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Noriko Hessmann

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Noriko Hessmann

Speech Pathology & Audiology

Office Phone number: 780-492-0840

2-70 Corbett Hall
University of Alberta
Edmonton AB T6G 2G4

Subject areas and related deposits

  • Adults

    • Alternative Airway Clearance Techniques in Healthy Adults: A Normative Database

      Purpose To create a normative database of 160 participants across a variety of commonly used airway clearance behaviours in healthy adults. This is the beginning phase of a larger project that aims to explore airway clearance behaviours in patients with neuromuscular diseases and conditions. As part of the project, Speech-Language Pathology students did an extensive literature review and are participating in some data collection and analysis. Methods & Analysis Spirometry measures of coughing, throat clearing, hawking, sniff nasal pressure and forced expiration were conducted on healthy age-matched individuals. Normative data is presented in terms of means and standard deviations to help guide selection and timing of appropriate airway clearance interventions. Clinical Significance The normative database may serve as a reference point for assisting with diagnosis and future research in this area. This project has the potential to make significant contributions to the clinical management of patients with weak cough due to a variety of neuromuscular diseases.

  • Alberta Aphasia Camp

    • The effects of Alberta Aphasia Camp on quality of life for people living with Aphasia

      Background: In aphasia therapy, there has been a shift in focus from impairment-level intervention towards ones focusing on enhancing life participation. Within Canada and the United States there exist several weekend camps that provide examples of participation-level interventions for people with aphasia (PWA); however there is presently limited evidence for the efficacy of camp-based models. Purpose: The purpose of the Alberta Aphasia Camp (ABAC) was to provide PWA and their care partners (CPs) the opportunity to experience therapy, recreational activities, respite, and to create social connections in a supported communication environment. The purpose of this research project was to examine the efficacy of a retreat-based treatment model as a means of increasing the quality of life and life activity/participation in PWA. Methods: ABAC was held at YoWoChAs Outdoor Education Center on September 12-14, 2014. Data from nine PWA and five CPs are reported here. Three assessment tools were used to gather pre- and post-camp data: the Assessment for Living with Aphasia (ALA), the Australian Therapy Outcome Measures (AusTOMs), and the Communicative Effectiveness Index (CETI). Outcomes & Results: Significant improvements were observed from pre- to post-camp on the ALA (participation domain, personal domain, composite score), the AusTOMS (expressive and receptive language impairment scales, cognitive-communication activity limitation scale) and the CETI. Conclusions: Attending ABAC was associated with significant positive effects for PWA across all measures, providing evidence to suggest that a weekend retreat is an efficacious intervention model for participation-level improvement for PWA and their CPs.

  • Aphasia

    • Creating a Framework for the First Alberta Aphasia Camp: Literature Review, Interview Results, Logistical Research, and Insights from a Visit to the Aphasia Camp Northwest

      This paper outlines the authors’ efforts in researching and laying the framework for the inaugural aphasia camp to be implemented in Alberta, the Alberta Aphasia Camp (ABAC). This includes a review of previous research discussing the benefits of non-traditional therapy for people living with aphasia (PWA) and their caregivers. Additionally, this paper includes summaries of interview results with local PWA and family members regarding their preferences for a camp, the selection process of a camp location, and information regarding the authors’ visit to the Aphasia Camp Northwest (ACNW) in Portland, Oregon. This combination of findings provides the basis and rationale for the creation of the ABAC as well as recommendations for implementing the camp. The ABAC model is intended to provide an opportunity for PWA and their spouses, family and/or caregivers to enjoy respite in a therapeutic and supportive environment, aiming to foster re-engagement in life activities.

    • The Effect of Word Context on the Reading Ability of Individuals with Aphasia and Acquired Alexia

      Some individuals with acquired reading impairments (alexia) can read words in sentence contexts easier than in list format. It has been proposed that this may be due to relatively intact sentence production processes (Mitchum et al., 2005). In this project, we investigated this hypothesis in five individuals with fluent aphasia and acquired alexia. Participants read aloud words varying in part of speech (nouns, verbs, adjectives, functors) in sentence and list contexts; sentence production skills were quantified using the Quantitative Production Analysis (QPA; Saffran et al., 1989) on discourse samples. A 2 (context condition) x 4 (word type) ANOVA was used to determine a) if sentence contexts facilitate word reading, and b) which word types are facilitated. A regression analysis examined the relationship between QPA and reading accuracy in both contexts. Context (list vs. sentence) had a significant effect on word reading accuracy in only one of the five individuals in this study. Participants with aphasia were less accurate at reading verbs than functors in both list and sentence contexts. Results of the regression analysis revealed that the mean length of utterance in the discourse samples significantly predicted the accuracy of word reading in sentences. Only one participant demonstrated a context effect in reading words. This participant also had a much slower reading rate than the others in the group, which may have contributed to this effect. Further research studies are needed to better characterize the nature of context effects in reading.

  • Augmentative and Alternative Communication (AAC)

    • AAC Device Design Elements That May Contribute to Use During Play

      The following review aimed to discover what elements in AAC interface design best facilitate AAC use in play in order to support children with complex needs in their linguistic, cognitive, and social development. The review explored how AAC use helps in development and how AAC effectiveness can be increased – in general and in the context of play, specifically. Drawing from research in the realms of AAC device development, visual cognitive neuroscience, children’s perspectives on AAC, and toy development, it described elements in every feature of AAC interface design that could be used to better support AAC use in play. The review determined that, despite a great deal of information that may improve the design of AAC device interfaces to facilitate play, more research is needed specifically on AAC use with physically and developmentally challenged children, research on very young children, the use of AAC within the context of play, underlying visual processes of both normal and impaired vision, and what appeals to AAC device users and their peers.

    • Case Study of an Individual Who Uses Augmentative and Alternative Communication

      Speech generating communication devices (SGCD) are speech aids that help individuals who have severe speech impairments meet the needs of daily communication. They are commonly used by individuals who have congenital, developmental or acquired disabilities in which their ability to speak has been hampered. The acquisition of a new SGCD often has a profound impact on the individual, the families, and those in their surroundings. The participant was recruited through the Glenrose Rehabilitation Hospital I CAN Centre for Assistive Technology and the Alberta Aids to Daily Living (AADL) program. In this study, a person who uses a SGCD, her family, and supporting individuals were interviewed and observed to determine the impact of SGCD acquisition. The observations and interviews were transcribed and analyzed for pertinent themes. It was found that although the device had drawbacks, overall the benefits of the device were life changing for the individual and those around her. Personal Factors and strategies for using the device also impacted how well the device was used and perceived by others.

  • Aural (re)habilitation

    • The Effect of Short-term, Intensive, Aural (Re)habilitation Training on Measures of Functional Communication and Quality of Life in a Cochlear-implanted Adult with Pre-lingual Deafness

      In Canada, the number of adults with pre-lingual hearing loss who receive a cochlear implant (CI) is growing; however, most of the adult CI centers in Canada reported that “the majority of their patients did not need rehabilitation services post-implant” (Fitzpatrick & Brewster, 2010, p. 293). The researchers found no study of the effectiveness of short-term, intensive, speech-perception programs for adult CI recipients with pre-lingual deafness. This case study employed a multi-treatment (i.e., Live Therapy and Home Therapy), single-subject design to measure outcomes related to functional communication (i.e., intonation, self-monitoring, closed-set comprehension) and quality of life (i.e., Cochlear Implant Function Index and interview) associated with an intensive 10-week program. Post-treatment, the participant showed improvement in selected functional communication skills. The outcomes of the current study are hoped to provide evidence to the debate of whether or not such rehabilitation services are of benefit to adults who have pre-lingual deafness and use a CI; and whether or not rehabilitation services should become publicly funded.

  • Autism Spectrum Disorder (ASD)

    • The Intensity of Services Delivered to Preschool Children with Autism Spectrum Disorder in the Edmonton Area

      Background: This study describes the intensity of services received by preschool children with autism spectrum disorder (ASD) in the Edmonton area. Method: Sixty eight families were asked to describe the services their preschool children utilized at 4 time points: within 4 months of diagnosis, 6 months later, 12 months later and at the time of entering school. Data was coded into 11 service types and collapsed into three broad categories: Behavioural, Developmental and General. The average number of hours per week of each category of service as well as the average total number of hours of service was calculated at each time point. Results: The average total number of hours per week of services delivered to children in the Edmonton area increased across time points. At the first, second and fourth assessment times the highest number of hours of service were received by children who were getting a combination of Behavioural and Developmental services. At the third time point, the greatest average intensity resulted from the Developmental plus General services combination. Preschool children with ASD in the Edmonton area did not receive General services delivered alone at time point 3 or Behavioural services delivered alone at time points 3 and 4.

