT were highly variable. Therefore, untrained participants were divided into two groups: 10 untrained accurate and 10 untrained inaccurate. Comparison of TS with untrained accurate individuals revealed significant differences between groups and across conditions. Compared with immediate vocal matching of target tones, pitch-matching accuracy was significantly reduced, given musical chord and noise interference unless the target tone was presented in the musical chord. A direct relationship between pitch matching and pitch discrimination was revealed. Across pitch-matching conditions, TS were consistently more accurate than UT. Pitch-matching accuracy diminished when auditory interference consisted of chords that did not contain the target tone and noise.

Effects of increasing time delays on pitch-matching accuracy in trained singers and untrained individuals.

Trained singers (TS) generally demonstrate accurate pitch matching, but this ability varies within the general population. Pitch-matching accuracy, given increasing silence intervals of 5, 15, and 25 seconds between target tones and vocal matches, was investigated in TS and untrained individuals. A relationship between pitch discrimination and pitch matching was also examined. Thirty-two females (20-30 years) were grouped based on individual vocal training and performance in an immediate pitch-matching task. Participants matched target pitches following time delays, and completed a pitch discrimination task, which required the classification of two tones as same or different. TS and untrained accurate participants performed comparably on all pitch-matching tasks, while untrained inaccurate participants performed significantly less accurately than the other two groups. Performances declined across groups as intervals of silence increased, suggesting degradation of pitch matching as pitch memory was taxed. A significant relationship between pitch discrimination and pitch matching was revealed across participants.

Pitch discrimination and pitch matching abilities with vocal and nonvocal stimuli.

Various stimulus types have been investigated in pitch discrimination and pitch matching tasks. However, previous studies have not explored the use of recorded samples of an individual's own voice in performing these two tasks. The purpose of this study was to investigate pitch discrimination and pitch matching abilities using three stimuli conditions (participant's own voice, a neutral female voice, and nonvocal complex tones) to determine if pitch discrimination and/or pitch matching abilities are influenced by the type of stimuli presented. Results of the pitch discrimination tasks yielded no significant difference in discrimination ability for the three stimuli. For the pitch matching tasks, a significant difference was found for the participants' voice versus neutral female voice and the participants' voice versus tonal stimuli. There was no significant difference in pitch matching ability between the neutral female voice and the tonal stimuli. There was no significant correlation between pitch discrimination and pitch matching abilities for any of the three stimuli types. These results suggest that it is easier to match the pitch of one's own voice than to match the pitch of a neutral female voice and nonvocal complex tones, although no difference was found for pitch discrimination abilities. One possible implication of this study is that differences in matching the pitch of one's own voice compared to matching other stimuli types may help to differentiate the source of singing inaccuracy (motor vs discrimination skills).

Relations of pitch matching, pitch discrimination, and otoacoustic emission suppression in individuals not formally trained as musicians.

Research has yielded a relationship between pitch matching and pitch discrimination. Good pitch matchers tend to be good pitch discriminators and are often judged to be vocally talented. Otoacoustic emission suppression measures the function of the efferent auditory system which may affect accuracy for pitch matching and pitch discrimination. Formally trained musicians show pitch matching and pitch discrimination superior to those of nonmusicians and have greater efferent otoacoustic emission suppression than nonmusicians. This study investigated the relationship among pitch matching, pitch discrimination, and otoacoustic emission suppression in individuals with no formal musical training and who showed varied pitch matching and pitch discrimination. Analysis suggested a significant relationship between pitch matching and pitch discrimination but not between otoacoustic emission suppression and pitch matching and pitch discrimination. Findings are presented in the context of previous research indicating a significant relationship between otoacoustic emission suppression and musical talent in trained musicians.