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  1. Article ; Online: Modality Synchronization When People With Aphasia Read With Text-to-Speech Support.

    Hux, Karen / Knollman-Porter, Kelly / Wallace, Sarah E / Bevelhimer, Andrew / Singh, Yutika

    American journal of speech-language pathology

    2024  Volume 33, Issue 3, Page(s) 1504–1512

    Abstract: Purpose: Text-to-speech (TTS) technology potentially benefits people with aphasia by presenting content through two modalities simultaneously; however, for this to help, eye fixations must synchronize with the auditory rendition of words. Researchers ... ...

    Abstract Purpose: Text-to-speech (TTS) technology potentially benefits people with aphasia by presenting content through two modalities simultaneously; however, for this to help, eye fixations must synchronize with the auditory rendition of words. Researchers have yet to explore how often and to what extent people with aphasia achieve modality synchronization. This retrospective analysis examined the percent of words people with aphasia see and hear concurrently when reading passages presented via TTS technology. Text-to-speech (TTS) technology potentially benefits people with aphasia by presenting content through two modalities simultaneously; however, for this to help, eye fixations must synchronize with the auditory rendition of words. Researchers have yet to explore how often and to what extent people with aphasia achieve modality synchronization. This retrospective analysis examined the percent of words people with aphasia see and hear concurrently when reading passages presented via TTS technology.
    Method: Nine adults with aphasia had their eye movements tracked while processing TTS passages at a preselected default rate of 150 words per minute. Modality synchronization occurred whenever fixation on a written word occurred during the time span beginning 300 ms before auditory presentation and ending at the next word's initiation. Correlations between standardized test scores, unsupported reading rate, and modality synchronization percentages were informative about the association of aphasia and reading impairment severity with achievement of synchronicity.
    Results: Three participants demonstrated consistent modality synchronization; average synchronicity ranged from 67% to 76% of passage words. One participant displayed inconsistent synchronization within passages and achieved an average of 58%. The remaining five participants rarely achieved synchronization, with fixations typically lagging substantially behind the auditory presentation. A significant positive correlation occurred between paragraph reading comprehension test scores and modality synchronization percentages.
    Conclusions: A default TTS presentation rate does not result in dual modality synchronization for most people with aphasia. This lack of synchronization may contribute to inconsistencies in the benefit people with aphasia experience when provided with TTS support.
    MeSH term(s) Humans ; Aphasia/psychology ; Aphasia/physiopathology ; Reading ; Male ; Female ; Middle Aged ; Aged ; Retrospective Studies ; Fixation, Ocular ; Adult ; Communication Aids for Disabled ; Eye Movements ; Eye-Tracking Technology ; Time Factors
    Language English
    Publishing date 2024-02-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1154406-5
    ISSN 1558-9110 ; 1058-0360
    ISSN (online) 1558-9110
    ISSN 1058-0360
    DOI 10.1044/2024_AJSLP-23-00334
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Variations in Eye-Gaze Behaviors Evident When Five Adults With Aphasia-Based Alexia Read Multisentence Passages.

    Hux, Karen / Knollman-Porter, Kelly / Bevelhimer, Andrew / Wallace, Sarah E

    American journal of speech-language pathology

    2023  Volume 33, Issue 1, Page(s) 173–188

    Abstract: Purpose: The problems that people with aphasia encounter when reading passages are poorly understood. This study's purpose was in-depth examination of eye-gaze behaviors exhibited by five people with aphasia-based alexia.: Method: Five adults with ... ...

    Abstract Purpose: The problems that people with aphasia encounter when reading passages are poorly understood. This study's purpose was in-depth examination of eye-gaze behaviors exhibited by five people with aphasia-based alexia.
    Method: Five adults with aphasia-based alexia and five neurotypical adults (NAs) read paragraphs while having their eye movements recorded. Acquired data included descriptive characterization of overall eye-gaze behaviors and determination of the (a) percent of fixated words, (b) average fixation duration, (c) average initial and total summed fixation durations of processing attempts on individual words, and (d) effects of word length and frequency on fixation durations. Careful examination of these data allowed examination of consistencies and discrepancies among people with aphasia and supported speculation about underlying deficits.
    Results: Case participants exhibited unique fixation behaviors in comparison to one another and to neurotypical adults. Case participants' total reading time, percent of fixated words, average fixation duration, and average initial and total summed fixation durations on passage words exceeded those of neurotypical adults. Four of five exhibited positive word length and negative word frequency correlations with fixation durations.
    Conclusions: People with aphasia display eye-gaze behaviors unique to them and differing from those of NAs when reading texts. Better understanding of the connection between specific eye-gaze behaviors and problems decoding words, linking them with lexical-semantic information, and constructing meaning from written content is necessary to further progress in developing effective assessment tools and treatments.
    MeSH term(s) Adult ; Humans ; Fixation, Ocular ; Eye Movements ; Semantics ; Dyslexia ; Aphasia/diagnosis ; Aphasia/etiology
    Language English
    Publishing date 2023-10-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1154406-5
    ISSN 1558-9110 ; 1058-0360
    ISSN (online) 1558-9110
    ISSN 1058-0360
    DOI 10.1044/2023_AJSLP-23-00160
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Continuum of Care Following Sports-Related Concussion.