    • Reliability of the Pragmatic Rating Scale in High Functioning Adults with Autism Spectrum Disorder

      Background: Pragmatic skills are, by definition, impaired in people with Autism Spectrum Disorders (ASD). These difficulties can negatively influence a person’s interpersonal relationships, their ability to find employment and their overall quality of life. Currently, there is little research that characterizes the pragmatic communication difficulties that affect high-functioning adults with ASD. The Pragmatic Rating Scale (Paul et al., 2009) is one scale that may prove helpful for quantifying pragmatic impairments but its reliability has not been documented in adults with ASD. Purpose/Aim: To determine if the Pragmatic Rating Scale can be used to make reliable judgments regarding the quality of communication in high functioning adults with ASD. Method: Following training, audio recordings of simulated job interviews of twenty adults with ASD and twenty controls, matched for chronological- and nonverbal mental-age plus five unmatched ASD participants, were transcribed using Systematic Analysis of Language Transcripts (SALT; Miller & Iglesias, 2008) and then rated using the Pragmatic Rating Scale. Pairs of raters independently evaluated each interview. Inter-rater agreement was determined by using the following formula: {number of agreements/(number of agreements + number of disagreements)} x 100. Overall, raters achieved consistently high reliability calculated to 90% for ‘broad reliability’ and 88% for inter-rater reliability. Having a reliable tool to help identify areas of need and strengths regarding pragmatic skills in people who have ASD could help facilitate success in the workplace and in gaining employment.

  • Behavioural assessment

    • Behavioural Assessment of Language Processing using the Dual Route Model and Independence Equations

      The independence equations employed by Castles et al. (2006) and McDougall et al. (2005), have been used to provide evidence for a dual route model of reading. However, such reports have been limited to basic naming tasks. To test the robustness of previous claims, we examined the utility of the independence equation in predicting the regular word reading ability of normal reading adults in a lexical decision task. Participants were asked to read regular words (REGs; e.g., hint), exception words (EXCs; e.g., pint), non-words (NWs; e.g., bint) and pseudohomophones (PHs; e.g., pynt) and push a button based on whether the stimuli sounded like a real word. Both reaction time and accuracy rates were measured. Regression analyses were used to evaluate variance accounted for in actual REG reading performance given a predicted REG performance that was calculated from PHs and EXCs performance and the application of the independence equation. Results showed that both reaction time and accuracy measures could be used in the independence equation to accurately predict REG reading performance. This study provides further evidence for the mathematically independent relationship between the sight vocabulary and the phonetic decoding systems and support for the Dual Route Model of reading.

  • Bone-anchored device

    • Comparison of Audiologic Results Obtained from Patients with No Hearing Aid, a Transcutaenous and a Percutaneous Bone Anchored Device

      The present study evaluates outcomes for individuals to determine how much better a patient’s hearing will be with a bone-anchored device on a headband than with no hearing aid, and how much better a patient’s hearing will be with the bone-anchored device connected to an implant compared to the headband. 19 adult bone-anchored device users with bilateral or unilateral, conductive or mixed hearing loss were recruited from the Bone Conduction Amplification Program at the Institute for Reconstructive Sciences in Medicine (iRSM) in Edmonton, Alberta, Canada. In this study, a repeated measures design was used where each subject experienced the unaided, percutaneous and transcutaneous test conditions. The outcome measures included bone conduction hearing thresholds, the Quick Speech-in-Noise test (QuickSIN) and most comfortable listening level (MCL). Thresholds were found to be worse under the transcutaneous test condition, and the magnitude of threshold differences between the transcutaneous and percutaneous test conditions depended on the frequency under test. Signal-to-noise ratio (SNR) loss and MCL values were highest in the unaided condition, significantly better in the transcutaneous condition compared to the unaided condition and significantly better still in the percutaneous condition compared to both the unaided and transcutaneous conditions. This study provides information to guide clinicians in counselling patients on how much better their hearing will be with a headband or implant compared to unaided, and the implant compared to the headband.

  • Bone-Anchored Hearing Aid (Baha)

  • Capacity assessment

    • Current Practices and Challenges Associated with Administering Capacity Assessments for Individuals with Aphasia: A Review of the Literature

      In this paper, I provide an overview of aphasia and the issue of capacity assessment, followed by a summary of the current literature on the topic. The goals of this paper are to discuss current practices and challenges in capacity assessment and to provide a foundation for researchers to guide future studies in this area. Across authors and articles it is evident that there is a need for improvement upon the current guidelines for the administration of capacity assessments for individuals with communication disorders. Information gathered from these studies demonstrated that the highly verbal nature of capacity evaluations makes individuals with aphasia, who have difficulty understanding information and expressing themselves, vulnerable to losing their right to self-determination. These patients are faced with numerous decisions regarding their health and well-being, decisions that must be made amidst a flurry of complex medical terminology, varying opinions and emotional instability. When the family and treatment team question the patient’s ability to make informed decisions, it is important that the treatment team consider the patient’s communication limitations to make certain a fair and accurate assessment. In the reviewed papers, various strategies and clinical protocols are suggested to improve upon the way in which individuals with aphasia are assessed for capacity. Several articles recognized the importance of involving professionals who specialize in communication and cognition in the capacity assessment process. The articles describe numerous ways speech-language pathologists can support patients and treatment teams in addressing communication limitations. One article highlighted the benefits of using alternative and augmentative communication equipment and techniques to allow individuals with severe communication impairments the ability to express their choices more independently. In another article, the authors outlined a model for providing information in a way that facilitates comprehension and included making accommodations for a proxy to support the patient. As a whole, the literature emphasized the complex nature of evaluating capacity in this population and impressed upon the importance of considering individual variability when administering capacity assessments.

  • Case study

    • Case Study of A Child Who Uses a Speech Generating Communication Device

      Speech generating communication devices (SGCD) help individuals with severe speech impairments meet the needs of daily communication. They are commonly used by individuals who have congenital, developmental and/or acquired disabilities in which their ability to speak has been impaired. The primary aim of this study was to gain an in-depth understanding of how a child uses augmentative and alternative communication methods, specifically a Speech Generating Communication Device (SGCD) supplied by Alberta Aids to Daily Living (AADL), and how the device has impacted the life of the child and his family. Interviews of the child’s family, teachers, and support workers, in addition to observations at home and at school, provided the opportunity to observe the device’s use and impact in real world contexts.

  • Children

    • Children's Expression of Emotional and Cognitive Mental States in their Story Generation from Pictures

      Background: The term mental state can be used to describe a person’s emotional or cognitive condition (i.e. feelings, thoughts, or perceptions). Narratives provide an important context for the use of mental state words, since stories in Western culture frequently describe characters’ thoughts and feelings. As children develop the ability to understand other individuals’ perspectives, they may be expected to produce a greater number and variety of mental state words in narrative contexts. Purpose: Our study was designed to investigate children’s use of mental state words or expressions in narratives. We compared the frequency and type of mental state terms used by children ages 4-9 in a narrative context. By means of such analysis, we hoped to gain insight into the ways in which the use of emotional and cognitive mental state terms develops over the course of childhood. Methods/Procedure: Our participants were 60 randomly selected, typically developing children from the ENNI normative sample: 10 children (5 male, 5 female) from each year in the 4-9 year old age range. We documented the number of cognitive and emotional words present in each participant’s transcript. Subsequently, regression analyses were used to determine whether syntax, story grammar, and/or age predict the type and quantity of mental state words or expressions that typically developing children use in narratives. Results: Only participant age was found to predict the percentage of emotional mental state terms used in children’s narratives. The regression analyses did not reveal any significant predictors for the percentage of cognitive mental state terms used in a narrative context.

  • Children adopted from China

    • Early grammatical acquisition in children adopted from China as infants/toddlers

      Children adopted internationally have a special course of exposure to language as they abruptly switch from hearing the sounds of their birth language, to which they typically are not further exposed post-adoption, to the sounds of a new language (Glennen, 2002; Roberts et al., 2005). The quick transition to a new language and rapid attrition of the birth language is a challenge developmentally. This study looked at the English grammatical development of children adopted from China in comparison to that of norms based on non-adopted peers. Age at time of adoption had a significant impact on grammatical development. Children adopted from China acquired English bound morphemes in the same sequential order as non-adopted peers, but were delayed in their acquisition due to their later onset of exposure to English. The older children were at the time of adoption, the faster they acquired bound morphemes and complex sentences. However, because older children had more grammar to learn in order to catch up to non-adopted peers, they lagged further behind.

  • China

  • Clear speech

    • The Use of Clear Speech as an Intervention for Older Adults with Hearing Loss: A Scoping Literature Review

      The research team conducted a scoping review of literature related to the concept of “Clear Speech” and its application with older individuals who have hearing loss. The application of Clear Speech is hypothesized to improve speech intelligibility and thus to increase comprehension of speech by a communication partner who has hearing impairment. There are profound communication and psychosocial consequences of hearing loss in older adults. Communication partners of individuals with hearing loss need to make changes to their way of speaking because these individuals are unable to completely modify their communication impairment, even with hearing aids. Clear Speech is a way to bridge the gap in communication; however, it cannot be applied in nursing homes, clinical settings and everyday interactions until it is fully understood. The end result of this comprehensive search is the realization of a picture of both the advances and the gaps in existing knowledge about Clear Speech resulting from all empirical investigations and applications of Clear Speech as a communicative aid to date.

