We congratulate the 2018 speech-language pathology student grant recipients!
Each student received a $1,500 grant from LSVT Global for the 2018-2019 academic year. These unrestricted grants provide funding to support their treatment research projects. Read more about the winners and their projects below!
Download information about our 2019 Student Grant competition for speech-language pathology students HERE. Letters of Intent are due March 15, 2019. Domestic and International applications are welcome.
Speech-Language Pathology Awardees
Kelly Zafira
Speech Language Pathologist
PhD Student
University of Kansas
“Semantic feature analysis and self-cueing strategies in aphasia”
To be an effective communicator, one must have ready access to words stored in memory. Persons with aphasia are known to exhibit varying degrees of word finding difficulty. This can have a significant impact on these individuals’ ability to communicate wants and needs, putting them at greater risk for social isolation and increased dependence. One type of intervention, semantic feature analysis, has been shown to improve retrieval of words that are explicitly practiced in therapy, by providing cues of semantically related words. There is limited evidence, however, that standard delivery of this intervention leads to improved retrieval for other words, even those that are semantically related to words rehearsed in therapy. The long-term goal of this proposed research is to optimize the implementation of semantic feature analysis to increase its generalized effects on word finding abilities.
The first step toward this long-term goal is the proposed set of single-case experiments which is designed to measure the effects of (a) the selection of practice words that are of high vs. low personal interest to the participant and (b) the use of a hand-held string of beads to facilitate self-cueing of target words during communication breakdowns. The study will utilize a multiple baseline design across both subjects and behaviors. Observed outcomes will provide preliminary information about the efficacy/effectiveness of this combined treatment approach for word-finding. Aim 1 is to establish whether persons with aphasia make greater use of semantic feature analysis at times of word retrieval failure if the semantic cueing strategy is explicitly taught, and is supplemented by a small, symbol coded strand of beads – each representing a different semantic feature. It is hypothesized that Semantic Feature Analysis with explicit training and use of the beaded cueing tool will increase word finding to improve recall of treated words. Aim 2 is to determine whether patient use of the online cueing strategy leads to significantly better recall of words under three separate target conditions: within-category words, unrehearsed within-category words, and generalization words that are not closely semantically related to trained target words.
The likely impact of this research is that a potentially promising word finding intervention with generalization to non-targeted words, and generalization beyond the single word level will be identified for persons with aphasia – this generalization component is currently lacking in existing word-finding treatments.
The findings will also contribute to theories concerning the type of exemplars trained (targeted versus untargeted words, and within category versus across category words). Finally, the study will provide information regarding the need for explicit instruction and practice using bead-facilitated self-cueing and the effects of high vs. low interest in target words.
Carrie Donohue
Speech Language Pathologist
PhD Student
University of Pittsburgh
“The Impact of a Combined Respiratory Intervention on Cough and Swallow Function in Patients with Amyotrophic Lateral Sclerosis (ALS)”
Amyotropic Lateral Sclerosis (ALS) is a rapidly progressing neurodegenerative disease that results in physical mobility, speech, cough, and swallowing impairments. Dysphagia and its sequelae as a result of impaired respiratory function is responsible for mortality in a large number of patients with ALS. Historically, limited treatment options have been implemented in patients with ALS due to the neurodegenerative nature of the disease. However, recent research has revealed that moderate exercise training may be beneficial rather than detrimental in these patients. This study aims to: 1. Determine the safety and tolerability of a combined respiratory intervention compared to Expiratory Muscle Strength Training (EMST) alone in patients with ALS. 2. Determine the impact of EMST+ respiratory-swallow coordination on pulmonary and swallow function and swallowing related quality of life compared to EMST alone and a natural control group. Specifically, this study will investigate the following questions: 1. Is EMST+ Respiratory-swallow coordination training safe and well tolerated in patients with ALS? 2. Does a combined respiratory intervention (EMST+ respiratory-swallow coordination training) lead to improvement or improved trajectory of decline in pulmonary function tests and swallow function and swallowing-related quality of life compared to EMST alone in patients with ALS?
Twenty-four patients with ALS (with a goal of 18 patients completing the study) will be recruited from the University of Pittsburgh and Pittsburgh V.A. ALS clinics. Study groups will include a natural control group, an EMST only group, and an EMST+ respiratory-swallow coordination group with six patients in each group. Patients who are eligible to enroll in the study based on inclusion and exclusion criteria will be consented and undergo baseline measurements of respiratory and surrogates of swallow function during a visit to ALS clinic. After a 5-week lead-in period, baseline respiratory and surrogates of swallow function will be repeated. Following this visit, patients in the EMST only and EMST+ respiratory-swallow coordination group will begin the intervention period for 5 weeks with weekly home visits from the PI, a speech-language pathologist (SLP). After the intervention period, patients will return to clinic to complete measurements of respiratory and surrogates of swallow function again. At this time, participants will have the option to continue the intervention for an additional 5 weeks to assess maintenance. The first aim of this study is to determine safety and tolerability of EMST+ respiratory-swallow coordination training in patients with ALS. This pilot data will then be used to conduct a larger respiratory intervention study in patients with ALS. For this reason, a power calculation for sample size was not conducted for this study. However, based on previous work, we expect to see an improvement or improved trajectory of decline of respiratory function and surrogates of swallow function in the EMST and EMST+ respiratory-swallow coordination groups. If the sample size is not large enough, data will be analyzed using single subject case design. To determine safety and tolerability of the intervention, attrition rate of participants in the study will be tracked and calculated. Descriptive and qualitative data analysis will be used for interpreting adverse outcomes and patient reports of fatigue associated with the intervention.
Assuming a large enough sample size is obtained, generalized linear mixed effects models will be used to determine the extent to which EMST alone and EMST+ respiratory-swallow coordination training predict variation in pulmonary function measures, surrogates of swallow function, and swallowing related quality of life. Other variables included in the model will include age, gender, disease progression as determined by the ALSFRS-R, and dysphagia severity as determined by the EAT-10. To compare changes between outcome measures at the second baseline visit to the post-intervention visit for each group and between groups, a paired t-test will be used with a regression model. Depending on the distribution of the data, the appropriate regression model will be selected. Based on published work using EMST in patients with ALS and in other neuromuscular diseases, we hypothesize: 1. These respiratory interventions will be safe and well tolerated in patients with ALS. 2. EMST+ respiratory-swallow coordination training will lead to improvement or improved trajectory of decline in pulmonary and swallow function and swallowing related quality of life compared to EMST alone.