    Brown, Jessica / Knollman-Porter, Kelly

    American journal of speech-language pathology

    2020  Volume 29, Issue 3, Page(s) 1389–1403

    Abstract: Purpose Although guidelines have changed regarding federally mandated concussion practices since their inception, little is known regarding the implementation of such guidelines and the resultant continuum of care for youth athletes participating in ... ...

    Abstract Purpose Although guidelines have changed regarding federally mandated concussion practices since their inception, little is known regarding the implementation of such guidelines and the resultant continuum of care for youth athletes participating in recreational or organized sports who incur concussions. Furthermore, data regarding the role of speech-language pathologists in the historic postconcussion care are lacking. Therefore, the purpose of this retrospective study was to investigate the experiences of young adults with history of sports-related concussion as it related to injury reporting and received follow-up care. Method Participants included 13 young adults with history of at least one sports-related concussion across their life span. We implemented a mixed-methods design to collect both quantitative and qualitative information through structured interviews. Participants reported experiencing 42 concussions across the life span-26 subsequent to sports injuries. Results Twenty-three concussions were reported to a parent or medical professional, 14 resulted in a formal diagnosis, and participants received initial medical care for only 10 of the incidents and treatment or services on only two occasions. Participants reported concussions to an athletic trainer least frequently and to parents most frequently. Participants commented that previous experience with concussion reduced the need for seeking treatment or that they were unaware treatments or supports existed postconcussion. Only one concussion incident resulted in the care from a speech-language pathologist. Conclusion The results of the study reported herein shed light on the fidelity of sports-related concussion care management across time. Subsequently, we suggest guidelines related to continuum of care from injury to individualized therapy.
    MeSH term(s) Adolescent ; Athletic Injuries/diagnosis ; Athletic Injuries/epidemiology ; Athletic Injuries/therapy ; Brain Concussion/diagnosis ; Brain Concussion/therapy ; Continuity of Patient Care ; Humans ; Retrospective Studies ; Sports ; Young Adult
    Language English
    Publishing date 2020-05-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1154406-5
    ISSN 1558-9110 ; 1058-0360
    ISSN (online) 1558-9110
    ISSN 1058-0360
    DOI 10.1044/2020_AJSLP-19-00131
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: mTBI evaluation, management, and referral to allied healthcare: practices of first-line healthcare professionals.

    Wallace, Tracey D / Knollman-Porter, Kelly / Brown, Jessica / Schwartz, Amber / Hodge, April / Brown, Gregory / Beardslee, Jennifer / Gore, Russell K

    Brain injury

    2024  Volume 38, Issue 1, Page(s) 32–44

    Abstract: Primary objective: To gain an understanding of current evaluation practices, post-injury recommendations, and referrals to allied healthcare professions (AHP) by first-line healthcare professionals (FHPs) providing care for people with mild traumatic ... ...