  • Clinician perspectives

    • “There’s an app for that”: Clinician perspectives on the iPad as an intervention tool for children

      Technology use in assessment and intervention in speech-language pathology is an area of rapid growth. Decisions about what type of device to use should be evidence based and take into account best practice principles (BPPs) within speech-language pathology. This study explored the benefits and limitations of the iPad as an intervention tool for children in speech-language pathology. Three groups of clinicians (students, new graduates, and experienced clinicians) discussed their beliefs about best practice principles in intervention and their views and uses of technology through initial and final focus groups. Ten themes emerged from the focus groups, and will be discussed in detail in this paper. The participants received instruction on the iPad and key applications for use in the profession and evaluated those applications by examining how well the apps align with best practice principles using an “iPad Application Rating Sheet”. This study demonstrated that speech-language pathologist’s (SLP) beliefs about BPPs are important when choosing materials. This paper will highlight the clinical implications of iPad use in intervention, the promise of the technology, the value of explicit consideration of BPPs, and the strengths and limitations of current applications. Clinician suggestions for modifications of applications, for desirable qualities in new applications, and for clinical use of applications will also be discussed.

  • Cognitive assessment

    • Cognitive Assessment and Robot Skills of Children with Motor Impairments

      Currently, cognitive function of children with motor impairment is difficult to assess because most cognitive assessment tasks require manipulation of small objects and/or verbal intelligibility. Research has demonstrated that play using robots allows children with motor impairments to manipulate objects and experience activities that are comparable to those of typically developing children. (Cook, Adams, & Harbottle, 2007). Poletz, Encarnacao, Adams & Cook (2010) examined the cognitive concepts of causality, negation, binary logic and sequencing with typically developing children through robot facilitated tasks. This pilot study replicated the robot tasks with two children with motor impairments. The small sample size prevented comparisons with statistical analysis to be done; however consistencies observed between the two studies suggest that the robot tasks have the potential to be developed into a cognitive proxy measure. Changes in methodology to better standardize and increase the functional applications of the robot tasks are also discussed.

  • Collaboration

    • The Darkside of Collaboration: A pilot study

      It is commonly believed that collaboration enhances quality of life for both practicing professionals and for their clients (D’Amour & Oandasan, 2005). Hebert (2005) comments that “many of us are ‘true believers’ in interprofessional practice” (Herbert, 2005, p.3), suggesting that the voice of those who do not participate willingly in interprofessional collaboration activities is not well-represented in the interprofessional collaboration literature. This study examines the negative aspects of interprofessional collaboration as reported in a survey completed by students in rehabilitation medicine. The major reoccurring categories that emerged as deterrents to collaboration related to logistics, team function and the professionals involved. These superordinate categories are supported by the literature that explores the barriers to interprofessional collaboration, though some new subordinate categories within the categories emerged that were not prominent in the literature.

    • The Darkside of Collaboration: Part 2

      Interprofessional collaboration is prevalent in the healthcare field. Both students and practitioners are expected to take part in interprofessional collaboration. Most research focuses on the positive aspects of interprofessional collaboration, which includes better patient care, lower healthcare costs, and increased job satisfaction of healthcare workers. This study focused on students’ perceptions of interprofessional collaboration, and why they might not want to collaborate. The categories that emerged from the study were as follows: professional issues, communication difficulties, logistics and interpersonal issues. These categories are supported in the literature as barriers to collaboration.

  • Dementia

    • Conversations during mealtimes in long-term care: A case study of verbal and non-verbal communication in dementia

      Individuals with dementia who live in long-term care facilities often lack opportunities for social interaction. Mealtimes provide such an opportunity, yet there are few studies of the nature of communication during mealtimes. The purpose of this 900 project was to examine verbal and non-verbal communication behaviours of one individual with Alzheimer’s disease during mealtimes in a long-term care facility. Methods and Analysis: We observed 18 videotaped mealtime sessions of an 84-year-old man with dementia and analyzed verbal and non-verbal communication using existing frameworks adapted for our study. We analyzed our data descriptively, using frequency counts. The results of this study may contribute to the knowledge base on communication of individuals with moderate-severe dementia in long term care settings. Also, we make information available on the process of establishing and testing a framework for classifying nonverbal communication behaviours, which fills a gap in the literature.

  • Developmental dysarthria

    • Relationships between Speech and Language Features of Children with Developmental Dysarthria and Listener Effort

      This study described the expressive language characteristics of 12 children with dysarthria and cerebral palsy based on analysis of 50-utterance spontaneous speech samples. Children were between four and 12 years old and had receptive and expressive language ages of at least three years. Relationships between measures from the language analysis (mean length of utterance in morphemes - MLUm, number of different words - NDW, subordination index - SI, percent correct use of obligatory bound morphemes) and speaking rate, intelligibility (Test of Children’s Speech Plus – TOCS+ sentence measure) and listener-effort ratings for the spontaneous sample were also investigated. The children demonstrated a range of expressive language abilities. Eight had at least one expressive language measure (MLUm, NDW, SI) within normal limits compared to same-aged children with typical speech and language development. Contrary to what has been reported, most of the children marked obligatory morphemes with a high degree of accuracy. SI was the only language measure correlated significantly with intelligibility scores. Six participants used a slow rate of speech (< 2 syllables per second) (Shriberg, Kwiatkowski & Rasmussen, 1990). Speaking rate alone did not predict intelligibility scores or listener ratings of the amount of effort required to understand the children’s spontaneous utterances. Stepwise multiple regression analysis revealed that intelligible words per minute (IWPM), obtained from TOCS, was the only significant predictor of listener effort (adjusted R2 = 0.715; p< 0.0). SI did not contribute additional unique variance. This suggests that IWPM, a measure of speech efficiency based on the TOCS+ 80-word sentence imitation task, can estimate perceived relative effort needed to understand a dysarthric child’s spontaneous speech.

  • Edmonton Narrative Norms Instrument (ENNI)

  • EPL

    • Analysis and revision of an Edmonton Public Library materials pamphlet for adults with neurological communication disorders

      Adults with neurological communication disorders have the potential to benefit from the materials, technology, and services available at their local libraries. The purpose of this project was to analyze and revise the form, content, and use of a materials pamphlet intended to facilitate access to the Edmonton Public Library (EPL) system by adults with neurological communication disorders. This pamphlet was initially developed as a previous SPA 900 project. Our project involved analysis and revision of the first draft of the pamphlet, gathering of feedback on the revised version of the pamphlet from clinical SLPs, and further revisions based on this feedback. By evaluating and amending this resource, we anticipate that the utility of the pamphlet has been further improved, bringing the resource closer to implementation, and to the ultimate goal of reducing the activity limitations and participation restrictions faced by adults with neurological communication disorders.

    • EPL Resource Brochure for Adults with Neurological Communication Disorders

      The Edmonton Public Library (EPL) is a community resource that offers a variety of materials, technology and services as well as an extensive on-line database of digital materials for the public to utilize. The purpose of this project was to identify EPL’s existing resources and assistive technologies that would benefit adults with neurological communication difficulties and summarize these resources in a document that could later be used to facilitate interactions between adults with neurological communication disorders and the Edmonton Public library. The final document, an aphasia-friendly brochure, was developed based on information gained from multiple sources. All of the team members explored the EPL website and also went to a branch of the EPL, making observations regarding accessibility and available services. This was followed by a meeting with EPL staff, and a review of current literature to gather evidence and rationale to support which resources to include in the resource guide. These resources were divided into categories based on challenges individuals with neurological communication disorders may face (e.g. difficulties with mobility, memory, and attention) to facilitate identification of materials and supports best suited for the target population. The brochure was designed to be aphasia-friendly (e.g. reading level, font, pictures, and amount of whitespace). The final product was a four-page aphasia-friendly working prototype brochure of resources at the EPL for adults with communication disorders.

  • Error taxonomy

    • What’s in an Error? Development of an Error Taxonomy for Phonological Awareness

      There are currently no studies that examine the types of phonemic awareness errors children are making on tests of phonemic awareness. This study aimed to: (a) develop a taxonomy to categorize the different types of errors made on a test of phoneme segmentation by grade one children, (b) determine which error categories and error types occur most frequently, and (c) determine which types of words were the most difficult to segment. We examined errors made by 215 children on a test of phoneme segmentation, and developed a taxonomy for classifying the different categories and types of errors observed. The most frequently occurring category of errors was Addition errors, specifically the addition of a schwa vowel to a phoneme in the word. Additionally, children made more errors on test items that contained consonant blends. Knowledge of the different types of phonemic awareness errors children make will be valuable for teachers and speech-language pathologists when providing phonemic awareness instruction or intervention. Further research in this area is required to determine how meaningful different types of phonemic segmentation errors are in relation to overall phonemic awareness abilities and reading abilities.

