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Allegra B. AppleUse of Traditional Articulation Therapy and a Self-Monitoring Technique to Remediate a Kindergartener's /s/ Production
The purpose of this study was to evaluate the effectiveness of traditional articulation therapy (Van Riper, 1963) combined with a self-monitoring technique to remediate /s/ production in a 5-year, 5-month old Caucasian female. Throughout the study, the clinician pointed out the accuracy of the participant's /s/ productions, the participant clicked a tally counter to monitor /s/ productions, and client-centered stimulus materials were used. Results showed statistically significant improvement in /s/ production at both the sentence and connected speech levels. Suggestions for a broader range of treatment applications are discussed. Pp. 1-11.
Erica Bland, B.S.
Use of a Modified Camperdown Program and Prolonged-Speech Techniques to Reduce Prolongations in an Adult Who StuttersThe effect of combining traditional prolonged-speech techniques and a modified Camperdown
Program to reduce inaudible prolongations (i.e. blocks) in conversation and oral reading tasks was assessed in the treatment of an adult with a moderate to severe fluency disorder. Using a single-subject AB design, treatment involved within-and-beyond clinic speech samples, self-rating of stuttering severity, and fundamental principles of prolonged-speech (e.g. easy onset, continuous phonation, gentle articulatory contact). Results, which produced a mixed outcome, revealed a reduction of blocks from 3.0%SS (percentage of stuttered syllables) to 2.2%SS in conversational speech and 3.65% to 1%SS in oral reading. While not statistically significant in relation to p-values, the effect sizes for both contexts were large. Reduction of blocks occurred in both contexts, but did not generalize. It is unclear which aspects of treatment were instrumental in reducing the dependent variable or which prolonged-speech techniques were systematically observed. Implications, both clinical and theoretical, are discussed. Pp. 12-23.
*Matthew GuggemosComputer-Assisted Treatment for Accent Modification: Preliminary Data and Lessons Learned
The effects of two computer-based treatments on an adult Mandarin-accented English speaker's production of final-position consonant-/l/ clusters were examined, using a single-subject experimental design. Treatment 1's goal was to improve target sound production at the word level by combining tongue placement exercises, clinician feedback, and real-time visual spectrographic feedback. Treatment 2's goal was to improve target sound production at the sentence level, using both clinician feedback and speech-recognition software. Both treatments were effective in improving the participant's production of the target sound. These findings indicate that computer-based real-time biofeedback treatments may improve Mandarin-accented English speakers' production of final-position consonant-/l/ clusters. Pp. 24-32.
*Paper presented at the Annual Convention of the American Speech- Language-Hearing Association, November, 2007, Boston, MA.
Jaclyn Moy
The Effectiveness of a Combination of Vocal Hygiene, Vocal Function Exercises, and Resonant Voice Therapy on Voice Quality in an Adult with a Voice DisorderPrevious studies have evaluated the effectiveness of Vocal Hygiene, Vocal Function Exercises, and Resonant Voice Therapy when used individually, though these techniques have not been evaluated when used in combination. This study evaluated the effectiveness of the combination of these techniques on voice quality in an adult female diagnosed with a voice disorder. Before and after eight weeks of treatment, the participant's voice was recorded and assessed using auditory perceptual and acoustic measurements. Results showed that the combination of Vocal Hygiene, Vocal Function Exercises, and Resonant Voice Therapy had a positive effect. These findings are consistent with previous results, which found each of these techniques to be effective in treating voice disorders. Further research to determine long-term effects of these treatments on generalization is warranted. Pp. 33-39.
Heidi Musgrave
Initiation of Follow-up Questions in an Adult with General Anxiety DisorderThe effect of modified Social Skills Training methods in combination with a cognitive component on the initiation of follow-up questions was investigated using a single subject design in an adult with pragmatic language disorder as well as General Anxiety Disorder and depression. Participant reviewed video models, and completed conversation worksheets to improve her initiation of follow-up questions in role-play scenarios with the examiner, while generalization was tested in conversations with unfamiliar persons outside of the research setting. Results indicated that the client increased the number of follow-up questions in a role-play with the examiner, but the treatment effect did not generalize to conversations outside of the research setting. Statistical and clinical significance measures showed that treatment had a positive effect on the dependent variable. Pre post treatment observational assessment of pragmatic language also showed changes in performance. Clinical implications regarding the impact of the treatment are discussed. Pp. 40-53.
*Lisa Roeder
Improve Verbal Output using Response Elaboration Training and Motor Learning Strategies for a Speaker with Broca's Aphasia and Apraxia of SpeechThis study examined the effects of two treatment techniques - expanding vocabulary and motor learning strategies - on the verbal output of an adult with chronic Apraxia of Speech (AOS) and Broca's aphasia. Treatment 1 (expanding vocabulary) implemented a modified version of Response Elaboration Training (RET) wherein self-initiated responses to pictures were elaborated. Treatment 2 (motor learning strategies) was added to RET half way through treatment wherein specific sound production of words identified from RET were targeted. The dependent variable was improving content information units (CIUs) per picture. Results indicate a positive change in behavior. For example, an improvement on the Aphasia Quotient (AQ) of the Western Aphasia Battery (WAB) improved 38.2 to 52.8 and CIUs improved 50% to 69.5%. Results support the use of RET and motor learning strategies to improve CIUs and suggest that combining approaches may be beneficial to adults with chronic AOS and Broca's aphasia. Pp. 54-67.