    Abstract Primary objective: To gain an understanding of current evaluation practices, post-injury recommendations, and referrals to allied healthcare professions (AHP) by first-line healthcare professionals (FHPs) providing care for people with mild traumatic brain injury (mTBI).
    Research design: Survey study.
    Methods and procedures: Physicians, physician assistants, nurse practitioners, nurses, and athletic trainers (
    Main outcomes and results: FHPs surveyed reported being confident in their ability to evaluate patients with suspected mTBI, relying most heavily on patient-reported symptoms and physical signs as methods of evaluation. Most FHPs reported making recommendations to compensate for the symptoms experienced following mTBI diagnosis. In contrast, FHPs expressed challenges in the evaluation and management of symptoms associated with mTBI along with limited knowledge of and referrals to AHPs.
    Conclusions: Overall, FHPs feel confident in the diagnosis of mTBI but experience assessment and management challenges. AHPs are underutilized on mTBI management teams calling for a need for multidisciplinary collaboration on research, education, and rehabilitation efforts to optimally care for people experiencing mTBI symptoms.
    MeSH term(s) Humans ; Brain Concussion/diagnosis ; Brain Concussion/therapy ; Health Personnel ; Delivery of Health Care ; Surveys and Questionnaires ; Referral and Consultation
    Language English
    Publishing date 2024-02-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 639115-1
    ISSN 1362-301X ; 0269-9052
    ISSN (online) 1362-301X
    ISSN 0269-9052
    DOI 10.1080/02699052.2024.2309245
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: A Mixed-Methods Exploration of the Experience of People With Aphasia Using Text-to-Speech Technology to Support Virtual Book Club Participation.

    Wallace, Sarah E / Hux, Karen / Knollman-Porter, Kelly / Patterson, Briana / Brown, Jessica A

    American journal of speech-language pathology

    2023  Volume 32, Issue 6, Page(s) 2768–2791

    Abstract: Purpose: This mixed-methods research sought to examine the experience of people with aphasia who used text-to-speech (TTS) support to read a novel for virtual book club participation.: Method: Six people with chronic aphasia used a TTS system to ... ...

    Abstract Purpose: This mixed-methods research sought to examine the experience of people with aphasia who used text-to-speech (TTS) support to read a novel for virtual book club participation.
    Method: Six people with chronic aphasia used a TTS system to review portions of a novel about which they conversed during eight virtual book club meetings occurring over 5 weeks. During one-on-one interactions prior to each meeting, participants answered comprehension questions and provided feedback about reading experiences. Then, during group meetings, they reviewed and discussed relevant book content and predicted upcoming content. During a structured individual interview, participants reflected on their supported reading and book club experience.
    Results: Participants reported a range of reading confidence prior to study participation, mostly influenced by decreased comprehension or reading speed. After book club participation, four participants expressed increased confidence. Some reported searching for key words and skipping difficult words as strategies additional to TTS support. All reviewed at least some book sections more than once either with or without TTS support. Highly motivated participants expressed low frustration and high reading ease and enjoyment. Perceived comprehension was roughly consistent with actual comprehension across participants. Most believed TTS support promoted faster reading than otherwise possible. Participants liked adjustable features affecting speech output rate, word or sentence highlighting, and font size. Psychosocial benefits included decreased isolation and increased friendship.
    Conclusions: The findings extend previous evidence about perceived and actual benefits associated with TTS support. People with aphasia express positive experiences when given TTS support during book club participation.
    MeSH term(s) Humans ; Speech ; Aphasia/psychology ; Comprehension ; Reading ; Technology
    Language English
    Publishing date 2023-09-07
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1154406-5
    ISSN 1558-9110 ; 1058-0360
    ISSN (online) 1558-9110
    ISSN 1058-0360
    DOI 10.1044/2023_AJSLP-23-00094
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Collaborative Goal Setting: A Clinical Approach for Adults With Mild Traumatic Brain Injury.

    Brown, Jessica / Ackley, Kristen / Knollman-Porter, Kelly

    American journal of speech-language pathology

    2021  Volume 30, Issue 6, Page(s) 2394–2413

    Abstract: Purpose Speech-language pathologists (SLPs) have many available procedural options when setting treatment goals. Extant literature supports goal setting protocols that include and value the perspectives of the client; however, in practice, rehabilitation ...