  • Figures of speech

    • Understanding Figures of Speech in Children with Autism Spectrum Disorder

      Children with autism spectrum disorder (ASD) are said to interpret language literally. If so, they would have trouble understanding figurative language, independent of their language level. Idioms (e.g. “skating on thin ice”) are a type of figurative language that are used frequently. In this pilot study, we investigated comprehension of figurative language in cognitively-able children with ASD between the ages of 6 and 14 years old to see if their ability to correctly interpret the figurative meaning of idioms (a) increases with age and (b) is better when the idioms are presented in context rather than alone. We assessed idiom comprehension by administering 3 tasks, using the same 10 unfamiliar idioms in each. Each task provided a different level of contextual support. In the first task, participants were asked to define the idiom when it was presented in isolation. In the second task, they were asked to define the same idioms, but after hearing the idiom used in a story. In the third task, participants selected the correct option from three pictured alternatives after hearing the same story. Our hypothesis was that understanding idioms would be better in older children and would be better when the idioms were presented in context rather than in isolation. The results of this study supported our hypotheses and showed that the average number of idiomatic responses increased across age groups on all three tasks, and increased within age groups as the amount of context was increased. These results would suggest that context plays an important role in understanding of idioms regardless of a child’s age.

  • Head and neck cancer patients

  • Idiom comprehension

    • The Development of Idiom Comprehension in Children with Autism Spectrum Disorder

      This project is concerned with the development of idiom comprehension in children with Autism Spectrum Disorder (ASD). The performance of four children between the ages of 6 and 13 years, with High Functioning Autism (HFA), was compared on different idiom interpretation tasks. The three idiom interpretation tasks included defining idiomatic expressions in isolation, within a given context, and in a pictured multiple choice task. Ten unfamiliar idioms were used in all three tasks. The results were analyzed by comparing the performance of the participants across the three age groups, 6, 9-10 and 12-13 years of age. Their idiom interpretation abilities were also compared to Levorato and Cacciari’s model of idiom comprehension in typically developing children. The findings from this investigation will provide an opportunity to explore how age and the processing of contextual information contribute to the developmental course of idiom comprehension in children with ASD. This study found that children with HFA develop idiom comprehension through the same stages as typically developing children. It also shows that context plays an important role in idiom comprehension.

  • Idiom familiarity

    • Familiarity of Idioms in Canadian 12-year old Children

      Idioms are expressions in which the literal meaning differs from the meaning of that same expression when it occurs within a certain context. This study will determine whether idioms determined to be familiar in previous studies are still familiar and whether Canadians rate the familiarity of idioms similarly to participants in other countries.

  • Individuals who stutter

    • Exploring the Viability of Exposure to Stories of Individuals Who Stutter as a Learning Tool

      Background A large body of literature suggests that individuals who stutter, (“IWS”), are subjected to negative stereotypical attitudes and perceptions held by speech language pathologists (“SLPs”). Although there has been improvement in SLPs’ perceptions of IWS, there continues to be a need to provide student SLPs with first hand experiences with stuttering to facilitate the development of an empathic understanding of the impact of stuttering. A new method was investigated by Connatty et al. (2010), (the “Connatty study”) to engender in student SLPs an empathic understanding of the impact of stuttering. The Connatty study used qualitative methods in which the student SLPs were researcher-participants. Participants used reflective journaling to record their reactions as they viewed video-recordings of IWS. The author was a participant in the Connatty study during the data collection and reflection summary phases only. Her data was used in the Connatty study’s thematic analysis completed by the remaining participants. Purpose The purpose of this study is to provide a nuanced understanding of the individual reflections of a student SLP (i.e., the author) who participated in the Connatty study and to examine the congruence between the author’s summarized reflections and the thematic results of the Connatty study. Conclusion The author concluded that viewing video-recordings of IWS talking about stuttering is a viable method for developing in student SLPs an empathic understanding of stuttering and of IWS. She also indicated that the project helped her to develop an empathetic understanding of IWS. Congruency with the Connatty study is discussed.

  • IntD 410

    • Qualitative analysis of student reflections on interprofessional collaboration education

      Qualitative analysis was conducted on 30 written reflections completed by pre-service health science students enrolled in Interdisciplinary Team Development 410 at the University of Alberta. Five themes emerged from the analysis: (1) experience of cohesiveness, collaboration and communication of team; (2) learning about or appreciation of team roles; (3) importance of gaining knowledge about other professions; (4) importance of client or family centered care; (5) positive educational experience. In addition, autoethnographic analysis was conducted on reflections written by the researchers, who were also enrolled in the course. Student reflections were compared to researcher reflections and commonalities and differences were discussed.

  • Interface design study

  • International adoption

    • Early Language Development in Children Adopted from Ethiopia

      The number of children who are adopted internationally has been steadily increasing. However, there is a limited amount of research on how language typically develops in this population. This study followed 20 children under the age of 5 who were adopted from Ethiopia to North America. Longitudinal surveys, including the MacArthur-Bates Communicative Development Inventories (MCDI; Fenson et al., 2007), were used to record their language progression at 3 month intervals post adoption. Results were compared to those of children adopted from China and to norms for non-adopted peers. Children who were adopted at a younger age (< 6 mos) showed similar language development patterns to their non-adopted peers. However, children who were adopted at an older age took longer than those adopted at a younger age to catch up to age norms. Ethiopian children who were adopted at a later age ( >12 mos) showed much steeper growth curve in their expressive language than children who were adopted at a younger age. Children adopted from China showed similar patterns of language development. This information is important for clinicians and parents to understand the unique language development of their children and what it means for communication.

  • Interprofessional collaboration

    • Darkside of Collaboration - Part 3

      Interprofessional collaboration (IPC) is a practice that has clearly established links to improved patient outcomes. Yet in spite of these benefits, many professionals (and students in professional programs) have lamented over inefficiency and lack of time for collaboration in explanations of why IPC isn’t always practical. This begs the question—if IPC is such a well-supported practice, why is there still resistance? This study outlines survey results from graduate-level rehabilitative medicine students focusing on negative experiences of IPC. The results indicate that perceived lack of efficacy, poor communication, and unaddressed power differentials each play a contributing role in discouraging student professionals from collaborating interprofessionally.

  • IPad

    • A hotspot for contemporary SLP Practice: Using the iPad in Therapy with Adults

      This study examined whether the iPad and associated apps facilitates therapy with adults, and how it can be successfully integrated into speech-language pathology. Of the 28 participants in the study, 16 were clinicians and 12 were students in the MSc. Speech-Language Pathology program at the University of Alberta. The participants were divided into 11 Experienced and 18 Inexperienced users based on previous clinical use of the iPad with adults. All participants attended an Initial focus group, and although Experienced users were not required to attend, most participants attended a Learning session and a Final focus group. Data was analyzed using a mixed methods design. Focus group data was analyzed using qualitative summative content analysis, and descriptive data analysis was used to characterize the information from the App Rating Scale. Eight categories were outlined for participants during focus groups, and the ninth category, Need for Clinical Judgement emerged from the data alone. The data also showed a trajectory of clinician use of the iPad from non-users to emergent to integrated users, with differing barriers identified and uses employed at each stage. The data also showed some variations between Inexperienced and Experienced users, Initial and Final focus groups, and the preceding pediatric study and the current study. It was concluded that the iPad is a viable tool in speech-language pathology practice with clinicians, administration and app developers all having a role to play in maximizing use of this tool, and the profession must keep up with other healthcare professions as technology continues to permeate the healthcare field.

    • Using iPad apps to support meaningful communication: Educational resources for parents

      This project focused on knowledge-translation through the development of educational tools to support parents in using apps in ways that encourage interaction and language use. Best practice principles related to early language learning were used to guide the development of resources. The goal of resource development was to transfer the principles of language learning to the application (app) environment. Apps were selected and reviewed based on a pilot study conducted in concert with Alberta Health Services (Borys, DesJarlais, Sample, Wilson, & McFarlane, 2014; Fleming, Minaudo & McFarlane, 2014). These studies indicated a need for education regarding iPad use for parents and teachers. To meet this need, educational screencasts and app demonstrations were created to highlight strategies that expose children to meaningful social interactions with communication partners and focus on targeted areas of speech and language development. Three key areas of language development were included: early narratives, early sentence development and early literacy skills. The resources are accessible on the University of Alberta’s Communication Sciences and Disorders website: communication-sciences-and-disorders/msc-in-speech-language-pathology.

  • Language acquisition

  • Language development

    • Language Development in School-age Children Adopted from Haiti: A Longitudinal Study

      The language development of children adopted internationally is a topic of growing interest, however, most studies have investigated children adopted from China or Eastern Europe. This project is a follow-up study that explored the language development of school-age children who were adopted from Haiti between the ages of 6 and 43 months. Seventeen participants had been assessed at 2 to 7 years of age in previous studies conducted by University of Alberta MSc-SLP students. Thirteen of these children were re-assessed at 7 to 12 years of age for the current study. They were given a battery of standardized tests to evaluate vocabulary, receptive and expressive language, narrative comprehension/expression, and reading abilities. Results were compared with established norms for these tests, which provided an indication of the participants’ development in comparison to a general population of monolingual, non-adopted children. Each participant’s follow-up results were also compared to their performance on similar measures in the previous study. As a group, the children performed within the average range for language development, however, considerable variability existed among individual scores and some children had areas of concern. The children’s school-age scores were weakly to moderately correlated with the earlier measure of receptive vocabulary and moderately to strongly correlated with earlier measures of expressive/receptive language. The language scores for 3 children were consistently lower during the school-age years compared to the preschool years while 10 children showed little change. Overall the results indicate that language skills at school-age continue to be comparable to those of monolingual non-adopted peers.

