Auditory-motor adaptation is a form of sensorimotor learning in which human subjects gradually (i.e., over several trials) adjust the movements of their speech articulators when experiencing experimentally manipulated auditory feedback. For example, it is well documented that subjects lower their formant frequencies (i.e., acoustic output resonant frequencies that are determined by the articulators’ positions) in response to a real-time upward shift of these formants in the perceived auditory feedback. Our long-term goal of translating such auditory-motor learning protocols into clinical applications for individuals with speech disorders requires an understanding of the central nervous system’s tolerance for feedback delays. Indeed, one potential problem for efficient sensorimotor learning arises when movement-related feedback is delayed: perceiving the consequences of one’s own actions with a delay results in this sensory information being processed similar to externally-generated, rather than self-generated, sensory input. In the present study, we follow up on recent work in which we found that auditory-motor learning in speech is completely abolished with feedback delays of 100 ms or more. Here, we tested whether shorter delays also have a negative impact on speech auditory-motor learning. Twelve adult subjects read out loud monosyllabic words while a digital vocal processor applied a 2.5 semitones upward shift to all formants in the auditory feedback signal that was presented through insert earphones. In separate conditions, this feedback was delayed by 0, 33, 66, or 100 ms. Measurements of the subjects’ extent of auditory-motor learning across all conditions will be presented and interpreted in the context of current models of sensorimotor learning.
 

Although efficacious treatment options are available for children who stutter, currently existing treatments for adults who stutter are generally ineffective and time-consuming with relapse rates as high as 50-70%. Thus, there is an urgent need for innovative stuttering treatment approaches that are both effective and efficient. Here, we explore the use of neurofeedback training as a novel tool in reducing stuttering frequency. Neurofeedback is a type of biofeedback that enables individuals to self-regulate particular aspects of brain activity (e.g., slow cortical potentials or activity in specific frequency bands) through real-time visual feedback. Neurofeedback protocols targeting various activation patterns have already been tested extensively for the clinical management of disorders such as epilepsy, ADHD, and Tourette’s syndrome. In the present preliminary study, we examined whether or not the direct regulation of a brain wave called the mu rhythm (8-13 Hz) shows promise for reducing the primary symptoms of stuttering. Three adults who stutter completed 12 sessions of neurofeedback training over a 6-week period. Brain activity was recorded with an electroencephalography (EEG) system and, after on-line filtering, these data were used to provide visual feedback about activity in the mu frequency band. Participants played a video game in which the goal was to change the color of a balloon by increasing or decreasing their mu rhythm activity. Reading and conversational speech samples were audio- and video-recorded before and after each training session for the offline calculation of stuttering frequency. Data collection has been completed and analysis of each participant’s stuttering frequency within and across sessions is ongoing. Results will provide initial data regarding the potential use of EEG-based neurofeedback as a new clinical tool in the treatment of stuttering.

Children with Autism Spectrum Disorder (ASD) experience debilitating social communication deficits that often lead to lifelong difficulties building social relationships. With high prevalence estimates (1:68 children) (Baio, 2014), it is crucial to study social influences, such as family and social networks, on the development of individuals with ASD. As the primary partners in early social interactions, caregivers shape the lives of children with ASD. However, family contributions to the peer social competence and friendships of children with ASD are not well understood. This research will (1) describe caregiver activities that aim to support peer interactions and (2) examine the relationship between caregiver support and peer social competence and friendship quality in children with ASD. Participants include 24 children with ASD, ages 10-13 years old (mean age 11 years, 9 months) and their caregivers. The participants have diverse levels of cognitive ability, from very low to average on the Differential Abilities Scale-Second Edition, and severity of ASD symptoms, from mildly to severely impaired based on the Autism Diagnostic Observation Scale, Second Edition. Independent variables measure caregiver support activities of arranging, hosting, and monitoring peer play sessions in the home using the Peer Social Contact Questionnaire (PSCQ). Dependent measures include (1) the PSCQ to examine children’s interactions with specific peers during at-home play; (2) the Friendship Qualities Scale to investigate the quality of children’s reciprocal friendships based on five dimensions of friendship: companionship, help, security, closeness, and conflict; and (3) the Social Skills Rating System to provide a rating of peer social competence. Preliminary results indicate that the majority of children with ASD have at least one friend. We anticipate that caregiver arranging, hosting, and monitoring will be positively correlated with peer social competence and friendship quality (Guralnick, Neville, Connor, & Hammond, 2003; Meek, Robinson, & Jahromi, 2012; Guralnick & Neville, 1997).

The voice is the primary means by which humans communicate their intentions and emotions. When there is a disruption in a person’s voice, it can affect his or her physical, social, and psychological health. Yet, we still lack strong evidence for which tools to use when diagnosing voice disorders, documenting voice function, or assessing outcomes related to voice interventions. While auditory-perceptual measures are currently the “gold standard”, they are subjective and may result in poor reliability. As a result, there has been growing pressure to search for objective, reliable, and valid methods to measure vocal function, and acoustic analysis of vocal function has become more frequent among clinicians. However, we do not have strong evidence about which acoustic measure or software program best discriminates between speakers with and without voice disorders. Therefore, the objective of this study is to determine the diagnostic accuracy (sensitivity and specificity) of two different acoustics analysis programs to identify the presence (or absence) of voice disorders. In this study, 175 voice samples from patients with a variety of voice disorders (n=100) and control speakers (n =75) will be analyzed. The analysis will include two acoustic programs that are currently used by voice clinicians: a) Praat, a free downloadable program; and b) the Analysis of Dysphonia in Speech and Voice (ADSV), which is a commercially available program. A cepstral measure, called cepstral peak prominence, will be used to determine whether the voice sample falls within the recognized parameters for a disordered or typical voice. We hypothesize that ADSV will show better sensitivity and specificity than Praat, but that neither program will categorize all samples correctly. Results of this study will help practicing clinicians decide which tools to use to assess patients with voice disorders.

Good communication is crucial to a patient's healthcare experience and an integral part of a nurse's role in providing care. Patients with communication disorders are susceptible to poorer health outcomes and decreased satisfaction with services due to breakdowns in communication with nurses. Literature suggests that nurses should receive training on how to effectively communicate with these patients, but it is unclear whether this training is currently included in nursing school curriculum. What are nursing students at universities across Washington State being taught about how communication disorders impact medical interactions, or how to better communicate with patients who struggle? Are these students lacking the necessary education and training to provide quality care for patients with communication disorders? In an attempt to answer these questions, survey data will be collected from junior and senior nursing students at the University of Washington, as well as from faculty responsible for developing nursing student curriculum at UW and other in-state universities regarding the current communication skills curriculum being taught in this area. Based on preliminary findings we hypothesize that a gap exists in nursing student curriculum related to how to communicate effectively with this patient population, and that the survey data collected will show that nursing students in Washington State are not currently being taught about communicating with patients with communication disorders. The key implication of this study will either suggest a need for nursing school curriculum to implement communication skills training targeted toward patients with communication disorders or show that students are in fact receiving this training. The addition of education and training in this area can help nurses improve the quality of care for this patient population.