    Abstract Purpose Speech-language pathologists (SLPs) have many available procedural options when setting treatment goals. Extant literature supports goal setting protocols that include and value the perspectives of the client; however, in practice, rehabilitation professionals may lean toward expert models of care when planning treatment. Our purpose is to describe a newly developed approach for SLPs and individuals with mild traumatic brain injury (mTBI) to work together to build meaningful, relevant goals. Method We utilized a multiple case study format to exemplify goal setting procedures. Specifically, we describe procedures and outcomes for a 29-year-old female 28 days postinjury and a 70-year-old male 9 months postinjury. Results Clients who engaged in this protocol worked collaboratively with a clinician to identify strengths and challenges postinjury, select and prioritize goal areas, and discuss and develop meaningful, personalized treatment activities. For both participants, use of the proposed protocol resulted in meaningful goals that addressed their self-reported deficits as well as their respective cognitive-linguistic deficits noted on objective, standardized measures. Conclusions Clinician and client collaboration during treatment goal development can facilitate increased client motivation and functional outcomes. The described approach is feasible from a clinical resource standpoint and promotes a systematic approach to placing the client at the forefront of clinical decision making to enhance therapeutic gains. Such client-centered approaches may be particularly valuable for individuals with mTBI who experience substantial cognitive and communicative challenges but may maintain high levels of self-awareness postinjury.
    MeSH term(s) Adult ; Aged ; Brain Concussion/diagnosis ; Brain Concussion/therapy ; Clinical Decision-Making ; Communication Disorders ; Female ; Goals ; Humans ; Male ; Motivation
    Language English
    Publishing date 2021-09-16
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1154406-5
    ISSN 1558-9110 ; 1058-0360
    ISSN (online) 1558-9110
    ISSN 1058-0360
    DOI 10.1044/2021_AJSLP-21-00078
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Optimizing Effective Communication While Wearing a Mask During the COVID-19 Pandemic.

    Knollman-Porter, Kelly / Burshnic, Vanessa L

    Journal of gerontological nursing

    2020  Volume 46, Issue 11, Page(s) 7–11

    Abstract: Mandated face mask use for health care providers, secondary to COVID-19, creates an additional communication barrier for older adults with cognitive, communication, and/or hearing challenges. Face masks can soften a speaker's voice, conceal vocal tone, ... ...

    Abstract Mandated face mask use for health care providers, secondary to COVID-19, creates an additional communication barrier for older adults with cognitive, communication, and/or hearing challenges. Face masks can soften a speaker's voice, conceal vocal tone, and hide facial expressions that relay essential non-verbal information. An inability to understand health care information or words of support can lead to frustration, anxiety, and decreased quality of life. Therefore, the purpose of this article is to review the current research, provide clinical examples, and highlight communication strategies, supports (i.e., written, gestural, and picture supports), and modifications to personal protective equipment that health care providers can implement, in isolation or combined, to improve communication with older adults. [Journal of Gerontological Nursing, 46(11), 7-11.].
    MeSH term(s) Aged ; Betacoronavirus/isolation & purification ; COVID-19 ; Communication ; Communication Barriers ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/virology ; Humans ; Masks ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/virology ; Professional-Patient Relations ; Quality of Life ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-10-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603140-7
    ISSN 0098-9134
    ISSN 0098-9134
    DOI 10.3928/00989134-20201012-02
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: First-Line Health Care Providers' Reported Knowledge of and Referrals to Speech-Language Pathologists for Clients With Mild Traumatic Brain Injury.

    Knollman-Porter, Kelly / Brown, Jessica A / Wallace, Tracey / Spitz, Shelby

    American journal of speech-language pathology

    2021  Volume 30, Issue 5, Page(s) 2214–2227

    Abstract: Purpose People with mild traumatic brain injury (mTBI) may experience deficits in cognition or communication that go unnoticed by first-line health care providers (FHPs). Speech-language pathologists (SLPs) assess and treat these domains yet are often ... ...

    Abstract Purpose People with mild traumatic brain injury (mTBI) may experience deficits in cognition or communication that go unnoticed by first-line health care providers (FHPs). Speech-language pathologists (SLPs) assess and treat these domains yet are often underrepresented on mTBI multidisciplinary teams. This study's aim was to evaluate FHPs' reported knowledge of and referral practices to SLPs for individuals across the life span with mTBI. Method Physicians, physician assistants, nurse practitioners, nurses, and athletic trainers (
    MeSH term(s) Brain Concussion ; Humans ; Pathologists ; Referral and Consultation ; Speech ; Speech-Language Pathology
    Language English
    Publishing date 2021-07-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1154406-5
    ISSN 1558-9110 ; 1058-0360
    ISSN (online) 1558-9110
    ISSN 1058-0360
    DOI 10.1044/2021_AJSLP-20-00373
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Perceptions of people with aphasia about supporting reading with text-to-speech technology: A convergent mixed methods study.

    Hux, Karen / Wallace, Sarah E / Brown, Jessica A / Knollman-Porter, Kelly

    Journal of communication disorders

    2021  Volume 91, Page(s) 106098

    Abstract: Introduction: Text-to-speech (TTS) technology is a possible reading support for people with aphasia; however, adoption for functional reading remains rare, and people with aphasia may have limited knowledge about TTS. Given this situation coupled with ... ...