  • Language intervention

    • The Effects of Language Intervention on Children’s Narrative Abilities

      Narratives are an important part of language that is incorporated into our everyday lives. Not only do narratives predict future success in school, but they also have a large impact on our social interactions. This study evaluated the effectiveness of a classroom-based language intervention program on narrative abilities. Participants included 27 Kindergarten and Grade 1 students from First Nations, Metis and Inuit (FNMI) communities. The language intervention targeted phonological awareness, mean length of utterance (MLU), and narrative development. The Edmonton Narrative Norms Instrument (ENNI) was administered both pre- and post-intervention to measure story grammar units and MLU. A paired samples t test was used to analyze pre- and post-test data (changes in use of story grammar units and increase in MLU) from the study. The results of the current research found that both MLU and story grammar units increased in a narrative task from pre-treatment to post-treatment samples. Our findings were consistent with previous research that found that language intervention is effective in increasing narrative abilities as measured by story grammar and MLU.


  • LSVT Loud

    • The Effects of LSVT®LOUD (Lee Silverman Voice Treatment) on the Speech Intelligibility of Children with Spastic Cerebral Palsy and Children with Down Syndrome

      Purpose: This study examined the effects of the Lee Silverman Voice Treatment (LSVT®LOUD) on the speech intelligibility of children with cerebral palsy (CP) and children with Down syndrome (DS). Method: Naïve listeners were recruited to decode the pre- and post-treatment recorded single-word speech tokens of 7 children with CP and 9 children with DS in an open-set identification task. A total of 10 speakers responded to the speech token set of each child. The responses were coded for accuracy in whole word intelligibility, percentage of consonants correct, initial consonants correct, final consonants correct, vowels correct, and multisyllabics/syllable structures correct. Paired t-tests were performed for each measure on the pre- and post-treatment tokens. The results were compared to available pre- and post-treatment acoustic data (dB SPL and maximum phonation duration). Parent interview data and pre- and post-treatment rating scales also were analyzed and compared to the results from listener responses. Results: Overall, the listeners were more accurate in decoding the post-treatment speech tokens than the pre-treatment tokens. Parents also perceived improvements in the speech of the children post-LSVT. Conclusions: Improvements in respiratory support and laryngeal control resulting from LSVT have potential spreading effects to the articulatory system that may serve to enhance intelligibility in children with CP and children with DS.

  • Lung Volume Recruitment (LVR)

    • Lung Volume Recruitment in Patients with Amyotrophic Lateral Sclerosis

      Purpose The primary purpose of this 900 project was to explore the effects of Lung Volume Recruitment (LVR) on voice and speech in patients with Amyotrophic Lateral Sclerosis (ALS) through the development of analysis protocols for several dependent measures. Methods Speech and voice data from a larger study were analyzed using protocols developed for the purposes of this project. Results No significant therapeutic benefit was found for any dependent measure examined in this study. Study protocols were developed and students achieved high inter-rater reliability when analyzing data according to guidelines. Implications Although researchers and clinicians have suggested a therapeutic benefit of LVR on voice and speech in patients with ALS, the results of the current study do not support these claims. Possible reasons for the findings and directions for future research are discussed.

  • Magnetic Resonance Imaging (MRI)

    • Investigating Lesion Size and Neuroimaging Methods with Magnetic Resonance Imaging in People With Aphasia

      The aim of this study was to investigate the effect of lesion size on performance on various cognitive and linguistic tasks in three individuals with left-hemisphere stroke. Findings from previous research studies have indicated mixed results, with some studies arguing that the location of the lesion has a greater impact on recovery after stroke. Researchers were also interested in determining which method of lesion mapping generated the most accurate measure of the individual’s lesion size while reducing mapping duration. Subjects underwent an MRI scan, after which lesions were mapped onto brain images using the MRIcron program. Graphs were generated that plotted lesion size against participant performance on each task and data was analyzed through visual inspection and slope analysis of graphed lines. No consistent pattern of decline in task performance was observed with increasing lesion size across linguistic and cognitive tasks. In addition, it was determined that the manual method of mapping (MTM) was superior to the semi-automated technique (STM), as it provided greater flexibility and a higher level of accuracy, especially for larger lesions.

  • Maternal conversational dominance

    • The Effects of a Child-Controlled Robot on Maternal Conversational Dominance During Play: A Case Study

      Previous research has indicated parents of children with cerebral palsy and other complex communication difficulties exhibit high levels of control during communication exchanges. The current study investigated differences in maternal communication with a child with complex communication deficits in two free play sessions. During the first play session, referred to as the No Robot session, the child and her mother played with a set of toys provided by the researchers. The second free play session, referred to as the Robot condition, incorporated a means for the child to actively participate in the interactions, in that the child controlled a Lego RCX Mindstorm™ robot, operated by using three switches. The mother’s utterances were coded in each of the play sessions and analyzed for features of conversational dominance. The researchers predicted that the mother would demonstrate decreases in Yes/No and Open-Ended Questions, decreases in Direction of Action, and decreases in Direction of Attention in the Robot condition as compared to the No Robot condition. Results indicate that the mother’s rate of question-asking decreased in the play session with the robot. The mother also showed decreases in statements of Direction of Attention in the robot condition. Contrary to the researchers’ hypothesis, the mother increased her use of statements of Direction of Action in the play session with the robot. Overall, the mother did show evidence of changing her conversational style when her child was afforded a more active role in free play sessions.

  • Mathematics

    • An investigation of the language produced by a child with physical disabilities while directing a partnered math activity with and without the use of a Lego robot

      Previous research at the Assistive Technology Lab at the University of Alberta has found that the use of robots can facilitate participation for children with disabilities in performing mathematics activities. The focus of the current study was to describe the language used by a child with cerebral palsy (CP) while completing math activities with a typically developing peer both without (baseline) and with (intervention) a Lego robot. The researchers aimed to determine whether the child would be able to complete the task more independently with the robot, and therefore produce less ‘task completion’ language (i.e., asking for help). The absolute number of times that the participant asked for help was very similar for both the baseline and the intervention conditions. However, the language itself was different. In the baseline condition, the participant mostly named the object he wanted with the intent of having the teacher hand it to him, whereas during the intervention session the language was more specific, directive and addressed to the other student. It was noteworthy that although the participant was in a wheelchair, he had minimal physical limitations in his upper body at the time of the study; he also had strong language and strong social skills. The researchers concluded that the use of a Lego robot to complete math activities was not particularly beneficial for this child with minimally restricting physical limitations, and that further research is warranted regarding the use of compensatory robots by users who may be more physically limited and also use augmentative and alternative communication (AAC) systems.

  • Motivational Interviewing (MI)

    • The effectiveness of a shortened training module on Motivational Interviewing skill acquisition

      Motivational Interviewing (MI) is a therapeutic technique that has been increasingly used in health care, and MI training for health care professionals has been progressively more promoted. This study investigated the effectiveness of a modified version of the traditional two-day workshop in Motivational Interviewing. Physical Therapy students completed the training as part of their curriculum and chose to participate in the study on voluntary basis. Comparisons were made between pre and post measures of a number of MI adherent skills used in written and role-play scenarios. Students demonstrated an increase in the use of open-ended questions, and the score of MI Spirit in their role-plays, as well as an increase in their score on the written scenarios. Reflection to Question ratio and the percent of Complex Reflections did not increase in the role-plays following the workshop. This shortened workshop was successful in promoting the use of basic Motivational Interviewing skills.

  • Motivational Inteviewing (MI)

    • Improving Motivational Interviewing Skills

      Motivational interviewing is a counseling technique used to support patients as they adopt behaviors consistent with positive health change. There is data to support its effectiveness in a variety of health care settings and with a variety of health challenges. MI involves assisting the client to make lasting behavioral changes by encouraging discussion focused on accepting and adopting new or different behaviours. Several techniques are used, including open-ended questions, affirmations, summaries and reflective listening. Reflective listening is an important component of this method and appears to be more difficult for clinicians to learn. The current recommended structure for MI training is a two-day workshop with follow-up coaching and practice, which is often too intensive to be feasible for busy clinicians and students. This study will examine an alternative teaching method by incorporating standardized clients (actors trained to simulate clients who are resistant to change) role-plays, as well as traditional lectures and learning groups into a module delivered to health science students. Pre and post measures of motivational interviewing skills will be obtained via two validated methods: analysis of written responses to clinical scenarios and analysis of video taped interactions. Measures will be analyzed to examine the effectiveness of the above training components. The results of this study will aid in the planning of training sessions for clinicians in the area of motivational interviewing by providing more efficient and effective ways in which to learn the skills necessary for this technique.