*Paper presented at the Annual Convention of the American Speech- Language-Hearing Association, November, 2007, Boston, MA.
Mirhiya Sampson
The Effect of Communicative Temptations Therapy on Eye Contact to Gain Joint AttentionThe purpose of this study was to assess the effectiveness of communication temptation therapy on the use of appropriate eye contact. It was hypothesized that communication temptation therapy, a treatment based on structuring activities to elicit a particular behavior, will increase the use of appropriate eye contact in a 5 year old boy. Eye contact was calculated during 10-minute unstructured probe sessions, at the beginning of each 55-minute treatment session. The results revealed a statistically significant increase from a mean of .67 attempts at eye contact in 3 baseline trials to a mean of 4 attempts at eye contact in 14 probe sessions. The lack of sources of normative data for eye contact and the implications of the study are discussed. Pp. 68-74.
Marcy Smith
Using Treatment of Underlying Forms to Address Syntactic Deficits in an Individual with Anomic AphasiaThis experiment examined the hypothesis that using of Treatment of Underlying Forms (Thompson, Shapiro, Kiran & Sobecks, 2003) to train production of syntactically complex sentences with Wh-movement, results in generalization to less complex sentences that are linguistically related. Using a single subject, ABA experimental design, one individual with anomic aphasia and symptoms of agrammatism, was trained to produce sentences with object-relative clausal embedding. Results of the study confirmed the Complexity Account of Treatment Efficacy (Thompson et al., 2003), indicating that training syntactically complex structures results in generalization to less complex sentences which have processes in common. Treatment also resulted in improvements in narrative discourse in terms of syntactic accuracy and complexity in narrative discourse. Pp. 75-85.
Stephanie Wood
Effects of Spaced Retrieval (SR) Training on Verb Production in Sentences in a Person with AphasiaThis study evaluated the effectiveness of Spaced Retrieval (SR) training on verb production at the sentence level in a 58-year-old male with Wernicke's aphasia. Using a single subject AB research design, treatment effectiveness was measured for sentence productions of fifteen functional verbs chosen by the participant and his caregivers. In a series of trials repeated over increasing time intervals, the participant produced the target verbs in sentences while looking at pictures and using written cues of the target verbs within a cueing hierarchy. Results of this study showed improved speech production of the target verbs in sentences during treatment. However, a post-assessment social validation measure revealed that the participant reported no generalization outside of therapy sessions. These findings indicate that SR training may be a beneficial method for verb recall and production at the sentence level within a controlled setting. Directions for further research are discussed. Pp. 86-94.
Editor's NoteVolume Fourteen of Student Research Papers in Communicative Sciences and Disorders continues the tradition of melding theory and practice into clinical research. Students in the Department of Communicative Sciences and Disorders at California State University, East Bay (formerly CSU Hayward) continue to demonstrate active learning about the clinical research process. Overarching goals of the course in which the students complete these projects are for students to begin their professional clinical responsibilities of becoming astute consumers and producers of clinical research. This endeavor dovetails with the American Speech-Language-Hearing Association Focused Initiative on Evidence-based Practice and the trend in speech-language pathology to demonstrate treatment efficacy and effectiveness.
Several of these student authors presented their work in poster format at the Student Research Forum in the Department of Communicative Sciences and Disorders in December 2006 and at the Distinguished Lecture Series in Communicative Sciences and Disorders in May 2007. Two students presented their papers at the American Speech-Language-Hearing Association Annual Convention in Boston, MA in November 2007. Several other authors have submitted their work for presentation at the California Speech-Language-Hearing Association Annual Convention in 2008. All contributing authors are to be commended for their efforts and products.
The articles in Volume Fourteen were approved by the California State University Institutional Review Board. Each student submitted an IRB application and also designed the treatment protocol, collected and analyzed data using current methods of single-case research design, and prepared the results for dissemination. The data emanating from these reports add evidence to our literature base and support the effectiveness of treatment techniques for individual participants. In the process of completing their studies and preparing their reports, the students learned valuable research skills and tools which can be transferred to their clinical settings.
Volume Fourteen contains ten papers selected from 29 submissions. The topics address a broad range of communication disorders, including treatment for clients with disfluency, aphasia, general anxiety disorders, and apraxia of speech. All of the research projects were created, implemented, analyzed and written during the Fall Quarter 2006.
The reports in Volume Fourteen are distributed on a limited basis to interested individuals and to CSD departments at sister institutions. Individual papers from this and previous volumes may be ordered through inter-library loan. Please direct requests to the Library at California State University, East Bay. Abstracts of this and previous volumes may be accessed online at http://class.csueastbay.edu/commsci/abtstres.htm.
I hope you find these reports of value in clinical practice and will join me in welcoming these talented individuals to the profession.
Janet Patterson, Editor
July 2007
Ordering information:
To order any of the above papers, send a request through regular inter-library loan to California State University, East Bay Libraries, Hayward, California 94542. Include author, title, volume, call number and page numbers.