    Abstract Introduction: Text-to-speech (TTS) technology is a possible reading support for people with aphasia; however, adoption for functional reading remains rare, and people with aphasia may have limited knowledge about TTS. Given this situation coupled with inherent communication challenges associated with aphasia, the purpose of this convergent mixed methods study was to explore the perceptions of participants about desired features, benefits, and drawbacks of TTS technology after having engaged in one-on-one education and guided practice activities.
    Methods: Nineteen adults with chronic aphasia completed a single education and guided practice session followed by close-ended questions and participation in a semi-structured interview to explain preferences, concerns, beliefs, and opinions about potential TTS technology benefits and drawbacks. Three participants had previously used TTS technology for functional reading; all others had some prior exposure but did not use a system for functional purposes.
    Results: Seventeen of 19 participants expressed TTS technology interest after education and guided practice activities. Participants endorsed selection of a preferred voice, control of speech output rate, and highlighting as priority features. Frequently endorsed benefits were improved comprehension and increased reading independence; some participants believed they would succeed in reading a greater variety of materials, communicate more with others, participate in more reading activities, and/or read faster. The greatest concern was mastering device operation; other concerns related to understanding the voice output, needing another person's help for system use, and matching the speech output rate to a preferred reading rate.
    Conclusions: Overall, most participants had positive perceptions about possible benefits afforded by TTS technology. Practitioners need to provide opportunities for people with aphasia to learn about and explore TTS systems to determine whether adoption is desired.
    MeSH term(s) Adult ; Aphasia ; Comprehension ; Humans ; Perception ; Reading ; Speech
    Language English
    Publishing date 2021-03-11
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 3011-9
    ISSN 1873-7994 ; 0021-9924
    ISSN (online) 1873-7994
    ISSN 0021-9924
    DOI 10.1016/j.jcomdis.2021.106098
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  10. Article ; Online: Auditory Comprehension Interventions for People With Aphasia: A Scoping Review.

    Wallace, Sarah E / Patterson, Janet / Purdy, Mary / Knollman-Porter, Kelly / Coppens, Patrick

    American journal of speech-language pathology

    2022  Volume 31, Issue 5S, Page(s) 2404–2420

    Abstract: Purpose: This scoping review examined studies reporting restorative treatments designed to improve auditory comprehension in people with aphasia.: Method: We searched eight databases using keywords ... aphasia, auditory comprehension, treatment, ... ...

    Abstract Purpose: This scoping review examined studies reporting restorative treatments designed to improve auditory comprehension in people with aphasia.
    Method: We searched eight databases using keywords aphasia, auditory comprehension, treatment, intervention, and rehabilitation, for studies published between 1970 and 2020. Searches returned 170 records, and after applying exclusionary criteria, 28 articles remained. For each article, two authors independently extracted data on study design parameters, participant characteristics, treatment protocol, and treatment outcomes, including generalization.
    Results: Studies were categorized by treatment focus: direct auditory (n = 7), mixed auditory (n = 13), or indirect (n = 8). Study designs were group (n = 12), single-subject experimental design (n = 11), or case study (n = 5). Fifteen studies had a control condition and/or a control group. Thirteen studies included two to 10 participants. Aphasia severity and auditory comprehension severity were infrequently reported, and most participants were greater than 1-year poststroke. Treatment targets and tasks varied. Sessions ranged from 8 to 240 min, once or more per week, for eight to 60 total sessions over 2-20 weeks. Impairment-based outcome measures were typically used. Improvement and generalization were regularly reported; however, authors frequently did not report statistical significance.
    Conclusions: A variety of treatments have addressed auditory comprehension deficits in people with aphasia, with many reporting improvements in auditory comprehension for some people. However, the variability in treatment tasks and delivery and outcome measurements preclude confidently offering specific clinical recommendations for implementing auditory comprehension treatments. Gaps identified by the current study may guide the development and exploration of transparent, repeatable, patient-centered treatments.
    Supplemental material: https://doi.org/10.23641/asha.21291345.
    MeSH term(s) Humans ; Comprehension ; Aphasia/therapy ; Aphasia/rehabilitation ; Treatment Outcome
    Language English
    Publishing date 2022-10-17
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 1154406-5
    ISSN 1558-9110 ; 1058-0360
    ISSN (online) 1558-9110
    ISSN 1058-0360
    DOI 10.1044/2022_AJSLP-21-00297
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