  • Non-Invasive Ventilation (NIV)

    • The Effects of Non-Invasive Ventilation Treatment on Airway Clearance and Swallowing in Individuals with ALS

      Amyotrophic Lateral Sclerosis (ALS) is a motor neuron disease characterized by the degeneration of both upper and lower motor neurons. These impairments cause functional limitations in many motor systems, including those supporting respiration and swallowing. As ALS progresses, specific treatments exist to minimize the symptoms of respiratory insufficiency. One of these treatments, non-invasive ventilation (NIV), is currently used as a respiratory therapy, as it decreases the rate of decline of an individual's forced vital capacity (FVC). However, its effect on specific respiratory abilities (airway clearance) and swallowing has not been studied systematically. In this 900 project, we analyzed data from a larger study in which the following research question was posed: what is the effect on airway clearance and swallowing in individuals with ALS after NIV treatment? Using a single-subject pre-post design, researchers measured forced vital capacity (FVC), sniff nasal pressure (SnP) and peak cough flow (PCF) of three individuals with ALS before and after NIV treatment. Results indicated a positive treatment effect, which provides a foundation for further research on this topic.

  • Nonverbal communication (NVC)

    • Nonverbal communication of individuals with dementia: An overview

      Individuals with Alzheimer’s type dementia will have diminished ability to communicate verbally as the disease progresses. Therefore, nonverbal communication (NVC) through the use of and facial expression, gestures, and body language is essential for connecting with others and expressing wants and needs. The purpose of this SPA 900 project was to examine the current state of the literature relating to NVC and dementia. A comprehensive review of the literature was performed across nine databases. Four hundred and fifty-four articles were identified in the initial search. After applying exclusion criteria based on title and abstract, 65 articles remained. Several themes across the literature were revealed including emotions and facial expressions of people with dementia, interpersonal communication interactions with caregivers, pain assessment, and intervention relating to the arts. Areas for future research are discussed.

  • Peak Cough Flow (PCF)

    • Effects of Positional Changes on Airway Clearance Behaviour of Individuals with Amyotrophic Lateral Sclerosis and Healthy Age Matched Controls

      Peak cough flow (PCF) is a measure of cough strength and capacity. According to American Thoracic Society (ATS) standards, patients should be seated upright during pulmonary function testing. However, the effect of sitting angle on PCF and other measures of cough function in patients with ALS has not been studied systematically. This project evaluated whether there was a difference in PCF during coughing when patients with ALS sat with 90 degrees forward flexion (FF) as compared to 80 degrees FF. Ten patients with ALS participated in the pilot study. A within-group, pre-test post-test design was used and previously collected measures of PCF were analyzed. Patients were seated in a modified chair that placed patients at 90 and then 80 degrees FF. The dependent measure was the maximum of three coughs. A comparison was made between 90 and 80 degrees of FF across measures of PCF, pre-cough inspiratory volume, and cough volume acceleration. A procedural manual describing the method of analyzing cough mechanics was developed. Results indicated an increase in values when participants sat at 80-degrees FF during a cough. These results suggest that FF may be beneficial to patients who are experiencing moderate to severe symptoms of ALS, and substantiate the evidence for use of FF as a non-invasive means of enhancing symptom-management of pulmonary function; and ultimately prolonging independence and Quality of Life. Future directions are also discussed.

  • Preschool children

  • Pseudostuttering

    • Developing an Understanding of Stuttering in Student Speech-Language Pathologists: A Comparison of Two Learning Experiences

      Purpose: This qualitative study explored and compared students’ perceptions of pseudo-stuttering and the viewing of video-recordings of adults who stutter in (a) developing an understanding of the nature and impact of stuttering, and (b) preparing students to provide treatment in the future. Pseudo-stuttering is a form of disability simulation (Ham, 1990) in which students pretend to stutter in various situations. Methods: This study used an autoethnographic design in which six student speech-language pathologists were participant-researchers. As participant-researchers, we completed six pseudo-stuttering experiences and viewed twenty video-recordings. We recorded our reactions after each experience and completed a final comparison reflection. Summaries of reflections were analyzed to explore themes inherent in the data. Thereafter, a literature review on the use of pseudo-stuttering and other methods to educate students about the impact of stutter was undertaken. Results: We found that the pseudostuttering and video-viewing experiences led to an increase in empathy and understanding of stuttering. We also gained clinical skills and insight for future practice from both of the experiences. The majority of the results from the pseudostuttering experience were consistent with those in the literature. At present there is no published literature regarding the use of a video-viewing component in the education of student speech-language pathologists.

    • Student speech-language pathologists’ perceptions of the advantages and disadvantages of pseudostuttering and viewing video-recordings of adults who stutter (AWS) as learning tools in developing an understanding of the nature and impact of stuttering

      This study explored student speech-language pathologists’ perceptions of the advantages and disadvantages of pseudostuttering and viewing video-recordings of adults who stutter (AWS) as learning tools in developing an understanding of the nature and impact of stuttering. An autoethnographic design was used in which we, two student speech language pathologists were participant-researchers. We completed six pseudostuttering experiences and viewed twenty videos of adults who stutter. Reflective journaling was used to record our thoughts, feelings, and reactions to these learning experiences and thematic analysis was undertaken to identify themes inherent in our data. Themes reflected our acquired understanding of the following; (1) the interaction of core personality traits and responses to stuttering, (2) emotional and cognitive reactions to stuttering, (3) the impact of external influences on interactions and conversation dynamics, and (4) the variability in stuttering and its impact on all aspects of life. Our findings indicate that pseudostuttering and viewing videos of adults who stutter lead to a deep understanding of stuttering and deep empathy for individuals who stutter. We recommend that both experiences be used in training clinicians. However, we recommend that the video viewing experience precede the pseudostuttering experience because we believe that first learning about the physical and social impact of stuttering will enrich the pseudostuttering experience.

  • Rapid automatized naming (RAN)

    • Rapid Automatized Naming and Adult Reading Abilities: Review

      Rapid automatized naming (RAN) tasks have been used to investigate underlying reading skills, understand reading impairment, and evaluate how to improve literacy instruction for typical and atypical readers. The two main areas of study have focused on the phonological and orthographic knowledge of children. In this review adult reading is investigated alongside the predictive qualities of the RAN task, expanding the focus of RAN tasks beyond the initial developmental stages of reading. The reviewed articles and information provide a strong argument that RAN tasks are predictive of adult reading ability, however further research is needed in order to provide additional detail about, and support for the relationship between RAN tasks and adult reading.

  • Reading comprehension

    • Examining Cognitive Mechanisms of Text Comprehension Using Eye-tracking And Working Memory Measures

      Traditionally, research on reading comprehension has relied on offline measures such as answering questions after reading a passage. However, for individuals with aphasia (an acquired neurological language impairment), working memory impairments may confound such measures. In contrast, eye-tracking methods represent an online method of assessing comprehension processes during reading, and may be especially helpful for individuals with aphasia because they do not require a verbal response. Moment-to-moment comprehension processes can be inferred based on eye-movement measures, including number and duration of fixations and number of regressions. In general, these measures tend to increase when readers encounter inconsistencies in text, but are dependent on both working memory capacity and the distance between inconsistent words. The purpose of the present study is to investigate the relationship between working memory capacity and reading comprehension, as indexed by online (eye-movement) measures. Two measures of working memory (n-back and reading span) will be compared to determine which is better correlated with eye movements associated with reading comprehension. This study will take the first steps in establishing the relationship between on-line text-reading comprehension in relation to working memory in healthy individuals. Control group measures will be used as a reference to compare to individuals with aphasia. In this article we describe the development of stimuli for eye tracking and behavioural assessments, and describe procedures for analyzing the data.

  • Reliability

    • Reliability of Online Scoring of First Mentions in the Edmonton Narrative Normative Instrument

      When a story is told, referring expressions are used to introduce referents (characters and objects). This must be done so that the listener clearly understands that the character or object is new to the story (Schneider & Hayward, 2010). The ability to use referents correctly, according to the shared physical context and the preceding linguistic context, develops throughout the early school years (Hickmann, 2003). The term First Mentions (FM) has been coined to refer to the referring expressions that children use when introducing characters and objects when telling a story (Schneider & Hayward, 2010). Recently, in the Edmonton Narrative Norms Instrument (ENNI; Schneider, Dubé, & Hayward, 2002), a specific scoring system was developed to evaluate the appropriateness and sophistication of FMs through transcription analysis (Schneider & Hayward, 2010). The norms produced allow speech-language pathologists to differentiate between typically developing children and children with specific language impairment (Schneider & Hayward, 2010). This research examined whether it is possible to use the scoring system reliably when listening to the stories on tape, without transcribing. To determine reliability, stories from the original study were scored 'online' by listening to recordings of 41 narratives of children from the original ENNI study (Schneider & Hayward, 2010) and applying the FM scoring system while listening to the recordings. Cohen’s Kappa coefficient was used to determine reliability between transcription and online FM scoring. This statistical measure assessed inter-rater agreement between the FM scores and adjusted for probabilities of occurrence of individual FM categories (Rosner, 2006). Results indicated strong agreement (κ = .874) between the two analysis types. This research result indicates online scoring of FM is appropriate for speech-language pathologists to use.

  • Reliability study

    • Exploring Pragmatic Language Dysfunction in High Functioning Speakers with Autism Spectrum Disorder: A Reliability Study for Transcription using Systematic Analysis of Language Transcripts (SALT)

      Children with Autism Spectrum Disorder (ASD) commonly experience difficulties with pragmatic language use. To determine how cognitive load affects the pragmatic language use of high-functioning children with ASD, 11 children between the ages of 7 and 12 and diagnosed with ASD performed talk-aloud number line tasks of increasing difficulty. Their performance will be compared to 11 typically developing children matched on chronological age and non-verbal mental age. All children involved in the study spoke English as their first language, and had no known neurological disorder. A future study will focus on the pragmatic performance of the participants and the investigators expect to find that children with ASD make more pragmatic errors than matched controls and that all participants make more errors on longer number lines. This phase of the study focused on transcription of the data. With appropriate training, graduate research students transcribed the samples using Systematic Analysis of Language Transcripts (SALT) software. Inter-rate reliability of better than 80%was achieved.

  • Resilience

    • Resilience in stroke survivors: identifying factors that contribute to successful adaptation

      Health care providers report that individuals with similar levels of impairment after stroke have markedly different outcomes (Hartman-Maeir et al., 2007). Pilot studies of stroke survivors suggest that resilience may be a primary mediating variable accounting for the fact that some individuals recover higher levels of function and reintegration into society than would be predicted by their initial prognoses. Researchers define resilience as, “positive adaptation despite experiencing significant adversity that normally would be expected to bring about negative outcomes” (Luthar, 2006, p. 739). Researchers have recently used the resilience framework as a useful mechanism to identify factors that foster positive outcomes in individuals living with chronic health conditions. Multiple protective factors are theorized to contribute to resilience in individuals post- stroke: [1] active cultivation of hope and optimism along with mitigation of depressive symptoms (Allen, Savadatti, Levy, & Gurmankin, 2009; Cherry, Galea, & Silva, 2008; Uomoto, 2008); [2] strong social and emotional support networks (Cherry et al., Glymour, Weuve, Fay, Glass & Berkman, 2008; Nahlén & Saboonchi, 2010; Tomberg, Toomela, Ennok & Tikk, 2007; Uomoto, 2008); [3] active, solution-driven coping styles underpinned by the belief in one’s power to affect positive change (Abbott, Hart, Morton, Gee, & Conway, 2008; Fok, Chair, & Lopez, 2005; Nahlén & Saboonchi, 2010; Sofaer-Bennett, Moore, Lamberty, & O’Dwyer, 2007; Tomberg et al., 2007; [4] high motivation to continue to keep active and attaining goals (Cherry et al., 2008; Sofaer-Bennett et al., 2009; and [5] be relatively young (Hildon, Smith, Netuveli, & Blane, 2008).

  • Resource manual

    • Parent Activities: Development of Cognitive Skills using Robots

      This is a resource for parents of children with physical limitations. Typically developing children learn and develop their cognitive, language, social, and motor skills by interacting with their environment. For example, playing with toys and physically manipulating objects help children learn vocabulary and language concepts about those objects, as well as their properties. Children with physical limitations may not be able to explore their world in this way, and so their opportunities for learning are more limited. Robots can be used to provide children with a means to play and learn where they might otherwise be unable to. This resource manual shows parents a variety of ways in which robots can be used to help promote their child's development through a number of fun learning activities.

  • Robot effects

    • Effect of a Child-Controlled Robot on Mother’s Communicative Dominance during Play Interaction with a Child with Cerebral Palsy: a Case Study

      Children who have severe physical disabilities often have great difficulty interacting and learning through play, and their expressive language is commonly limited. During play, mothers are frequently more directive in their interaction with children with disabilities. This might change if the child has more control over the environment. Research on the use of robots during play has shown that children with severe physical disabilities, limited fine motor abilities, and limited expressive language, vocalize more both during and after play interaction with a robot. This study examined the effect of the use of a child-controlled robot on maternal communicative dominance in the communication between a mother and her child with cerebral palsy. Using video recorded free-play sessions collected in a previous project, we coded the communicative functions that occurred between the mother and child during play for two conditions: the first with only the child’s toys, and the other with both the child’s toys and a robot. Results showed that while the mother decreased her use of Yes/No Questions and increased her use of Open Ended Questions as expected, there was very little overall change in her use of Choice Questions, Direction of Attention, and Direction of Action. The child did not increase the frequency of her overall communication. The results of this study indicated that the presence of a child-control robot slightly decreased maternal communicative dominance.

  • Robotic play

    • Parent Activities: Development of Children's Cognitive Skills using Robots

      Typically developing children learn and develop their cognitive, language , social and motor skills by interacting with their environment. This includes playing with toys and physically manipulating objects. Children with physical limitations may not be able to fully explore their world in this way, so their opportunities for learning are limited. Robots can provide children with a means to play and learn, that they might otherwise be unable to do. Parent materials have been developed to show parents a number of different ways that robots can be used to help promote their child’s development through fun learning activities. A manual, play items and the robot were distributed to parents to use with their children. The parents were asked to review the manual's accessibility and ease of use. The parents' feedback was evaluated in order to examine the experience of the parents and children of using the manual at home.

  • Speech & Language Workbook

    • The Brain Care Center’s Workbook for Individuals with Aphasia - Take Home Practice for Speech and Language

      This paper outlines the process involved in the development of a speech and language focused workbook that was created in collaboration with the Brain Care Center, in Edmonton, Alberta. ‘A Workbook for Individuals with Aphasia – Take Home Practice for Speech and Language’ was created to support and encourage communication for individuals with speech and language needs resulting from left hemisphere stroke, who have acquired a language impairment called aphasia. After an initial consultation with the Brain Care Center, a literature search was completed to identify the rationale for inclusion of each of the four main sections of the workbook: word finding, reading, writing, and cognition. Another literature search was also completed to find effective therapy techniques for each of the aforementioned areas of language. These evidence-based techniques formed the basis of the activities that were designed to be implemented by a layperson in a home setting. This paper also contains the evidence and rationale for the inclusion of additional sections of the workbook regarding socialization strategies, an educational sheet about aphasia, a wallet size information card, and community resources available within the Edmonton region for individuals with aphasia. The resource workbook was designed for home practice with a caregiver to allow individuals with aphasia opportunities to build skills for reintegration into the community and improvement of daily living skills, thereby increasing the individuals’ quality of life. The evidence-based activity and resource workbook was presented to the Brain Care Center through an in-service in October, 2011.

  • Speechies

    • Speechies Speak Out Blog: Exploring the Role of Social Media in Promoting University Programs

      The Speechies Speak Out blog was created to advocate the Speech Language Pathology & Audiology program at the University of Alberta and to attract prospective students. Weekly updates or "posts" included highlighting the experiences and perspectives of students, as well as integrating current topics of research. The end goal of the project was to detail the process of setting up the blog and to develop an understanding of what motivated people to read it. This was done by monitoring changes in viewership over time and examining three questions: (1) Will the blog show an increase in viewership over time?; (2) What category of posts received the most views or was most popular?; and (3) How were people referred to the site? The results from data collected for one year revealed that the blog showed an increase in viewership of almost 200% over 10 months, with an average increase of 25.5% per month. The posts in the categories of Student Perspectives (1,328 views) and Events at Corbett Clinic (641 views) received the greatest overall views. Most viewers were referred from outside sources, with Facebook being the top referrer. These results suggest that the blog was a successful tool in promoting interest in the program and that posts directly relevant to the school and its students were most effective at drawing in viewers. Other professional university programs may therefore choose to develop a blog with a student-life focus while using third party social media sites, such as Facebook and Twitter, as referral tools to positively impact viewership and program promotional efforts.

  • Storytelling

    • The Effect of Static versus Animated Story Stimuli on Children’s Ability to tell Stories

      Storytelling tasks are commonly used to assess language in a functional context. However, the quality of children's stories can vary depending on how stories are elicited. Research (Pearce, 2003; Schneider & Dubé, 2005) has shown differences in children’s narratives when retelling stories from oral and picture stimuli. We examined an additional type of story elicitation method: animated stimuli. The purpose of our study was to determine whether 4- and 5-year-old children provide more story grammar information with an animated version of the story than with a static version. Each child told a story from animated and static stimuli. The stories were then scored for amount of story grammar information and scores were compared from the two conditions. The results from the study demonstrated that the number of story grammar units included in children’s narratives when presented with an animated stimulus did not differ from the number of SG units included when presented with a static stimulus. Therefore, when choosing presentation formats of narratives for teaching, assessment, and treatment purposes for this age group, a static presentation of a narrative appears to be just as effective as an animated presentation.

  • Stuttering

    • Exploring the Viability of Exposure to Stories of Individuals Who Stutter as a Learning Tool

      Background/Purpose The negative stereotype associated with stuttering has been shown to be both persistent and robust. The stereotype persists not only in the general public, but also in the student clinician population and practicing speech-language pathologists (SLPs). It is recognized that such perceptions have the potential to impact the delivery of treatment to individuals who stutter; however, efforts to change them have met with limited success. Thus, the purpose of this study was to explore the viability of viewing video-recordings of people who stutter in order to engender in student SLPs an empathetic understanding of people who stutter and the impact of stuttering on these individuals. Methods This study used an autoethnographic design in which the personal experiences of the participant researchers illuminated the culture under study (in this case, the culture under study is SLPs who are preparing to treat communication disorders). In this study, student SLP’s written reflections about their experience of viewing video-recordings of adults who stutter were thematically analyzed. Results Overall, stereotypic reactions and perceptions toward stuttering and adults who stutter changed as a result of the video-viewing experiences. That is, participants gained a richer understanding of the physical manifestations of stuttering and the psycho-emotional-social aspects associated with it. In particular, from their newly acquired understanding of stuttering, participants developed empathy for people who stutter, which they felt would impact their ability to provide treatment for stuttering in the future, and their confidence in doing so. Conclusions Participants felt that watching the video-recordings and reflecting upon them was a valuable learning tool. It increased their knowledge, empathy, and awareness of listener attitudes. The results of this study have important implications for the training of SLPs who will, in the future, be involved in the delivery of stuttering treatment.

  • Swallowing

    • Multifaceted treatment approaches for speech and swallowing: Case studies and systematic reviews

      The purpose of this project was to provide in-depth information on commonly used strengthening treatments for neurogenic swallowing and speech disorders in adults. A case example format is used in which details are provided regarding treatments provided to two clients with swallowing and speech disorders of different etiologies. Following the case examples, a systematic review and quality appraisal of each treatment technique are reported. Limitations of the case studies, future research directions, and the use of a novel device for hyolaryngeal strengthening are discussed. Keywords: speech therapy, swallowing, tumor abstraction, stroke, head lift exercises, tongue strengthening, Lee Silverman Voice Treatment, expiratory muscle strength training

  • Symptom management

  • Teasing and Bullying video (TAB)

    • Perceptions of Children who Stutter Regarding the Use of the Teasing and Bullying (TAB) video

      Background. Children who stutter are teased and bullied. Langevin (1999) developed the Teasing and Bullying: Unacceptable Behaviour (TAB) program for use in schools. The TAB program includes a videotape that discusses teasing and bullying and provides information that educates students about stuttering. Purpose. Although the TAB video was developed in consultation with children who stutter, their views on how the video should be used in their classrooms and schools have not been systematically investigated. The goal of this research project was to learn how children who stutter think the TAB video should be used. Method. This study examined archival data collected from 40 children who stutter who were in treatment. After watching the TAB video, the children completed a questionnaire that asked whether they thought it was a good idea to show the video to other students, whether they would want the video to be shown in their school and/or classroom, and whether they would like to be present in the room or not when the video was being shown. Closed and open questions were used. Results. This study found that 97.1% of participants think it is a good idea to show the video to as many students as possible, of which 88.9% preferred to be in the room if the video was shown. Thematic analysis of qualitative responses indicated that the majority of children wanted the video shown in their class because there were bullies in their class and it would show bullies what it feels like to be bullied. Conclusion. Overall, the results suggest that the use of the TAB video in schools is supported by children who stutter.

  • Technology

    • Implementing technology into clinical practice: Speech-Language Pathologists and iPad use

      Recent advancements in mobile technology and increased use of mobile devices are influencing service delivery in healthcare settings, including the field of speech-language pathology. Although limited research exists in this area, an increasing number of speech-language pathologists (SLPs) have expressed interest in using these tools within a clinical setting. This study is part of a larger project examining the use of iPads by speech-language pathologists in Alberta Health Services (AHS), a large, province-wide health agency. This component of the study examined SLPs’ perceptions about iPad use before and after using the device for a 9 to 12 month period, how the iPad fit into their clinical practice, what benefits or limitations were reported, and what recommendations clinicians have for integrating iPad use in a clinical setting. Both qualitative and quantitative data were collected through online surveys as well as initial and final focus groups. After dealing with initial challenges surrounding device setup and app acquisition, iPad use increased across the period of use. Clinicians identified a number of themes surrounding clinical iPad use, such as the need for IT support, time and education. Results and discussion also included suggestions for future iPad implementation within a large health agency.

  • TOCS+

    • Predicting the Speech Intelligibility Scores of Children with Dysarthria and Cerebral Palsy from Phonologic and Phonetic Measures of Speech Accuracy

      Measures of speech sound accuracy (e.g., percent consonants correct or PCC) and direct measures of intelligibility (e.g., percent words identified correctly) are used to determine the severity of a child’s speech disorder. However, the relationship between these measures has not been reported for children with dysarthria. This study examined the relationships between several segmental (PCC, percent vowels correct or PVC, percent phonemes correct or PPC, PCC-R, PVC-R, PPC-R) and whole word (percent whole word accuracy; proportion whole word proximity) measures of speech sound accuracy obtained from phonetic transcription and direct measures of intelligibility based on word identification by unfamiliar listeners. Measures were based on audio recordings of TOCS+ imitated word and sentence samples obtained from 12 children with dysarthria and cerebral palsy (CP). Children ranged in age (4 - 12 years) and severity of CP (levels I to V on the GMFCS-ER). Phonetic transcription of the recordings incorporated a subset of narrow diacritics from the extIPA to capture sound error patterns of children with dysarthria and CP. PCC had the strongest correlation with intelligibility for the word samples (r = 0.764) and PCC and PCC-R had the strongest correlation (r = 0.931) with the sentence samples. While PCC rank ordered the children by severity of speech disorder in a similar way to the intelligibility scores, the magnitude of the difference between PCC and intelligibility scores varied substantially by severity of speech disorder, with the greatest difference for children with the lowest intelligibility scores.

  • Traumatic Brain Injury (TBI)

    • Development of “The Cognition and Communication Home Workbook for Individuals with Traumatic Brain Injury”

      “The Cognition and Communication Home Workbook for Individuals with Traumatic Brain Injury” was designed to target speech, language and communication deficits and build upon strengths of individuals with a traumatic brain injury (TBI). Development of the workbook was requested by the Brain Care Center (BCC), a non-profit agency serving clients who have sustained a brain injury. This workbook is based on the process-oriented home rehabilitation format, which emphasizes personal self-awareness and self-regulation (Warden et al., 2000). The home workbook contains stimulation activities, scripts, social games and templates that can be used to improve day-to-day functioning. Staff at the BCC will choose and distribute activities that match client needs. Personally and socially, this workbook will provide much-needed community reintegration support. Created out of a need to rehabilitate adults with brain injury back into their community, workbook activities are based on evidence obtained through a literature review of TBI and community reintegration. The TBI workbook was developed alongside a workbook for individuals with speech and language disorders following left-hemisphere stroke and included: meetings with BCC and the partner group who developed the stroke workbook, review of the literature, and development of tasks and activities for the workbook. Following completion, an in-service was provided to the BCC on how the workbook was created and designed to be used. This paper describes the process followed in the development of the workbook including the evidence supporting the activities, as well as limitations, suggestions for improvement, and potential future directions.

  • Videoconferencing

    • Videoconferencing vs. Face-To-Face: A Comparison of Results from Two Articulation Testing Conditions

      The use of videoconferencing to provide speech-language services has been promoted by such agencies as Alberta Health Services. It allows previously un-serviced, rural areas to access direct speech services from a speech-language pathologist (SLP), while also reducing the costs associated with traveling therapists. However, little research has been conducted on the validity of articulation assessments in child populations via videoconferencing. The purpose of this study was to determine whether or not the same results would be obtained from an articulation test administered under two conditions: face-to-face (FTF) and videoconferencing (VC). A computer-based articulation screening tool was administered to 33 kindergarten children in Lac La Biche, Alberta. Each participant was tested in both conditions, with the order of administration counterbalanced and with approximately four weeks between each administration. Results were compared across the two conditions using paired t-tests. Specific measures included the number of target sounds in error, the number of target sounds produced correctly (overall and by word position and sound class – fricatives, stops, etc.), prompt use and test administration time. Results showed that there was no significant difference between scores obtained in the VC and FTF condition. However, in the VC condition, children required more prompting and test administration time was longer. Certain sound classes (i.e. nasal and liquids) scored better in the VC condition. Overall, it was found that videoconferencing is a valid avenue to screen kindergarten children for articulation errors. However, small perceptual differences in articulation may be more difficult to identify.

  • Volitional airway protection technique

  • White matter

    • An in-house lab manual for analyzing white matter pathways in children who stutter

      Diffusion tensor imaging (DTI) proves to have great potential for investigating the white matter network of the brain. The ability to study these pathways may offer important insight into the neurological differences of people with communication disorders. However, due to the high level of technological complexity, which frequently results in a number of data artifacts, quality control of the data is essential for accurate results (Oguz, 2014). Currently, research in the field of DTI lacks rigorous and uniform DTI data quality check standards. This manuscript will act as an in-house manual describing how to prepare quality diffusion MR data for DTI analysis with two commonly used analysis software, FMRIB Software Library (FSL) and Explore DTI. This manual will highlight the preprocessing stages and data quality analysis for both programs in order to facilitate future research for students and scientists in the field of speech-language pathology.